Filip Bieg, Agnieszka Dąbek, Paweł Paśko

The role of creatine supplementation in the prevention and support of treatment of sarcopenia and myopenia – a narrative review

2026-04-17

Introduction. Current nutritional guidelines increasingly emphasize the need for personalized interventions in individuals with chronic diseases, with particular attention to maintaining muscle mass and proper muscle function, crucial for preserving physical performance and overall patient condition. Myopenia and sarcopenia are common yet still under-recognized complications of chronic diseases, significantly affecting treatment course, prolonging hospitalization, increasing the risk of complications, and negatively impacting both short- and long-term prognosis while simultaneously reducing physical performance and quality of life.

Aim of the study. The aim of this study was to analyze available scientific evidence regarding the use of creatine supplementation in individuals with chronic diseases, with particular emphasis on its effects on muscle mass and function, as well as the risk of developing myopenia and sarcopenia.

Methods. A literature review was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases from 1.11.2025 to 15.12.2025, covering original research articles published in English, review papers, and meta-analyses related to creatine supplementation, sarcopenia, and chronic diseases.

Results. The evidence from meta-analyses indicates that creatine supplementation may lead to an increase in fat-free mass and improvements in muscle strength, particularly when combined with resistance training. The most commonly used supplementation protocols included a loading phase of 20 g per day, divided into four doses for 5–7 days, followed by a maintenance dose of 5 g per day, or a direct maintenance dose of 5 g per day without a loading phase. Limited clinical studies in the individuals with chronic kidney diseases have demonstrated potential benefits in terms of improved nutritional status and preservation of muscle mass.

Conclusions. Creatine may represent a promising component of nutritional support in the prevention and adjunctive treatment of myopenia and sarcopenia, particularly in older adults and the individuals with chronic conditions, such as chronic kidney disease, rheumatoid arthritis, or inflammatory bowel disease, who are at increased risk of muscle mass and functional decline. Potential benefits may also extend to recovery periods, including post-hospitalization or during episodes of immobilization, when the increased muscle loss is commonly observed. The most pronounced effects appear to occur when creatine supplementation is combined with resistance training. Creatine may contribute to maintaining muscle mass, strength, and overall physical performance. However, further well-designed clinical studies are needed to evaluate its efficacy, determine optimal dosing, and assess safety.

Keywords: creatine, sarcopenia, myopenia, supplementation.

© Farm Pol, 2025, 81(9): 563–572