Performance, strength and power. This is the best-supported element. The ISSN position stand states that after creatine loading, performance of high intensity and/or repetitive exercise is generally increased by 10 to 20 percent depending on the magnitude of increase in muscle phosphocreatine . The stand lists potential ergogenic benefits including increased single and repetitive sprint performance, increased work performed during sets of maximal effort muscle contractions, increased muscle mass and strength adaptations during training, enhanced glycogen synthesis, increased anaerobic threshold, increased work capacity, enhanced recovery and greater training tolerance .

Rapid muscle energy production. This is established physiology rather than a contested claim. The ISSN stand is built on the premise that supplementation increases intramuscular creatine stores, which can improve exercise capacity via the phosphocreatine system.

Recovery. Supported, but with hedged language in the source itself. The ISSN notes that creatine supplementation can help athletes recover from intense training, with co-ingestion of creatine and large amounts of glucose enhancing creatine and carbohydrate storage in muscle , and that creatine loading prior to an exhaustive exercise bout promoted greater glycogen restoration than carbohydrate loading alone, which matters because glycogen replenishment is important to promoting recovery and preventing overtraining during intensified training periods . A separate ISSN review adds that there is evidence creatine supplementation may reduce muscle damage and enhance recovery from intense exercise, with one study reporting less muscle enzyme efflux and better maintenance of isokinetic muscle performance during recovery from exercise-induced muscle damage , and that individuals supplementing experienced less muscle damage, inflammation, and muscle soreness in response to running 30 km and during four weeks of intensified training .

Women's health. Partially supported, with explicit evidence gaps. The 2021 Nutrients review found that creatine supplementation among pre-menopausal females appears to be effective for improving strength and exercise performance, while post-menopausal females may also experience benefits in skeletal muscle size and function when consuming high doses of creatine at 0.3 g per kg per day, with favorable effects on bone when combined with resistance training . Critically, the same authors state that despite extensive research on creatine, evidence for use among females is understudied, and females exhibit 70 to 80 percent lower endogenous creatine stores compared to males . Their 2025 follow-up concludes that creatine may improve mood and cognitive function, potentially alleviating symptoms of depression, and that emerging evidence suggests benefits during pregnancy and post-menopause, though data on perimenopausal women remains limited .

Memory and brain energy. Weakest element. A meta-analysis found that supplementation with creatine monohydrate improved memory, attention time, and processing speed in adults, however the cognitive benefits were largely influenced by the age, sex, and health status of the participants . That meta-analysis was subsequently challenged, and the authors conceded the point: in their reply, the authors acknowledged that the letter writers correctly identified a flawed statistical analysis that warranted correction pertaining to the increased statistical power of the previous meta-analysis, caused by the inclusion of multiple memory-related outcomes from each study . The underlying rationale remains plausible: from an energy perspective the brain is very metabolically demanding, creatine plays a key role in brain bioenergetics, and there is some evidence that supplementation can augment brain creatine stores, which could increase memory . Note the word "could."

The "bulky" question and lean mass. The strongest recent test complicates the muscle-building portion of the infographic. Desai et al. randomised 63 participants, 34 female and 29 male, mean age 31, to 5 g per day of creatine monohydrate for 13 weeks comprising a wash-in plus 12 weeks of resistance training, or to a control group, with lean body mass measured by DXA . The result: following the wash-in, both groups gained 2 kg after resistance training and there were no differences between them for lean body mass growth, although sex analysis found that only females in the supplement group gained more lean body mass than controls, up to 1.61 kg . The senior author stated that taking five grams of creatine per day does not make any difference to the amount of lean muscle mass people put on while resistance training, and that the benefits of creatine may have been overestimated in the past due to methodological problems with previous studies . This finding cuts against "bulky" but also against "helps build lean muscle" at that dose.