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Creatine Monohydrate in Adolescent Athletes: A Critical Narrative Review of Performance, Safety, and Considerations for Responsible Use

Álvaro Farfán-Díaz, Camila Fuentes-Hinojosa, Marcelo Andrade-Oyarzun, Exal Garcia-Carrillo, Iván Molina-Márquez, Rodrigo Yáñez-Sepúlveda, Antonio Castillo-Paredes, Dario Barrera-González, Felipe Montalva-Valenzuela
Adolescents 2026 6(4):59

Bibliography

DOI
10.3390/adolescents6040059
Funding
The authors reported that the review received no external funding.
Competing interests
The authors declared no conflicts of interest.

Study snapshot

DesignCritical narrative review with structured literature search and design-specific methodological appraisal
ModelHuman evidence synthesis
Sample17 core athletic primary studies: 5 direct adolescent studies, 11 age-adjacent or mixed-age studies, and 1 adult contextual study
InterventionCreatine monohydrate in adolescent and age-adjacent athletic populations; studied protocols ranged from 0.03–0.3 g/kg/day or fixed 5–30 g/day, with loading and non-loading strategies
Duration5 days to 32 weeks across the athletic evidence base
EndpointsPower and repeated-sprint performance; Jumping and sport-specific technical outcomes; Rehabilitation outcomes; Renal, hepatic and cardiometabolic safety; Hydration and cramping; Dose heterogeneity; Sex and maturation gaps; Product quality and responsible use

What the study showed, in plain terms

This 2026 critical narrative review deliberately separates evidence that directly studied adolescents from age-adjacent, pediatric-clinical and adult evidence. Its core athletic synthesis contained 17 primary studies: only five were classified as direct adolescent evidence, eleven were mixed-age or age-adjacent, and one adult study was retained for context.

The review found plausible task-specific benefits in some power, sprint, jumping, technical and rehabilitation outcomes, but many outcomes were neutral and some apparent improvements existed only within the creatine group rather than in a valid between-group comparison. Short-term tolerability was generally reassuring, while the evidence remained too small, short and male-dominated to establish long-term safety or an adolescent-specific benefit-risk ratio.

Key findings

  • Only 5 of 17 core athletic studies met the review’s strict direct-adolescent criterion; directness and methodological quality were graded separately.
  • Controlled results suggest possible task-specific benefits, but laboratory improvements should not automatically be translated into better competition performance.
  • No consistent clinically important renal, hepatic, cardiometabolic, hydration or cramping pattern emerged from controlled youth studies within the doses and durations studied.
  • The longest athlete-specific exposure identified was a 32-week mixed-age, uncontrolled female football cohort; biochemical findings were reassuring but cannot establish causal safety for adolescents.
  • Adolescent athletic protocols ranged from 0.03 to 0.3 g/kg/day and fixed 5–30 g/day for 5 days to 32 weeks. The authors explicitly state that no adolescent-specific optimal dose has been established.
  • The review recommends a precautionary framework: food-first, family-involved, professionally supervised, single-ingredient quality-controlled use with planned reassessment rather than routine recommendation or categorical prohibition.

What this study can and cannot tell us

This is a critical narrative review rather than a meta-analysis. The search was structured and the 17 core athletic studies underwent design-specific JBI appraisal, but a complete conventional search-flow denominator could not be reconstructed, no meta-analysis or formal certainty grading was performed, and the review did not produce a pooled estimate.

Most athletic studies were small, short, male-dominated and incompletely reported for randomization, allocation, blinding, maturation, comparative effects and adverse-event ascertainment. Female, prepubertal and long-term adolescent data remain especially sparse.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology