Creatine orotate is a compound that combines creatine with orotic acid, and it is marketed as a supplement for muscle health and athletic performance. The primary rationale for its use in supporting or treating "muscle tone" (often referring to muscle strength, mass, or function) is based on the well-established role of creatine itself in muscle physiology. Creatine supplementation is scientifically validated to increase muscle phosphocreatine stores, improve high-intensity exercise capacity, and, over time, support increases in muscle mass and strength, particularly when combined with resistance training.

However, specific studies on creatine orotate are extremely limited; most research and clinical validation pertain to creatine monohydrate. There is no robust clinical evidence that creatine orotate provides superior or unique benefits for muscle tone compared to other forms of creatine. The addition of orotic acid has not been shown to meaningfully enhance muscle-related outcomes in humans. Some animal studies suggest orotic acid might have metabolic effects, but this has not translated into clear clinical advantages.

In summary, the use of creatine (including creatine orotate) for supporting muscle tone is grounded in scientific evidence, but the evidence specifically for creatine orotate is weak. The strength of evidence for creatine monohydrate is high, but for creatine orotate specifically, it is limited, resulting in a low evidence rating.