What are the effects of creatine (creatine monohydrate) supplements?

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Last updated: April 2, 2025View editorial policy

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From the Guidelines

Creatine supplements are a safe and effective way to improve exercise performance, particularly for high-intensity activities, with a recommended dosage of 3-5 g/day, as supported by the UEFA expert group statement on nutrition in elite football 1. The dosage can be taken consistently, without the need for a loading protocol, although some may choose to follow a loading phase of ~20 g/day for 5-7 days before dropping to a maintenance dose. Key points to consider when taking creatine supplements include:

  • Taking the supplement with a mixed protein/CHO source (~50 g of protein and CHO) may enhance muscle creatine uptake via insulin stimulation 1
  • The supplement works by increasing the body's phosphocreatine stores, which helps regenerate ATP during intense exercise, allowing for more work or repetitions before fatigue
  • Timing of the supplement is not critical, as long as it is taken daily, and it is best taken with water or in a post-workout shake
  • Most people may experience a slight weight gain (1-3 pounds) from water retention in muscles
  • Creatine has an excellent safety profile for healthy individuals, though those with kidney issues should consult a healthcare provider before use, as noted in the study published in the British Journal of Sports Medicine 1.

From the Research

Benefits of Creatine Supplements

  • Creatine supplementation is popular amongst athletes and exercising individuals for improving muscle mass, performance, and recovery 2.
  • Accumulating evidence suggests that creatine supplementation produces beneficial effects in older and patient populations 2.
  • Creatine supplementation increases muscle performance in short-duration, high-intensity resistance exercises 3.
  • Creatine may provide additional benefits including enhanced postexercise recovery, injury prevention, rehabilitation, as well as a number of potential neurologic benefits 4.

Safety and Side Effects of Creatine Supplements

  • Creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day) 2.
  • The most common adverse effect is transient water retention in the early stages of supplementation 3.
  • Long-term creatine supplementation does not significantly affect clinical markers of health in athletes 5.
  • Long-term oral creatine supplementation does not impair renal function in healthy athletes 6.
  • Short- and long-term supplementation is safe and well tolerated in healthy individuals and in a number of patient populations 4.

Dosage and Administration of Creatine Supplements

  • Effective dosing for creatine supplementation includes loading with 0.3 g·kg·d for 5 to 7 days, followed by maintenance dosing at 0.03 g·kg·d 3.
  • Loading doses are not necessary to increase the intramuscular stores of creatine 3.
  • Creatine monohydrate is the most studied form of creatine, and other forms such as creatine ethyl ester have not shown added benefits 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Creatine supplementation.

Current sports medicine reports, 2013

Research

Creatine Supplementation: An Update.

Current sports medicine reports, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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