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Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports

Richard B Kreider, Drew E Gonzalez, Kelly Hines, Adriana Gil, Diego A Bonilla
J Int Soc Sports Nutr 2025 22(Suppl 1):2488937

Bibliography

PubMed
PMID 40198156
PubMed Central
PMC11983583
DOI
10.1080/15502783.2025.2488937
Funding
Texas A&M Exercise and Sports Nutrition Lab supported study personnel; publication APC was funded by Alzchem Group AG for a Creatine for Health special issue. Authors state funders had no role in analysis, interpretation, writing or publication decision.
Competing interests
Richard Kreider and Diego Bonilla reported creatine-industry relationships; Kreider chairs AlzChem's scientific advisory board. Other authors disclosed varying industry relationships or none, as detailed in the paper.

Study snapshot

DesignCross-study safety analysis of human creatine trials, adverse-event databases and social-media reports
ModelHuman
Sample685 creatine clinical trials; 12,839 creatine participants and 13,452 placebo participants represented in trial analysis
InterventionPredominantly creatine monohydrate across clinical trials; mean reported dose about 12.5 g/day in included creatine studies
DurationIncluded studies ranged up to 14 years
EndpointsReported adverse effects; Gastrointestinal symptoms; Muscle cramping/pain; Renal markers; Adverse-event reports

What the study showed, in plain terms

Large safety analysis examining whether creatine supplementation is associated with more reported side effects than placebo across the clinical-trial literature.

Key findings

Overall side-effect reporting was similar between creatine and placebo groups, with no significant multivariate difference across the evaluated side-effect categories; participant-level gastrointestinal and cramping differences were not significant.

What this study can and cannot tell us

Study-level synthesis depends on how adverse events were reported in the underlying trials and does not replace dedicated long-term surveillance for every population.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction