Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of intervention trials
PubMed 32549301 · doi:10.3390/nu12061780
What was done
A systematic review and meta-analysis assessing the risk of adverse outcomes associated with oral creatine monohydrate supplementation specifically in female participants. A search identified 656 creatine intervention studies; 58 included only females, and 29 studies reported monitoring for adverse outcomes.
What was found
Across 29 studies comprising 951 participants, no deaths or serious adverse outcomes were reported. Meta-analysis stratified by dosing regimen showed no statistically significant differences in: - Total adverse events: RR 1.24 (95% CI 0.51 to 2.98) - Gastrointestinal events: RR 1.09 (95% CI 0.53 to 2.24) - Weight gain: MD 1.24 kg pre-intervention (95% CI -0.34 to 2.82) to 1.37 kg post-intervention (95% CI -0.50 to 3.23) - Renal or hepatic function parameters (no significant differences reported).
Why it matters
Most safety literature on creatine monohydrate has focused on male or mixed-sex cohorts. This study provides female-specific synthesized evidence that creatine supplementation does not increase the risk of adverse events, gastrointestinal distress, weight gain, or renal/hepatic impairment.
Limits
Only 29 studies (951 total participants) monitored adverse outcomes, resulting in wide confidence intervals and limited power to detect rare events. Surveillance and reporting of side effects across primary trials were inconsistent and sparse.
Cited by
- supports Recent meta-analyses show that gastrointestinal side effects from creatine supplementation are not significantly higher than placebo.