What is creatine?

Creatine is a naturally occurring substance in the body, produced primarily in the liver and kidneys. It is also found in small amounts in certain foods, such as meat and fish.

How does it work?

Creatine works by increasing the availability of a molecule called adenosine triphosphate (ATP) in the muscles, which is used as a source of energy during high-intensity exercise. When the body's stores of ATP are depleted, creatine can help replenish them, allowing for increased physical performance and reduced fatigue.

What can happen if I have an imbalance or deficiency?

A deficiency in creatine is rare, as the body can produce enough of it naturally. However, low levels of creatine may occur as a result of certain medical conditions or treatments, such as kidney disease or use of certain medications.

What forms does it come in?

Creatine is available as a dietary supplement in various forms, including powder, capsules, and liquids.

What does Creatine Monohydrate help with?

Creatine is a compound your body makes and stores in muscle. It is also sold as a cheap white powder called creatine monohydrate. Athletes have used it for decades.

• Getting stronger and more powerful in the gym
  Strong evidence — many controlled human trials of training with creatine. In controlled trials, people who took creatine gained more strength and power than people on placebo. It is well established that creatine helps refill the muscle's fast energy store. That lets you push harder in each set, and the gains add up over a training block.
  Evidence grade A · Traditional tier T0
• Sprints, intervals and other short bursts of hard effort
  Strong evidence — dozens of controlled trials in sport settings. Dozens of controlled trials found better power and sprint output with creatine. The sports studied include sprinting, rowing, wrestling, cycling intervals and team sports. The gain shows up most in repeated short bursts of maximal effort.
  Evidence grade A · Traditional tier T0
• Building muscle and lean mass
  Strong evidence — many controlled trials pairing creatine with training. Trials found more lean mass in people who trained and took creatine. Fuller creatine stores let them train with more volume and intensity, which drove growth over time. Early weight gain is water pulled into muscle cells, not fat, and lab work suggests that water shift supports protein building.
  Evidence grade A · Traditional tier T0
• Muscle loss with age (sarcopenia)
  Strong evidence — one of the most studied strategies in older adults, tested with resistance training. Creatine plus resistance training is among the most studied ways to hold on to muscle in later life. Trials in older adults found better muscle mass and function than training alone. Older muscle appeared to respond better to exercise, which slowed the usual decline.
  Evidence grade A · Traditional tier T0
• Bouncing back after hard training
  Early evidence — smaller human studies of muscle damage and soreness. Smaller human studies found less sign of muscle cell damage and less inflammation after hard sessions. Athletes who took it steadily reported faster recovery and less soreness, so they trained more often. Results differ from study to study.
  Evidence grade C · Traditional tier T0
• Brain fog and slow thinking
  Early evidence — small and mixed human studies, strongest under sleep loss. Human studies reported better memory, faster processing and better mental performance with creatine. The clearest results came during sleep loss or mental fatigue. Brain cells recharge energy with creatine much as muscle cells do, but that is basic physiology, not a trial result.
  Evidence grade C · Traditional tier T0
• Low mood and depression
  Early evidence — emerging clinical research, mostly in women and as an add-on. Emerging clinical research suggests creatine may support mood. The signal looked strongest in women, and in people whose depression had not responded to antidepressants alone. In that work it was added to the drugs, not swapped for them.
  Evidence grade C · Traditional tier T0
• Bone strength in older adults
  Early evidence — preliminary trials in older adults, all paired with resistance training. Trials in older adults reported promising changes in bone mineral density. The clearest signals came from women past menopause who also did resistance training. Researchers think the extra strength, and so harder training, plays a large part.
  Evidence grade C · Traditional tier T0
• Brain and nerve conditions
  Not yet tested in people — early research only; no settled human result on file. Creatine is being studied for Parkinson's disease, brain injury and Huntington's disease. The reason is that brain cells use a lot of energy, and that energy pathway is well understood. The research is still emerging, so there is no clear human answer yet.
  Evidence grade insufficient · Traditional tier T0

What Creatine Monohydrate has not been shown to do

• It has not been shown to burn fat; the early weight gain is water inside muscle cells.
• It has not been shown to build muscle or strength on its own, without training.
• It has not been shown to help bone without resistance training alongside it.
• It has not been shown to replace antidepressants; the mood studies added it to them.

How to read this:

Each use above carries its own grade. A means steady results from randomised human trials. B means at least one good human trial. C means small, mixed or early human work. D means weak or conflicting human evidence. Insufficient means no human study on file. This page reports what studies found. It is not medical advice, and it lists options rather than telling you what to take.

What can Creatine Monohydrate help prevent?

• Age-related muscle loss when combined with resistance training
• Cognitive decline associated with aging and sleep deprivation
• Excess muscle damage from high-intensity training (may reduce exercise-induced muscle injury markers)

Which foods are rich in it?

• Beef
• Pork
• Salmon
• Tuna
• Herring
• Sardines
• Mackerel
• Cod
• Haddock
• Halibut

What are possible side effects?

• Common: Nausea, diarrhea, stomach pain, muscle cramping, weight gain
• Mild: Dizziness, headache, bloating
• Moderate: Dehydration, muscle strain or injury
• Severe: Kidney damage, liver damage, heart problems
• Overdose: None reported
• Withdrawal: None reported

What's the recommended daily dose?

The average recommended daily dose of creatine is 3-5 grams per day, taken in divided doses.

How many days does it take to work?

The effects of creatine supplementation may begin to be seen in as little as 1-2 weeks, with the full effects typically being observed after 4-12 weeks of continuous use.

What time of day is best to take it?

Creatine can be taken at any time of day, as the timing does not appear to significantly impact its effectiveness.

Is it best to take it with or without food?

Creatine can be taken with or without food. However, taking creatine with a meal or with a source of carbohydrates may enhance its absorption and improve its effectiveness.