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Komura K, et al. Effectiveness of creatine monohydrate in mitochondrial encephalomyopathies. Pediatr Neurol. 2003;28(1):53–8. Earnest CP, Almada AL, Mitchell TL. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin Sci (Lond). 1996;91(1):113–8.

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Wright GA, Grandjean PW, Pascoe DD. The effects of creatine loading on thermoregulation and intermittent sprint exercise performance in a hot humid environment. J Strength Cond Res. 2007;21(3):655–60.Shelmadine BD, et al. Effects of thirty days of creatine supplementation on total homocysteine in a pilot study of end-stage renal disease patients. J Ren Nurs. 2012;4(4):6–11. Ellery SJ, et al. Dietary creatine supplementation during pregnancy: a study on the effects of creatine supplementation on creatine homeostasis and renal excretory function in spiny mice. Amino Acids. 2016;48(8):1819–30. Taes YE, et al. Creatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patients. Kidney Int. 2004;66(6):2422–8. Yes, taking creatine monohydrate daily within recommended doses is generally safe for healthy individuals. Osbakken M, et al. Creatine and cyclocreatine effects on ischemic myocardium: 31P nuclear magnetic resonance evaluation of intact heart. Cardiology. 1992;80(3–4):184–95.

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Thomas DT, Erdman KA, Burke LM. Position of the academy of nutrition and dietetics, dietitians of Canada, and the American college of sports medicine: nutrition and athletic performance. J Acad Nutr Diet. 2016;116(3):501–28. Devries MC, Phillips SM. Creatine supplementation during resistance training in older adults-a meta-analysis. Med Sci Sports Exerc. 2014;46(6):1194–203. Ling J, Kritikos M, Tiplady B. Cognitive effects of creatine ethyl ester supplementation. Behav Pharmacol. 2009;20(8):673–9. McGuine TA, Sullivan JC, Bernhardt DT. Creatine supplementation in high school football players. Clin J Sport Med. 2001;11(4):247–53. Creatine and phosphocreatine play an important role in maintaining myocardial bioenergetics during ischemic events [ 33]. For this reason, there has been interest in assessing the role of creatine or phosphocreatine in reducing arrhythmias and/or improving heart function during ischemia [ 185, 186, 187, 188, 189, 190, 191, 192, 193, 194]. In a recent review, Balestrino and colleagues [ 33] concluded that phosphocreatine administration, primarily as an addition to cardioplegic solutions, has been used to treat myocardial ischemia and prevent ischemia-induced arrhythmia and improve cardiac function with some success. They suggested that creatine supplementation may protect the heart during an ischemic event. Thus, prophylactic creatine supplementation may be beneficial for patients at risk for myocardial ischemia and/or stroke. AgingDeldicque L, et al. Kinetics of creatine ingested as a food ingredient. Eur J Appl Physiol. 2008;102(2):133–43.

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Prepared as a Position Stand on behalf of the International Society of Sport Nutrition with approval of Editors-In-Chief, Founders, and Research Committee Members. Funding Deminice R, Jordao AA. Creatine supplementation decreases plasma lipid peroxidation markers and enhances anaerobic performance in rats. Redox Rep. 2015;21(1):31–36. Poortmans JR, Francaux M. Adverse effects of creatine supplementation: fact or fiction? Sports Med. 2000;30(3):155–70.

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Valtonen M, et al. Central nervous system involvement in gyrate atrophy of the choroid and retina with hyperornithinaemia. J Inherit Metab Dis. 1999;22(8):855–66. Poortmans JR, et al. Effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol Occup Physiol. 1997;76(6):566–7. Creatine monohydrate is not only the cheapest and most common form of creatine, but it’s also the best choice. It’s been researched well, and no other formulation has been shown to be more beneficial in terms of improving performance. Rosene JM, Whitman SA, Fogarty TD. A comparison of thermoregulation with creatine supplementation between the sexes in a thermoneutral environment. J Athl Train. 2004;39(1):50–5.

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Spillane M, et al. The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. J Int Soc Sports Nutr. 2009;6:6. Ziegenfuss TN, et al. Effect of creatine loading on anaerobic performance and skeletal muscle volume in NCAA division I athletes. Nutrition. 2002;18(5):397–402.

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Cancela P, et al. Creatine supplementation does not affect clinical health markers in football players. Br J Sports Med. 2008;42(9):731–5.