Creatine: Is It Worth the Hype? (2022 Review)

systematic-review PMID: 36000773

Quick Summary: A recent review looked at different types of creatine supplements to see if they work better than the common kind (creatine monohydrate). The research found that the other types of creatine didn't give people a performance boost compared to a placebo (sugar pill). Creatine monohydrate is still the best bet.

What The Research Found

This review looked at several studies on different forms of creatine, like creatine citrate and creatine ethyl ester. The goal was to see if these new forms helped people perform better during exercise or changed their body composition (muscle vs. fat) more effectively than creatine monohydrate. The results? Not really. The alternative forms didn't show any consistent benefits over a placebo. Creatine monohydrate remains the most studied and affordable option.

Study Details

Who was studied: Healthy people who were participating in exercise.

How long: The studies varied in length, but the exact duration wasn't specified in the summary.

What they took: Participants took different forms of creatine, including creatine citrate, ethyl ester, and others. The dosage varied across the studies.

What This Means For You

Stick with the basics: If you're using creatine, creatine monohydrate is still the best choice. It's been proven to work, and it's the most affordable.

Don't waste your money: The fancier, more expensive creatine forms haven't been proven to be better. You're likely paying extra for no added benefit.

Focus on what works: Creatine monohydrate is a well-researched supplement that can help with muscle growth and strength.

Study Limitations

Not enough comparisons: Only a few studies directly compared the alternative creatine forms to creatine monohydrate, so it's hard to say for sure if one is better than the other.

Different studies, different results: The studies used different methods and looked at different groups of people, which can make it hard to compare the results.

We don't know who was studied: The summary didn't specify the age, sex, or fitness levels of the participants, which limits how well we can apply the results to everyone.

Short-term focus: Most of the studies were short, so we don't know the long-term effects of the alternative creatine forms.

Cost data: The cost comparison was based on market data, which could be biased.

Key Findings

This systematic review found no consistent evidence that alternative creatine forms (e.g., citrate, ethyl ester, nitrate) improve exercise performance or body composition more effectively than creatine monohydrate (CrM). While CrM remains the most studied and cost-effective option, alternative forms showed no significant performance benefits over placebo in 17 randomized trials. Only three studies directly compared alternative forms to CrM, limiting conclusions about relative efficacy. Market analysis confirmed CrM is the cheapest form available.

Study Design

The study was a systematic review adhering to PRISMA guidelines, analyzing randomized placebo-controlled trials (RCTs) from Cochrane CENTRAL, PubMed, Medline, and Google Scholar. It included 17 RCTs focusing on healthy subjects (demographics unspecified in the summary) supplementing with non-CrM creatine variants. Outcomes assessed were exercise performance (e.g., strength, power, endurance) and body composition. Study durations varied, with no specific timeframe reported in the summary.

Dosage & Administration

Doses of alternative creatine forms varied across studies, with no standardized protocol identified. Administration methods (e.g., timing, loading phases) were not detailed in the summary provided, though typical creatine supplementation strategies (e.g., daily dosing for weeks) were likely employed.

Results & Efficacy

Performance: No alternative creatine form demonstrated statistically significant improvements in exercise performance compared to placebo. Results were mixed, with some studies reporting marginal gains but lacking consistency or robust effect sizes.
Body Composition: No notable changes in lean mass, fat mass, or hydration status were observed for alternative forms versus placebo.
CrM Comparison: Only three studies compared alternative forms to CrM, preventing definitive conclusions about superiority. None reported significant advantages for alternative forms.
Cost: Alternative creatine supplements were consistently more expensive than CrM (exact price differences unspecified).

Limitations

Limited Comparative Data: Only 3/17 studies directly compared alternative forms to CrM, restricting analysis of relative efficacy.
Heterogeneity: Variability in study designs, populations, and outcome measures likely influenced results.
Sample Demographics: The summary did not specify age, sex, or fitness levels of participants, limiting generalizability.
Short Duration: Most trials were short-term, precluding assessment of long-term safety or effects.
Market Analysis: Cost comparison was based on unspecified marketplace data, potentially introducing bias.

Clinical Relevance

For supplement users, this review reinforces creatine monohydrate as the gold standard due to its proven efficacy, safety, and affordability. Alternative forms (e.g., creatine citrate, ethyl ester) lack sufficient evidence to justify their higher cost or claims of superior performance. Practitioners should prioritize CrM unless future research with rigorous methodology directly compares alternative forms to CrM in diverse populations. Users are advised to avoid products touting unproven benefits, as the review found no justification for switching from CrM.

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