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International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine
ISSN consensus review (2017) synthesizing human trials on creatine monohydrate: consistent ergogenic signals for high-intensity work when muscle stores rise, broad safety narrative in healthy people across short and multi-year exposures in reviewed literature, and discussion of clinical/rehab niches separate from OTC gym use.
What this is
A narrative position stand from the International Society of Sports Nutrition—useful as a field map and safety framing document, not a single pooled endpoint meta-analysis.
Headline synthesis (authors)
- Performance / training: supplementation raises intramuscular creatine and is associated with better high-intensity exercise performance and training adaptations in the cited trial corpus.
- Beyond gym metrics: authors summarize literature threads on recovery, injury/rehab tolerance, thermoregulation, and selected neuro / concussion research agendas—heterogeneous by diagnosis and dose.
- Safety: authors conclude short- and long-term use (reports up to ~30 g/day in some research contexts and multi-year community surveillance) is generally well tolerated in healthy individuals and several patient groups they review—still read renal monitoring, medication, and pediatric contexts in primary papers.
- Habitual low intake: authors argue ~3 g/day dietary-equivalent chronic intake may be worth studying for population health—distinct from acute loading schedules.
How to use on this wiki
Pair with the linked Desai et al. 2024 meta-analysis for quantified RT + creatine body-composition estimates in adults <50 y; use this row for breadth, controversy handling, and safety language.
Outcomes
- Performance ImprovementPosition-stand synthesis: creatine supplementation increases intramuscular creatine and is associated with improved high-intensity exercise performance and greater training adaptations across cited trials.
- Effect Size (Cohen's d / SMD)Authors summarize human data as showing short- and long-term creatine supplementation (including multi-year community monitoring in reviewed studies) is safe and well tolerated in healthy individuals when used appropriately; read full text for renal and pediatric caveats.
- Effect Size (Cohen's d / SMD)Narrative review also catalogs clinical research directions (e.g., neurodegenerative disease, metabolic, pregnancy contexts)—evidence quality varies by indication; do not generalize gym-dose RCTs to those populations without clinician oversight.