What are the uses and dosages of creatine (Creatine Monohydrate) supplementation?

Creatine Uses and Dosages

Creatine monohydrate supplementation should begin with a loading phase of 20g daily (divided into 4 equal 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

Primary Uses of Creatine

Creatine monohydrate has several evidence-based applications:

• Athletic Performance Enhancement:

  • Increases muscular force and power
  • Improves high-intensity exercise performance
  • Reduces fatigue in repeated bout activities
  • Enhances skeletal muscle mass and strength 2, 3
  • Most effective for short-duration, high-intensity activities 4

• Clinical Applications:

  • Beneficial in muscular dystrophies 5
  • Potential benefits in neurodegenerative diseases (Huntington's, Parkinson's) 2, 6
  • May enhance post-exercise recovery and injury rehabilitation 2
  • Supports aging populations by preserving lean muscle mass 1, 7

Dosage Recommendations

Standard Protocol:

• Loading Phase: 20g daily divided into 4 equal doses (5g each) for 5-7 days 1
• Maintenance Phase: 3-5g daily 1, 3

Alternative Protocol:

• Skip loading phase and take 3-5g daily, though it may take longer to reach saturation 7

Administration Tips:

• Take with a mixed protein/carbohydrate source (approximately 50g each) to enhance muscle creatine uptake via insulin stimulation 1
• After discontinuation, creatine levels return to baseline in approximately 4-6 weeks 1

Safety Considerations

• Hydration: Maintain adequate hydration (at least 2.7 liters daily) while supplementing 1
• Expected Effects: Weight gain of 1-2kg during the first week due to water retention is normal 1
• Contraindications:
  • Avoid use in severe hepatic impairment (Child-Pugh Class C) 8
  • Use with caution in moderate hepatic impairment (Child-Pugh Class B) 8
  • Discontinue if evidence of renal dysfunction appears 1
  • Consult healthcare provider before use if pre-existing kidney disease is present 1

Common Misconceptions Addressed

• Kidney Function: Short and long-term supplementation (up to 30g/day for 5 years) is generally safe and well-tolerated in healthy individuals 2
• Not an Anabolic Steroid: Creatine is a naturally occurring compound found in food and produced by the body 7, 6
• Fat Mass: Creatine does not directly increase fat mass; weight gain is primarily due to increased water retention and lean muscle mass 7
• Effectiveness in Both Sexes: Benefits are observed in both males and females 7

Monitoring

• Ensure adequate hydration by monitoring:
  • Urine output of at least 0.5 ml/kg/hour
  • Pale yellow urine color 1
  • If urine output is less than 4 ml/kg over 8 hours, increase water intake 1

Creatine monohydrate is one of the most extensively studied supplements with a strong safety profile when used as directed. The benefits for both athletic performance and potential clinical applications make it a valuable supplement when used appropriately and with proper hydration.