Creatine's Rebrand
“The most dangerous phrase in the language is: we’ve always done it this way.”
- Grace Hopper (Computerworld, 1976)
When I was in high school around Y2K, creatine was the substance your coach warned you about in the same breath as steroids. It would wreck your kidneys.
Twenty-five years later, my 75-year-old mother would be asking me about it as prominent women’s health voices sing its praises.
Creatine’s rebrand over the last two decades has been breathtaking. It has achieved “miracle pill” status that almost every other supplement would envy.
The story of how creatine rebranded is a microcosm of how scientific research is nuanced, slow and necessary. Safety risks are real and cannot be easily allayed without years or decades of well-run clinical trials. Thankfully, researchers are more patient than consumers.
What did the original published science on creatine actually say?
Creatine itself is not new. French chemist Michel Eugène Chevreul isolated it from meat broth in 1832 and named it from the Greek kreas, meaning flesh. Cyrus Fiske and Yellapragada Subbarow described its phosphorylated form in muscle in 1927. For the next sixty years, creatine was a curiosity of biochemistry textbooks.
The consumer story begins in 1992. A team of Swedish researchers published results showing oral supplementation meaningfully enhanced muscle chemistry in a healthy human.1 Further research in 1993 confirmed the finding that 20g daily supplementation loading increased muscular output under high stress.2 Anthony Almada and Ed Byrd founded EAS in 1993 and were the first to commercially sell creatine in the US.
After the 1992 Barcelona Olympics, gold medalists Linford Christie and Sally Gunnell confirmed they had used creatine, turning academic biochemistry into a locker-room hot topic.
Why did the public perception sour so quickly?
What happened next is a classic case study in how a single unverified anecdote can reshape consumer behavior for a decade.
In the late 1990s, three young American wrestlers died during rapid weight-cutting. Creatine use was reported. No causal link was ever established — the deaths were attributed to dehydration and electrolyte collapse — but the FDA opened a preliminary review in 1997. In 2000, the American College of Sports Medicine (ACSM) roundtable advised against creatine use in adolescents and anyone with pre-existing renal concerns.3 That same year, the French Agency for Food Safety (AFSSA) went further and effectively banned creatine sales, citing theoretical carcinogenic and renal risk.4
This is the environment in which my high school coach was operating. It was not irrational. The available guidance, from serious institutions, counseled caution.
But the data did not support the caution. Beginning in 1999, several studies were published that followed competitive athletes using creatine for up to five years and found no decline in renal function.5 Ron Terjung’s ACSM roundtable in the same volume in 2000, read carefully, said the evidence against creatine was weak. The AFSSA quietly walked back its position in 2007.
When did the scientific consensus actually flip?
The pivot point was likely 2017. Almost 2 decades after the initial published research in 1999 that indicated safety, Richard Kreider’s 2017 “position stand” paper confirmed the safety and efficacy of creatine supplementation in exercise, sport, and medicine.6 The 2017 paper reviewed more than 500 studies and concluded — in unusually direct language for a sports nutrition journal — that creatine monohydrate is among the most effective and safest supplements available, with documented benefits extending beyond athletic performance to neurological disease, recovery from brain injury, and healthy aging.
The International Olympic Committee’s 2018 consensus statement on dietary supplements named creatine one of five supplements with strong evidence for performance benefit, alongside caffeine, beta-alanine, sodium bicarbonate, and nitrate.7 This is what institutional vindication looks like.
Three research threads widened the aperture from the “thing that helps young men lift more” to something closer to “basic nutrient with under-explored upside”:
· Cognition. Darren Candow at the University of Regina and Eric Rawson at Messiah University have produced a steady drip of papers since the mid-2010s showing creatine’s role in brain bioenergetics, particularly under conditions of stress, sleep deprivation, or age-related decline.
· Women. Abbie Smith-Ryan’s lab at UNC Chapel Hill published the 2021 review Creatine Supplementation in Women’s Health reframing creatine as particularly relevant for peri- and post-menopausal women given the muscle and bone loss associated with that transition.8
· Mood. Lyoo et al.’s 2012 paper in the American Journal of Psychiatry showed creatine augmentation accelerated SSRI response in women with depression — a finding that has been replicated in smaller follow-ups and is now generating serious academic attention.9
Why did the consumer catch up in 2024 and not 2017?
This is the part that interests me most. The science was broadly settled by 2017. The guidelines were updated by 2018. The sales inflection did not happen until 2023.
US retail creatine sales sat around $400M for much of the late 2010s. By 2024, category estimates run above $1B, with some of the sharpest growth coming from female buyers who would not have touched the product a decade earlier. The catalyst was not a new paper. It was a change in who was talking about the paper.
Andrew Huberman, Mary Claire Haver, Peter Attia and a wave of women’s health creators on Instagram and TikTok did what peer-reviewed journals and the ACSM position could not: they put creatine into the same conversation as protein, sleep, and resistance training. The framing shifted from “performance enhancer” to “foundational nutrient that is under-consumed in a society that eats less red meat than it used to.”
Podcasts changed the perception much more than scientific research did.
A more recent population-wide appreciation of strength training (see Too Much Cardio?) has also led to interest in creatine. Many of the compound’s positive effects on muscle growth are only catalyzed by regular strength training.
What is the investor lesson?
Consumer preferences do not update in real time with the research. They update when a trusted interpreter translates the research into a story that fits someone’s existing identity — the longevity-seeker, the menopausal woman rebuilding bone density, the father trying to keep pace with his kids. The research was done. The story took another six years to arrive.
For those of us who invest in consumer health, this is both humbling and actionable. The scientific literature is a leading indicator; mass market consumer behavior is a lagging one. The window between those two points is usually where the best category opportunities live.
The magic pill obsession (see Magic Pill Obsession) is alive and well. The difference with creatine is that, for once, the pill mostly works.