Does Creatine Supplementation Hinder Exercise Heat Tolerance or Hydration Status? A Systematic Review With Meta-Analyses
Open accessAbstract
Objective: To critically assess original research addressing the effect of creatine supplementation on exercise heat tolerance and hydration status. Data Sources: We searched the electronic databases PubMed, Scopus, Web of Science, SPORTDiscus, and Rehabilitation & Physical Medicine, without date limitations, for the following key words: creatine, exercise, thermoregulation, dehydration, hyperthermia, heat tolerance, exertional heat illnesses, and renal function. Our goal was to identify randomized clinical trials investigating the effect of creatine supplementation on hydration status and thermoregulation. Citations from related articles also were identified and retrieved. Data Synthesis: Original research was reviewed using the Physiotherapy Evidence Database (PEDro) Scale. One author initially screened all articles. Fifteen of 95 articles examined the effects of creatine on thermoregulation or hydration status (or both). Two independent reviewers then reviewed these articles. Ten studies were selected on the basis of inclusion and exclusion criteria. The PEDro scores for the 10 studies ranged from 7 to 10 points (maximum possible score = 10 points). Conclusions: No evidence supports the concept that creatine supplementation either hinders the body's ability to dissipate heat or negatively affects the athlete's body fluid balance. Controlled experimental trials of athletes exercising in the heat resulted in no adverse effects from creatine supplementation at recommended dosages.
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Creatine supplementation does not increase the incidence of dehydration.
“dehydration [111, 112, 117, 122, 127–129, 242]”
From International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (2017) · cites this paper as [127]
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].”
From Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports (2025) · cites this paper as [95]
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- Authors
- Lopez, R. M., Casa, D. J., McDermott, B. P., Ganio, M. S., Armstrong, L. E., & Maresh, C. M.
- Affiliations
- University of Connecticut (US)
- Venue
- Journal of Athletic Training
- Published
- 2009-03
- Volume
- 44
- Issue
- 2
- Pages
- 215-223
- ISSN
- 1062-6050 (ISSN-L)
- PMC
- PMC2657025
- OpenAlex
- W2108782933
- Cited by
- 66
- References
- 69
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 6 · 2014: 2 · 2013: 2 · 2012: 2
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Athletic Training (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- creatine supplementation, thermoregulation, hydration status, dehydration, hyperthermia, exertional heat illness, renal function, fluid balance, athletes
- MeSH terms
- Body Temperature Regulation, Creatine, Dehydration, Female, Fever, Hot Temperature, Humans, Male, Oxygen Consumption, Reference Values, Risk Factors, Sensitivity and Specificity, Water-Electrolyte Balance, Exercise, Exercise Tolerance, Dietary Supplements
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