Creatine Monohydrate Supplementation: Dosage and Precautions
The recommended dosage for creatine monohydrate supplementation is a loading phase of 20g daily (divided into 4 doses of 5g) for 5-7 days, followed by a maintenance dose of 3-5g daily, while ensuring adequate hydration of at least 2.7 liters of fluid daily. 1
Proper Dosing Protocol
Loading Phase (Optional but Effective)
- 20g per day divided into 4 equal doses (5g each) for 5-7 days 1
- Alternative calculation: 0.3 g/kg/day for 5-7 days 2
- Note: While loading is common, it is not strictly necessary to increase intramuscular creatine stores 2
Maintenance Phase
- 3-5g per day for ongoing supplementation 1
- Alternative calculation: 0.03 g/kg/day 2
- Typically continued for 4-6 weeks, though longer periods are common 2
Timing and Absorption
- Taking creatine with a mixed protein/carbohydrate source (approximately 50g each) may enhance muscle creatine uptake via insulin stimulation 1
- After discontinuation, creatine levels return to baseline after approximately 4-6 weeks 1
Hydration Requirements and Precautions
Hydration Guidelines
- Consume at least 2.7 liters of fluid daily while supplementing with creatine 1
- Adequate hydration can be indicated by:
- Urine output of at least 0.5 ml/kg/hour
- Pale yellow urine color 1
- Decreased urine output (less than 4 ml/kg over 8 hours) may indicate inadequate hydration 1
- Increase water intake by 500-1000 ml on days with moderate to intense physical activity 1
Side Effects and Monitoring
Common Side Effects
- Weight gain of 1-2kg during the first week due to water retention 1, 3
- Potential gastrointestinal discomfort in some individuals 4
Renal Considerations
- Creatine appears safe for healthy individuals at recommended doses 3, 5
- Discontinue creatine if you experience any evidence of renal dysfunction 1
- Those with pre-existing kidney disease should consult with a healthcare provider before supplementation 1, 5
- Creatine supplementation may increase serum creatinine levels, which could falsely suggest renal dysfunction 5
Special Populations and Considerations
Contraindications
- Pre-existing kidney disease (consult healthcare provider) 1, 5
- Use with nephrotoxic medications (increased risk of renal dysfunction) 5
- Safety not established in children and adolescents 5
Quality Considerations
- Choose pharmaceutical-grade creatine monohydrate from reputable manufacturers 4
- Creatine monohydrate is the most studied form; other forms such as creatine ethyl ester have not shown added benefits 2
Common Misconceptions
- Creatine is not an anabolic steroid 3
- When used properly, creatine does not cause dehydration or muscle cramping 3
- Creatine does not inherently increase fat mass 3
By following these evidence-based guidelines for creatine monohydrate supplementation, individuals can maximize benefits while minimizing potential risks.