Shao · Regulatory toxicology and pharmacology : RTP 2006 · narrative review and risk assessment · n=?

Risk assessment for creatine monohydrate.

Cited 58 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and toxicological risk assessment framework without formal systematic review or meta-analysis

PubMed 16814437 · doi:10.1016/j.yrtph.2006.05.005 · record verified 2026-08-26

What was done

Authors conducted a safety risk assessment on creatine monohydrate supplementation using existing human and animal literature. Human data analyzed included acute high-dose protocols (~20 g/day for ≤1 week), chronic lower-dose protocols (3–5 g/day for up to 1 year), and combination regimens. The applicability of standard Upper Level of Intake (UL) criteria was evaluated against Observed Safe Level (OSL) and Highest Observed Intake (HOI) methods.

What was found

The abstract reports no raw numerical effect sizes or safety endpoints. Based on the OSL risk assessment framework, safety evidence was determined to be strong for chronic supplementation up to 5 g/day, establishing this intake as the OSL. While higher acute doses showed no adverse effects, data were deemed insufficient to establish long-term safety above 5 g/day.

Why it matters

This evaluation establishes a formal Observed Safe Level of 5 g/day for chronic creatine monohydrate intake within sports nutrition and supplement regulatory frameworks.

Limits

The abstract omits the number of studies reviewed, sample sizes, and specific clinical or biochemical parameters assessed, and notes insufficient data to determine chronic safety for doses above 5 g/day.

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