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The Complete Guide to Creatine: Everything You Need to Know

Everything you need to know about creatine

Creatine is one of cheapest and most widely used gym supplements by casual gym goes and athletes alike. Even with the huge amount of research that exists on creatine use, there is also a lot of confusion and misinformation regarding it’s usage, safety, efficacy, and effects on body composition.

Here we are going to break down everything you need to know about creatine so you can find out if it might be something you want to use. If you already are using it, find out how to use it most effectively and clear up any concerns or myths you might have heard!

What Is It?

Creatine is a naturally occurring non-protein amino acid that is found in muscle tissue, most commonly in red meat and seafood. It started to rise in popularity in supplement form in the 1990s. In the human body, creatine is combined with a high energy phosphate group to form ‘phosphocreatine’ AKA ‘creatine phosphate’ and then stored in your muscle tissue.

When the body needs to produce a large amount of energy quickly, such as in a heavy lift or a sprint, the phosphate part of the creatine molecule is split off.  It’s then used by the body to help rapidly produce the large amounts of energy (ATP) that is required. The more creatine that is available, the more energy is able to be produced. This rapid production of energy when training enables greater high-intensity performances, giving greater stimulus to the body, and overall increases training adaptations (AKA ‘gains’).

Creatine phosphate molecule

The body synthesizes a small amount of creatine, which it also exists in the diet – the main sources being red meat and seafood. The only problem is that it is very difficult to eat enough whole food to significantly boost and maintain high levels of stored creatine. For example, you’d likely have to eat at least a kilogram of beef or fish per day, every day, to maintain the optimal intramuscular store of creatine!

Red Meat and Fish

When you supplement with the appropriate amount of creatine, the amounts stored in your muscles increase to reach a ‘saturation level’ which can provide you with high-intensity fuel for longer than you would be able to achieve without supplementation.

TLDR; creatine breaks down during exercise, and eventually runs out. It can be reformed while resting between sets to use again, but the more you have, the longer you can train at high intensity before fatigue.

Better training = better results! Although some creatine comes from diet, its really hard to eat enough meat to saturate your muscles with creatine. So, supplements are an easy way to do this.

Who Is It Useful For?

Almost anyone! Creatine has been shown to:

  • Improve post-exercise recovery
  • Play a role in injury prevention
  • Modulate thermoregulation
  • Assist rehabilitation
  • Positively influence concussion
  • Potentially play a role in spinal cord neuroprotection

Creatine supplementation is most commonly thought of as a gym supplement that is beneficial to those doing weight training (Hint: it is) – and in this article, we’ll be focusing mainly on the performance aspect of creatine. However, it’s benefits go far beyond just those seen in exercise performance but we will save that for another time!

Dietary creatine only comes from animal foods: there is no ‘plant-based creatine’. However, creatine can be made synthetically in a lab and plenty of vegan creatine supplements exist! As it is not found in plant foods, vegetarians (and likely by extension vegans) have significantly lower intramuscular creatine stores than non-vegetarians, and therefore are likely to benefit even more from creatine supplementation than those consuming a balanced diet.

There is a large body of evidence supporting the use of creatine in training and many different sports. Studies have shown benefits in weight lifting (and general resistance training), running, soccer, swimming, mixed martial arts, cycling, American football, rugby league, and many, many other forms of sport and exercise:

Effects and Benefits! 

There has been strong evidence around for decades on how effective creatine is in improving fat-free mass and strength gains in the gym. Basically, if you’re already training and not using it – adding creatine to your diet and training will yield superior increases in lean body mass. This is well studied, particularly in exercises such as squat and bench press, when compared to not using it.

Creatine vs placebo

To give you an idea, some of the specific benefits found when using creatine have been:

  • Increased maximal power and maximal strength on single and repeat sets of muscle contractions (5–15%) found in exercises such as in bench press, squats, leg press, leg extension, chest press
  • Increased single-effort sprint performance (1–5%) i.e. decreased sprint times (15-100m)
  • Increased repetitive sprint performance (5–15%)
  • Decreased recovery times
  • Support significantly greater gains in strength, power, and body mass with no change in body fat percentage
  • Increases vertical jump height and power output, reduces the decay in performance in jumping ability in sport (ie soccer, basketball, football)
  • Increased time to exhaustion and work capacity to fatigue (i.e. you can go for longer)
  • Increased intramuscular water storage i.e improve hydration status

Benefits aren’t just limited to males either. Females supplementing with creatine are just as likely to see significant gains in maximal strength, intermittent exercise capacity, and lean body mass

Another interesting side effect of creatine is that it has been shown to further enhance muscle glycogen supercompensation. That’s a fancy way of saying if you are carb-loading, you can load EVEN MORE carbs into the muscles if you load with creatine, during or better yet, before starting to carb-load. This could have some interesting implications for anyone who utilises strategies involving carb depletion for a sporting event, weight cuts, or is generally looking to carb load for a performance!

How to Take It?

Creatine is most typically taken in 2 phases: a ‘loading’ phase of 5 to 7 days, then a ‘maintenance’ phase of however long you want to use it for (i.e. Ever). These phases are designed to reach and then maintain peak muscle creatine stores.

Loading Phase

This phase lasts for 5 to 7 days. The goal here is to bring your muscle creatine stores up to reach a saturation point as quickly and efficiently as possible. Most research shows that taking 20-25g per day for 5 days will do this. Typically the aim is to take 5g of creatine 4 or 5 times per day.

You could take all 20g at once or 10g 2 times per day -this will depend on individual tolerance as some people are fine with these doses- but most of the evidence has come from smaller, more frequent serves. Occasionally some people may experience some gastrointestinal discomfort when taking large doses in a single sitting, so 5g doses are typically used to avoid this issue.

Maintenance Phase

This phase can essentially last for as long as you want (see ‘Side Effects’ below for more information on safety over time).

Basically, a small amount of creatine is degraded then excreted in urine each day. So, the body needs to replenish between 2–3 g of creatine per day to maintain creatine stores depending on muscle mass.

To maintain saturation levels, taking between 3 to 5g per day is sufficient to do this in most people. If you have a larger amount of muscle mass then you may want to aim towards the higher end.

Note: your body will still degrade creatine even on non-training days, so it’s best to continue your maintenance dose, even on rest days.

Slow Loading

If the idea of loading with large amounts of creatine in the first week is not appealing to you, studies have also shown that it is also possible to increase creatine stores and likely to reach peak creatine saturation by taking smaller dosages of 3g. Therefore loading is not necessary.

If you choose not to load, it still works it takes a much longer time to reach saturation levels – muscle creatine levels have been found to have increased by 20% after 28 days of 3g per day (rather than full saturation after 5-7 days if loading as above).

Do You Need to Deload or ‘Cycle off’ Creatine?

The short answer to this is no, you do not. Later in this article, I’ll go over side effects or long-term risks, but essentially there are minimal concerns with long term creatine usage.

There are various myths such as long-term supplementation will decrease your body’s sensitivity to creatine (not true), and that it will affect your body’s ability to synthesise it if you don’t cycle off (also not true). 

If you do want to cycle off, or if you stop taking the maintenance dose, due to the natural breakdown, and excretion of creatine your intramuscular levels will decline back to pre-supplementation levels after approximately 30 days.

This also means if you forget to take creatine occasionally during your maintenance phase, the normal 3-5g dose should be effective in topping your stores back up and you don’t need to go through the whole Loading Phase again.

A potential negative aspect of cycling off is the interruption of habit-forming behaviours. Everyone knows what it’s like to “fall off the wagon”, whether it be diet, training, supplements, getting 8 hours sleep – whatever!

It’s not uncommon for lifters to stop taking creatine and then continue to forget about it on a consistent basis. When you’re on a roll, it is often easier to maintain a good routine and we all know how hard it can be to rebuild those positive habits. 

Do You Need to Time Creatine Intake?

Short answer: not really. Creatine intake has been show to improve muscle strength and lean tissue mass more than nothing/placebo, regardless of timing.

However – the same study showed that creatine AFTER a resistance training session improved lean mass more than creatine before a session.

So, if you are really getting specific about timing, it is likely best to have it after training. An easy way to do this is in a water bottle or protein shake after your training session.

Consistently having it on a daily basis should be the main priority though. 

Loading Creatine With Carbohydrate?

There has been some research showing that taking carbohydrate alongside creatine during the loading phase can augment the uptake of creatine into muscle. However,  a significant amount of carbs are needed for this – approximately 100g per dose of creatine to see the most benefit. 

The numbers: creatine loading without carbs increases muscle stores by about 20mmol/kg. Adding 93g of carbs adjacent to each creatine dose was found to increase this by 60%, taking muscle stores to around 32mmol/kg. 

4 serves of ~100 grams of carbs per day, throughout 5 days of loading would add about ~2 kilograms of carbs and ~8,000 calories to your diet over this time. 

Practically, unless you need to increase your muscle creatine stores very rapidly, you will reach a point of muscle saturation over time anyway. The addition of so much simple carbohydrates to your diet might not be A) worth it and, B) tolerable.

Having creatine with protein (50g) and fewer carbs (47g) has also been shown to increase creatine uptake, and may be more realistic than carbs alone, but this is still a huge amount of extra calories 4x per day for 5 days. 

The take-away from this is that the exact protocol above is likely not a realistic option, but consumption of carbs (and protein) does help with creatine uptake.

If you’re having protein and carbs anyway, add your creatine in with it.

Are There Side Effects?

There is a mountain of evidence showing the safety of creatine at the prescribed doses, not just in males.

The main side effect people tend to associate with creatine is ‘weight gain’ or bloating from carrying water. Some people think creatine makes them look “puffy”, but this is not the case.

Creatine does have a weight gain effect, causing the body to hold additional intracellular water (detailed below). I’ve seen this in myself and many clients over the years with rapid weight increases of up to 2 or 3kgs. The scientific literature supports this, finding 1-2kg increases in lean body mass are typical during the first week/loading phase.

It is important to note that not all weight gained while taking creatine is due to water. With proper training the body lays down new muscle tissue (and more so with creatine), contributing to lean weight gain. If you are over-consuming calories, there is also the potential for fat gain regardless of creatine intake. 

Creatine and water

The creatine stored in the muscle changes the intracellular osmotic pressure. This pressure results in a pulling movement, drawing water into the cell, where it is stored. This contributes to total body weight gain. Again: the water is stored INSIDE the muscle cell.

Cells have a finite storage capacity and once you are at peak creatine levels, water weight does not continue to increase nor does it just pile up in other areas of the body. Once the muscles are full saturated with creatine, no more can be stored, ceasing further movement of more water into the muscle -once the tank is full, it can’t hold more water. 

As the volume of the muscle cell is increased, the muscle cells themselves do swell, increasing the physical size of your muscles. However, general “puffiness” or oedema-like fluid retention is not related to creatine supplementation. The only time this increase in weight may be a concern is in athletes who are competing in a sport with weight limits or weight ins. Weight increase in endurance atheletes also may not be ideal depending on specific circumstances.

Is Creatine Beneficial for Endurance Athletes?

Questions have been raised in marathons or ultra-endurance events where carrying an extra kilogram or two of water weight over such long distances may negatively impact performance.

Marathon Runner

Practically, this would likely depend on how long the athlete has trained with creatine. If someone has been supplementing for long periods of time, any intracellular water-based increases in weight would essentially feel normal. The extra water held with creatine also confers the additional benefits of ‘hyperhydration’ and more efficient regulation of body temperature in the heat. These effects may positively contribute to balancing any small weight gain effect in an endurance event.

It is also interesting to note that there is plenty of research suggesting that this increase in water weight is likely just a short term effect. Over the course of multiple weeks/months, the evidence actually does not make it seem like there is this longer-term impact on water weight that most people would expect related to this short-term impact. 

Studies show that short and long-term supplementation at various amounts of creatine (even up to 30 g/day for 5 years) is safe and well-tolerated. This has been shown in healthy individuals, and in populations ranging from infants to the elderly. In fact, the International Society of Sports Nutrition position states that “significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan”.

Can Creatine Cause Baldness?

It is not likely that creatine could cause baldness but here is the science:

  • Dihydrotestosterone (DHT) is a normal hormone in the body that has overall androgenic effects, helping maintain muscle mass, and promoting sexual health and fertility (especially in males)…but: it is also the hormone that is linked with genetic male pattern baldness.
  • Creatine has been shown to increase DHT. There has not been a huge deal of research into this specific area of creatine and hair loss but one study found an increase of around 50% of DHT levels when loading creatine.
  • The study didn’t look at hair loss so there were no hair loss effects measured. Even with the 50% increase that was seen, those DHT levels were still in the normal natural rage.

The rational interpretation of these findings is that while creatine is safe to consume at a range of dosages over a long period of time, it may increase DHT. At this point, there is no science to definitively say that creatine does or does not affect balding. Not all studies allow you to draw direct cause-and-effect high-level breakthroughs such as ‘fans make you cooler when its hot or humid’! 

creatine homer

if you don’t have any existing issues with the liver and kidneys, negative effects from creatine simply aren’t found by weight of evidence. They are typically misunderstood reaserch, hearsay, or conjecture. There is evidence in many populations, including athletes that taking creatine has zero long term detrimental effects on the liver or the kidneys. This study was done with doses between 5-20g per day for 3 months up to almost 6 years with no negative effects.

Creatine While Cutting?

Yes, you can take it while dieting or trying to lose weight.

It will not cause you to gain body fat, nor want to eat more food. 

By now you know creatine contributes to weight gain through increasing lean muscle mass and intracellular water content. Creatine and fat gain is a completely different story. Fat gain, at its most simplistic level, is determined by the calories you consume vs the calories you burn.

If you eat more calories than you need, you will typically gain not only weight but gain it through storing body fat. Calorically, a few grams of creatine is not going to contribute to fat gain.

If you are gaining fat while taking creatine, your overall diet and caloric intake are likely what needs assessing.

There have been some anecdotal reports of people suffering muscle cramps, strains and tears. There is little evidence to substantiate any increased risk with creatine supplementation. It is always possible these occur from exercise or activity regardless.

How Much Does It Cost?

Creatine is not an expensive supplement. When purchasing, I would recommend looking for “Creatine Monohydrate” which is the most common, and most well-studied form of creatine.

I have found it online or in supplement stores for as little as $19AUD per kg. Which at a generous 5g serving, works out to be 200 serves at 9.5 cents per serve (even less at 5.7 cents if you’re using 3g per serve). $19 every 6 months or so seems pretty affordable!

There are various other forms of creatine that you might see marketed including Creatine Hydrochloride, Buffered Creatine, Creatine Ethyl Ester, various forms of liquid creatine etc.

To my knowledge, there aren’t any real reliable studies that these other forms have any superior benefit over standard creatine monohydrate. They are typically just more expensive, and any claims to be better than creatine monohydrate are typically marketing hype and spin to help justify the higher price.

To Summarise:

Creatine is not an ‘essential’ nutrient – the body can produce it, and you are also likely getting some from dietary sources if you include meat in your diet. Is it 100% necessary to supplement creatine? No.

Is there a potential performance benefit to be gained across a wide range of sports and exercises with pretty much no risk and minimal cost? Yes.

If you are unsure about creatine or any other supplement or if it is suitable to you, it’s always a good idea to sit down with a dietitian that can help personalise your nutrition program.

All that being said, creatine is very cheap, very safe, competition legal supplement, that has a plethora of highly researched, proven benefits with very low risk to consumers.

By Tyler Brooks

Tyler has a Bachelor of Nutrition and Exercise Sciences and completed his Masters of Dietetics through the University of Queensland after moving away from a long career in the fitness industry. As part of his education he worked with dietitians at the Brisbane Broncos rugby league club, is currently working with the Qld Women's Rugby 7's team, and has continued to follow his passion for performance nutrition. Tyler is a believer in 'practice what you preach'. Outside of helping people achieve their goals through diet and exercise, he competes in powerlifting and loves experimenting with his own nutrition and diet to find the best ways to support various training and body composition goals.