What is the recommended dosage of creatine (Creatine Monohydrate) for a generally healthy individual with no pre-existing kidney or liver disease looking to enhance athletic performance?

Creatine Monohydrate Dosing for Athletic Performance Enhancement

For healthy individuals seeking to enhance athletic performance, use a loading phase of 20 g/day divided into four equal doses (5 g each) for 5-7 days, followed by a maintenance dose of 3-5 g/day. 1

Loading Phase Protocol

• Dosing: 20 g/day divided into four equal 5 g doses taken throughout the day for 5-7 days 1
• Mechanism: This rapidly saturates muscle creatine stores, increasing phosphocreatine availability for high-intensity exercise 1
• Expected outcome: Increases muscle total creatine and phosphocreatine concentrations, improving high-intensity repeated sprint performance 1

Maintenance Phase Protocol

• Dosing: 3-5 g/day as a single dose for the duration of supplementation 1
• Duration: Can be continued safely for extended periods (studies demonstrate safety up to 5 years at doses up to 30 g/day) 2
• Alternative approach: If avoiding the 1-2 kg body mass increase associated with loading is desired, use 2-5 g/day for 28 days to achieve similar muscle saturation without rapid weight gain 1

Optimization Strategies

• Timing with nutrition: Concurrent consumption with a mixed protein/carbohydrate source (~50 g of each) enhances muscle creatine uptake via insulin stimulation 1
• Post-exercise application: 20 g of creatine (5 g doses on four occasions) beginning on the same day as fatiguing exercise may promote muscle glycogen resynthesis in the first 24 hours post-exercise 1

Performance Benefits

• Primary effects: Improves high-intensity repeated sprint performance, enhances training capacity, and increases muscle strength, power, and lean body mass 1
• Additional benefits: May support brain function and enhance chronic training adaptations 1
• Best suited for: Short-duration, high-intensity activities rather than endurance sports 3

Safety Considerations

• Expected side effects: Potential for 1-2 kg body mass increase after loading phase, primarily due to water retention from the osmotic effect of increased intramuscular creatine 1, 4
• Safety profile: No negative health effects following appropriate protocols in healthy individuals 1
• Long-term safety: Short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals 2
• Washout period: Approximately 4-6 weeks are required following chronic supplementation for muscle creatine levels to return to baseline 1

Important Caveats

• Individual response: Vegetarians and those with low dietary creatine intake generally show the largest increases in muscle creatine stores 5
• Product quality: Commercially marketed creatine products do not meet pharmaceutical quality control standards, raising concerns about impurities or inaccurate dosing 3
• Contraindication: This dosing applies only to healthy individuals without pre-existing kidney or liver disease 3