Creatine
Uses
Creatine (creatine monohydrate) is a colorless, crystalline substance used in muscle tissue for the production of phosphocreatine, an important factor in the formation of adenosine triphosphate (ATP), the source of energy for muscle contraction and many other functions in the body.1, 2
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
This supplement has been used in connection with the following health conditions:
| Used for | Why |
|---|---|
3 Stars Athletic Performance and Non-Weight Bearing Endurance Exercise 15 to 20 grams daily for five or six days | Taking this supplement for five or six days may improve performance of high-intensity, short-duration exercise (like sprinting) or sports with alternating low- and high-intensity efforts. (creatine monohydrate) is used in muscle tissue for the production of phosphocreatine, a factor in the formation of ATP, the source of energy for muscle contraction and many other functions in the body. Creatine supplementation increases phosphocreatine levels in muscle, especially when accompanied by exercise or carbohydrate intake. It may also increase exercise-related gains in lean body mass, though it is unclear how much of these gains represents added muscle tissue and how much is simply water retention. Over 40 double-blind or controlled studies have found creatine supplementation (typically 136 mg per pound of body weight per day or 15 to 25 grams per day for five or six days) improves performance of either single or repetitive bouts of short-duration, high-intensity exercise lasting under 30 seconds each. Examples of this type of exercise include weightlifting; sprinting by runners, cyclists, or swimmers; and many types of athletic training regimens for speed and power. About 15 studies did not report enhancement by creatine of this type of performance. These have been criticized for their small size and other research design problems, but it is possible that some people, especially elite athletes, are less likely to benefit greatly from creatine supplementation. Fewer studies have investigated whether creatine supplementation benefits continuous high-intensity exercise lasting 30 seconds or longer. Five controlled studies have found creatine beneficial for this type of exercise, but one study found no benefit on performance of a military obstacle course run. Most studies of endurance performance have found no advantage of creatine supplementation, except perhaps for non-weight bearing exercise such as cycling. Long-term use of creatine supplementation is typically done using smaller daily amounts (2 to 5 grams per day) after an initial loading period of several days with 20 grams per day. Very little research has been done to investigate the exercise performance effects of long-term creatine supplementation. One study reported that long-term creatine supplementation improved sprint performance. Four controlled long-term trials using untrained women, trained men, or untrained older adults found that creatine improved gains made in strength and lean body mass from weight-training programs. However, two controlled trials found no advantage of long-term creatine supplementation in weight-training football players. Creatine supplementation appears to increase body weight and lean body mass or fat-free mass, but these measurements do not distinguish between muscle growth and increased water content of muscle. A few double-blind studies using more specific muscle measurements have been done and found that combining creatine supplementation with strength training over several weeks does produce greater increases in muscle size compared with strength training alone. |
2 Stars Athletic Performance and High-Intensity, Short Duration Exercise or Sports with Alternating Low- and High-Intensity Efforts 15 to 20 grams a day for five or six days | Supplementing with creatine may improve performance of non-weight bearing endurance exercises such as cycling. (creatine monohydrate) is used in muscle tissue for the production of phosphocreatine, a factor in the formation of ATP, the source of energy for muscle contraction and many other functions in the body. Creatine supplementation increases phosphocreatine levels in muscle, especially when accompanied by exercise or carbohydrate intake. It may also increase exercise-related gains in lean body mass, though it is unclear how much of these gains represents added muscle tissue and how much is simply water retention. Over 40 double-blind or controlled studies have found creatine supplementation (typically 136 mg per pound of body weight per day or 15 to 25 grams per day for five or six days) improves performance of either single or repetitive bouts of short-duration, high-intensity exercise lasting under 30 seconds each. Examples of this type of exercise include weightlifting; sprinting by runners, cyclists, or swimmers; and many types of athletic training regimens for speed and power. About 15 studies did not report enhancement by creatine of this type of performance. These have been criticized for their small size and other research design problems, but it is possible that some people, especially elite athletes, are less likely to benefit greatly from creatine supplementation. Fewer studies have investigated whether creatine supplementation benefits continuous high- intensity exercise lasting 30 seconds or longer. Five controlled studies have found creatine beneficial for this type of exercise, but one study found no benefit on performance of a military obstacle course run. Most studies of endurance performance have found no advantage of creatine supplementation, except perhaps for non-weight bearing exercise such as cycling. Long-term use of creatine supplementation is typically done using smaller daily amounts (2 to 5 grams per day) after an initial loading period of several days with 20 grams per day. Very little research has been done to investigate the exercise performance effects of long-term creatine supplementation. One study reported that long-term creatine supplementation improved sprint performance. Four controlled long-term trials using untrained women, trained men, or untrained older adults found that creatine improved gains made in strength and lean body mass from weight-training programs. However, two controlled trials found no advantage of long-term creatine supplementation in weight-training football players. Creatine supplementation appears to increase body weight and lean body mass or fat-free mass, but these measurements do not distinguish between muscle growth and increased water content of muscle. A few double-blind studies using more specific muscle measurements have been done and found that combining creatine supplementation with strength training over several weeks does produce greater increases in muscle size compared with strength training alone. |
2 Stars Chronic Obstructive Pulmonary Disease 5 grams three times a day for two weeks, and then 5 grams once daily | Creatine has been shown to increase muscle strength, muscle endurance, and overall health status. In a double-blind study, people with COPD received or a placebo for 12 weeks. After the first 2 weeks of supplementation, all participants underwent an outpatient pulmonary rehabilitation program. Compared with the placebo, creatine significantly increased muscle strength, muscle endurance, and overall health status, but not exercise capacity. The amount of creatine used in this study was 5 grams three times a day for 2 weeks, and then 5 grams once a day for 10 weeks. |
2 Stars High Cholesterol 20 grams per day as a loading dose and 10 grams per day as an ongoing dose | Clinical trials examining the effect of creatine on cholesterol metabolism have yielded mixed results. Creatine is a peptide often used as a supplement to support muscle growth. In a preliminary trial, 40 physically active men who took 20 grams of creatine monohydrate daily for one week were found to have significantly decreased levels of total and LDL-cholesterol levels. A placebo-controlled trial in 30 men found 20 grams per day of creatine for five days followed by 10 grams per day for 23 days in conjunction with a strength training program lowered total cholesterol more than strength training plus placebo or creatine alone. However, in a placebo-controlled trial in 22 healthy men in an exercise training program, creatine, at a dose of 20 grams per day for one week followed by 10 grams per day for eleven weeks, did not lower cholesterol levels more than placebo. In addition, 25 grams of creatine daily for a week followed by 5 grams daily for eleven weeks did not lower cholesterol levels more than placebo in a controlled trial in 19 men participating in a strength training program. One placebo-controlled trial examined the effect of creatine supplementation in 34 adult men and women with high cholesterol levels and found creatine, at 20 grams per day for five days followed by 10 grams per day for 51 days, lowered total cholesterol levels relative to placebo after four and eight weeks, but the effect disappeared by week 12. |
1 Star High Triglycerides Refer to label instructions | One trial found that supplementing with significantly lowered serum total triglycerides in both men and women. A double-blind trial found that a supplement of 5 grams of plus 1 gram of glucose taken four times per day for five days followed by twice a day for 51 days significantly lowered serum total triglycerides in both men and women. However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program. Creatine supplementation in this negative trial was lower—only five grams per day was taken for the last 11 weeks of the study. |
How It Works
How to Use It
Two methods are used for supplementing with creatine. In the loading method, 20 grams of creatine per day (in four divided amounts mixed well in warm liquid) are taken for five to six days.3 Muscle creatine levels increase rapidly, which is beneficial if a short-term rise in force is needed, such as during a weight-lifting competition, football game, or sprinting. To maintain muscle creatine levels after this loading period, 2–10 grams per day may be effective.4, 5
In another method, 3 grams of creatine monohydrate per day are taken over an extended training period of at least four weeks, during which muscle creatine levels rise more slowly, eventually reaching levels similar to those achieved with the loading method.6 However, no trials testing exercise performance changes have been done using this method. Taking creatine with sugar appears to maximize muscle uptake.7, 8
Caffeine intake should not be excessive, as large amounts may counteract the benefits of creatine supplementation.9
Where to Find It
Creatine is produced naturally in the human liver, pancreas, and kidneys. It is concentrated primarily in muscle tissues, including the heart. Animal proteins, including fish, are the main source of the 1–2 grams per day of dietary creatine most people consume. Supplements in the form of creatine monohydrate are well absorbed and tolerated by the stomach.
Possible Deficiencies
People involved in intense physical activity, especially those limiting their intake of red meat, may have low muscle stores of creatine. Several muscle diseases, as well as rheumatoid arthritis, and chronic circulatory and respiratory diseases, are associated with lowered creatine levels.10
Interactions
Interactions with Supplements, Foods, & Other Compounds
Interactions with Medicines
Certain medicines interact with this supplement.
Replenish Depleted Nutrients
none
Reduce Side Effects
- Atorvastatin
In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
- FluvastatinIn a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
- LovastatinIn a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
- PitavastatinIn a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
- PravastatinIn a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
- RosuvastatinIn a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
- SimvastatinIn a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.
Support Medicine
none
Reduces Effectiveness
none
Potential Negative Interaction
none
Explanation Required
none
Side Effects
Side Effects
Little is known about long-term side effects of creatine, but no consistent toxicity has been reported in studies of creatine supplementation. In a study of side effects of creatine, diarrhea was the most commonly reported adverse effect of creatine supplementation, followed by muscle cramping.11 Some reports showed that kidney, liver, and blood functions were not affected by short-term higher amounts12, 13 or long-term lower amounts 14, 15 of creatine supplementation in healthy young adults. In a small study of people taking 5–30 grams per day, no change in kidney function appeared after up to five years of supplementation.16 However, interstitial nephritis, a serious kidney condition, developed in an otherwise healthy young man, supplementing with 20 grams of creatine per day.17 Improvement in kidney function followed avoidance of creatine. Details of this case strongly suggest that creatine supplementation triggered this case of kidney disease. Creatine supplementation may also be dangerous for people with existing kidney disease. In one report, a patient with nephrotic syndrome (a kidney disorder) developed glomerulosclerosis (another serious kidney condition) while taking creatine. when the creatine was discontinued, the glomerulosclerosis resolved.18
Muscle cramping after creatine supplementation has been anecdotally reported in three studies.19, 20, 21
References
1. Greenhaff PL, Bodin K, Soderlund K, et al. Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis. Am J Physiol 1994;266:E725-30.
2. Greenhaff PL. Creatine and its application as an ergogenic aid. Int J Sport Nutr 1995;5:94-101.
3. Greenhaff PL. The nutritional biochemistry of creatine. J Nutr Biochem 1997;8:610-8.
4. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997;83:2055-63.
5. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc 2000;32:654-8.
6. Hultman E, Soderlund K, Timmons J, et al. Muscle creatine loading in man. J Appl Physiol 1996;81:232-7.
7. Green AL, Hultman E, Macdonald IA, et al. Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in man. Am J Physiol 1996;271:E821-6.
8. Feldman EB. Creatine: a dietary supplement and ergogenic aid. Nutr Rev 1999;57:45-50.
9. Vandenberghe K, Gills N, Van Leemputte M, et al. Caffeine counteracts the ergogenic action of muscle creatine loading. J Appl Physiol 1996;80:452-7.
10. Silber ML. Scientific facts behind creatine monohydrate as a sports nutrition supplement. J Sports Med Phys Fitness 1999;39:179-88 [review].
11. Juhn MS, O'Kane JW, Vinci DM. Oral creatine supplementation in male collegiate athletes: a survey of dosing habits and side effects. J Am Diet Assoc 1999;99:593-5.
12. Sewell DA, Robinson TM, Casey A, et al. The effect of acute dietary creatine supplementation upon indices of renal, hepatic and haematological function in human subjects. Proc Nutr Soc 1998;57:17A.
13. Poortmans JR, Auquier H. Renaut V, et al. Effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol Occup Physiol 1997;76:566-7.
14. Earnest C, Almada A, Mitchell T. Influence of chronic creatine supplementation on hepatorenal function. FASEBJ 1996;10:4588.
15. Almada A, Mitchell T, Earnest C. Impact of chronic creatine supplementation on serum enzyme concentrations. FASEBJ 1996;10:4567.
16. Poortmans JR, Francaux M. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc 1999;31:1108-10.
17. Koshy KM, Griswold E, Schneeberger EE. Interstitial nephritis in a patient taking creatine. N Engl J Med 1999;340:814-5 [letter].
18. Pritchard NR, Kaira PA. Renal dysfunction accompanying oral creatine supplements. Lancet 1998;351:1252-3 [letter].
19. Hultman E, Soderlund K, Timmons J, et al. Muscle creatine loading in man. J Appl Physiol 1996;81:232-7.
20. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997;83:2055-63.
21. Juhn MS, Tarnopolsky M. Potential side effects of oral creatine supplementation: a critical review. Clin J Sport Med 1998;8:298-304 [published erratum appears in Clin J Sport Med 1999;9:62].
Last Review: 06-01-2015
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