Creatine is generally safe for guys on ADT if kidney function is normal and being checked with routine labs. It won’t raise testosterone or PSA. The main thing creatine does is help muscles recycle energy a little faster, so some lifters can squeeze out an extra rep or recover quicker between sets. That said, the effect is usually modest—especially for men on ADT. The big benefits for preserving muscle and strength come from consistent weight training, good protein, and calcium/vitamin D. Creatine can support that effort, but it’s not a game-changer on its own.