Creatine
Also called: creatine monohydrate, micronized creatine, creatine hydrochloride (HCl), buffered creatine, creatine gummies.
The best-documented performance supplement, whose reference form remains the monohydrate despite the forms sold as superior.
What it is
Creatine regenerates muscle ATP through phosphocreatine, which supports short, intense, repeated efforts. The body makes some, food covers about half of the daily requirement of 1 to 3 g, and a supplement raises muscle stores by 20 to 40%. People buy it for strength, muscle mass and, increasingly, for cognition.
What the label does not say
- The loading phase is optional: 20 g per day (0.3 g/kg) for 5 to 7 days or 3 g per day for 28 days give similar muscle accumulation, about 20% (ISSN, Antonio 2021). Health Canada allows both, including 3 to 5 g per day without loading for at least 4 weeks.
- The initial weight gain is water: 0.5 to 1 L of retention during loading (ISSN), 1 to 2 kg in one month according to the NIH, hence the statement "you may gain weight" required by Health Canada. Over 5 to 10 weeks of training, the ratio of intracellular water to muscle mass does not differ from placebo.
- Blood creatinine rises because creatine breaks down into it (1 to 2% of stores per day), not because the kidney is suffering: Antonio (2021) concludes that at recommended doses creatine does not cause kidney damage in healthy people and that an elevated creatinine on a supplement is unlikely to reflect a drop in kidney function. Blood work read without knowing you take it can raise a false alarm.
- Creatine is not stable in solution: 4% degradation into creatinine at pH 5.5 and 21% at pH 3.5 after 3 days at 25 °C (ISSN), and Health Canada does not allow liquid forms. Gummies are a moist and often acidic matrix; no analysis of their actual content was found in a source accepted here.
The forms on the shelf
- Monohydrate: 88% creatine by weight according to the NIH, the form used in nearly all trials. The ISSN (International Society of Sports Nutrition) considers unfounded the claims that other forms degrade less or enter muscle better.
- Hydrochloride (HCl): sold for its solubility, but 78.2% creatine by weight, less than the monohydrate, and no trial of superior muscle uptake or performance in the Kreider review (2022).
- Buffered (alkaline), ethyl ester, nitrate, citrate: none retains more creatine than the monohydrate according to the ISSN; the ethyl ester degrades into creatinine.
- Micronized: finer particles, better suspension, no difference in muscle uptake reported in the sources consulted. Purity: Kreider (2022) flags contaminants (dicyandiamide, dihydrotriazine, lead, mercury) in some raw materials.
Published reference values
- Health Canada: loading of 15 to 20 g per day (maximum 5 g per dose) for 5 to 7 days then 2 to 5 g per day, or 3 to 5 g per day for at least 4 weeks. No recommended intake or upper limit: it is not an essential nutrient.
- The ISSN describes up to 30 g per day for 5 years as safe and well tolerated in healthy people and in several patient populations; Antonio (2021) finds no rise in DHT, no hair loss, no cramps or dehydration.
- Cognition: 16 trials (492 participants) give a modest effect on memory (SMD 0.31, moderate certainty), nothing on executive function or attention after age 60; a 2026 review in older adults counts only 2 trials and concludes that the data are limited. The ISSN notes that the brain requires higher and longer doses than muscle.
When
Any time, every day: the effect depends on muscle saturation, not on the day's dose. Retention is a little more consistent with carbohydrates or with carbohydrates and protein (ISSN).
To mention to a professional
- Kidney disorder (Health Canada asks you to consult before use), upcoming blood work including creatinine or estimated filtration rate (the prescriber needs to know you take it), pregnancy and breastfeeding: check with a health care professional.
From the plate first
According to the ISSN, one pound of raw beef or salmon provides about 1 to 2 g of creatine. Vegetarians have lower muscle stores (90 to 110 mmol/kg of dry muscle versus about 120) and respond more to the supplement.
Sources
- Kreider et al., ISSN position stand: safety and efficacy of creatine supplementation, JISSN 2017
- Antonio et al., Common questions and misconceptions about creatine supplementation, JISSN 2021
- Kreider et al., Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds, Nutrients 2022
- Health Canada, natural health product monograph, Creatine monohydrate
- NIH Office of Dietary Supplements, Dietary Supplements for Exercise and Athletic Performance (Health Professional)
- Xu et al., The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis, Frontiers in Nutrition 2024
- Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults, Nutrition Reviews 2026
Educational information, drawn from the sources above. It does not replace the advice of a health professional, who remains the reference for your situation, your medications, pregnancy or breastfeeding.