Should I take creatine (a dietary supplement)?

Should You Take Creatine?

Yes, creatine supplementation is recommended if you engage in high-intensity, short-duration exercise or strength training, as it consistently improves performance, increases muscle strength and power, and has an excellent safety profile with no negative health effects when following appropriate protocols. 1, 2

Performance Benefits

Creatine supplementation provides several well-established benefits for athletic performance:

• Improves high-intensity repeated sprint performance by increasing muscle creatine stores and enhancing phosphocreatine resynthesis, which is critical for rapid energy production in the ATP-CP system 1, 2
• Enhances training capacity and chronic training adaptations, including increases in muscle strength, power, and lean body mass 1, 2
• May support brain function with regular supplementation 2
• Improves exercise performance in short-duration, high-intensity resistance exercises that rely on the phosphocreatine shuttle for ATP production 3

Evidence-Based Dosing Protocol

The British Journal of Sports Medicine provides clear dosing recommendations 1, 2:

Loading Phase (Optional but Faster)

• 20 g/day divided into four equal doses (5 g each) for 5-7 days to rapidly saturate muscle creatine stores 1, 2
• Concurrent consumption with a mixed protein/carbohydrate source (~50 g of each) may enhance muscle creatine uptake via insulin stimulation 1

Maintenance Phase

• 3-5 g/day as a single daily dose for the duration of supplementation 1, 2
• This is the evidence-based standard for athletes in high-intensity strength or sprint training 2

Alternative Lower-Dose Approach

• 2-5 g/day for 28 days can avoid the associated weight gain while still increasing muscle creatine stores 1, 2
• Loading doses are not necessary to increase intramuscular creatine stores, though they work faster 3

Safety Profile

Creatine has an excellent safety record when used appropriately:

• No negative health effects following appropriate protocols at recommended doses 1, 2
• Short-term and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and various patient populations ranging from infants to the elderly 4
• Studies show supplementation up to 8 weeks with high doses has not been associated with major health risks 5

Expected Side Effects

• Potential 1-2 kg body mass increase after creatine loading, primarily due to water retention associated with the osmotic effect of increased intramuscular creatine 1, 2, 5
• Transient water retention is the most common adverse effect in early stages of supplementation 3

Important Caveats

• If you have evidence of renal dysfunction, discontinue creatine 1
• When combined with other supplements or taken at higher than recommended doses for several months, there have been rare cases of liver and renal complications 3
• Creatine monohydrate is the most studied form; other forms such as creatine ethyl ester have not shown added benefits 3

Timing Considerations

• Daily consumption is required because muscle creatine levels return to baseline approximately 4-6 weeks after stopping supplementation 1, 2
• This means you need consistent daily intake during your training period to maintain elevated muscle creatine stores 2

Who Benefits Most

Creatine is most beneficial for:

• Athletes engaged in high-intensity, short-duration activities (sprinting, weightlifting, repeated sprint sports) 1, 2, 4
• Individuals performing resistance training who want to increase muscle mass and strength 4, 6
• Those seeking enhanced post-exercise recovery and injury prevention 4, 6

Bottom Line

Daily maintenance dosing of 3-5 g is the evidence-based standard for anyone engaged in high-intensity strength or sprint training, with an optional loading phase of 20 g/day for 5-7 days if you want faster results 2. The supplement is safe, effective, and well-studied, with benefits extending beyond just athletic performance to potential neuroprotective and clinical applications 4, 7.