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 0.78
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11 support 1 contradict 0 tested null 2 mixed · 14 sources, 12 independent groups · 2 superseded — pooled inside a review, counted once
What the evidence shows
Creatine monohydrate plus resistance training reliably adds strength and about 1.1 kilograms of lean mass over training alone, across many randomised trials. The effect is modest and training-dependent: without resistance training the body-composition effect is negligible, and some supporting meta-analyses pooled strength only, with no body-composition endpoint.
The evidence (17)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| López-Moreno M, Muñoz A, Aguilar-Navarro M, Gutiérrez-Hellín J, Franco-Andrés A, López-López P, Crespo-Cañizares A, Marrero-Fernández P, Forbes SC 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 the available text does not say. Authors add that 'Longer-term studies are needed to confirm the effectiveness and safety'. |
| Delpino FM, Figueiredo LM, Forbes SC, Candow DG, Santos HO 2022 · Nutrition | meta-analysis | supports | high | Creatine added to resistance training increased lean body mass by ~1.1 kg versus training alone. |
| Gualano B, Macedo AR, Alves CR, Roschel H, Benatti FB, Takayama L, de Sá Pinto AL, Lima FR, Pereira RM 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 I, Pandit A, Smith-Ryan AE, Simar D, Candow DG, Kaakoush NO, Hagstrom AD 2025 · Nutrients | RCT | contradicts | moderate | Creatine increased lean body mass mainly when combined with resistance training, with negligible effect without training. |
| Gu J, Li Y, Xiao J, Zhang Y 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 JS, Duncan ND, Mazzetti SA, Staron RS, Putukian M, Gómez AL, Pearson DR, Fink WJ, Kraemer WJ 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, Afridi S, Bonnechère B 2025 · Journal of clinical medicine | 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 JD 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 Z, Qiu B, Li R, Han Y, Petersen C, Liu S, Zhang Y, Liu C, Candow DG, Del Coso J 2024 · Nutrients | meta-analysis | supports | high | Creatine plus resistance training significantly increased muscle strength gains in adults under 50 across pooled RCTs. |
| Liu S, Huang N, Wu W, OuYang X, Luo Y, Zhong Y, Wang M, Xiao L 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 R, Piñero A, Coleman M, Mohan A, Sapuppo M, Augustin F, Aragon AA, Candow DG, Forbes SC, Swinton P, Schoenfeld BJ 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, Miguel-Ortega Á, Martínez-Ferrán M, Fernández-Lázaro D, Busto N, Mielgo-Ayuso J 2026 · GeroScience | 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, Yeh TP, Lin SC, Liu PJ, Bai D, Chen IH 2026 · Int J Med Sci | meta-analysis | mixed | moderate | SR/MA pooling protein, amino acids and creatine plus exercise. Skeletal muscle mass g=0.065 (-0.353 to 0.482), appendicular lean mass g=0.197 (-0.177 to 0.571), fat-free mass g=0.069 (-0.110 to 0.249), all pooled across supplement types; no creatine-only estimate. |
| Dempsey RL, Mazzone MF, Meurer LN 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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