Supplements · Metabolic & Cardiometabolic
creatine monohydrate increases muscle mass and strength
In plain terms: Does creatine monohydrate help build muscle?
Strong support Supplements 🔬 Includes disconfirming
Part of: 🧪 creatine
RefutedContestedStrong support
consensus score 0.72
Yes — creatine plus resistance training reliably adds strength and roughly a kilo of lean mass across many trials; the effect is real though modest and depends on actually training.
📅 Last reviewed: 2026-07-14 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
MechanismIn-vitroAnimalObservationalRCTMeta-analysis
How the studies fall
11 support 1 contradict 0 tested null 3 mixed · 15 sources, 12 independent groups · 2 superseded — pooled inside a review, counted once
The evidence (17)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| López-Moreno M et al 2026 · European Journal of Applied Physiology | RCT | supports | low | Triple-blind RCT, 20 physically active vegan adults (10 per arm), 4wk creatine 0.1 g/kg/day vs placebo, no training co-intervention: 'significant increases in skeletal muscle mass (+ 0.3 kg), total body water (+ 1.4 kg), and BMI (+ 0.3 kg/m2), along with reduced body fat (-1.4 kg) compared to controls (p < 0.05)'. Quality low: the water gain is ~4.7x the muscle-mass gain over 4 weeks and the body-composition method is not named in the abstract, so a water-independent muscle gain is cannot-tell from available text. Authors add that 'Longer-term studies are needed to confirm the effectiveness and safety'. |
| Delpino 2022 · Nutrition | meta-analysis | supports | high | Creatine added to resistance training increased lean body mass by ~1.1 kg versus training alone. |
| Gualano 2014 · Exp Gerontol | RCT | supports | moderate | Creatine plus resistance training improved leg/bench press strength and appendicular lean mass versus training alone. ↩ SUPERSEDED — pooled in the review above, counted once |
| Desai 2025 · Nutrients | RCT | contradicts | moderate | Creatine increased lean body mass mainly when combined with resistance training, with negligible effect without training. |
| Gu 2026 · Front Nutr | meta-analysis | supports | moderate | Creatine augmented strength, performance and lean mass gains particularly when combined with resistance training in young men. |
| Volek 1999 · Med Sci Sports Exerc | RCT | supports | moderate | Creatine with heavy resistance training produced greater muscle fiber hypertrophy and performance than placebo. ↩ SUPERSEDED — pooled in the review above, counted once |
| Kazeminasab F, Kerchi AB, Sharafifard F, Zarreh M, Forbes SC, Camera DM, Lanhers C, Wong A, Nordvall M, Bagheri R, Dutheil F 2025 · Nutrients | meta-analysis | supports | moderate | STRENGTH HALF ONLY — this meta-analysis pooled no body-composition outcome. Its inclusion criterion was '(2) outcomes were muscular strength using chest or bench press, handgrip, leg press, squat, vertical jump, or Wingate peak power;' so it bears on the strength component of this claim and is silent on muscle mass. Across 69 RCTs (1937 adults), creatine beat placebo on bench/chest press (WMD = 1.43 kg, p = 0.002) and squat (WMD = 5.64 kg, p = 0.001) but not on handgrip (p = 0.10) or leg press (p = 0.11), with power gains in vertical jump (1.48 cm) and Wingate (47.81 W); 'benefits were not uniform across all outcomes or subgroups'. Compound scoping fits the claim: 'approximately 95% of the 69 included studies used creatine monohydrate'. Quality moderate, not high: 63 of 69 trials lacked both participant blinding and intention-to-treat analysis, Egger's test flagged publication bias on the two largest pools, and a co-author discloses creatine-manufacturer advisory roles. |
| Devries MC, Phillips SM 2014 · Med Sci Sports Exerc | meta-analysis | supports | moderate | Meta-analysis of randomized placebo-controlled trials, 357 older adults, 12.6 ± 4.9 wk of resistance training: 'Cr + RT increased total body mass (P = 0.004) and fat-free mass (P < 0.0001) with no effect on fat mass as compared with RT alone.' The measured endpoint is fat-free mass, not directly imaged or biopsied muscle; over ~13 wk fat-free mass does not separate contractile protein from creatine's intracellular water retention, though the fat-mass null does establish the gain as lean tissue. The abstract says 'Cr' throughout and does not confirm that every pooled trial used the monohydrate form specifically. |
| Osama M et al 2025 · study_type: RCT | RCT | supports | low | Double-blind RCT, 40 knee-osteoarthritis patients (40-70y) on physical therapy + resistance exercise, 4wk: creatine group showed significant improvement in body composition parameters (p<0.05) alongside strength (IMS, p<0.001) versus placeb |
| Branch 2003 · Int J Sport Nutr Exerc Metab | meta-analysis | supports | moderate | Meta-analysis of 96 papers / 100 randomized, placebo-controlled, subject-blinded studies: 'Small, but significant (ES > 0, p < or = .05) ES were reported for BC (n=163, mean +/- SE=0.17 +/- 0.03)' — 'BC' pools body mass with lean body mass, and n=163 counts effect sizes, not participants or studies. The gain is concentrated in the loading phase: 'ES was greater for change in BC following a loading-only CS regimen (0.26 +/- 0.03, p=.0003) compared to a maintenance regimen (0.04 +/- 0.05)'. Directionally supportive but small, and the abstract gives no way to separate contractile tissue from intracellular water. 2003 synthesis (literature through ~2002) — cite as the first quantitative synthesis, not as a current effect-size estimate. |
| Wang 2024 · Nutrients | meta-analysis | supports | high | Creatine plus resistance training significantly increased muscle strength gains in adults under 50 across pooled RCTs. |
| Liu 2025 · Eur Rev Aging Phys Act | meta-analysis | supports | moderate | Creatine plus resistance training significantly improved lower-limb strength and lean tissue mass in older adults. |
| Naddafha S, Antonio J, Kreider RB, Stout JR 2026 · J Int Soc Sports Nutr | meta-analysis | supports | moderate | Lean mass pooled from 5 trials (k=5, n=338 — not the full 7-RCT/n=608 review): MD +0.37 kg (95% CI +0.05 to +0.69, p=0.05; SMD +0.30; I2=25%), with a 95% prediction interval of -0.10 to +0.84 that crosses zero. Effect is training-conditional: with RT, MD +0.32 kg (95% CI +0.08 to +0.56); without RT, MD -0.14 kg (95% CI -0.44 to +0.16), subgroup interaction p=0.03. Authors' GRADE moderate certainty. Leave-one-out range +0.28 to +0.46 kg; dropping Aguiar 2013 renders it non-significant (p=0.08). |
| Burke 2023 · Nutrients | meta-analysis | mixed | moderate | Direct-imaging hypertrophy showed only a very small benefit of creatine plus resistance training over placebo. |
| Ramos-Hernández R et al 2026 · study_type: RCT | RCT | mixed | moderate | Randomized crossover trial, 30 older adults, 6wk creatine+HMB vs placebo with a mixed conditioning program (incl. resistance training): significant time×group interaction for muscle mass parameters, but within-group creatine+HMB changes in |
| Chen KH et al 2026 · study_type: meta-analysis | meta-analysis | mixed | moderate | Meta-analysis of 14 RCTs (763 women across reproductive stages, incl. 3 creatine trials) combined with exercise: no significant effect on skeletal muscle mass (g=0.065, 95% CI -0.353 to 0.482), appendicular lean mass, or fat-free mass; only |
| Dempsey 2002 · J Fam Pract | meta-analysis | supports | moderate | Oral creatine produced a modest but significant increase in maximal strength in healthy adults. |
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