Creatine is a compound the body makes from the amino acids glycine, arginine and methionine, and gets in small amounts from meat and fish. It is used as a supplement to support short bursts of high-intensity exercise, such as sprinting and weight lifting. Creatine monohydrate is the most widely used and studied form.
Also known as: creatine monohydrate.
Creatine has no Recommended Dietary Allowance or upper limit. The NIH Office of Dietary Supplements (ODS) describes a typical protocol in studies: a 5 to 7 day loading phase of 20 g a day split into four 5 g portions, then 3 to 5 g a day; or about 3 to 6 g a day for 3 to 4 weeks with no loading phase. Creatine monohydrate is 88% creatine by weight. These are study protocols, not a recommendation.
It is sold in the US as a dietary supplement. Under the 1994 dietary supplement law (DSHEA), FDA does not approve dietary supplements before they are marketed, and the maker, not FDA, is responsible for safety and labeling. There is no FDA-approved creatine drug.
ODS says the liver and kidneys make about 1 g of creatine a day, and that a 154-pound person has about 120 g of creatine and phosphocreatine, almost all in skeletal and heart muscle. In studies, short-term creatine (5 to 7 days) often increased strength and power for repeated maximal efforts; it seems to be of little value for endurance sports. Responses vary, and vegetarians, with less creatine in muscle, may respond more. ODS says other forms, such as creatine ethyl ester or buffered creatine, have not been shown to work better than monohydrate.
The most consistent side effect is weight gain from water held in muscle: ODS cites a 1 to 2 kg rise in a month with a strength-training program. ODS calls creatine safe for short-term use by healthy adults and cites evidence that several years of use is safe; anecdotal reports include nausea, diarrhea, muscle cramps and heat intolerance. Creatine breaks down into creatinine, which the kidneys clear. A 2019 meta-analysis (de Souza e Silva) concluded that creatine did not cause kidney damage in the amounts and durations studied. If you have kidney disease, ask your clinician first.
Creatine taken by mouth is stored in muscle, mostly as phosphocreatine, and its effect depends on how full those stores are rather than on blood levels after one dose. We could not find a single published half-life that applies, so we do not list one. ODS notes that daily loading for 5 to 7 days, or 3 to 6 g a day for 3 to 4 weeks, were used in studies to raise muscle stores.
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