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J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. eCollection 2017.

International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.

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Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843-4243 USA.
Nutrition Research Unit, QPS, 6141 Sunset Drive Suite 301, Miami, FL 33143 USA.
Department of Health and Human Performance, Nova Southeastern University, Davie, FL 33328 USA.
The Center for Applied Health Sciences, 4302 Allen Road, STE 120, Stow, OH 44224 USA.
Post Active Nutrition, 111 Leslie St, Dallas, TX 75208 USA.
Collins Gann McCloskey & Barry, PLLC, 138 Mineola Blvd., Mineola, NY 11501 USA.
Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2 Canada.
High Performance Nutrition, LLC, Mercer Island, WA 98040 USA.
Vitargo Global Sciences, Inc., Dana Point, CA 92629 USA.
Supplement Safety Solutions, LLC, Bedford, MA 01730 USA.


Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson's, Huntington's disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).


Adolescents; Athletes; Children; Clinical applications; Ergogenic aids; Muscle power; Muscular strength; Performance enhancement; Safety; Sport nutrition

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