Creatine: What It Does and How to Take It

Creatine: What It Does and How to Take It

Creatine is one of the most researched supplements in sports nutrition, and one of very few that reliably does something. It is cheap, it is safe for healthy people, and it works for most lifters. Here is what you need to know, without the marketing.

What it does
Your muscles use creatine phosphate as fuel for short, hard efforts, like a heavy set of 5 to 10 reps. Taking creatine tops up those stores. In practice that means a rep or two more per set, which over months adds up to more strength and a bit more muscle than you would get without it. It will not replace training or food. It makes good training a little more productive.

How to take it

• Type: creatine monohydrate. That is the form nearly all the research uses.
  
• Amount: 3 to 5 g a day, every day, rest days included.
  
• Timing: it does not matter much. Take it whenever you will remember, with a meal or in your shake.
  
• Loading: optional. Taking 20 g a day, split into four servings, for five to seven days fills your muscles in about a week instead of three to four weeks. It upsets some stomachs, and you end up in the same place either way.
  
• Breaks: not needed. You can take it all year.
  

What to buy
Plain, unflavoured creatine monohydrate powder from a brand that has its products tested by an outside lab. Creatine HCl, buffered creatine, ethyl ester, liquid creatine and the other "advanced" forms cost more and have no better evidence behind them. Ethyl ester actually did worse than monohydrate in studies. If the label is mostly marketing words, keep walking.

What to expect
Most people gain 1 to 2 kg on the scale in the first few weeks. That is water stored inside the muscle, not fat, and it does not make you look soft. Some people notice a clear difference in the gym, others barely notice anything. People who eat little meat and fish often respond the most, because their stores start out lower.

Common worries

• Hair loss: this comes from one small study in 2009 that saw a rise in DHT. That result has not been repeated, and no study has shown actual hair loss from creatine.
  
• Kidneys: long term studies in healthy people have found no harm. If you have kidney disease, talk to your doctor before you use it.
  
• Cramps and dehydration: not supported by the research. Drink as you normally would.
  
• Stomach trouble: usually from large single servings. Split it up or skip the loading.
  

Creatine and bloodwork
This one catches people out. Creatine raises creatinine in your blood, and creatinine is what labs use to estimate kidney function (eGFR). A lot of muscle mass and a hard session the day before do the same. So your kidney numbers can look worse on paper than they really are. Tell the doctor you take creatine and that you train hard. If a kidney value comes back high, ask about a cystatin C test, which creatine does not affect. More on testing in Bloodwork for Lifters.

Questions about creatine? Reply here.