Creatine, long hailed in athletic circles for its muscle-boosting prowess, is increasingly attracting the attention of clinicians and medical researchers as a potential therapeutic tool in medicine. The question now posed by recent scientific reviews, such as the one published in Medscape’s “Creatine: Is the Supplement Ready for Clinical Use?,” is whether creatine is truly ready to transition from gyms and fitness centres into hospital wards and clinics as a mainstream medical supplement.
Originally popularised for its role in enhancing athletic performance and accelerating muscle recovery, creatine has for decades been a staple in the diets of athletes, bodybuilders, and fitness enthusiasts. Its effects as an ergogenic aid—substances that improve sports performance—have been fairly well established in scientific literature, with consistent evidence that it can improve strength, increase lean muscle mass, and speed up workout recovery in healthy individuals. In Thailand, where health and fitness trends often follow global patterns, creatine supplementation is familiar among young adults, personal trainers, and university athletes. However, newer research is probing the benefits of creatine far beyond muscle and athleticism, venturing into treatment of neurological, metabolic, and even mental health conditions.
The growing clinical interest in creatine is partially fueled by laboratory and controlled clinical trial results suggesting that this simple molecule—commonly found in red meat and produced naturally by the body—might benefit patients with disorders ranging from muscle wasting and neurodegenerative diseases to traumatic brain injury and depression. For example, studies published in PubMed have linked creatine supplementation with improvements in muscle strength, functional capacity, and overall quality of life in elderly people and patients with muscular dystrophy, while animal models and small human studies point toward possible neuroprotective effects during or after brain injury.
Experts featured in the Medscape report highlight both promise and caution. One leading rehabilitation physician from a major US medical centre is quoted as saying, “The safety profile of creatine is reassuring in the context of short-term use in healthy adults, but data in clinical populations and in long-term scenarios remain limited.” This sentiment is echoed by a clinical nutritionist interviewed for the same review, who adds, “Creatine can’t be seen as a miracle cure, but it certainly deserves further attention for its broad applicability in medicine, especially in settings where muscle loss or neurological decline is a concern.” The article also cites recent meta-analyses and systematic reviews, which suggest moderate benefits for muscle wasting and some promising signals for neurological disease—but not enough robust, large-scale data for universal medical adoption.
In Thailand, where sarcopenia (age-related muscle loss) and stroke are prominent health concerns among an aging population, the possibility of harnessing a safe, affordable supplement like creatine for clinical use is especially intriguing. Officials from leading Thai teaching hospitals have already begun informal discussions about the possibility of launching small-scale trials of creatine among older adults and stroke survivors, inspired by early Western findings. A faculty member from a leading Bangkok medical university points to the need for locally-led research: “Most studies so far are based on Western cohorts. We need Thailand-specific safety data, particularly considering genetic, dietary, and environmental factors unique to Thai patients.”
Thailand’s cuisine, based heavily on fish, rice, and vegetables, typically provides much lower dietary creatine than Western diets rich in red meat. As a result, Thai patients may, on average, start with lower baseline creatine stores, which potentially affects both safety (risk of side effects) and efficacy (therapeutic benefit) of supplement use. Thai clinicians, therefore, are encouraged to follow international developments while remaining alert for new research tailored to regional needs.
Although creatine remains widely available as an over-the-counter supplement in Thai pharmacies and sports outlets, the guidelines for clinical use are far from settled. The Thai Food and Drug Administration (FDA) currently classifies creatine as a dietary supplement, not as a medicinal product, and has not yet approved any formal medical claims for its use beyond general nutritional support. Leading Thai doctors urge caution, noting that while adverse effects appear minimal in most published studies, risks could emerge when used chronically, in high doses, or in patients with kidney or liver disease.
Globally, creatine supplementation is also under the spotlight for potential side effects and ethical concerns, especially regarding use among teenagers and pregnant women. Renal specialists emphasise that patients with preexisting kidney problems should avoid creatine unless under close clinical supervision, as rare instances of kidney strain have been reported in medical literature. The question of optimal dosing for non-athletic, clinical populations also remains unanswered, with ongoing research hoping to clarify appropriate regimens for patient groups as diverse as frail older adults, brain injury survivors, and individuals with mood disorders.
Some critics, including public health officials, worry about a rush to medicalise yet another popular supplement before Thailand’s regulatory framework is ready to monitor and control clinical use. They stress the importance of clear education for the general population, who may misinterpret headlines and start unsupervised self-medication. This is especially pertinent in Thailand’s vibrant social media environment, where supplements of all kinds are frequently hyped with little scientific oversight, sometimes resulting in avoidable complications.
In recent years, international reviews published in leading medical journals—including the Journal of the International Society of Sports Nutrition—have unanimously called for more large-scale, well-controlled studies to understand the full risk-benefit profile of creatine for clinical patients. From its established safety among trained athletes to its tentative use among the elderly or ill, creatine’s reputation is cautiously robust but incomplete.
Looking ahead, Thailand stands to benefit from the global momentum surrounding creatine research, but only with proper local trials, clinician training, and regulatory vigilance. Medical educators recommend that until more evidence is available, Thai patients and families should only consider creatine supplements under medical supervision, especially if they have underlying health conditions. In the meantime, policymakers are urged to prioritise investment in local research, data collection, and patient monitoring, so that future discoveries about creatine’s clinical use become relevant and safe for all Thais.
To conduct further research yourself, review the recent Medscape summary, consult recent PubMed publications, and talk with your doctor before considering supplementation for health reasons. As with many nutritional questions, the best decisions are made in partnership with experienced medical professionals who understand both the latest science and the Thai patient’s needs.