Those considering creatine supplementation for the goal of regional muscle hypertrophy should consider the practical significance of the small magnitude of effect

compared to a placebo, the magnitude of this effect was trivial to small

To be clear, there is a minuscule effect observed over the relatively short time scale of the studies. What people do is erroneously assume that your “gains” will compound the same way interest compounds with money, so someone hawking the supplement will point to one of the more positive studies (for every hundred studies, we’ll get 5 that erroneously say it’s extremely good, with 95% confidence!) and argue that even minuscule amounts of extra progress will result in much better results over a long period of time.

In reality muscle hypertrophy actually works the opposite way. The further along you are the slower you progress lol. Furthermore, there has literally never been a study on the muscle building effects of creatine supplementation over a long period of time. We have no evidence whatsoever to suggest you’ll be better off at the 1 year mark, 3 years, 5 years, and so on. (There have been observational studies performed up to the 5 year mark, but only looking for negative side effects. No word on the benefits at that point)

This is all also ignoring serious methodological issues regarding the studies themselves. We just don’t have a reliable way to measure regional muscle hypertrophy at such a small scale. There is work being done at the moment trying to repeat some of the more positive studies while controlling for sudden water retention (which causes most measurement methods to false positive) and so far every time they do that they fail to replicate the original findings.

But yeah, even awaiting the controlled reviews to play out, based on the current flawed and overly optimistic studies, experts are saying “trivial to small” to the point where it has questionable practical significance. Which is why I say next to worthless instead of totally worthless.

As a side note, believe it or not, the international powerlifting federation officially recommends against creatine supplementation and even protein powder. Mainly because there are significant systemic contamination issues across all supplements and they keep finding banned substances in the powders. The amounts are probably small enough not to affect your health but pose a problem for athletes during drug testing