Tier 2 — strong

Creatine supplementation in the pediatric and adolescent athlete-- A literature review

Gregory A Metzger, Peter M Minneci, Alison Gehred, Alexis Day, Kevin E Klingele
J Orthop 2023 38:73-78

Bibliography

PubMed
PMID 37008451
PubMed Central
PMC10063391
DOI
10.1016/j.jor.2023.03.010
Funding
The authors reported that no funding was received for the study.
Competing interests
The authors declared no conflicts of interest.

Study snapshot

DesignPRISMA-ScR-guided literature review / scoping-style evidence review
ModelHuman
Sample13 included studies; 268 participants; mean ages across studies ranged from 11.5 to 18.2 years
InterventionCreatine supplementation in healthy pediatric/adolescent participants; common research protocols included 0.3 g/kg/day loading for 7 days or fixed 20 g/day loading, with only 4 of 13 studies using a 5 g/day maintenance phase
DurationPredominantly short-term; only 4 of 13 studies included maintenance dosing, lasting 22–49 days
EndpointsSport-specific performance; Strength and power; Body water and body mass; Physiologic markers; Safety reporting; Growth and development evidence gaps

What the study showed, in plain terms

This 2023 review is one of the clearest maps of the direct creatine literature in healthy pediatric and adolescent athletes. PubMed and EMBASE yielded 9,393 records, but only 13 studies involving 268 participants met the review criteria.

The evidence was narrow: 77% of the included studies were randomized controlled trials, yet 85% involved soccer players or swimmers, overall study quality was judged poor, performance results were inconsistent, and none of the studies was designed primarily to answer a safety question.

Key findings

  • Thirteen studies involving 268 participants were included; mean study ages ranged from 11.5 to 18.2 years.
  • Most studies were randomized trials, but the evidence was concentrated heavily in soccer and swimming and did not show a consistent overall athletic-performance benefit.
  • The most common loading protocol was 0.3 g/kg/day for 7 days; fixed 20 g/day loading was also common. These are descriptions of research protocols, not validated prescriptions for teenagers.
  • Only four studies used a maintenance phase, each using 5 g/day for 22–49 days.
  • In one adolescent soccer study summarized by the review, seven days of creatine was associated with approximately 2.3 L greater total-body-water gain and about 1.0 kg greater body-mass gain than placebo.
  • No included study was designed specifically to evaluate adverse effects or establish long-term safety.

What this study can and cannot tell us

The total evidence base was only 13 studies and 268 participants, with heavy concentration in two sports, heterogeneous protocols, limited statistical power and poor overall study quality. The review therefore cannot establish a universal performance effect, safe age cutoff, optimal dose or long-term safety profile.

A minor reporting inconsistency appears within the paper: the abstract/results and study table report 13 included studies, while one figure caption states 12. The review’s primary text and tabulated synthesis support the count of 13.

Related papers in the corpus

Tier 1
Evaluating the Safety of Creatine Monohydrate in Adolescents: A Systematic Review of Renal, Hepatic, and Cardiometabolic Outcomes
Allen Rubinchuk et al. · Cureus · 2026
Tier 2
Creatine Monohydrate in Adolescent Athletes: A Critical Narrative Review of Performance, Safety, and Considerations for Responsible Use
Álvaro Farfán-Díaz et al. · Adolescents · 2026
Tier 2
Creatine Supplementation in Children and Adolescents
Andrew R Jagim et al. · Nutrients · 2021
Tier 4
Use of Performance-Enhancing Substances
Michele LaBotz et al. · Pediatrics · 2016

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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