Creatine Monohydrate

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This supplement has been used in connection with the following health conditions:

Used for	Amount	Why
Athletic Performance and Non-Weight Bearing Endurance Exercise	15 to 20 grams daily for five or six days	Taking this supplement for five or six days may improve performance of high-intensity, short-duration exercise (like sprinting) or sports with alternating low- and high-intensity efforts.
Athletic Performance and Non-Weight Bearing Endurance Exercise 15 to 20 grams daily for five or six days Creatine (creatine monohydrate) is used in muscle tissue for the production of phosphocreatine, a factor in the formation of ATP, the source of energy for muscle contraction and many other functions in the body.³^{, 4} Creatine supplementation increases phosphocreatine levels in muscle, especially when accompanied by exercise or carbohydrate intake.⁵^{, 6} It may also increase exercise-related gains in lean body mass, though it is unclear how much of these gains represents added muscle tissue and how much is simply water retention.⁷ Over 40 double-blind or controlled studies have found creatine supplementation (typically 136 mg per pound of body weight per day or 15 to 25 grams per day for five or six days) improves performance of either single or repetitive bouts of short-duration, high-intensity exercise lasting under 30 seconds each.⁸ ^{, 9} ^{, 10} ^{, 11} ^{, 12} ^{, 13} ^{, 14} Examples of this type of exercise include weightlifting; sprinting by runners, cyclists, or swimmers; and many types of athletic training regimens for speed and power. About 15 studies did not report enhancement by creatine of this type of performance. These have been criticized for their small size and other research design problems, but it is possible that some people, especially elite athletes, are less likely to benefit greatly from creatine supplementation.¹⁵ Fewer studies have investigated whether creatine supplementation benefits continuous high- intensity exercise lasting 30 seconds or longer. Five controlled studies have found creatine beneficial for this type of exercise,¹⁶ but one study found no benefit on performance of a military obstacle course run.¹⁷ Most studies of endurance performance have found no advantage of creatine supplementation, except perhaps for non-weight bearing exercise such as cycling. ¹⁸ ^{, 19} ^{, 20} Long-term use of creatine supplementation is typically done using smaller daily amounts (2 to 5 grams per day) after an initial loading period of several days with 20 grams per day. Very little research has been done to investigate the exercise performance effects of long-term creatine supplementation. One study reported that long-term creatine supplementation improved sprint performance.²¹ Four controlled long-term trials using untrained women,²² trained men,²³ or untrained older adults found that creatine improved gains made in strength and lean body mass from weight-training programs.²⁴ ^{, 25} However, two controlled trials found no advantage of long-term creatine supplementation in weight-training football players.²⁶ ^{, 27} Creatine supplementation appears to increase body weight and lean body mass or fat-free mass, but these measurements do not distinguish between muscle growth and increased water content of muscle.²⁸ ^{, 29} A few double-blind studies using more specific muscle measurements have been done and found that combining creatine supplementation with strength training over several weeks does produce greater increases in muscle size compared with strength training alone.³⁰ ^{, 31} ^{, 32}

Used for	Amount	Why
Athletic Performance and High-Intensity, Short Duration Exercise or Sports with Alternating Low- and High-Intensity Efforts	15 to 20 grams a day for five or six days	Supplementing with creatine may improve performance of non-weight bearing endurance exercises such as cycling.
Athletic Performance and High-Intensity, Short Duration Exercise or Sports with Alternating Low- and High-Intensity Efforts 15 to 20 grams a day for five or six days Creatine (creatine monohydrate) is used in muscle tissue for the production of phosphocreatine, a factor in the formation of ATP, the source of energy for muscle contraction and many other functions in the body.³³^{, 34} Creatine supplementation increases phosphocreatine levels in muscle, especially when accompanied by exercise or carbohydrate intake.³⁵^{, 36} It may also increase exercise-related gains in lean body mass, though it is unclear how much of these gains represents added muscle tissue and how much is simply water retention.³⁷ Over 40 double-blind or controlled studies have found creatine supplementation (typically 136 mg per pound of body weight per day or 15 to 25 grams per day for five or six days) improves performance of either single or repetitive bouts of short-duration, high-intensity exercise lasting under 30 seconds each.³⁸ ^{, 39} ^{, 40} ^{, 41} ^{, 42} ^{, 43} ^{, 44} Examples of this type of exercise include weightlifting; sprinting by runners, cyclists, or swimmers; and many types of athletic training regimens for speed and power. About 15 studies did not report enhancement by creatine of this type of performance. These have been criticized for their small size and other research design problems, but it is possible that some people, especially elite athletes, are less likely to benefit greatly from creatine supplementation.⁴⁵ Fewer studies have investigated whether creatine supplementation benefits continuous high- intensity exercise lasting 30 seconds or longer. Five controlled studies have found creatine beneficial for this type of exercise,⁴⁶ but one study found no benefit on performance of a military obstacle course run.⁴⁷ Most studies of endurance performance have found no advantage of creatine supplementation, except perhaps for non-weight bearing exercise such as cycling. ⁴⁸ ^{, 49} ^{, 50} Long-term use of creatine supplementation is typically done using smaller daily amounts (2 to 5 grams per day) after an initial loading period of several days with 20 grams per day. Very little research has been done to investigate the exercise performance effects of long-term creatine supplementation. One study reported that long-term creatine supplementation improved sprint performance.⁵¹ Four controlled long-term trials using untrained women,⁵² trained men,⁵³ or untrained older adults found that creatine improved gains made in strength and lean body mass from weight-training programs.⁵⁴ ^{, 55} However, two controlled trials found no advantage of long-term creatine supplementation in weight-training football players.⁵⁶ ^{, 57} Creatine supplementation appears to increase body weight and lean body mass or fat-free mass, but these measurements do not distinguish between muscle growth and increased water content of muscle.⁵⁸ ^{, 59} A few double-blind studies using more specific muscle measurements have been done and found that combining creatine supplementation with strength training over several weeks does produce greater increases in muscle size compared with strength training alone.⁶⁰ ^{, 61} ^{, 62}

Used for	Amount	Why
Chronic Obstructive Pulmonary Disease	5 grams three times a day for two weeks, and then 5 grams once daily	Creatine has been shown to increase muscle strength, muscle endurance, and overall health status.
Chronic Obstructive Pulmonary Disease 5 grams three times a day for two weeks, and then 5 grams once daily In a double-blind study, people with COPD received creatine or a placebo for 12 weeks. After the first 2 weeks of supplementation, all participants underwent an outpatient pulmonary rehabilitation program. Compared with the placebo, creatine significantly increased muscle strength, muscle endurance, and overall health status, but not exercise capacity.⁶³ The amount of creatine used in this study was 5 grams three times a day for 2 weeks, and then 5 grams once a day for 10 weeks. Learn More

Used for	Amount	Why
High Cholesterol	Refer to label instructions	One trial found that supplementing with creatine significantly lowered serum total cholesterol and triglycerides in people with high cholesterol.
High Cholesterol A double-blind trial found that 20 grams per day of creatine taken for five days, followed by ten grams per day for 51 days, significantly lowered serum total cholesterol and triglycerides, but did not change either LDL or HDL cholesterol, in both men and women.⁶⁴ However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program.⁶⁵ Creatine supplementation in this negative trial was lower—only 5 grams per day were taken for the last 11 weeks of the study. Learn More

Used for	Amount	Why
High Triglycerides	Refer to label instructions	One trial found that supplementing with significantly lowered serum total triglycerides in both men and women.
High Triglycerides A double-blind trial found that a supplement of 5 grams of creatine plus 1 gram of glucose taken four times per day for five days followed by twice a day for 51 days significantly lowered serum total triglycerides in both men and women.⁶⁶However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program.⁶⁷ Creatine supplementation in this negative trial was lower—only five grams per day was taken for the last 11 weeks of the study. Learn More

Also indexed as:

creatine supplements,
exercise,
muscle disorder,
myopathy,
work outs,
working out,
workouts

About this treatment

How to Use It

Two methods are used for supplementing with creatine. In the loading method, 20 grams of creatine per day (in four divided amounts mixed well in warm liquid) are taken for five to six days. Muscle creatine levels increase rapidly, which is beneficial if a short-term rise in force is needed, such as during a weight-lifting competition, football game, or sprinting. To maintain muscle creatine levels after this loading period, 2–10 grams per day may be effective.

In another method, 3 grams of creatine monohydrate per day are taken over an extended training period of at least four weeks, during which muscle creatine levels rise more slowly, eventually reaching levels similar to those achieved with the loading method. However, no trials testing exercise performance changes have been done using this method. Taking creatine with sugar appears to maximize muscle uptake.

Caffeine intake should not be excessive, as large amounts may counteract the benefits of creatine supplementation.

Where to Find It

Creatine is produced naturally in the human liver, pancreas, and kidneys. It is concentrated primarily in muscle tissues, including the heart. Animal proteins, including fish, are the main source of the 1–2 grams per day of dietary creatine most people consume. Supplements in the form of creatine monohydrate are well absorbed and tolerated by the stomach.

Possible Deficiencies

People involved in intense physical activity, especially those limiting their intake of red meat, may have low muscle stores of creatine. Several muscle diseases, as well as rheumatoid arthritis, and chronic circulatory and respiratory diseases, are associated with lowered creatine levels.

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Last Review: 05-11-2011

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

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