Creatine
The most-studied performance supplement on earth. Builds strength and lean muscle, supports brain energy under stress, and is increasingly used for cognitive support in women and older adults.
Hundreds of RCTs for strength, power, lean mass. Growing evidence for cognition under sleep loss (Earnest et al.), mood (some antidepressant signal), bone density (indirect, via muscle pull), and exercise performance in women in particular. Saturation: 3–4 weeks. Performance effects: 4–8 weeks.
Creatine is a small molecule built from three amino acids (arginine, glycine, methionine) that the body uses to rapidly regenerate ATP — the energy currency of cells. Found in red meat and fish, and made in modest amounts by the liver. Supplementation saturates muscle and brain stores beyond what diet alone can deliver. The research base is enormous: thousands of trials showing improvements in strength, power output, lean mass, and recovery. More recent work shows benefits for cognition under sleep deprivation and stress, mood, and bone density — making creatine relevant well beyond the gym.
- Form
- Creatine monohydrate — the standard, the cheapest, the most studied. Don't pay extra for HCl, ethyl ester, or 'micronised' versions — they don't outperform monohydrate. Look for Creapure-branded creatine for purity.
- Dose
- 3–5 g/day. Larger people (>180 lbs / 80 kg) trend to 5g; smaller people fine at 3g. Loading phase (20 g/day for 5 days) is optional — saturation happens in 3–4 weeks at 5g either way.
- Timing
- Anytime. With or without food. Post-workout slightly better for muscle uptake but the effect is small. Consistency matters far more than timing.
- Schedule
- Daily, indefinitely. No cycling needed.
- Side effects
- Mild intracellular water retention (lean mass and water — NOT bloat). Some report GI upset at high single doses (split if so). The 'creatine causes kidney damage' concern is debunked in healthy adults.
- Interactions
- Stimulants — additive performance / heart-rate effect at high doses. Caffeine + creatine — early concern that caffeine blunted creatine has not held up in better-designed studies.
- Contraindications
- Pre-existing kidney disease — creatine elevates serum creatinine (the test marker) even without causing damage; this confuses interpretation of kidney function. Discuss with nephrologist if relevant. Otherwise none.
- Lab markers
- Serum creatinine will rise modestly on creatine — this is normal and does not indicate kidney damage. Cystatin C is a more accurate kidney function marker if you need one. Muscle biopsy creatine content for research; not done clinically.
- Food sources
- Red meat (beef, lamb), pork, salmon, herring, tuna. ~1–2 g per pound of muscle meat. Vegetarians have ~50% lower baseline creatine stores — they get the biggest boost from supplementation.
Pairs with
Protein / amino acids (creatine works best with adequate dietary protein for muscle synthesis). Carbohydrates (mild insulin-driven uptake). HMB (creatine + HMB synergy in muscle preservation). Resistance training (the actual driver — creatine amplifies what training is already doing).
within Amino acids & derivatives