How do creatine (muscle strength supplement) supplements work in the body and what are their benefits?

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Last updated: June 17, 2025View editorial policy

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From the Guidelines

Creatine supplements work by increasing phosphocreatine stores in muscles, which helps produce more ATP (energy) during high-intensity exercise, and the recommended dose is typically 3-5 grams of creatine monohydrate daily, as supported by the most recent study 1. The benefits of creatine supplements include increased strength and power output during resistance training and high-intensity exercise, improved muscle recovery, and modest gains in lean muscle mass over time. Some key points to consider when taking creatine supplements include:

  • Taking a loading phase of 20 grams daily for 5-7 days before dropping to a maintenance dose, as suggested by 1
  • Consuming creatine with a mixed protein/CHO source to enhance muscle creatine uptake via insulin stimulation, as noted in 1
  • Staying well-hydrated to minimize potential side effects, such as water retention
  • Using creatine monohydrate, which is the most researched and cost-effective form, as preferred by most users It's also important to note that creatine works because muscles use phosphocreatine to rapidly regenerate ATP during intense efforts lasting 10-15 seconds, allowing you to maintain higher performance during activities like weightlifting or sprinting, as supported by the study 1. Additionally, the study 1 highlights the importance of considering the potential effects of creatine supplementation on kidney function, particularly in individuals with pre-existing kidney disease, although it does not provide direct evidence for the benefits of creatine supplements. Overall, the current evidence suggests that creatine supplements can be a safe and effective way to improve athletic performance, as long as they are used in conjunction with a well-balanced diet and proper hydration, as recommended by 1.

From the Research

How Creatine Supplements Work in the Body

  • Creatine supplements increase muscle performance in short-duration, high-intensity resistance exercises by increasing phosphocreatine stores in skeletal muscles, which improves ATP production 2, 3, 4.
  • Creatine supplementation promotes a faster regeneration of adenosine triphosphate between high-intensity exercises, leading to improved outcomes and increased performance 2.
  • The effective dosing for creatine supplementation includes loading with 0.3 g·kg·d for 5 to 7 days, followed by maintenance dosing at 0.03 g·kg·d, although loading doses are not necessary to increase intramuscular stores of creatine 3.

Benefits of Creatine Supplements

  • Increased strength, fat-free mass, and muscle morphology with concurrent heavy resistance training 2, 5.
  • Improved performance in high-intensity sprints or endurance training, although the effects of creatine diminish as the length of time spent exercising increases 2.
  • Faster regeneration of adenosine triphosphate between high-intensity exercises, leading to improved outcomes and increased performance 2.
  • Increased muscle mass, strength/power, and muscular endurance 4.
  • Safe for long-term use, with typical dosage of 3-5 g per day 4.

Potential Side Effects and Considerations

  • Transient water retention in the early stages of supplementation is a common adverse effect 3, 6.
  • Cases of liver and renal complications have been reported when creatine is taken at higher than recommended doses for several months or combined with other supplements 3.
  • Further studies are needed to evaluate the remote and potential future adverse effects from prolonged creatine supplementation 2, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Creatine supplementation with specific view to exercise/sports performance: an update.

Journal of the International Society of Sports Nutrition, 2012

Research

Creatine supplementation.

Current sports medicine reports, 2013

Research

Effects of creatine supplementation on exercise performance.

Sports medicine (Auckland, N.Z.), 1999

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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