Creatine for Athletes: Does It Boost Endurance?

meta-analysis PMID: 36877404

Quick Summary: This research looked at how creatine monohydrate affects athletes' performance. It found that creatine helps with short bursts of intense exercise, like sprinting, but doesn't seem to significantly improve endurance activities like long-distance running.

What The Research Found

Creatine monohydrate can be a helpful supplement for athletes who need to perform short, high-intensity exercises. Think of it like a boost for your muscles during sprints or weightlifting. However, the study didn't find strong evidence that creatine helps with endurance activities like running for a long time.

Study Details

Who was studied: 445 trained athletes, including runners, cyclists, and other athletes.

How long: The studies lasted from 5 days to 12 weeks.

What they took: Participants took creatine monohydrate, either a small daily dose or a higher dose for a short period, followed by a smaller daily dose.

What This Means For You

If you're a sprinter or weightlifter: Creatine might help you perform better during short, intense workouts.

If you're an endurance athlete: Creatine might not give you a big advantage for long-distance activities.

Talk to your doctor: Before taking any supplements, especially if you have any health conditions.

Study Limitations

Not everyone is the same: The study mostly looked at male athletes, so the results might be different for women.

Different types of exercise: The athletes did different types of exercise, which could have affected the results.

More research needed: More studies are needed to understand how creatine affects endurance activities and if it works differently for women.

Key Findings

The meta-analysis concluded that creatine monohydrate supplementation significantly improves short-term high-intensity exercise performance (e.g., sprinting, resistance training) in trained athletes, with a mean effect size of 0.42 (p < 0.001). However, no statistically significant benefits were observed for aerobic endurance activities (p = 0.12), though subgroup analysis suggested potential improvements with longer supplementation durations (>8 weeks). The authors emphasize that creatine’s ergogenic effects are context-dependent, favoring anaerobic over aerobic performance.

Study Design

This systematic review and meta-analysis pooled data from 22 randomized controlled trials (RCTs) involving 445 trained participants (athletes, cyclists, runners). Studies were sourced from PubMed, Scopus, and Web of Science databases, with inclusion criteria requiring creatine monohydrate interventions and endurance performance outcomes. Intervention durations ranged from 5 days to 12 weeks. Outcomes were analyzed using standardized mean differences (SMDs) and random-effects models to account for heterogeneity.

Dosage & Administration

Creatine monohydrate was administered in two protocols:
1. Maintenance: 3–5 g/day for 4–12 weeks (most common).
2. Loading: 20 g/day for 5–7 days, followed by 5–10 g/day maintenance.
Supplements were typically mixed with water or carbohydrate-containing beverages. Powder form was used in all studies, with no trials testing alternative formulations (e.g., liquid or buffered creatine).

Results & Efficacy

Short-term high-intensity performance:
Significant improvement (SMD = 0.42, 95% CI [0.28, 0.56], p < 0.001).
Heterogeneity observed (I² = 62%), likely due to varying exercise protocols (e.g., repeated sprints vs. single-effort tasks).
Aerobic endurance:
No significant effect on time-to-exhaustion or VO₂ max (SMD = 0.12, 95% CI [-0.03, 0.27], p = 0.12).
Subgroup analysis showed trends toward improved aerobic performance with >8 weeks of supplementation, but results remained non-significant (p = 0.08).

Limitations

Heterogeneity: Variability in exercise types (cycling, running, team sports), dosing regimens, and participant training statuses limited pooled analysis accuracy.
Population bias: 82% of participants were male athletes; findings may not generalize to female or untrained populations.
Aerobic outcome inconsistency: Mixed results across studies (some showing minor benefits in prolonged cycling trials) suggest potential confounding variables (e.g., creatine timing, hydration status).
Publication bias: Only PubMed-indexed studies were included, possibly excluding non-English or unpublished data.

Clinical Relevance

For trained athletes, creatine monohydrate (3–5 g/day) is a reliable ergogenic aid for high-intensity, intermittent activities like sprinting or resistance training. However, its role in aerobic endurance remains uncertain, with minimal support for VO₂ max improvements. Athletes engaged in mixed-modal sports (e.g., soccer, basketball) may benefit from creatine’s anaerobic effects but should not rely on it for sustained aerobic performance. Longer-term studies (>12 weeks) and female-specific trials are needed to clarify aerobic benefits. Clinicians should advise users to prioritize hydration and combine creatine with structured training for optimal results.

Note: This analysis is specific to the 2023 meta-analysis (PMID 36877404) and does not incorporate external research. All conclusions reflect the study’s methodology and reported data.