TL;DR — Bender et al. 2008
Bender and colleagues published a study in Nutrition Research (2008) examining the long-term safety of creatine supplementation in patients with Parkinson’s disease.
Over a 2-year period, 60 patients received either 4 g/day of creatine monohydrate or placebo alongside resistance training.
The study confirmed that creatine was safe, with no adverse effects on kidney or liver function (Bender et al., 2008) .
Functional benefits from combining creatine with exercise were also observed.
Background
Parkinson’s disease is a progressive neurodegenerative disorder characterized by the loss of dopamine-producing neurons, mitochondrial dysfunction, and oxidative stress.
Creatine’s role in cellular energy metabolism and its potential neuroprotective properties made it a candidate intervention.
Previous preclinical work, including Sullivan et al. (2000), had shown that creatine supplementation could protect against brain injury through mitochondrial support (Sullivan et al., 2000) .
Bender et al. sought to determine whether long-term creatine supplementation was safe and potentially beneficial in Parkinson’s patients.
Study Design
This was a randomized controlled trial with:
- Participants: 60 patients with diagnosed Parkinson’s disease
- Intervention: 4 g/day creatine monohydrate or placebo
- Duration: 2 years
- Monitoring: Regular blood tests for renal and hepatic function markers
- Additional intervention: Both groups participated in resistance training
Key Findings
1. Safety confirmed over 2 years
No adverse effects on renal function (creatinine clearance, BUN) or hepatic function (liver enzymes, bilirubin) were detected at any point during the 2-year study.
This extended the safety evidence from healthy populations to a clinical neurological population.
2. Functional benefits observed
Participants receiving creatine combined with resistance training showed improvements in functional capacity compared to placebo.
While the study was not powered to detect disease modification, the functional benefits were clinically meaningful.
3. Well tolerated
No participants withdrew from the study due to creatine-related side effects. Gastrointestinal tolerance was comparable between creatine and placebo groups.
Practical Implications
- Creatine is safe in neurological populations: This study extends the safety evidence beyond healthy athletes to patients with neurodegenerative disease
- Exercise plus creatine may benefit Parkinson’s patients: Combining resistance training with creatine supplementation appears to provide functional improvements
- Standard maintenance dosing works: 4 g/day is within the ISSN-recommended range and was well tolerated (Kreider et al., 2017)
- Long-term use is feasible: Two years of continuous supplementation produced no safety concerns
Malaysian Relevance
Parkinson’s disease affects approximately 20,000 Malaysians, with prevalence increasing as the population ages.
The safety data from this study supports the consideration of creatine as a complementary intervention alongside standard Parkinson’s medications and physical therapy programs.
Limitations
- Moderate sample size of 60 participants
- Not designed to detect disease modification or progression changes
- Single-center study
- Creatine form limited to monohydrate at one dose level
Full Citation
Bender A, Samtleben W, Elstner M, Klopstock T. Long-term creatine supplementation is safe in aged patients with Parkinson disease. Nutrition Research.
2008;28(3):172-178. doi:10.1016/j.nutres.2008.01.001
Where This Fits in the Evidence
The value of Bender and colleagues’ trial lies in its duration and its population: two years of 4 g/day in older Parkinson’s patients, with renal and hepatic markers tracked throughout and no adverse signal. Most creatine safety data come from young, healthy users, so extending a clean two-year record into a neurological group that takes other medications genuinely widens the evidence — and the dose used sits squarely within the ISSN position stand range. The functional gains seen alongside resistance training are encouraging but secondary; the study was not built to detect disease modification, so its firmest conclusion is about tolerability, not cure. For the broader evidence base, see our research library.
Sources & References
This article is based on the clinical trial by Bender et al. published in Nutrition Research (2008) and contextualized with Sullivan et al. (2000) and Kreider et al. (2017).
All citations reference PubMed-indexed publications.