In this guide, I’m going to break down the supplement science of creatine monohydrate in an unbiased way. we will cover creatine monohydrate benefits, side effects, dosage, and much more.
When it comes to supplements, I’m sure you’ve heard of creatine monohydrate. It’s certainly one of the most popular supplements on the market.
By the end of this guide, you will know all creatine monohydrate benefits and whether it’s right for you.
Download the Creatine Buyer’s Guide to learn exactly what to look for and get Keith’s top creatine supplement picks!
What is Creatine?
Creatine monohydrate is one of the most widely used and studied supplements to date. It’s also one of the most misunderstood when it comes to the general population. When you tell someone you take creatine; they automatically think you take steroids, which cannot be further from the truth.
It was first discovered through meat extraction by a French scientist in the 1830’s! The earliest documented reports of creatine increasing athletic performance were conducted by Swedish researcher Dr. Eric Hultman in the 80’s, but it wasn’t until the 90’s that its research grew exponentially. 
Creatine is formed inside our bodies from the amino acids arginine, glycine, and methionine. It’s primarily synthesized in our liver, kidneys, and pancreas and mostly stored within our muscles (95%). The remaining 5% is found in our brain, eyes, kidneys, and testes. 
Creatine is widely stored within our bodies as creatine phosphate or phosphocreatine (creatine attached to a phosphate molecule). The addition of phosphate is essential for creatine to provide its performance enhancing benefits. It’s both produced naturally in our bodies and found in foods like meat, fish, and eggs.
Creatine Monohydrate Benefits
To date, more than 500 studies have been conducted to examine creatine monohydrate benefits. Over 70% of these studies have found increases in performance, and none reported any detrimental effects. 
Main Bodybuilding Benefits:
- Increased exercise performance
- Increased muscle growth and size
- Improved recovery from exercise and injury
1. Increased Exercise Performance
Once inside the muscle, creatine acts as an energy reservoir (creatine phosphate) and donates phosphates to replenish adenosine triphosphate (ATP) during high-intensity exercise.
ATP is our cell’s energy currency. ATP is always being used in our body and must be regenerated to continue providing energy.
With high-intensity exercise, ATP is depleted rather quickly in muscle cells. This results in high amounts of adenosine diphosphate (ADP) and adenosine monophosphate (AMP). To maintain high performance, creatine phosphate donates its phosphate to regenerate ATP and continue providing energy to working muscles. Donation continues until the pool of creatine phosphate is used up in the muscle (usually around 10 seconds).
The additional creatine phosphate allows you to pump out a few more reps and use more weight, which can lead to more progress in the long run.
2. Increased Muscle Growth & Size
One way creatine monohydrate benefits you is by helping increase muscle growth and size. This is achieved by allowing you to use heavier weight and pump out a few more reps. This may lead to more growth because you’re able to maintain a higher intensity and accumulate more training volume, both of which are large factors for muscle growth.
Another was creatine can help you grow is by increasing insulin-like growth factor (IGF-1), which is a muscle growth signaling protein.
One 8-week study found creatine supplement benefits when paired with heavy resistance training. It significantly increases IGF-1 levels.  With a single bout of resistance training, creatine has been shown to increase positive gene expression and cellular signaling within skeletal muscle, which may favor a more anabolic environment. 
Many long-term studies show significant increases in muscle size. For example, a 12-week study found those receiving creatine gained double the amount of muscle than the placebo group during weeks 4 to 12. 
You can’t expect double progress to continue forever, but beginners should easily notice creatine monohydrate benefits.
Another way creatine monohydrate benefits you is by increasing intracellular water (inside the cell). This extra water has two benefits:
- A more hydrated cell will perform/function better and the increased water within the muscle cell gives it a full, round appearance.
- The increased water inside the muscle causes cellular swelling and can have important benefits.
Cell Swelling Benefits: 
- It increases muscle protein synthesis, which is the creation of new muscle protein (muscle building).
- It decreases muscle protein breakdown, which is the loss of muscle protein (muscle loss).
Many people hear that creatine monohydrate causes water retention and are fearful of taking. What they don’t realize is the water retention is where we want it, inside the muscle!
The overwhelming majority of studies show creatine monohydrate benefits muscle growth and size in both the short and long term.
3. Improved Recovery from Exercise & Injury
The increased protein synthesis and decreased protein breakdown discussed in the last section leads to shorter recovery periods. This allows you to hit the muscle harder and more frequent, both of which will result in more muscle growth in the long run.
Creatine has been shown to decrease several markers of muscle damage post exercise which may lead to a shorter recovery period. 
It acts as an antioxidant within our muscles. One study found it to decrease oxidative DNA damage and lipid peroxidation induced by a single bout of resistance exercise.  This demonstrates the powerful antioxidant benefits of creatine monohydrate.
Supplementing with creatine monohydrate benefits those that are injured. It has been shown to offset the decline of GLUT4 (a glucose transporter in muscle) during immobilization.  The changes in GLUT4 can lead to higher concentration of glycogen and creatine within the muscle, which may shorten time to recover from injury.
In summary, creatine can decrease the amount of time needed to recover from exercise and may reduce muscle loss during periods of injury.
Wait a Minute…
Some of you might be wondering if our bodies can make creatine on its own, why should we supplement with it? The problem is, our bodies can store more than we produce. You see, our bodies aren’t fully saturated with creatine. We often see benefits with supplementation because we’re able to top our system off, although some people don’t see benefits from creatine supplementation (non-responders).
Our bodies can only store so much creatine, and it is likely non-responders cannot store any more.  Another possible reason we see non-responders with creatine supplementation is their muscle fiber type. It was found that non-responders have low type-II fiber concentrations, which is where creatine is mainly stored. 
The majority of people will see creatine monohydrate benefits. Those that have a lower starting point will see the greatest benefit, like vegetarians and those that don’t eat many creatine containing foods. 
Creatine Monohydrate vs. Novel Forms
Because of the existence of non-responders to creatine and the extreme marketing tactics within the fitness industry, novel forms continue to come out today. All of which hope to gain an edge on old-fashioned creatine monohydrate. Many of these forms are yet to be studied directly with creatine monohydrate.
As mentioned earlier, this is the most studied form of creatine and is the least expensive! It also has extensive research showing its safety for healthy individuals.
Micronized creatine monohydrate is essentially the same thing as creatine monohydrate but has undergone a micronizing process, which reduces the granule size and may lead to better absorption.
Magnesium Creatine Chelate
Magnesium creatine chelate has become increasingly popular lately because it has shown to be at least as effective as monohydrate for increasing performance and possibly more efficient at increasing intracellular water concentrations.  If you remember earlier, we discussed the importance of intracellular water concentration in giving the muscle a fuller appearance.
The addition of magnesium allows it to be absorbed through a different transporter and may cause you to require less on a gram for gram basis when compared with monohydrate.
Buffered Creatine & Creatine HCL
Both buffered creatine (creatine with a high pH) and creatine HCL (creatine with a low pH) are converted into plain old creatine when they reach the stomach.
Neither has been shown to outperform monohydrate, but creatine HCL may have slightly better water solubility.
Pyruvate is an intermediate in a lot of metabolic processes. It’s thought that when bonded with creatine, it increases its bioavailability and uptake into muscle but this is yet to be confirmed.
Creatine pyruvate studies show similar benefits as creatine monohydrate although it hasn’t been directly compared, so we don’t know which is better at this point.
Citrate is a salt that’s commonly bonded with creatine. Just like with creatine pyruvate it has shown benefits of improved work capacity and delayed fatigue, but has not been studied directly against creatine monohydrate.
At this point, we cannot determine if it’s a good alternative to creatine monohydrate.
Creatine Ethyl Ester
Interestingly, creatine ethyl ester has been shown to be less effective than monohydrate.  It also appears to be somewhat unstable and often degrades into the waste product creatinine.  Despite this, it’s still marketed as a good monohydrate alternative.
Because of this, we don’t recommend creatine ethyl ester.
Which Form of Creatine Is Best?
On a gram for gram basis, creatine monohydrate contains more creatine (the compound providing benefit) than most novel forms. This means you will need to consume fewer grams of creatine monohydrate. The only exception would be magnesium creatine chelate.
Once our muscles are fully saturated with creatine, it’s unlikely the claimed increased stability, solubility, and uptake of novel forms will even matter.
Creatine monohydrate is still the least expensive and most studied form to date. No form has been shown to outperform monohydrate, so save your money and go with old fashioned creatine monohydrate or micronized creatine monohydrate.
Should I Buy Powder, Pills, Tablets, or Liquid?
I would avoid liquid creatine products because when creatine is suspended in liquid for an extended period of time, it degrades into creatinine (a waste product). Other than that, There’s no difference between forms. It won’t matter if you purchase powder, pills, or tablets. Just buy the form that’s easiest for you to consume.
Creatine Monohydrate Side Effects
To date, the only validated side effect of creatine in healthy individuals is weight gain.  The weight gained is from increased water retention. I know what you might be thinking, isn’t that a bad thing? Well, it depends on where this water is stored!
Most often when people are retaining water, they are holding it in their extracellular space (outside of cells). This water can cause one to look watery and bloated. If you remember earlier, we mentioned water retention from creatine is stored inside of the muscle cells. This water provides the muscle a fuller look and leads to a more anabolic environment.
Once you stop taking creatine, the water retention will go away, but you will keep all the muscle you have gained while taking the supplement. What I don’t understand is why anyone would want this good water retention to go away.
Creatine safety has been studied for decades with no reports of issues in healthy individuals. Despite this, long-term safety remains a topic of debate.
Is Creatine Harmful to the Kidneys?
People often hear creatine is detrimental to the kidneys because of a few case reports in individuals with pre-existing kidney problems. In one instance, an individual with a severe kidney disorder experienced impaired kidney function while taking creatine but it stopped once he discontinued supplementation. 
Another report was in a person with a single kidney that was loading creatine (he consumed 20g/day for five days followed by 5g/day for 30 days). They found his serum creatinine increased, and its clearance decreased.  All other kidney function labs were normal.
You cannot apply the results of these case studies to healthy individuals, yet that’s exactly what the media did. From decades of research on creatine, we have no evidence to suggest it’s unsafe in healthy individuals.
Does Creatine Cause Muscle Cramps and Dehydration?
A recent meta-analysis (a study of multiple studies) revealed that when properly dosed, creatine can actually help fight off dehydration and decrease muscle cramps.  They observed increased total body water, decreased core body temperature, and increased plasma volume during exercise which all point to hyperhydration as opposed to dehydration.
Creatine and Women
Should women take creatine?
Well, it depends on their goals, but if they want to experience the benefits of creatine monohydrate discussed earlier, then yes.
Creatine monohydrate benefits women the same as it does for men, but women will likely not see as much benefit because they have less muscle mass (where creatine is stored).
Taking creatine and lifting weights is not going to cause women to look bulky or build a bunch of muscle. I often hear from women that are afraid of building too much muscle. This is simply not going to happen if you’re a woman and natural (don’t take steroids). You aren’t going to turn into Ms. Olympia by lifting weights and taking creatine.
Dosing of creatine should be a very simple concept, but people often overcomplicate it with cycling and loading because they think it has additional benefits.
Take 3-5g/day (depending on your size) for as long as you want to receive creatine monohydrate benefits. It should be taken every single day, and it doesn’t matter what time or what you take it with. The important point here is just to take it.
There’s no set “creatine cycle” but some suggest 3 months on and 1 month off, or 1 month on and 2 weeks off. Neither is going to provide any better of results and are both pointless.
The rational causing some to think cycling creatine is necessary is that your body stops making its own when you supplement it. This may be true but once you stop taking it, your bodies natural production will start back up again. This is different than steroids, where if you’re always “on” it can cause serious problems when you do come off.
Creatine loading is a strategy used to saturate your creatine stores rather quickly, usually within a week. This is accomplished by consuming a large amount (20g/day) for 5-7 days. If you just started taking creatine and wish to saturate your body quickly, consume 20g/day for 5-7 days (split into 4 or 5 doses) followed by a maintenance dose of 3-5g/day as long as you want benefits.
Creatine monohydrate loading is not necessary. If you plan to take it for a long period of time, your body will be fully saturated at a lower dose in around 30 days anyway, so it’s completely up to you.
- Creatine monohydrate is one of the most studied supplement on the market today.
- It has been shown to be safe countless times in healthy individuals.
- Creatine monohydrate benefits include increased performance, increased muscle building, and improved recovery from exercise or injury.
- It’s not magic but will provide noticeable results if you’re a responder and a beginner.
- Don’t waste your money on novel forms. Purchase a creatine monohydrate powder, pills, or tablets to gain all creatine monohydrate benefits.
- Loading is optional and only saturates your body quicker.
- Take 3-5g/day of creatine monohydrate as long as you want its benefits.
Download the Creatine Buyer’s Guide to learn exactly what to look for and get Keith’s top creatine supplement picks!
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