Creatine is not an anti-inflammatory, pooled trial data suggest

Creatine has one of the strongest evidence bases in sports nutrition for strength and body composition, and in recent years a second storyline has emerged: that it might also calm inflammation, whether the short-lived kind triggered by hard exercise or the chronic low-grade kind linked with ageing. Individual randomised trials have pointed in different directions, leaving the question open. Since anti-inflammatory benefits would broaden creatine's appeal well beyond the gym, pinning down whether the effect is real matters to a great many people who already take it.

Following PRISMA 2020 guidelines and a protocol registered on PROSPERO, the reviewers gathered randomised placebo-controlled trials in which neither participants nor researchers knew who was taking creatine. Eight trials qualified, spanning healthy individuals, athletes and clinical populations, with a variety of doses and durations. The outcomes were inflammatory biomarkers, including C-reactive protein, interleukin-6, IL-1β, TNF-α and prostaglandin E2. Two reviewers independently extracted the data and assessed risk of bias, and the certainty of the evidence was graded using the GRADE framework.

Creatine produced no significant acute effect on C-reactive protein, and no significant chronic effect on either C-reactive protein or interleukin-6; for the chronic outcomes, the included trials agreed with each other closely. The certainty of evidence was rated moderate for all outcomes. The authors note that certain benefits were observed under intense endurance conditions, but results remained inconsistent across populations. Missing outcome data was the most frequent limitation across the trials, and risk of bias varied between them.

This pooling pushes back on a growing narrative around creatine as a general anti-inflammatory agent. It does not touch the supplement's established effects on strength and body composition, which were never in question here. What it does is move the anti-inflammatory claim from plausible to unsupported on current human trial evidence, with the possible exception of intense endurance settings, where signals appeared but were inconsistent. The authors call for well-powered trials with standardised protocols to establish whether any niche benefit genuinely exists.

If you take creatine for strength, muscle or training performance, nothing here changes the picture. If you have seen it promoted as a way to lower inflammation, this is a reason for scepticism: across eight placebo-controlled trials, the inflammatory markers simply did not move. Anyone weighing a supplement purchase specifically for inflammation would be acting on a claim the pooled human evidence does not currently support.