Evidence from more than four controlled clinical trials demonstrates that creatine supplementation is well-tolerated across multiple pediatric neurological conditions, including traumatic brain injury, muscular dystrophy, leukaemia-related complications, and inborn metabolic disorders. Crucially, no safety signals have emerged even when doses reach five times typical adult athletic levels. Despite this consistent safety profile documented over two decades, many regulatory bodies maintain restrictions on pediatric creatine use—restrictions that the 2025 International Society of Sports Nutrition position statement now identifies as lacking scientific support. For healthcare providers managing children with neurological conditions, this evidence suggests that creatine may represent a safe therapeutic option worth considering. The disconnect between regulatory policy and clinical evidence underscores the importance of evidence-based decision-making in pediatric supplement and therapeutic use.
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