Creatine Monohydrate: A Research-Backed Supplement for Performance and Muscle Gain

Creatine monohydrate is one of the most thoroughly studied and widely recognized dietary supplements available, particularly valued for its profound impact on high-intensity training, strength, and muscle mass. It is supported by a strong body of evidence, making it one of a handful of ingredients with solid support for its use as a performance-enhancing supplement or ergogenic aid.

Sources and Synthesis

Creatine is synthesized endogenously (within the system) in the liver and kidneys from amino acids. Once synthesized, it is stored primarily in muscle tissue.

Humans can also obtain creatine from external sources, predominantly animal foods. An 8 oz serving of several popular sources provides the following content:

Source (8 oz serving)

Creatine Content

Herring

2.0 to 4.0 g

Beef (lean)

1.5 to 2.5 g

Pork

1.5 to 2.5 g

Salmon

1.5 to 2.5 g

Milk

0.05 g

Role in Performance and Muscle Growth

The primary function of creatine is to regenerate intracellular ATP stores via the phosphocreatine system during periods of high-intensity activity. The phosphocreatine energy system is crucial during high-intensity exercises of short duration, or repeated high-intensity efforts over a prolonged period, such as in team sports. Delaying fatigue in this system can prolong maximal effort, leading to improved performance.

Creatine monohydrate supplementation is backed by extensive research demonstrating its effectiveness at increasing muscular stores and enhancing muscle mass when combined with resistance training. The superior gains in muscle tissue that users experience are thought to result from greater training adaptations due to an increased capacity for high-intensity workload.

Research findings have shown that supplementing with creatine can significantly enhance athletic outcomes:

• Strength and Power: The ability to train more intensely and with greater workloads over time enables users to improve muscular power, strength, and lean mass. Two systematic reviews on randomized, placebo-controlled trials found that creatine supplementation enhanced lower-body strength performance in over 60 studies and upper-body strength performance in over 53 studies, particularly in exercises lasting less than three minutes, with the most pronounced effects in activities under 30 seconds.

• Sport Specificity: Creatine may benefit individuals participating in sports that heavily tax the phosphocreatine system and require repeated short bursts of high-intensity activity, such as soccer, basketball, rugby, rowing, tennis, and sprinting.

• Ergogenic Effects: One review of 300 studies found that 70% reported significant improvements in performance due to creatine supplementation, with none reporting significant negative impacts. Ergogenic findings included a 5% to 15% improvement in maximal power/strength and repetitive sprint performance, though only minimal (1% to 5%) improvement in single-effort sprints.

• Body Composition: Individuals who supplement with creatine monohydrate for one to three months have been shown to gain 1 to 2 additional kilograms of mass compared to control groups. Creatine may also aid in thermoregulation and enhance glycogen synthesis because of its ability to draw fluid into the muscle.

Supplementation Protocols

Creatine supplementation typically utilizes one of two methods, both of which have been shown to increase muscular creatine stores by 20% to 40%. Co-ingesting carbohydrate, with or without protein, alongside creatine monohydrate can increase its uptake and muscular retention.

1. Loading Phase followed by Maintenance: The first method involves a loading phase lasting five to seven days, during which the individual consumes 20 to 25 grams daily, or roughly 0.3 gram per kilogram of body weight, in doses split throughout the day. This method may result in faster loading and more immediate performance benefits due to higher creatine stores. This loading phase is followed by a maintenance phase, which consists of consuming a daily dose of 3 to 10 grams. A higher dose within the maintenance range (e.g., 10 grams) is likely more appropriate for individuals who have greater muscle mass.

2. Gradual Increase: The second method involves gradually increasing muscular stores by consuming a daily dose of 3 to 5 grams over a period of three to four weeks.

Upon cessation of use, creatine stores typically normalize within four to eight weeks.

Safety Profile and Forms

Short-term and long-term studies have consistently demonstrated the safety of creatine supplementation among healthy populations. A large body of work on the safety of creatine indicates that it does not result in muscle cramps, dehydration, heat illness, or any other adverse health effect, even when daily dosages ranging from 0.3 to 0.8 gram/kilogram of body weight have been examined for periods up to five years.

The only significant side effect of creatine use, which is generally desired, is weight gain due to increases in muscle mass and water retention.

Despite marketing claims suggesting otherwise, other forms of creatine—including creatine HCl, buffered creatine, alkalized creatine, and creatine ethyl ester—have not been proven to be more effective than creatine monohydrate. It is important to note that some individuals are considered "non-responders" and do not experience the reported benefits; this is likely due to having naturally elevated muscular stores of creatine.

To solidify understanding, consider creatine monohydrate as the fuel reserve station for high-intensity activity. By supplementing, you increase the storage capacity of this reserve fuel (phosphocreatine) in your muscles, allowing you to sustain maximal effort for slightly longer bursts or complete more high-quality repetitions before needing a rest.