The Ins and Outs of Using Creatine – What, When, Why, How?

Takeaway Tips

1. Stick to basics: Creatine monohydrate is the gold standard—other forms offer no advantage.

2. Keep it simple: 3 g daily is sufficient; no cycling required.

3. Expect small but real benefits: Power, performance and lean mass gains are modest but worthwhile.

4. Don’t fear myths: Creatine does not cause balding or kidney damage in healthy individuals.

5. Consistency matters most: Long-term daily use is just as good as daily use after “loading.”

Dr. Crionna Tobin (CT): Eric, creatine is often surrounded by myths—hair loss, kidney damage, or even being “just for bodybuilders.” Let’s start with the basics: what exactly is creatine?

Dr. Eric Helms (EH): Creatine is a compound made from the amino acids glycine, arginine, and methionine. About 90–95% of it is stored in our muscles, with the rest in the brain. It fuels our phosphocreatine system, which provides rapid energy for high-intensity efforts like sprinting, lifting, or jumping. While creatine occurs naturally in meat and fish, the amounts from most diets are too low to optimise muscle stores, and even if they weren’t, cooking meat reduces meat’s creatine content. That’s where supplementation comes in.

CT: Many still worry creatine might cause hair loss or kidney damage. Should athletes be concerned?

EH: The evidence doesn’t support those fears. A 2009 study raised concerns about increased DHT levels, which sparked the “hair loss” myth, but DHT levels were still within the normal range in that study and later work showed no direct link between creatine and balding. As for kidney health, and health generally, multiple long-term studies demonstrate creatine is safe in healthy individuals. The only minor side effect occasionally reported is gastrointestinal discomfort when very high loading doses are used.

CT: What about weight gain and water retention—another common concern?

EH: Creatine draws water into the muscle cell because of its osmotic effect. This is not harmful “bloating” but rather intracellular hydration that supports performance. Typical weight gain is around 1–2% of body mass, which reflects fuller, better-fuelled muscles—not fat gain.

CT: So, who benefits most from creatine?

EH: Anyone performing strength, power, or intermittent high-intensity sports. It’s also valuable for athletes looking to build, maintain or regain lean mass, for example during injury recovery. Vegetarians and vegans often respond particularly well, as their baseline muscle creatine levels are lower. Importantly, creatine is not just for men—female athletes benefit equally. Emerging research also suggests potential roles in brain health and recovery from concussion.

CT: Let’s talk timing and dosing. Should athletes load creatine?

EH: The science is straightforward: 3 g/day of creatine monohydrate is enough to saturate muscle creatine content over the course of 2-4 weeks for most people depending on their size. Loading phases (20 g/day for a week) saturate muscles a bit faster (in ~1 week), but over months or years of consistent use, it makes no difference. For the same reason timing isn’t critical. Some short-term studies show slightly faster uptake when creatine is taken with carbs or post-exercise, but again, the real key is daily consistency.

CT: Final thoughts?

EH: Creatine is one of the most studied, safe, and effective supplements available. The effects are modest but meaningful—improved strength, power, and lean mass. For serious athletes or anyone wanting to support performance and recovery, it’s a no-brainer.

References

• Antonio, J., et al. (2021). International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine.

• Burke, D. G., et al. (2003). Effect of creatine supplementation on performance and muscle morphology in men and women. Medicine & Science in Sports & Exercise.

• Buford, T. W., et al. (2007). Creatine supplementation and exercise performance: An update. JISSN

• Claudino, J. G., et al. (2019). Creatine supplementation in sports and health: Current state of knowledge and future directions. Nutrients,

• Van der Merwe, J., et al. (2009). Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clinical Journal of Sport Medicine

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