Creatine Monohydrate for Muscle Building
Creatine monohydrate is the most recommended form of creatine for building muscle mass, as it is the most extensively studied form with consistent evidence for increasing muscle strength, power, and lean body mass when combined with resistance training. 1, 2
Why Creatine Monohydrate Specifically
Creatine monohydrate has nearly 99% bioavailability, with almost all orally ingested creatine monohydrate either taken up by muscle or excreted in urine, and it is not degraded during normal digestion 2
Newer forms of creatine (such as creatine ethyl ester, buffered creatine, or liquid creatine) have no evidence of superior effectiveness or safety compared to creatine monohydrate 2, 3
The regulatory status, safety profile, and efficacy of creatine monohydrate is clearly established across global markets, whereas other forms lack this clear documentation 2
Mechanism and Muscle-Building Effects
Creatine monohydrate increases muscle creatine and phosphocreatine stores by approximately 15-40%, which enhances the resynthesis of ATP during high-intensity exercise 1, 2
It improves high-intensity repeated sprint performance and enhances training capacity, leading to chronic adaptations including increased muscle strength, power, and lean body mass 1
Meta-analysis of direct imaging studies (MRI, CT, ultrasound) shows creatine supplementation combined with resistance training produces small but consistent increases in muscle thickness in both upper and lower body (0.10-0.16 cm) 4
The supplement increases lean body mass by 1-2 kg, which occurs through both water retention in muscle cells and enhanced muscle protein synthesis 1, 5
Optimal Supplementation Protocol
Loading Phase (Optional but Faster):
- 20 g/day divided into four equal doses of 5 g each, taken for 5-7 days 1, 3
- This rapidly saturates muscle creatine stores 3
Maintenance Phase:
- 3-5 g/day as a single dose for the duration of supplementation 1
- Alternatively, 2-5 g/day for 28 days without a loading phase achieves similar muscle saturation while potentially avoiding the initial body mass increase 1
Optimization Strategy:
- Consume creatine with approximately 50 g of protein and 50 g of carbohydrates to enhance muscle uptake via insulin stimulation 1
- After discontinuation, muscle creatine levels return to baseline in 4-6 weeks 1
Safety Profile
No medically significant adverse effects have been reported in the literature when appropriate protocols are followed 1, 2, 5
The primary side effect is transient water retention causing 1-2 kg body mass increase in the early stages, particularly during loading 1, 3
Creatine supplementation is safe for both short-term and long-term use in healthy individuals 5
Cases of liver and renal complications have only occurred when creatine was combined with other supplements or taken at higher than recommended doses for several months 3
Creatine may alter serum creatinine levels (affecting estimated GFR calculations) but does not impair actual kidney function 6
Population-Specific Considerations
Younger adults appear to gain slightly more benefit from creatine supplementation compared to older adults, though both populations show positive responses 4
In older adults specifically, creatine supplementation increases body mass, enhances fatigue resistance, increases muscle strength, and improves activities of daily living 7
When combined with resistance training in older adults, creatine produces greater increases in lean body mass, strength, and bone mineral density compared to resistance training alone 7