The purpose of this article is to summarize the available literature concerning the prevalence of, ergogenic effects of, and adverse events associated with creatine supplementation. Key points: Phosphocreatine is a critical fuel for sprinting and other brief activities requiring high power outputs. Creatine supplementation in the diet can increase creatine and phosphocreatine levels in the muscles, but there are large individual differences in this response. Creatine use is common. Surveys indicate that 17-74% of athletes of various ages in a variety of sports use creatine supplements. Creatine supplementation has been shown to improve performance of brief (<30 s) high-intensity exercise, but there is limited evidence that it can enhance performance during exercise lasting longer than about 90 s. Creatine supplementation during resistance training may allow athletes to complete more repetitions per set of a given exercise and may allow them to "recover" more rapidly between sets. There appears to be no association between creatine supplementation and adverse side-effects in apparently healthy individuals.
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