Creatine for Bone Health
Verdict: Insufficient Evidence
Across 5 PubMed studies, the evidence for Creatine in Bone Health grades Tier D — counter-evidence. Research is still too limited to draw a firm conclusion.
D 🔴 D Counter-Evidence Insufficient Evidence
Why this grade7-layer evidence engine
⚖️
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.35
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
D · Insufficient Evidence
Confidence
84%
Highly consistent evidence
Evidence level
E2
Multiple high-quality MAs (≥2 independent, consistent)
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.352
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 negative 主導 (2 negative > 0 positive)，下層 RCT 不能推翻
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (5)L2 · primary research & systematic reviews
Creatine Supplementation During Resistance Training Does Not Lead to Greater Bone Mineral Density in Older Humans: A Brief Meta-Analysis
Finding: Pooled across 5 RCTs (n=193), creatine added no BMD benefit at any site: whole body MD 0.00 (95% CI -0.01 to 0.01, p=0.50), hip MD -0.01 (95% CI -0.02 to 0.01, p=0.26), femoral neck MD 0.00 (95% CI -0.01 to 0.01, p=0.71), lumbar spine MD 0.01 (95% CI -0.01 to 0.03, p=0.32).
View on PubMed A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health
Finding: Largest RCT to date (n=237) found NO effect on the primary endpoint femoral neck BMD (group x time p=0.84), nor total hip (p=0.69) or lumbar spine (p=0.44); creatine did preserve secondary bone-geometry surrogates — femoral neck section modulus (p=0.0011) and buckling ratio (p=0.011).
View on PubMed Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial
Finding: Independent 2-yr RCT (n=200 osteopenic women) found creatine did NOT alter BMD: aBMD declined equally in both arms (lumbar spine, femoral neck, total femur all group x time p>0.05), and bone markers, microarchitecture, and falls/fractures were unchanged, though lean/appendicular muscle mass increased (p<0.001).
View on PubMed Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women
Finding: Small pilot RCT (47 randomized, 33 completers) showed creatine attenuated femoral neck BMD loss (-1.2% vs placebo -3.9%, p<0.05) and increased femoral shaft subperiosteal width (p<0.05), with no difference at the lumbar spine or other sites.
View on PubMed Impact of creatine supplementation and exercise training in older adults: a systematic review and meta-analysis
Finding: Recent systematic review/meta-analysis in older adults confirms creatine's reliable benefits are on lean mass and strength, while bone outcomes remain limited and inconsistent, consistent with the null BMD signal from the large RCTs.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Supportive
FDA has no questions source↗
L4b EU EFSA
Supportive
cause and effect relationship has been established source↗
L4c UK NHS
Not addressed
Supplements containing creatine are widely used by athletes to improve performance source↗
L5a NIH Office of Dietary Supplements
Supportive
May increase strength, power source↗
L5b Mayo Clinic
Cautious
Some studies suggest that creatine may reduce markers of bone breakdown and support bone structure when combined with exercise. However, it has not consistently been shown to increase bone mineral density on its own. source↗