What does the evidence actually say?

What we hold on creatine, muscle and growth

Read as:creatinemusclegrowth

1 vetted claim matches all three terms. Strongest evidence first.

1. Supplementswell supported · human data

   A meta-analysis of 10 randomised trials using direct muscle imaging found that adding creatine to resistance training produces only a very small extra increase in muscle size compared with training plus placebo. Gains in upper- and lower-body muscle thickness were in the region of 0.10-0.16 cm.

   What it shows: Meta-analysis of 10 RCTs (44 outcomes) in healthy adults; the pooled effect was very small and its credible interval crossed zero; several authors declared ties to the creatine industry.Meta-analysis · Nutrients

   Full breakdown →Creatine monohydrate guide →Creatine Calculator →

   Source: The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy: A Systematic Review with Meta-Analysis. Nutrients 2023

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1. Trainingwell supported · human data

   Adding high-intensity interval training to a lifting programme did not compromise muscle hypertrophy or upper-body strength gains in a meta-analysis, though lower-body strength gains were slightly reduced (effect size -0.248): a penalty that trended larger with cycling-based HIIT than with running.

   What it shows: Meta-analysis pooling trials of concurrent HIIT and resistance training versus lifting alone; the lower-body effect was small and borderline (p = 0.049), and the cycling-versus-running difference was a non-significant trend.Meta-analysis · J Sports Sci

   Full breakdown →HIIT explained →One-Rep Max Calculator →

   Source: The compatibility of concurrent high intensity interval training and resistance training for muscular strength and hypertrophy: a systematic review and meta-analysis. J Sports Sci 2018
2. Trainingwell supported · human data

   A meta-analysis of 13 randomised controlled trials found moderate-intensity continuous cardio does not consistently increase muscle size in healthy adults, with a pooled effect close to zero compared with not exercising.

   What it shows: Meta-analysis of 13 RCTs in healthy adults; pooled effect was near zero but confidence intervals were wide, and the authors flag considerable variability in protocols, populations and measurement sensitivity, so a small effect cannot be fully ruled out.Meta-analysis · Appl Physiol Nutr Metab

   Full breakdown →Hypertrophy explained →Training Volume Calculator →

   Source: Does moderate-intensity continuous training promote muscle hypertrophy? A systematic review and meta-analysis of randomized controlled trials. Appl Physiol Nutr Metab 2025
3. Supplementswell supported · human data

   In a meta-analysis of 12 randomised trials (459 older adults with sarcopenia), adding branched-chain amino acid-rich supplements to resistance training improved only skeletal muscle index (SMD 0.337, p = 0.029). Grip strength, walking speed, chair-stand performance, SPPB score, knee extension strength, total lean mass and fat mass showed no significant advantage.

   What it shows: Meta-analysis of 12 randomised trials with only 459 participants in total, all older adults with sarcopenia; the one positive outcome had a confidence interval reaching close to zero and several functional measures pointed in inconsistent directions, so this cannot be read across to younger or healthy trainees.Meta-analysis · Arch Gerontol Geriatr

   Full breakdown →Sarcopenia explained →Protein Intake Calculator →

   Source: Effects of branched-chain amino acid-rich nutritional supplements combined with resistance training on body composition and body function in older patients with sarcopenia. Arch Gerontol Geriatr 2026
4. Women's Healthwell supported · human data

   A meta-analysis of 14 randomised trials (763 women across reproductive stages) found that adding protein, amino acids or creatine to exercise produced no significant improvement in skeletal muscle mass, appendicular lean mass, fat-free mass, bone mineral content or bone mineral density; only bench press (g = 0.279) and handgrip strength (g = 0.412) improved significantly, with no increase in adverse events.

   What it shows: Pooled from just 14 RCTs totalling 763 women, lumping together whole proteins, amino acids and creatine monohydrate, very different compounds, so heterogeneity is high and the null may hide effects of specific supplements. The authors note that trials were mostly shorter than 12 months and lacked site-specific bone measurements, and no head-to-head comparisons exist.Meta-analysis · Int J Med Sci

   Full breakdown →Creatine monohydrate guide →Protein Intake Calculator →

   Source: Nutritional Supplementation Combined with Exercise for Musculoskeletal Health in Women: A Systematic Review and Meta-Analysis Evaluating Proteins, Amino Acids, and Creatine across Reproductive Stages. Int J Med Sci 2026
5. Supplementswell supported · human data

   In a meta-analysis of 10 randomised trials with 1,154 participants, whey protein supplementation improved muscle mass and gait speed in older adults diagnosed with sarcopenia, and combining it with resistance training significantly increased handgrip strength.

   What it shows: Meta-analysis of 10 RCTs (1,154 older adults with diagnosed sarcopenia, community and hospital settings mixed); the authors say more studies are needed to validate the results.Meta-analysis · J Nutr Health Aging

   Full breakdown →Whey protein guide →Protein Intake Calculator →

   Source: Improving sarcopenia in older adults: a systematic review and meta-analysis of randomized controlled trials of whey protein supplementation with or without resistance training. J Nutr Health Aging 2024
6. Nutritionwell supported · human data

   Across 49 randomised trials with 1863 healthy adults, adding protein supplements to resistance training increased fat-free mass by 0.30 kg and one-rep-max strength by 2.49 kg on average. Once total protein intake passed roughly 1.62 g/kg/day, extra protein added nothing further to fat-free mass gains.

   What it shows: Meta-analysis of 49 RCTs in healthy adults training for at least six weeks, so the pooled effects are solid but small in absolute terms; the 1.62 g/kg/day ceiling comes from a break-point analysis of group averages, not an individualised threshold, and the senior author discloses dairy-industry grant support.Meta-analysis · Br J Sports Med

   Full breakdown →Muscle protein synthesis explained →Protein Intake Calculator →

   Source: A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med 2018
7. Recoverywell supported · human data

   Pooling 22 randomised trials, a single cold-water immersion after exercise did nothing for maximal isometric strength recovery and transiently blunted jump performance immediately afterwards, while its apparent benefit for muscle-damage markers vanished once publication bias was accounted for. The one reasonably consistent effect was lower reported soreness.

   What it shows: Systematic review and meta-analysis of 22 RCTs in healthy people comparing one cold-water immersion bout with passive rest; certainty was moderate at best for strength and very low for soreness, with substantial heterogeneity and publication bias affecting the creatine kinase result.Meta-analysis · PeerJ

   Full breakdown →Cold Water Immersion →Recovery Readiness Index →

   Source: Temporal dynamics of muscle strength recovery following acute cold-water immersion: a systematic review and meta-analysis. PeerJ 2026
8. Longevitywell supported · human data

   A 2026 meta-analysis in postmenopausal women found that creatine (around 5 g a day) alongside resistance training produced small but real gains in lean mass and leg strength, with no change in bone density and no safety signals.

   What it shows: Pooled from seven trials (608 women, median 38 weeks). Gains were modest, about 0.4 kg lean mass, and appeared mainly at ≥5 g a day with training; several trials had some risk-of-bias concerns, and bone density did not move.Meta-analysis (7 RCTs) · n=608 · postmenopausal women · J Int Soc Sports Nutr

   Full breakdown →Creatine monohydrate guide →Creatine Calculator →

   Source: Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: a systematic review and meta-analysis. J Int Soc Sports Nutr 2026
9. Supplementswell supported · human data

   Creatine monohydrate is the most robustly supported sports supplement there is: a large body of human trials and the ISSN position stand agree it reliably improves high-intensity performance and, with training, gains in strength and lean mass.

   Creatine monohydrate guide →Creatine Calculator →

   Source: Kreider RB, et al. ISSN position stand: safety and efficacy of creatine supplementation. J Int Soc Sports Nutr 2017;14:18

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