From the Guidelines
Creatine monohydrate is primarily used as a dietary supplement to enhance athletic performance, particularly for activities requiring short bursts of intense energy, and may also have implications in medical settings, such as affecting the assessment of glomerular filtration rate (GFR) in patients with kidney disease 1. When considering the use of creatine monohydrate, it's essential to understand its effects on the body. The typical dosage for athletic performance enhancement is 3-5 grams daily, with some individuals following a loading protocol of 20 grams daily for 5-7 days before reducing to a maintenance dose.
- Key points about creatine monohydrate include:
- It works by increasing phosphocreatine stores in muscles, which helps rapidly regenerate ATP during high-intensity exercise.
- This allows athletes to train harder, recover faster between sets, and potentially gain more muscle mass and strength over time.
- Beyond athletic performance, creatine may offer cognitive benefits and is being studied for potential therapeutic applications in certain neurological conditions.
- Most people tolerate creatine well, though adequate hydration is important when supplementing.
- For best results, creatine should be taken consistently, as its benefits accumulate over time rather than providing immediate effects. In medical contexts, such as the assessment of kidney function, creatine monohydrate can affect serum creatinine levels, potentially masking true kidney function, as observed in a study where a patient with a solitary kidney received 20 g of creatine monohydrate supplementation per day 1.
- Important considerations for medical professionals include:
- The potential for creatine supplementation to alter exogenous creatinine generation, which can impact the accuracy of GFR assessments using creatinine-based estimating equations.
- The need for careful evaluation of individuals with known kidney disease who are considering creatine supplementation, given the potential effects on kidney function assessments and the risk of nephrolithiasis associated with certain dietary supplements.
From the Research
Uses of Creatine Monohydrate
- Creatine monohydrate is a dietary supplement used to increase muscle performance in short-duration, high-intensity resistance exercises 2
- It is used to enhance power and strength, and to improve performance in intense exercise, especially during repeated bouts 3
- Creatine monohydrate supplementation can promote gains in lean body mass when used in conjunction with resistance training 3
- It can also be used to improve endurance performance, particularly in activities that require multiple surges in intensity and/or during end spurts 4
- Additionally, creatine supplementation may provide benefits including enhanced postexercise recovery, injury prevention, rehabilitation, as well as a number of potential neurologic benefits 5
Effective Dosing and Safety
- 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 2
- Creatine monohydrate is relatively safe with few adverse effects reported, the most common being transient water retention in the early stages of supplementation 2
- However, when combined with other supplements or taken at higher than recommended doses for several months, there have been cases of liver and renal complications 2
- Short-term creatine supplementation appears to be safe, but the safety of more prolonged creatine supplementation has not been established 6