Efficacy and Safety of Creatine as an Ergogenic Supplement for Athletes

A Literature Review

Abstract

Introduction: Creatine is one of the most studied and widely used ergogenic supplements for enhancing physical performance, particularly in high-intensity and short-duration sports such as weightlifting and swimming. Its popularity stems from its potential to increase strength, muscle power, and recovery capacity. However, prolonged use and high doses raise concerns about possible health risks, particularly regarding renal function. Objectives: To identify the ergogenic effects of creatine and discuss the evidence on its interactions and potential risks to renal health, aiming to clarify the conditions for its use. Methodology: A bibliographic search was conducted on the PubMed database, covering articles published between 2000 and 2023. Clinical studies evaluating the effects of creatine supplementation in athletes were included. Keywords used were "creatine," "athletic performance," and "renal function." Studies involving non-athletic populations or individuals with severe pre-existing conditions, as well as systematic reviews and meta-analyses, were excluded. Discussion: Creatine serves as a substrate for ATP regeneration in muscles and contributes to maintaining energy during high-intensity activities. Studies show that supplemented athletes experience significant increases in repetitive effort capacity and lean muscle mass, with more pronounced effects in anaerobic sports. Regarding safety, most studies have found no association between creatine use and renal damage in healthy individuals, even with prolonged supplementation. However, controversies exist about creatine's impact on individuals predisposed to kidney diseases, highlighting the need for medical supervision. Due to its benefits and popularity, the commercialization of products that fail to comply with ANVISA regulations has become a significant risk factor for its consumption. Conclusion: Creatine's efficacy as an ergogenic supplement has been confirmed, particularly in short-duration and high-intensity activities. Evidence suggests that creatine is safe for prolonged use in healthy athletes. However, it is recommended that athletes with risk factors for kidney disease use creatine under medical supervision. Clarifying the safety of creatine can contribute to its safe use in athletic populations, maximizing benefits while minimizing potential risks.