A Brief Synopsis of Creatine Monohydrate

07 May A Brief Synopsis of Creatine Monohydrate

Creatine monohydrate is a dietary supplement utilized by the athletic and general populations. The dietary supplement is a popular, commercially marketed sports supplement which proposes to facilitate ATP production in high intensity, short duration physical activities (Ransone, Lefavi, Jacobson, 2002). Most of the current literature on creatine monohydrate has investigated the benefits of this supplement from a physiological perspective, it has also shown to improve cognitive parameters (Machek & Bagley, 2018).

Creatine is a naturally occurring compound which can be synthesized in the body or consumed within dietary intakes (Haff, Kirksey, Stone, 1999). Approximately 95% of total body creatine is found within skeletal muscles, an additional 5% is in tissues of the brain, eyes, kidneys, and testes (Smith-Ryan & Antonio, 2013). The major role of creatine and PCr is to maintain ATP concentrations through the actions of the creatine kinase reaction (Haff et al., 1999). When intramuscular PCr stores become depleted, the ability for the resynthesis of ATP and production of energy is impaired (Haff et al., 1999). As a result, maximum or near maximum muscular performances are limited (Haff et al., 1999). This is a result of limited availability of PCr (Ransone et al., 2002).

Creatine Supplementation

The supplementation of creatine via a dietary supplement has demonstrated to increase creatine content of skeletal muscles (Haff et al., 1999). Studies indicate the overall muscular augmentation to be 20-50% with 5 grams of 4-6 times per day of creatine monohydrate (Haff et al., 1999). Additional studies show variances of these figures, though the supplementation presents increases in both free creatine and PCr (Haff et al., 1999).

Research indicates the supplementation of creatine has produced improvement in physical tests, created more optimal body composition, and improved blood markers such as reduced inflammatory indicators and decreased lactate (Machek & Bagley, 2018). Over 70% of the studies performed on creatine have produced statistically significant improvements with an average 5-15% increases in work performance for maximal effort muscle contractions, maximal power/strength performance, and single/repetitive sport performances (Smith-Ryan et al., 2013).

Creatine supplementation has shown to increase body mass. Studies have provided short term body mass increases of 0.7-1.6 kg (Haff et al., 1999). Long term studies in addition to increases in body mass indicate a positive correlation to the development of fat free mass (Smith-Ryan et al., 2013). Relative to physiological benefits, research has suggested creatine supplementation having a positive effect on the lipid profile of middle-age males and females with elevated levels of triglycerides (Haff et al., 1999).

Improvements in aerobic based activities from the usage of creating monohydrate supplementation is less substantial relative anaerobic based sports (Smith-Ryan et al., 2013). Though some research is evident of creatine and carbohydrate loading in unison increases glycogen storages in comparison to carbohydrate loading only (Smith-Ryan et al., 2013). A secondary aspect of creating resistance to aerobic fatigue in theory is the ability of it to spur mitochondrial respiration (Smith-Ryan et al., 2013). This stimulation in theory would assist in the process of mitochondria converting stored energy into ATP (Walzel et al., 2002).

Outside of the physiological benefits of creatine supplementation, research on the cognitive benefits exist. Creatine is an important compound for brain bioenergetics (Machek et al., 2018). Populations suffering from reduced cognitive function have been shown to benefit from creatine supplementation (Machek et al., 2018). Findings also indicate creatine supplementation is able to increase markers signifying optimal brain homeostasis (Machek et al., 2018). Cognitive benefits relative to the athletic populations, research is providing support for improvements in mental fatigue, sustained attention/focus, and memory recall (Machek et al., 2018).

Creatine Supplementing Procedures

Literature and research provide two basic supplementation protocols for the creatine monohydrate. The first, older, and more common protocol entails a loading phase followed by a maintenance phase (Smith-Ryan et al., 2013). During a traditional loading phase 20-25 g of creatine are ingested per day for 5-7 days (Haff et al., 1999). The daily doses are spread out evenly four times per day (Smith-Ryan et al., 2013). After completion of the loading phase where Creatine saturation is the goal, a maintenance phase commences with a dosage of 3-5 g per day (Smith-Ryan et al., 2013).

The more recent supplementation protocol does not include a loading phase and simply utilizes a maintenance dosage of 3-5 g per day (Smith-Ryan et al., 2013). This program will not produce as rapid of a creatine saturation of the muscles compared to loading, though research indicates stores from this method can be completely saturated within 28 days (Smith-Ryan et al., 2013). Two benefits from this process is the cost perspective being less relative to loading, and it may decrease gastrointestinal side effects and weight gain (Smith-Ryan et al., 2013). Finally, recently it is suggested dosing of creating should not be based on absolutes measures rather relative to total body or fat free mass (Smith-Ryan et al., 2013). Recent studies suggest that as little as .03 kg per day can provide some of the ergogenic benefits of the supplement (Smith-Ryan et al., 2013).

Finally cycling of the supplement is to be considered. Cycling is a reference of alternating between periods of creatine supplementation and periods of non-supplementation (Smith-Ryan et al., 2013). The non-supplementation period can be referred to as a wash-out period (Haff et al., 1999). The wash-out period is 3-6 weeks in length to allow for baseline levels of creatine to be restored (Haff et al., 1999).

Side Effects of Creatine Usage

The effects of creatine supplementation and potential benefits have been investigated, thought the long-term effects have yet to be determined (Ransone et al., 2002). Opposition to the usage of creatine suggest potential negative effects on the kidneys, increased risk of dehydration, and muscle cramps (Smith-Ryan et al., 2013). All three of these suggested negative effects have not been validated in literature or studies (Smith-Ryan et al., 2013). An additional negative effect linked to creatine supplementation is renal functioning (Ransone et al., 2013). Current research on this side effect does not support the proposed negative effect on renal functioning from creatine supplementation (Machek et al., 2018).

Finally, concern has been expressed regarding creatine supplementation and long-term suppression of endogenous creatine synthesis (Ranone et al., 2002). Endogenous creatine synthesis has been reported to decrease during times of creatine supplementation (Ranone et al., 2002). However, no research to current date in published form has supported this report on long term suppression of endogenous creatine synthesis due to supplementation (Ranone et al., 2002).


Haff, G. Kirksey, B. Stone, M. (1999) Creatine supplementation. Strength and conditioning journal, 21 (4) 13-23.

Machek, S. Bagley, J. (2018) Creatine monohydrate supplementation: Considerations for cognitive performance in athletes. Strength and conditioning journal, 40 (2) 82-91.

Ransone, J. Lefavi, R. Jacobson, B. (2002) Efficacy and safety of creatine supplementation: A review and recommendation. International sports journal, summer 31-41.

Rawson, E. Persky, A. (2007) Mechanism of muscular adaptations to creating supplementation. International sport/med journal, 8 (2) 43-53.

Smith-Ryan, A. Antonio, J. (2013) Sports nutrition and performance enhancing supplements, Ronkonkoma, NY: Limus Learning.

Walzel, B. Speer, O. Zanolla, E. Eriksson, O. Bernardi, P. Wallimann T. (2002) Novel mitochondrial creatine transport activity. Journal of biological chemistry, 277 (40) 503-511.