From the Guidelines
Creatine supplementation is generally safe for most healthy individuals when used as directed, with a recommended dosage of 3-5 grams daily. The most recent and highest quality study, published in 2021 1, supports the use of creatine supplementation for improving performance during high-intensity exercise. According to this study, a loading phase of 20 grams daily (divided into four equal daily doses) for 5-7 days can be used, followed by a maintenance phase of 3-5 grams daily (single dose) for the duration of the supplementation period.
Key points to consider when using creatine supplementation include:
- Starting with a lower dose to assess response, especially if used regularly in training and match play
- Concurrent consumption with a mixed protein/CHO source (~50 g of protein and CHO) may enhance muscle creatine uptake via insulin stimulation
- Staying well-hydrated while taking creatine is important to minimize any potential side effects, such as water retention, bloating, or digestive discomfort
- Those with pre-existing kidney or liver conditions should consult a healthcare provider before use, as creatine supplementation may affect kidney function or interact with other medications
It is also important to note that creatine monohydrate is the most researched and cost-effective form of creatine supplementation. While some studies have raised concerns about the potential nephrotoxicity of creatine supplementation, the evidence suggests that this risk is low when used as directed 1. Overall, the benefits of creatine supplementation for improving athletic performance and muscle growth outweigh the potential risks for most healthy individuals.
From the Research
Creatine Safety Overview
- Creatine supplementation is generally considered safe when used at recommended dosages (i.e., 3-5 g/day or 0.1 g/kg of body mass/day) 2, 3, 4.
- The majority of studies have shown that creatine supplementation is well-tolerated, with few adverse effects reported 2, 3, 4, 5.
Potential Adverse Effects
- Transient water retention is a common adverse effect in the early stages of supplementation 2, 5.
- Gastrointestinal complaints and muscle cramps have been reported, but the incidence is limited and not necessarily linked to creatine itself 4.
- There is no evidence to suggest that creatine supplementation causes kidney damage or renal dysfunction in healthy individuals 2, 6, 4.
- However, individuals with pre-existing renal disease or those at risk for renal dysfunction should exercise caution when using creatine supplementation 6, 4.
Special Populations
- The safety of creatine supplementation in children and adolescents has not been established 6.
- Older adults may benefit from creatine supplementation, but more research is needed to fully understand its effects in this population 2.
- Individuals with diabetes, hypertension, or reduced glomerular filtration rate should consult with a healthcare professional before using creatine supplementation 4.
Dosage and Administration
- The recommended dosage for creatine supplementation is 3-5 g/day or 0.1 g/kg of body mass/day 2, 3, 4.
- Loading doses are not necessary to increase intramuscular stores of creatine, but may be used to rapidly increase muscle creatine levels 5.
- Maintenance dosing can be used to maintain elevated muscle creatine levels over time 5.