Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports

Classified as probably not a substantial claim.

The adverse event report databases were searched for creatine in dietary supplements or products following accepted protocols.

“These databases were searched for “creatine’ in dietary supplements or products following accepted protocols [61,62].”

• cites [61] Timbo BB, Chirtel SJ, Ihrie J, et al. Dietary supplement adverse event report data from the FDA center for food safety and applied nutrition adverse event reporting system (CAERS), 2004–2013. Ann Pharmacother. 2018; 52(5): 431– 438. 29171279 sourceNot checked — no full text of the source
• cites [62] Ng JY, Munford V, Thakar H. Web-based online resources about adverse interactions or side effects associated with complementary and alternative medicine: a systematic review, summarization and quality assessment. BMC Med Inform Decis Mak. 2020; 20(1). PMC7653751 33167980 sourceCould not verify

  The Results section, under “Summaries of included online resources” (page unavailable), describes databases containing information on adverse effects and supplements. The Methods sections describe selecting and assessing those resources, not searching adverse-event report databases for creatine. Searches of our copy for “creatine” and “accepted protocols” found no passage documenting the claimed search. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

This review incorporated elements of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

“This review incorporated elements of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines [57].”

• cites [57] Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021. PMC8005924 33782057 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Anecdotally reported side effects and claims that creatine monohydrate is not as effective as other forms of creatine continue to permeate the Internet.

“Nevertheless, anecdotally reported side effects and claims that CrM is not as effective as other “forms” of creatine continue to permeate the Internet [2,50].”

• cites [2] Kreider RB, Jager R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022; 14(5): 1035. doi: 10.3390/nu14051035 35268011 PMC8912867 sourcePartly supported

  Section 8 (Creatine Monohydrate; page unavailable) describes anecdotal side-effect claims and says companies have used such claims in marketing. The Introduction (page unavailable) describes marketing claims that other forms are more effective than CrM. The Methods say the authors reviewed company websites, but the cited passages do not establish that these claims continue to permeate the Internet. (LLM, conf=0.79)

  Experimental — accuracy not yet measured
• cites [50] Jager R, Purpura M, Shao A, et al. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids. 2011 May; 40(5): 1369– 1383. 21424716 PMC3080578 sourcePartly supported

  The Summary (page not provided) reports marketing claims that newer forms of creatine are more effective and have fewer side effects than creatine monohydrate. It does not say that anecdotal side-effect reports or these claims continue to permeate the Internet. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

Professional organizations, athletic governing bodies, and the Office of Dietary Supplements at the National Institutes of Health recognize creatine monohydrate as a safe, effective, and legal nutritional strategy to enhance performance and training adaptations.

“Based on this evidence, professional organizations [12,16–18], athletic governing bodies [19]; and the Office of Dietary Supplements at the National Institutes of Health [20] recognize CrM as a safe, effective, and legal nutritional strategy to enhance performance and training adaptations.”

• cites [12] Kreider RB, Kalman DS, Antonio J, et al. International society of sports nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017; 14: 18. 28615996 PMC5469049 sourceSupported
• cites [16] Buford TW, Kreider RB, Stout JR, et al. International society of sports nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. 2007 Aug 30; 4(1): 6. doi: 10.1186/1550-2783-4-6 17908288 PMC2048496 sourceSupported
• cites [17] Rodriguez NR, DiMarco NM, Langley S, et al. Position of the American dietetic association, dietitians of Canada, and the American college of sports medicine: nutrition and athletic performance. J Am Diet Assoc. 2009 Mar; 109(3): 509– 527. 19278045 sourceNot checked — no full text of the source
• cites [18] Thomas DT, Erdman KA, Burke LM. Position of the academy of nutrition and dietetics, dietitians of Canada, and the American college of sports medicine: nutrition and athletic performance. J Acad Nutr Diet. 2016 Mar; 116(3): 501– 528. doi: 10.1016/j.jand.2015.12.006 26920240 sourceNot checked — no full text of the source
• cites [19] Maughan RJ, Burke LM, Dvorak J, et al. IOC consensus statement: dietary supplements and the high-performance athlete. Int J Sport Nutr Exerc Metab. 2018; 28(2): 104– 125. doi: 10.1123/ijsnem.2018-0020 29589768 sourcePartly supported

  The IOC consensus statement’s Overview reports that creatine improves repeated high-intensity performance and training adaptations, and notes no negative health effects with appropriate long-term use. Our copy does not explicitly establish the claim that creatine monohydrate is legal in sport; it also cautions that supplements can contain prohibited substances. This citation is attached to the athletic-governing-body portion of the sentence, not the claims about other organizations or the NIH. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [20] National Institutes of Health. Office of dietary supplements, dietary supplement fact sheets: dietary supplements for exercise and athletic performance. U.S. Department of Health and Human Services; 2021 [ cited 2021 Mar 29]. Available from: https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/Not checked yet

  Not checked in the free run.

May combine two claims.

To date, hundreds of clinical trials have been conducted in humans on healthy and medically managed populations with no adverse events reported and relatively few, if any, side effects noted.

“To date, hundreds of clinical trials have been conducted in humans on healthy and medically managed populations with no adverse events reported and relatively few, if any, side effects noted [2,4,12,50].”

• cites [2] Kreider RB, Jager R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022; 14(5): 1035. doi: 10.3390/nu14051035 35268011 PMC8912867 sourcePartly supported

  Section 8 (Creatine Monohydrate; page not provided) describes numerous controlled clinical trials, studies in healthy and clinical populations, and no reported side effects other than desired weight gain. It does not establish the specific count of hundreds of trials or explicitly say that no adverse events were reported. Its safety conclusion concerns creatine monohydrate, not all forms of creatine. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [4] Kreider RB, Stout JR. Creatine in health and disease. Nutrients. 2021; 13(2): 447. doi: 10.3390/nu13020447 33572884 PMC7910963 sourcePartly supported

  The Introduction and §4 (General Health Benefits; page unavailable) describe creatine research in healthy people and investigations of its therapeutic use in people with medical conditions. They do not establish that hundreds of human clinical trials reported no adverse events or relatively few side effects. (LLM, conf=0.78)

  Experimental — accuracy not yet measured
• cites [12] Kreider RB, Kalman DS, Antonio J, et al. International society of sports nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017; 14: 18. 28615996 PMC5469049 sourcePartly supported

  The Safety section reports extensive study in healthy and diseased populations, with no significant adverse health risks and weight gain as the only consistently reported side effect. It says over 1,000 studies were conducted, but does not establish that hundreds were human clinical trials; it also says creatine was rarely mentioned in adverse-event reports, rather than that no adverse events were reported. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [50] Jager R, Purpura M, Shao A, et al. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids. 2011 May; 40(5): 1369– 1383. 21424716 PMC3080578 sourcePartly supported

  The Creatine monohydrate section reports human safety studies and says the only clinically significant side effect reported was weight gain; the Summary says no medically significant side effects have been reported from creatine monohydrate supplementation. The paper does not establish that hundreds of clinical trials were conducted or that no adverse events of any kind were reported. Its safety conclusion also does not extend to newer forms of creatine. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Creatine monohydrate is considered Generally Recognized as Safe (GRAS) by the FDA in the United States and is the only form of creatine approved for sale in the United States, Canada, Europe, Australia, Japan, the Republic of Korea, and China.

“CrM is considered Generally Recognized as Safe (GRAS) by the Food and Drug Administration (FDA) in the United States [51] and is the only form of creatine approved for sale in the United States, Canada, Europe, Australia, Japan, the Republic of Korea, and China [2].”

• cites [51] GRN No. 931 Creatine Monohydrate. U.S. Department of health and human services. U.S. Food and Drug Administration; 2020.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [2] Kreider RB, Jager R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022; 14(5): 1035. doi: 10.3390/nu14051035 35268011 PMC8912867 sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

A few case study reports appeared in the literature suggesting adverse events despite other mitigating factors unrelated to creatine supplementation, which subsequently have been debunked.

“A few case study reports also appeared in the literature suggesting adverse events despite other mitigating factors unrelated to creatine supplementation [52–54] which subsequently have been debunked [15,55,56].”

• cites [52] Pritchard NR, Kalra PA. Renal dysfunction accompanying oral creatine supplements. Lancet. 1998 Apr 25; 351(9111): 1252– 1253. doi: 10.1016/S0140-6736(05)79319-3 9643752 sourceNot checked — no full text of the source
• cites [53] Révai T, Sápi Z, Benedek S, et al. Severe nephrotic syndrome in a young man taking anabolic steroid and creatine long term. Orv Hetil. 2003 Dec 7; 144(49): 2425– 2427. 14725210Not checked — no full text of the source
• cites [54] Robles EL, Pache KM, Gluck JS. Acute compartment syndrome of the leg caused by cocaine use, creatine supplementation and vigorous exercise. J Surg Case Rep. 2022 Nov; 2022(11): rjac502. doi: 10.1093/jscr/rjac502 36776243 PMC9907039 sourceSupported
• cites [15] Antonio J, Brown AF, Candow DG, et al. Part II. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2025 Dec; 22(1): 2441760. doi: 10.1080/15502783.2024.2441760 39720835 PMC11703406 sourceCould not verify

  The supplied References passages do not address the reported cases. A search of the paper’s sections on adverse effects found discussion of unsupported claims about male fertility and blood pressure, but no passage identifying adverse-event case reports, their unrelated mitigating factors, or their subsequent debunking. Searches included “case reports,” “adverse events,” and “confounding factors.” (LLM, conf=0.70)

  Experimental — accuracy not yet measured
• cites [55] Rawson ES, Clarkson PM, Tarnopolsky MA. Perspectives on exertional Rhabdomyolysis. Sports Med. 2017; 47(Suppl 1): 33– 49. PMC5371628 28332112 sourceSupported
• cites [56] Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021; 18(1): 13. doi: 10.1186/s12970-021-00412-w 33557850 PMC7871530 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The 2017 ISSN position noted that given the known benefits and safety profile of creatine supplementation, government legislatures and sports organizations who restrict and/or discourage the use of creatine may be placing athletes at greater risk.

“The 2017 position noted that given the known benefits and safety profile of creatine supplementation, government legislatures and sports organizations who restrict and/or discourage the use of creatine may be placing athletes at greater risk [12].”

• cites [12] Kreider RB, Kalman DS, Antonio J, et al. International society of sports nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017; 14: 18. 28615996 PMC5469049 sourceSupported

May combine two claims.

Present findings are consistent with other safety studies on creatine supplementation and the long-term study conducted in Parkinson's patients.

“They are also consistent with other safety studies on creatine supplementation [50,80,84–87,89,91–109] and the long-term study conducted in Parkinson’s patients [74].”

• cites [50] Jager R, Purpura M, Shao A, et al. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids. 2011 May; 40(5): 1369– 1383. 21424716 PMC3080578 sourceSupported
• cites [80] Volek JS, Mazzetti SA, Farquhar WB, et al. Physiological responses to short-term exercise in the heat after creatine loading. Med Sci Sports Exerc. 2001 Jul; 33(7): 1101– 1108. 11445756 sourceNot checked — no full text of the source
• cites [84] Greenwood M, Farris J, Kreider R, et al. Creatine supplementation patterns and perceived effects in select division I collegiate athletes. Clin J Sport Med. 2000 Jul; 10(3): 191– 194. 10959929 sourceNot checked — no full text of the source
• cites [85] Greenwood M, Kreider RB, Greenwood L, et al. Cramping and injury incidence in collegiate football players are reduced by creatine supplementation. J Athl Train. 2003; 38(3): 216– 219. 14608430 PMC233174 sourceNot checked — no full text of the source
• cites [86] Greenwood M, Kreider RB, Melton C, et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003 Feb; 244(1–2): 83– 88. 12701814 sourceNot checked — no full text of the source
• cites [87] Kreider RB, Melton C, Rasmussen CJ, et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003 Feb; 244(1–2): 95– 104. 12701816 sourceNot checked — no full text of the source
• cites [89] Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol (1985). 1997; 83(6): 2055– 2063. doi: 10.1152/jappl.1997.83.6.2055 9390981 sourceNot checked — no full text of the source
• cites [91] Hile AM, Anderson JM, Fiala KA, et al. Creatine supplementation and anterior compartment pressure during exercise in the heat in dehydrated men. J Athl Train. 2006 Jan-Mar; 41(1): 30– 35. 16619092 PMC1421498Not checked — no full text of the source
• cites [92] Watson G, Casa DJ, Fiala KA, et al. Creatine use and exercise heat tolerance in dehydrated men. J Athl Train. 2006 Jan-Mar; 41(1): 18– 29. 16619091 PMC1421496Not checked — no full text of the source
• cites [93] Easton C, Turner S, Pitsiladis YP. Creatine and glycerol hyperhydration in trained subjects before exercise in the heat. Int J Sport Nutr Exerc Metab. 2007 Feb; 17(1): 70– 91. 17460334 sourceNot checked — no full text of the source

May combine two claims.

Most studies show that creatine supplementation can benefit healthy active populations as they age and provide therapeutic benefits in some clinical populations.

“Most studies show that creatine supplementation can benefit healthy active populations as they age and provide therapeutic benefits in some clinical populations [2,4].”

• cites [2] Kreider RB, Jager R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022; 14(5): 1035. doi: 10.3390/nu14051035 35268011 PMC8912867 sourceSupported
• cites [4] Kreider RB, Stout JR. Creatine in health and disease. Nutrients. 2021; 13(2): 447. doi: 10.3390/nu13020447 33572884 PMC7910963 sourceSupported

Classified as probably not a substantial claim. May combine two claims.

The ISSN concluded in its 2007 and 2017 position stands that CrM was safe and effective for all ages and that additional research should evaluate potential therapeutic benefits of creatine in clinical populations.

“Consequently, the ISSN concluded in its 2007 [16] and the 2017 position stands [12] that CrM was safe and effective for all ages and that additional research should evaluate the potential therapeutic benefits of creatin in clinical populations that may benefit.”

• cites [16] Buford TW, Kreider RB, Stout JR, et al. International society of sports nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. 2007 Aug 30; 4(1): 6. doi: 10.1186/1550-2783-4-6 17908288 PMC2048496 sourcePartly supported

  The Conclusion calls creatine monohydrate safe and effective within established guidelines, and the Medical Safety section says more research is needed to determine its clinical utility. But the Children and Adolescents section limits the ISSN’s recommendation for younger athletes to specific conditions, so the 2007 stand does not establish safety and effectiveness for all ages without qualification. This verdict concerns the cited 2007 stand, not the separately cited 2017 stand; page numbers are unavailable in our copy. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [12] Kreider RB, Kalman DS, Antonio J, et al. International society of sports nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017; 14: 18. 28615996 PMC5469049 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Much of the misinformation about creatine comes from companies and influencers who promote different types of creatine as more effective than CrM with fewer side effects.

“Much of the misinformation about creatine comes from companies and influencers who are promoting different types of creatine as more effective than CrM with fewer “side effects” [2].”

• cites [2] Kreider RB, Jager R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022; 14(5): 1035. doi: 10.3390/nu14051035 35268011 PMC8912867 sourcePartly supported

  The Introduction (section 1; page unavailable) says companies market alternative forms of creatine as more effective than CrM and describes marketing claims that they have fewer side effects, despite little or no supporting evidence. The paper does not identify influencers as promoters or establish that these claims account for much of the misinformation about creatine. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

Side effects were reported in 13.2% of studies in the placebo groups and 13.7% of studies in the creatine-supplemented groups, with no significant difference between groups (p = 0.776).

“Side effects were reported in 13.2% of studies in the PLA groups and 13.7% of studies in the Cr-supplemented groups, with no significant differences observed between the groups (p = 0.776).”

• Also stated in: § Prevalence of studies reporting side effects · plain

  “In the placebo group, 86/652 studies (13.2%) reported side effects, while 94/685 (13.7%) reported side effects in creatine-supplemented (p = 0.776).”

May combine two claims.

The time series scanning revealed a continuous increase in YouTube comments with important peaks in July 2021, March 2022, August 2023, and September 2024.

“The time series scanning revealed a continuous increase in YouTube comments with important peaks in July 2021, March 2022, August 2023, and September 2024 (Figure 2(d)).”

May combine two claims.

Studies included sample sizes up to 874 participants and participants up to 77 years old in studies lasting up to 14 years.

“This included studies with sample sizes up to 874 participants and participants up to 77 years old in studies lasting up to 14 years.”

May combine two claims.

No other significant differences were observed in the number of studies reporting the remaining 33 side effects between the placebo and creatine-supplemented groups, with the difference in prevalence typically ±0.4%.

“No other significant differences were observed in the number of studies reporting the remaining 33 side effects between the placebo and creatine-supplemented groups, with the difference in prevalence reported typically ±0.4%.”

May combine two claims.

No significant differences were found on average sentiment; there was a neutral sentiment on creatine if considering mean values of the analyzed population (mean positive - mean negative = 0.0098).

“No significant differences were found on average sentiment; therefore, there was a neutral sentiment on creatine if we consider the mean values of the analyzed population (mean positive – mean negative = 0.0098).”

May combine two claims.

Among CAERS reports that contained creatine as an ingredient, 37% listed CrM as the only product the individual was consuming, and 63% contained other nutrients consumed with CrM.

“Among the CAERS that contained creatine as an ingredient, 37% listed CrM as the only product the individual was consuming, and 63% contained other nutrients consumed with CrM.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

We identified over 400 scholarly reviews and 100 meta-analyses about creatine supplementation.

“Additionally, we identified over 400 scholarly reviews and 100 meta-analyses about creatine supplementation.”

May combine two claims.

The percentage prevalence in the frequency of reported side effects was very small between creatine and placebos overall, and when categorized by sex, age, and comparing healthy and clinical populations.

“the percentage prevalence in the frequency of reported side effects was very small between those taking creatine and placebos overall, as well as when categorized by sex (Table S7), age (Table S8), and comparing healthy and clinical populations (Table S9).”

Probably not a substantial claim: may not pass S3 (load-bearing).

For "HCl," significant associations were found with words like "stomach," "better," "bloating," "superior," "expensive," "cost" and "soluble."

“In the case of “HCl,” significant associations were found with words like “stomach,” “better,” “bloating,” “superior,” “expensive,” “cost” and “soluble.””

Probably not a substantial claim: may not pass S3 (load-bearing).

A total of 129,782 comments were collected from YouTube videos published between April 2011 and February 2025 that contained the term "creatine" in their title or description.

“A total of 129,782 comments were collected from YouTube videos published between April 2011 and February 2025 that contained the term “creatine” in their title or description.”

May combine two claims.

No significant differences were observed when comparing the frequency of side effects among healthy and clinical populations, even though clinical populations generally consumed a greater amount of creatine for longer periods.

“No significant differences were observed when comparing the frequency of side effects among healthy and clinical populations, even though clinical populations generally consumed a greater amount of creatine for longer periods of time.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In the univariate analysis, 13,452 participants ingested placebos and 12,839 consumed creatine supplements (p = 0.411).

“Univariate analysis revealed that 13,452 participants ingested placebos, while 12,839 consumed creatine supplements (p = 0.411).”

May combine two claims.

4.21% of placebo participants reported a side effect, while 4.60% of creatine participants reported side effects (p = 0.828).

“Of these, 4.21% of participants ingesting placebos reported having a side effect, while 4.60% of participants consuming creatine supplements reported side effects (p = 0.828).”

May combine two claims.

The percentage prevalence of side effects was small, with differences between groups generally within ±0.5%.

“The percentage prevalence of side effects was small, with differences between groups generally within ± 0.5%.”

May combine two claims.

The average study had 19.7 participants who were 30.1 years old, 75.5 kg body mass, ingested supplements for 64.7 days, and consumed an average of 0.166 g/kg/d of supplements or 480 g total (about 12.5 g/d).

“Overall, the average study had 19.7 [17.4, 21.9] participants who were 30.1 [29.3, 30.9] years, 75.5 [74.9, 76.2] kg body mass, ingested the supplements for 64.7 [52.0, 77.3] days, and consumed an average of 0.166 [0.159, 0.173] g/kg/d of supplements or 480 [388, 623] g total of supplements (about 12.5 g/d).”

Probably not a substantial claim: may not pass S3 (load-bearing).

No significant differences were observed between those taking placebo and creatine supplements among demographic-related variables.

“No significant differences were observed between those taking PLA and Cr supplements among demographic-related variables.”

May combine two claims.

Of CAERS reports with creatine, only 15.8% involved ingestion of CrM with other nutrients, 47.3% involved other types of creatine, and 43.6% involved ingesting creatine with nutritional products or drugs.

“Of these, only 15.8% involved ingestion of CrM with other nutrients, 47.3% involved other types of creatine, and 43.6% involved ingesting creatine with nutritional products or drugs”

May combine two claims.

As sentiment strength increases, the number of YouTube comments decreases, with positive comments remaining more prevalent.

“As sentiment strength increases, the number of comments decreases, with positive comments remaining more prevalent.”

May combine two claims.

YouTube comments containing the word "monohydrate" remain generally neutral despite having a higher percentage of comments with weak and moderate positive sentiments (average positive - average negative = 0.1033).

“comments containing the word “monohydrate” remain generally neutral despite having a higher percentage of comments with weak and moderate positive sentiments (average positive – average negative = 0.1033)”

May combine two claims.

Overall, positive YouTube comments on creatine outnumber negative ones, though neutral comments show a slightly higher proportion of negativity.

“Overall, positive comments (blue) outnumber negative ones (orange), though neutral comments show a slightly higher proportion of negativity (Figure 2(a)).”

May combine two claims.

Relative creatine doses were higher in children and adolescents (0.280 g/kg/d) and taken for longer periods (324.1 days) than older cohorts.

“Additionally, relative creatine doses were higher in children and adolescents (0.280 [0.184, 0.375] g/kg/d) and taken for longer periods of time (324.1 [23.6, 624.5] d) than older cohorts.”

May combine two claims.

Our literature search revealed that over 680 clinical trials have been conducted in humans on creatine supplementation (95% as creatine monohydrate) on over 26,000 participants.

“Our literature search revealed that over 680 clinical trials have been conducted in humans on creatine supplementation (95% as creatine monohydrate) on over 26,000 participants.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Similar findings were seen when looking at the products associated with AERs from other databases.

“Similar findings were seen when looking at the products associated with AERs from other databases.”

May combine two claims.

Although some significant differences were noted among sex and age categories, the percent differences in frequency of side effects between placebo and creatine were in most cases less than ±0.5% and in some cases higher in those consuming placebos.

“Although some significant differences were noted among sex and age categories, the percent differences in the frequency of side effects between participants consuming placebos and creatine were, in most cases, less than ±0.5% and, in some cases, higher in those consuming placebos.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Both "HCl" and "monohydrate" were highly associated with each other, but the match percentage was lower for monohydrate.

“Both “HCl” and “monohydrate” were highly associated with each other, but the match percentage was lower for the latter.”

May combine two claims.

The AER analysis revealed evidence of inaccurate reporting and linking creatine to AERs.

“It also revealed evidence of inaccurate reporting and linking creatine to AERs.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Sentiment analysis suggests that a small percentage of the public may have a stronger negative view about creatine supplementation.

“while the sentiment analysis suggests that a small percentage of the public may have a stronger negative view about creatine supplementation”

• AssumptionRests on an assumption: Social media sentiment analysis accurately reflects public perceptions about creatine supplementation.

Classified as probably not a substantial claim.

This includes assessment of side effect symptomology and markers of health and renal function.

“This includes assessment of side effect symptomology and markers of health and renal function.”

May combine two claims.

The number of studies and frequency of participants experiencing other side effects were very low and not significantly different than placebos (±0.5%).

“Additionally, the number of studies and frequency of participants experiencing other side effects were very low and not significantly different than placebos (±0.5%).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Most identified reviews conclude that creatine supplementation can provide some performance and/or clinical benefit, and most meta-analyses report some efficacy.

“Most of those reviews conclude that creatine supplementation can provide some performance and/or clinical benefit, and most meta-analyses report some efficacy.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

A large percentage of AERs mention creatine but were not actually in the products listed.

“given a large percentage of AERs mention creatine but were not actually in the products listed”

Probably not a substantial claim: may not pass S3 (load-bearing).

The accuracy of the sentiment analysis method has been published previously.

“The accuracy of this method has been published previously [69].”

• cites [69] Thelwall M, Buckley K, Paltoglou G. Sentiment strength detection for the social web. J Am Soc Inf Sci Technol. 2012; 63(1): 163– 173. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Sentiment analysis has been shown to be an effective strategy for social web text analytics.

“This has been shown to be an effective strategy for social web text analytics [66] with large and variate applications [67,68].”

• cites [66] Kumar A, Garg G. Systematic literature review on context-based sentiment analysis in social multimedia. Multimedia Tools Appl. 2019; 79(21–22): 15349– 15380. doi: 10.1007/s11042-019-7346-5 sourceNot checked — no full text of the source
• cites [67] Chenworth M, Perrone J, Love JS, et al. Methadone and suboxone® mentions on twitter: thematic and sentiment analysis. Clin Toxicol. 2021: 1– 14. PMC9177078 33821724 sourceNot checked — no full text of the source
• cites [68] Saha G, Roy S, Maji P. Sentiment analysis of twitter data related to COVID-19. Impac AI data sci in response to coronavirus pandemic. Algoritms Intell Syst 2021. 169– 191.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

When people comment on HCl, they generally also mention monohydrate (37%), whereas the opposite occurs less frequently (17%).

“This might indicate that when people comment on HCl, they generally also mention monohydrate (37%), whereas the opposite occurs less frequently (17%).”

Classified as probably not a substantial claim.

In some cases, full details about study dosages, demographics of participants, and side effects were not provided.

“In some cases, full details about study dosages, demographics of participants, and side effects were not provided.”

Classified as probably not a substantial claim.

This analysis is limited to the information provided in publications about the safety of creatine supplementation.

“This analysis is limited to the information provided in publications about the safety of creatine supplementation.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Big data text analysis enables the use of manual judgments to identify parameters for disambiguating instances of automatically identified clues.

“it must be noted that big data text analysis enables us to use manual judgments to identify parameters for disambiguating instances of automatically identified clues [119].”

• cites [119] Wiebe J, Wilson T, Bruce R, et al. Learning subjective language. Comput Linguistics. 2004; 30(3): 277– 308. doi: 10.1162/0891201041850885 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

This type of misinformation only confused the public.

“This type of misinformation only confused the public.”

May combine two claims.

Present findings are similar to results reported in the authors' long-term creatine safety study on American football players, where up to 21 months of creatine supplementation (5-10 g/d) in division I American football players did not significantly affect markers of health or renal function.

“Present findings are similar to results reported in our long-term creatine safety study on American football players [86,87], where we showed that up to 21 months of creatine supplementation (5–10 g/d) in division I American football players did not significantly affect markers of health or renal function [87]”

• cites [86] Greenwood M, Kreider RB, Melton C, et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003 Feb; 244(1–2): 83– 88. 12701814 sourceNot checked — no full text of the source
• cites [87] Kreider RB, Melton C, Rasmussen CJ, et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003 Feb; 244(1–2): 95– 104. 12701816 sourceNot checked — no full text of the source

May combine two claims.

In some cases, AERs report symptoms creatine studies never observed in any clinical trial or are unrelated to the known effects of creatine supplementation.

“and in some cases report symptoms creatine studies never observed in any clinical trial or are unrelated to the known effects of creatine supplementation.”

• AssumptionRests on an assumption: AERs provide a valid indication of the prevalence of adverse events associated with creatine supplementation.

May combine two claims.

Collectively, these findings indicate that creatine supplementation is well tolerated and not associated with a disproportionate increase in any purported side effect or clinical marker of health.

“Collectively, these findings indicate that creatine supplementation is well tolerated and not associated with a disproportion increase in any purported side effect or clinical marker of health.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The Twitter (X) API has time and size restrictions that affect the process of data gathering.

“First, the Twitter (X) API has time and size restrictions that affect the process of data gathering.”

May combine two claims.

While individuals taking creatine supplements may experience GI issues and muscle cramping/pain, the incidence is low and not different from those taking placebos.

“This means that while individuals taking creatine supplements may experience GI issues and muscle cramping/pain, the incidence is low and not different from those taking placebos.”

May combine two claims.

Other studies found that creatine supplementation did not increase the incidence of musculoskeletal injuries, dehydration, muscle cramping, gastrointestinal issues, renal dysfunction, or long-term detrimental effects.

“Other studies directly assessed the merit of anecdotal reports of side effects and found that creatine supplementation did not increase the incidence of musculoskeletal injuries [84–87], dehydration [85,86,91–96], muscle cramping [80,85,86,92,97], gastrointestinal issues [84–87], promote renal dysfunction [87,89,98–107], or have long-term detrimental effects [50,87,106,108,109].”

• cites [84] Greenwood M, Farris J, Kreider R, et al. Creatine supplementation patterns and perceived effects in select division I collegiate athletes. Clin J Sport Med. 2000 Jul; 10(3): 191– 194. 10959929 sourceNot checked — no full text of the source
• cites [85] Greenwood M, Kreider RB, Greenwood L, et al. Cramping and injury incidence in collegiate football players are reduced by creatine supplementation. J Athl Train. 2003; 38(3): 216– 219. 14608430 PMC233174 sourceNot checked — no full text of the source
• cites [86] Greenwood M, Kreider RB, Melton C, et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003 Feb; 244(1–2): 83– 88. 12701814 sourceNot checked — no full text of the source
• cites [87] Kreider RB, Melton C, Rasmussen CJ, et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003 Feb; 244(1–2): 95– 104. 12701816 sourceNot checked — no full text of the source
• cites [91] Hile AM, Anderson JM, Fiala KA, et al. Creatine supplementation and anterior compartment pressure during exercise in the heat in dehydrated men. J Athl Train. 2006 Jan-Mar; 41(1): 30– 35. 16619092 PMC1421498Not checked — no full text of the source
• cites [92] Watson G, Casa DJ, Fiala KA, et al. Creatine use and exercise heat tolerance in dehydrated men. J Athl Train. 2006 Jan-Mar; 41(1): 18– 29. 16619091 PMC1421496Not checked — no full text of the source
• cites [93] Easton C, Turner S, Pitsiladis YP. Creatine and glycerol hyperhydration in trained subjects before exercise in the heat. Int J Sport Nutr Exerc Metab. 2007 Feb; 17(1): 70– 91. 17460334 sourceNot checked — no full text of the source
• cites [94] Dalbo VJ, Roberts MD, Stout JR, et al. Putting to rest the myth of creatine supplementation leading to muscle cramps and dehydration. Br J Sports Med. 2008; 42(7): 567– 573. 18184753 sourceNot checked — no full text of the source
• cites [95] Lopez RM, Casa DJ, McDermott BP, et al. Does creatine supplementation hinder exercise heat tolerance or hydration status? A systematic review with meta-analyses. J Athl Train. 2009 Mar-Apr; 44(2): 215– 223. 19295968 PMC2657025 sourceNot checked — no full text of the source
• cites [96] Rosene JM, Matthews TD, McBride KJ, et al. The effects of creatine supplementation on thermoregulation and isokinetic muscular performance following acute (3-day) supplementation. J Sports Med Phys Fitness. 2015; 55(12): 1488– 1496. 25781214Not checked — no full text of the source

May combine two claims.

While more clinical trials reported GI issues and muscle cramping/pain in creatine users versus non-users, the percentage incidence was small, and the total number of participants experiencing these issues in all studies was not significantly different between those taking creatine and placebos.

“These findings indicate that while more clinical trials reported these issues in creatine users versus non-users, the percentage incidence was small, and the total number of participants experiencing these issues in all studies was not significantly different between those taking creatine and placebos.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The query strategy normally matches many irrelevant YouTube comments and tweets.

“Also, the query strategy normally matches many irrelevant YouTube comments and tweets as well.”

May combine two claims.

AERs do not provide enough detail to assess causality and may not be attributed to creatine supplementation.

“Although AERs do not provide enough detail to assess causality and may not be attributed to creatine supplementation”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

These data objectively support the positive impact of bridging the gap between high-level researchers and the general population through social media.

“these data objectively support the positive impact of bridging the gap between high-level researchers (e.g. Creatine For Health is an initiative that brings together the world’s leading creatine researchers to accelerate awareness of the role of creatine supplementation in health and clinical diseases) and the general population through social media.”

• AssumptionRests on an assumption: Social media sentiment analysis accurately reflects public perceptions about creatine supplementation.

May combine two claims.

Given creatine has been taken billions of times since it became a popular dietary supplement in the early 1990s, the lack of AERs reported in worldwide databases is consistent with the lack of side effects observed in clinical trials.

“Given creatine has been taken billions of times since it became a popular dietary supplement in the early 1990s, the lack of AERs reported in worldwide databases is consistent with the lack of side effects observed in clinical trials.”

• AssumptionRests on an assumption: Creatine has been taken billions of times since it became a popular dietary supplement in the early 1990s.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Some studies only mentioned side effects from those taking creatine with no mention of side effects from taking placebos, which would overinflate the frequency reported with creatine supplementation.

“Some studies only mentioned side effects from those taking creatine with no mention of side effects from taking placebos which would overinflate the frequency reported with creatine supplementation.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Some of the side effects reported in AERs appear unrelated to the known effects of creatine supplementation.

“some of the side effects reported appear unrelated to the known effects of creatine supplementation”

Probably not a substantial claim: may not pass S3 (load-bearing).

Full details are not provided in AERs to assess causality.

“It should also be noted that full details are not provided in AERs to assess causality.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

Inaccurate information on the Internet and social media platforms has persisted, confusing the public and healthcare professionals.

“Yet, inaccurate information on the Internet and social media platforms has persisted, confusing the public and healthcare professionals.”