Creatine and MSM Supplementation Benefits
Creatine Monohydrate: Strong Evidence for Performance Enhancement
Creatine monohydrate supplementation significantly increases muscle strength, power, and lean body mass while enhancing training capacity and recovery, with strong evidence supporting its use in high-intensity, short-duration exercise. 1
Primary Mechanisms of Action
- Increases intramuscular phosphocreatine stores by approximately 20%, which enhances rapid ATP resynthesis during high-intensity exercise 2
- Catalyzes the reversible phosphocreatine reaction to produce immediate energy during intense physical activities 2
- Prevents ATP depletion while potentially stimulating protein synthesis and stabilizing biological membranes 3
Performance and Body Composition Benefits
- Improves high-intensity repeated sprint performance by increasing available energy for short-duration, powerful movements 1, 2
- Enhances chronic training adaptations including increased muscle strength, power, and lean body mass 1, 2
- Increases muscle mass through enhanced training capacity and protein synthesis 4
- May support brain function through increased cerebral phosphocreatine stores, though this mechanism requires further study 1, 2
- Enhances post-exercise recovery and may aid in injury prevention and rehabilitation 4
Evidence-Based Dosing Protocol
Loading Phase:
- 20 g/day divided into four equal 5g doses for 5-7 days to rapidly saturate muscle creatine stores 1, 2, 5
- Alternative: 0.3 g/kg body weight per day for 5-7 days 5
Maintenance Phase:
- 3-5 g/day as a single dose for the duration of supplementation 1, 2
- Alternative: 0.03 g/kg body weight per day 5
Lower-Dose Alternative:
- 2-5 g/day for 28 days avoids the body mass increase associated with loading while still effectively increasing muscle creatine stores 1, 2
Optimization Strategy:
- Consume with ~50g protein and ~50g carbohydrate to enhance muscle creatine uptake via insulin stimulation 1, 2
- Creatine levels return to baseline 4-6 weeks after cessation 1, 2
Safety Profile and Side Effects
- No negative health effects reported when following appropriate protocols 1, 2
- Primary side effect is 1-2 kg body mass increase, typically from water retention or increased protein synthesis in early supplementation stages 2, 5
- Safe and well-tolerated in both short- and long-term use in healthy individuals and various patient populations 4
- No increased risk of total adverse outcomes, renal dysfunction, or hepatic complications in females 6
- Transient water retention is the most common adverse effect in early supplementation 5
Important Clinical Considerations
- Creatine monohydrate is the most studied form; other forms like creatine ethyl ester have not shown added benefits 5
- May affect creatinine-based GFR calculations by altering exogenous creatinine generation, but does not affect actual renal function 7
- Individual variability in response exists; trial in training before competition use 1
- Use only third-party tested products to minimize contamination risk with banned substances 1
MSM (Methylsulfonylmethane): Insufficient Evidence
No high-quality guideline or research evidence was provided regarding MSM supplementation for exercise performance or recovery. The available evidence focuses exclusively on creatine monohydrate, which has robust support from major sports medicine organizations including the UEFA Expert Group 1 and multiple systematic reviews 8, 4, 6.
Key Distinction
While creatine has strong evidence from elite sports medicine guidelines 1 and is recognized as one of the few performance supplements with stronger evidence compared to others like β-alanine or nitrate 1, MSM lacks comparable evidence in the provided literature for athletic performance or recovery benefits.