Research Signal – Source date 2026-07-21
Creatine users in a large online survey often wanted to keep taking it, even when they were unsure they had received the benefit they were seeking. The pattern was especially visible around cognition: brain and cognitive performance were the most common goals, but most people who chose that goal did not report a matching perceived benefit.
The finding is not evidence that creatine failed to improve anyone’s cognitive performance. It is a report of what respondents believed they experienced. The study is useful because it separates several outcomes that are easy to collapse into one: perceived benefit, satisfaction, side effects and intention to continue.
A large survey captured a specific kind of user
The study, published July 21, 2026, used an online questionnaire sent to approximately 110,000 users of a supplement-tracking application with recorded creatine use. The reported analytical sample included 2,178 people who were current users or had used creatine during the previous 12 months. The sample was nearly evenly divided between women and men, and the median age was 55. Most participants were middle-aged or older rather than young competitive athletes.
That recruitment route matters. People who track supplements may be more engaged with health information than people who do not. Participation also depended on receiving and completing a digital invitation. The results therefore describe the experiences and beliefs of this app-user sample, not the prevalence of benefits, symptoms or misconceptions among all people who take creatine.
The questionnaire asked about goals, perceived benefits, knowledge, side effects, satisfaction and plans to continue. It was a one-time cross-sectional survey, so it could identify associations between these measures but could not establish what caused what.
Satisfaction did not guarantee a matched benefit
At the overall level, 55% of respondents said they perceived a benefit. Mean satisfaction was 7.8 out of 10, and 98% said they intended to continue supplementation. Those figures can coexist. Someone may value an experience overall, feel that creatine fits their routine or remain hopeful about longer-term effects without noticing the specific result they originally wanted.
Cognitive performance was the most commonly endorsed goal, selected by 67.8% of respondents. Among those people, 64.4% did not report a matching perceived cognitive benefit. In other words, the percentage refers to people who had already identified cognitive performance as a goal; it is not the percentage of all respondents who believed creatine had harmed or failed their cognition.
The comparison with strength helps show why the denominator matters. Among respondents who endorsed strength as a goal, 45.3% reported a matched perceived benefit, leaving 54.7% without one. The study found unmet expectations in each of the five goal areas with a matched benefit question, but the cognitive result had the largest mismatch.
The authors discuss one possible explanation involving dose and timing. The most common reported dose in this sample was 5 grams per day, which they compare in their discussion with cognitive trials using doses from 5 to 20 grams per day. They describe this as a possible dose-translation issue, particularly because cognitive effects may depend on the circumstances and timescale studied in trials. The survey itself did not test whether a higher dose, a longer period or a different regimen would close the gap, and it did not identify an optimal cognitive regimen.
Reported tolerability and benefit varied across the sample
Women reported side effects more often than men in adjusted analyses. The prevalence ratio was 1.48, meaning that the prevalence of reported side effects was estimated to be 48% higher in women than in men after accounting for the variables included in that model. This is a relative comparison, not an estimate that 48% of women experienced side effects or a statement about any individual’s risk.
Women also had lower adjusted odds of perceiving a benefit, with an odds ratio of 0.66 compared with men. Older age was independently associated with lower odds of perceived benefit as well. The model also found a flatter dose-benefit association for women through a prespecified gender-by-dose interaction. These results describe differences in reported experience within this sample; they do not establish biological-sex or hormonal mechanisms, and they do not show what dose would work best for women or older adults.
Satisfaction followed a different pattern. Gender identity was not independently associated with satisfaction in the primary satisfaction model. Greater knowledge, longer reported use, higher activity and endorsing more goals were associated with higher satisfaction, while a history of self-reported side effects was associated with lower satisfaction. Perceived benefit was strongly associated with satisfaction in a secondary model, which is unsurprising but still does not reveal the direction of influence.
Side effects were reported retrospectively and were not medically verified. They may reflect symptoms, prior beliefs about creatine, attribution to creatine or the influence of other supplements. Plans to continue also do not demonstrate later adherence, and people reporting different durations of use cannot be treated as though they represent successive stages of one person’s experience.
Knowledge was linked to more favorable reported experiences
The survey measured knowledge with statements about five common beliefs: whether creatine causes kidney damage, causes hair loss, is a steroid, benefits only weightlifters or is unsafe for long-term use. The correct answer was false for each statement. A sixth water-retention item was administered but excluded from the primary analysis because its wording could be interpreted as referring either to a temporary loading-phase hydration change or to a longer-term belief about fluid retention.
The resulting knowledge score was not a clinical test or a diagnosis of what any one respondent understood. Its marginal reliability was modest, so the authors emphasize interpreting the model-based score at the group level. Even with that limitation, knowledge was the most consistent positive correlate across the main reported outcomes, including perceived benefit, satisfaction, a positive-experience composite and above-common dosing.
The result makes education a reasonable research question, not a proven solution. Better knowledge might help people choose goals that match the evidence and interpret early experiences more realistically. But people who feel satisfied may also become more interested in learning, while longer-term users may have had more opportunities to acquire information. The survey cannot determine whether knowledge improved experience, experience encouraged knowledge or another factor influenced both.
An exploratory analysis combined item-response characteristics with a network model to identify beliefs that might connect with several other measures. The belief that creatine causes kidney damage emerged as the leading candidate misconception, with hair-loss beliefs also showing relatively high discrimination and long-term safety beliefs showing high network centrality. These are hypothesis-generating results from a cross-sectional model, not evidence that correcting one belief will change behavior or outcomes.
A one-time survey leaves the direction of change unresolved
The survey offers a detailed view of how current and recent users describe creatine, but it cannot show individual trajectories. A person who has stayed with creatine for a long time may be more satisfied, more knowledgeable or more comfortable with side effects than someone who stopped early. That pattern could make duration appear beneficial even if the underlying explanation is that dissatisfied users left the pool of respondents.
The same issue applies to knowledge. The people who remained engaged with a supplement-tracking application may differ from less engaged users before they ever completed the survey. Survivorship and self-selection can therefore make positive associations look stronger than they would in a broader population.
There was also no creatine-naive comparison group. A respondent’s perceived benefit was not measured against an untreated baseline, an objective cognitive test or an independently verified physical outcome. Goal endorsement without a matching perceived benefit therefore tells us about expectation and experience, not whether an objectively measurable effect was absent.
Prospective studies could test whether clearer onboarding, better expectation-setting or guidance tailored to different goals changes decisions and experiences. They would need to follow people over time and distinguish reported impressions from outcomes measured in a consistent way. The present study points toward those questions without answering them.
What clearer creatine guidance could change
For consumers, the practical value of clearer guidance would be better-informed decisions about whether to start or continue creatine, particularly for middle-aged and older users and for women seeking information that fits their goals and tolerability concerns. Guidance that distinguishes cognitive, strength, wellness and healthy-aging expectations could also make it easier to understand what a reported benefit does and does not mean.
That possibility remains conditional from the July 2026 perspective. Tailored information could improve decisions and experiences if prospective research establishes that it does, while appropriate regimens for particular goals still require testing. The survey’s contribution is to show where real-world users are already asking for clarity: what to expect, how to interpret benefits and side effects, and which beliefs deserve better evidence.
Key Sources
- Primary source: Real-world creatine supplementation: a large-scale cross-sectional study of use, knowledge, and experiences.
DOI or Journal Page · Peer-Reviewed Paper · 2026-07-21
Keep exploring