Creatine: What It Does and the Dose That Works

Creatine is the most studied sports supplement there is, and it is one of the few that does what people say it does. Most of the confusion around it comes from gym folklore about loading phases and water weight, so it is worth laying out plainly.

What it does

Muscle contracts using ATP, the molecule that carries energy. In a hard set, ATP runs down within seconds, and the fastest way to rebuild it is from phosphocreatine stored inside the muscle. Supplementing raises that store by roughly 20 to 40 percent. The result is one or two more quality reps near the end of a set, slightly higher power in sprints and jumps, and faster recovery between efforts. Across weeks of training, those extra reps add up to measurably more strength and a little more lean mass than training without it.

The brain uses creatine too, and brain stores rise with supplementation, though less than muscle. The cognitive data is smaller and more mixed than the strength data. It looks most consistent for tasks done under sleep deprivation or stress, and for people whose dietary intake is low, such as vegetarians. I would call it a reasonable possible benefit, not the main reason to take it.

The dose

3 to 5 grams of creatine monohydrate a day, every day. That is the whole plan. Loading phases of 20 grams a day for a week fill the muscle in about five days instead of three to four weeks, but they end in the same place, and the higher doses are what cause the stomach upset people complain about. Timing does not matter much. Take it with a meal, whenever you will remember it.

Monohydrate is the form with nearly all of the research behind it. Newer forms cost more and have not shown an advantage in head to head comparisons.

The water weight and the kidneys

Creatine pulls water into the muscle cell along with it. In the first few weeks most people gain 1 to 3 pounds, and that is water inside muscle, not under the skin and not fat. Cell swelling may itself be a growth signal, and either way the gain is a sign the muscle store is filling, not a side effect to fight. The scale moves once and then settles.

In healthy adults, decades of studies at 3 to 5 grams a day have not shown kidney or liver harm. One thing to know: creatine raises creatinine, the lab marker used to estimate kidney function, because creatinine is what creatine breaks down into. A slightly high creatinine on a panel from someone taking creatine usually reflects the supplement, not the kidneys. Tell whoever orders your labs. People with existing kidney disease are the group that should not take it without specific guidance.

For anyone lifting, this is the one supplement I bring up without being asked. We send people to our online dispensary for professional grade products, and clinic members get 35% off every order.

This article is educational and is not medical advice.

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