Rheumatoid arthritis. Early research shows that taking creatine by mouth daily increases lean muscle mass and may improve muscle strength, but does not improve physical functioning in adults with rheumatoid arthritis. In children, taking a specific supplement containing creatine and fatty acids twice daily for 30 days might reduce pain and swelling. But the effects of creatine alone are not clear.

Still, any supplement should be used carefully and after discussion with a dietitian or doctor. There are some potential health risks and side effects that you should be aware of before taking creatine. Muscle cramping, nausea, diarrhea, dizziness, gastrointestinal pain, dehydration, weight gain, water retention, heat intolerance, and fever have all been linked to the supplement. (13)
It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
Although it does not appear to influence baseline antioxidant enzymes (measured in red blood cells), one week of creatine loading in otherwise healthy young adults has increased red blood cell (RBC) content of the superoxide dismutase (SOD) enzyme in response to a sprint test by 8.1% immediately after exercise. This was no longer detectable after an hour since placebo increased to match.[299] Glutathione and catalase are unaffected.[299]
^ Jump up to: a b c d Brosnan ME, Brosnan JT (August 2016). "The role of dietary creatine". Amino Acids. 48 (8): 1785–91. doi:10.1007/s00726-016-2188-1. PMID 26874700. The daily requirement of a 70-kg male for creatine is about 2 g; up to half of this may be obtained from a typical omnivorous diet, with the remainder being synthesized in the body ... More than 90% of the body’s creatine and phosphocreatine is present in muscle (Brosnan and Brosnan 2007), with some of the remainder being found in the brain (Braissant et al. 2011). ... Creatine synthesized in liver must be secreted into the bloodstream by an unknown mechanism (Da Silva et al. 2014a)
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