Creatine Monohydrate Dosing
For creatine monohydrate supplementation, use a loading phase of 20 g/day divided into four equal doses for 5-7 days, followed by a maintenance dose of 3-5 g/day as a single dose. 1
Loading Phase Protocol
- Dose: ~20 g/day divided into four equal daily doses (5 g per dose) 1
- Duration: 5-7 days 1
- Purpose: Rapidly saturates muscle creatine stores 1
Maintenance Phase Protocol
- Dose: 3-5 g/day as a single dose 1
- Duration: Continue for the entire supplementation period 1
- Time to baseline: Approximately 4-6 weeks are required following cessation of chronic creatine supplementation for muscle creatine levels to return to baseline 1
Alternative Low-Dose Approach
If you want to avoid the 1-2 kg body mass increase associated with loading, use a lower dose approach of 2-5 g/day for 28 days, which achieves similar muscle creatine saturation without the rapid water retention. 1
Optimization Strategy
To enhance muscle creatine uptake, consume creatine concurrently with a mixed protein/carbohydrate source (~50 g of protein and carbohydrate), as this stimulates insulin release and improves creatine transport into muscle cells. 1
Special Application for Recovery
For promoting muscle glycogen resynthesis in the first 24 hours post-exercise, use 20 g of creatine divided into 5 g doses on four occasions beginning on the same day of fatiguing exercise. 1
Safety Considerations
- Expected body mass increase: 1-2 kg during the loading phase due to intracellular water retention 1
- Renal function monitoring: While creatine appears safe at recommended doses in healthy individuals 2, 3, 4, it may increase serum creatinine levels (a marker of muscle creatine stores, not necessarily renal dysfunction) 4
- Contraindications: Avoid in patients with pre-existing renal disease or those taking nephrotoxic medications 4
- Long-term safety: Short-term use at recommended doses (≤3 g/day maintenance) appears well-tolerated 2, 3, 4
Common Pitfalls to Avoid
- Do not exceed recommended loading doses: One case report documented acute renal failure in a patient taking 20 g/day for four weeks continuously (beyond the recommended 5-7 day loading period) 4
- Loading is optional: While loading accelerates creatine saturation, the same muscle creatine levels can be achieved with maintenance dosing alone over a longer period 3
- Creatine monohydrate is preferred: Other forms such as creatine ethyl ester have not demonstrated added benefits over monohydrate 3