Creatine: Introduction and Overview

Creatine is a naturally occurring compound (made from arginine, glycine and methionine) stored mainly in muscle and used to rapidly regenerate cellular energy (ATP). It is obtained both by diet (especially meat and fish) and by the body’s own synthesis, and it underpins short bursts of high-power activity. As a supplement (usually creatine monohydrate), it is extremely well-studied for boosting strength and muscle mass. In recent years creatine has also drawn attention for broader health and longevity benefits beyond exercise (e.g. brain and metabolic health). This review will focus on creatine’s benefits, practical usage (dosage, timing, forms), common myths (loading, diet limitations), and even a historical perspective on dietary creatine.

Key Benefits of Creatine

Muscle Mass & Strength: Creatine consistently enhances gains in lean mass and strength when combined with resistance trainingjissn.biomedcentral.com jissn.biomedcentral.com. Meta-analyses show that, in both young and older adults, creatine (typically 3–5 g/day) plus training increases muscle fiber size and overall strength significantly more than training alonejissn.biomedcentral.com jissn.biomedcentral.com. In other words, creatine amplifies the anabolic response to exercise, helping prevent age-related muscle loss (sarcopenia)jissn.biomedcentral.com jissn.biomedcentral.com.
Physical Performance & Recovery: By boosting muscle phosphocreatine stores, creatine improves performance in repeated high-intensity efforts (e.g. sprinting, weightlifting) and increases total training volume over timejissn.biomedcentral.com. It also appears to help recovery: studies report less muscle damage, inflammation, and soreness after hard workouts for those on creatinejissn.biomedcentral.com jissn.biomedcentral.com. In hot environments it can aid hydration and heat tolerance, potentially lowering heat-stress riskjissn.biomedcentral.com. Overall, creatine lets athletes and older adults train harder and recover faster.
Bone and Functional Health: Recent trials in older adults have found that creatine (usually with exercise) may help preserve bone density. For example, 10–12 weeks of creatine plus weight training increased bone mineral content in the arms and reduced bone loss in the hip of postmenopausal women, compared to training alonejissn.biomedcentral.com jissn.biomedcentral.com. Multiple reviews suggest that creatine plus resistance exercise improves muscle function, strength and possibly bone health in aging individuals, which could translate to fewer fractures and better physical functionjissn.biomedcentral.com jissn.biomedcentral.com.
Cognitive and Neurological Support: Creatine is also found in the brain, and animal studies show a neuroprotective effect (reducing damage from brain injury, stroke or aging)jissn.biomedcentral.com. Emerging human research suggests subtle cognitive benefits: a 2024 meta-analysis found that creatine monohydrate produced small but significant improvements in memory, attention and processing speed in adultsfrontiersin.org. These effects were most evident in people with cognitive challenges or higher brain energy demands (e.g. older adults, sleep-deprived individuals). (Note: overall cognition and executive function gains were smaller and need more studyfrontiersin.org.) Nonetheless, the evidence indicates creatine could be a useful supplement for preserving brain energy and function with agejissn.biomedcentral.com frontiersin.org.
Metabolic Health: Some small studies hint that creatine might benefit metabolic markers. For example, in older adults, 4 weeks of 5 g/day creatine significantly lowered fasting triglycerides and blood glucose compared to placebopmc.ncbi.nlm.nih.gov. This suggests potential cardiovascular and anti-diabetic effects (though larger trials are needed). A systematic review/meta-analysis of diabetics found mixed results: some studies saw blood sugar improvements, but overall the pooled effect on fasting glucose and insulin resistance was not statistically significantpubmed.ncbi.nlm.nih.gov. In practice, creatine may modestly improve lipid and glucose metabolism (especially when coupled with exercise), but it’s not a substitute for diet/exercise changespmc.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov.
Safety and Other Effects: Creatine is generally very safe at recommended doses (3–5 g/day). Large reviews and position stands report no evidence that normal creatine use harms kidney function, even after decades of widespread usejissn.biomedcentral.com. Common fears (dehydration, cramps, hair loss) are unsubstantiated: for example, creatine is not an anabolic steroid nor does it cause permanent water retentionjissn.biomedcentral.com jissn.biomedcentral.com. The only typical side effect is weight gain from increased muscle water and mass. On the contrary, creatine has antioxidant-like actions in cells and can protect DNA and mitochondria from oxidative stress, which may underlie some of its anti-aging potential (though these cellular effects are less well-quantified).

Dosage, Timing and Form: Practical Guidelines

Dosage (Maintenance): For most people, a steady dose of 3–5 grams daily is sufficient to saturate muscle creatine stores within a few weeksjissn.biomedcentral.com. This maintenance intake reflects what many studies use for long-term supplementation, and is also the typical amount produced endogenously or obtained from a high-meat diet. In fact, a 2021 evidence review (Antonio et al.) emphasizes that 3–5 g/day “is relatively well tolerated” and effective for improving muscle mass and performancejissn.biomedcentral.com. Heavier or larger individuals might lean to the upper end of this range (e.g. 0.1 g/kg/day, which is 7–8 g for a 70–80 kg person).
Loading Phase (Myth Debunk): A common myth is that you must “load” creatine (e.g. 20 g/day for 5–7 days) to see benefits. Research shows loading only speeds up saturation, but is not essential. Studies have found that taking ~3 g/day for ~4 weeks will achieve roughly the same muscle creatine levels as a traditional 20–25 g/day loading protocoljissn.biomedcentral.com jissn.biomedcentral.com. For example, Hultman et al. showed that ~3 g/day for 28 days led to the same ~20% increase in muscle creatine as 20 g/day for 6 daysjissn.biomedcentral.com. The recent ISSN review concludes that “you do not have to ‘load’ creatine” – simpler lower daily doses work well and avoid potential temporary weight gain or GI upsetjissn.biomedcentral.com. In practice, loading is only advised if you need creatine’s effects within a week; otherwise just take 3–5 g each day.
Timing: When you take creatine appears to be far less important than consistency. Because creatine works by elevating muscle stores over time, taking it any time of day (pre-workout, post-workout, or on rest days) is effective as long as total intake is maintained. One review notes that emerging studies show minimal difference between pre- vs post-workout dosingpmc.ncbi.nlm.nih.gov. Some data hint that post-workout might offer a slight edge for muscle gains, but the evidence is weak and conflictingpmc.ncbi.nlm.nih.gov. In short: don’t stress timing – just take creatine daily, at a time that helps you remember (e.g. with breakfast or your protein shake).
Form (Monohydrate vs Others): Creatine monohydrate is the gold standard. It’s the most-researched form, safe, inexpensive and proven. The ISSN review clearly states that alternative forms (creatine ethyl ester, salts, buffered, nitrate, etc.) have not been shown in any peer-reviewed study to increase muscle creatine better than monohydratejissn.biomedcentral.com. In fact, many of those newer forms have less bioavailable creatine (or more contaminants) per gram. Nearly 99% of ingested creatine monohydrate is absorbed into the blood and taken up by musclejissn.biomedcentral.com. Thus, for practical purposes, plain creatine monohydrate powder is the recommended supplement. It dissolves in water or juice and stays stable (solid powder is stable for years; liquid creatine slowly converts to creatinine, which is why creatine isn’t sold in ready-mixed drinks)jissn.biomedcentral.com.

Myths & Misconceptions about Creatine

Myth: Creatine causes kidney damage – This has been repeatedly debunked. Over 20 years of studies show no kidney impairment from normal creatine supplementation in healthy peoplejissn.biomedcentral.com. Early fears stemmed from isolated case reports (often involving pre-existing kidney issues or absurdly high doses) and confusion between creatine vs creatinine. In reality, transient rises in blood creatinine after eating meat or taking creatine are normal and do not reflect true kidney damagejissn.biomedcentral.com jissn.biomedcentral.com. Controlled trials have found no adverse renal effects from recommended dosingjissn.biomedcentral.com. Of course, anyone with a known kidney disease should consult a doctor, but for healthy adults creatine at 3–5 g/day is safejissn.biomedcentral.com.
Myth: Creatine causes hair loss or steroids – Creatine is not a steroid or hormone. One small study showed a rise in DHT (a hormone linked to baldness) during loadingjissn.biomedcentral.com, which sparked worries about hair loss. However, this has not been replicated, and no clinical evidence shows creatine causes baldness. Similarly, creatine does not convert to testosterone or anabolic steroids; it simply supports cellular energy. All reputable reviews agree: creatine is not an anabolic steroid and does not hormonally mimic onejissn.biomedcentral.com jissn.biomedcentral.com.
Myth: You can get enough from food. Animal products (meat, fish) do contain creatine – e.g. about 0.7 g per 6 oz (170 g) of cooked meatjissn.biomedcentral.com. But to reach 5 g/day from food alone one would need absurd amounts (several kilograms) of raw meat or fish every day. For example, salmon has roughly 4 g per kg, herring up to 10 g/kgverywellhealth.com. In practice, even a high-meat diet usually yields only 1–2 g of creatine per dayen.wikipedia.org, far below the supplement levels used in trials. Vegetarian diets contain virtually no creatine, and studies confirm vegans have significantly lower muscle creatine stores than meat-eatersverywellhealth.com. Thus, relying on diet alone makes it nearly impossible to match the doses (3–5 g/day) that produced benefits in clinical trials. Supplementation is the practical solution.
Myth: Loading is required or produces magical results. As noted above, loading simply speeds up muscle saturation but isn’t mandatory for effectjissn.biomedcentral.com jissn.biomedcentral.com. Taking creatine without a loading phase produces identical long-term results; it just takes a few weeks longer to reach full muscle stores. There is no “stall” in benefits if you skip the load – only the initial timeline is extendedjissn.biomedcentral.com jissn.biomedcentral.com. The ISSN review explicitly advises that lower daily doses (3–5 g) are sufficient and effectivejissn.biomedcentral.com.

Creatine vs Diet: How Much is in Food?

A typical omnivorous diet provides only ~1–2 g/day of creatine (roughly half from food, half synthesized)en.wikipedia.org jissn.biomedcentral.com. For example, beef contains about 0.5 g per 4 ozverywellhealth.com and chicken only ~0.3 g per 6 ozverywellhealth.com. Fish like tuna or salmon give around 0.2–0.4 g per servingverywellhealth.com. Thus, even an all-meat diet rarely tops 2 g.
To reach the 3–5 g/day used in longevity or performance research, one would need to consume several pounds of meat/fish daily. For example, 5 g is roughly equivalent to 8–10 servings of beef or 2–3 kilograms of codjissn.biomedcentral.com verywellhealth.com. This is impractical and unhealthy long-term (especially with concerns about red meat and processed meats).
In addition, cooking degrades creatine. When meat is heated, some creatine is converted to creatinine (which our kidneys clear). One study noted that eating a cooked meat meal caused a rise in serum creatinine (the breakdown product)pubmed.ncbi.nlm.nih.gov. In other words, the bioavailable creatine from cooked meat is even less than raw amounts would suggestpubmed.ncbi.nlm.nih.gov.
Bottom line: Diet alone can’t easily match the supplemental doses that have proven benefits. This is why many researchers and advocates argue for supplementing rather than relying solely on food sources.

“MPMD Derek” (MorePlatesMoreDates) on Creatine – Views and Critique

MorePlatesMoreDates (Derek) is a popular fitness commentator who has discussed creatine. His key points are:

Dosing: Derek acknowledges that 3–5 g/day saturates most people, but he argues many (especially larger or older individuals) may benefit from higher intakes (e.g. 10 g/day or more) to fully maximize their muscle creatine stores. He often mentions anecdotal cases of athletes taking 7–10 g/day for extra gains.
Form: He promotes standard creatine monohydrate (often with glycerol for hydration) as the go-to form. He typically dismisses expensive niche forms, echoing research that monohydrate is best.
Myth-busting: Derek agrees with scientific consensus that creatine is not a steroid, doesn’t harm kidneys, and that hair loss is not proven. He uses these points to debunk common gym myths.
Timing/Loading: He tends to downplay precise timing – saying taking it anytime (pre/post) will eventually work, similar to evidence. He often mentions loading only to fill stores quickly, but also notes it’s optional.

Critique and Context: In general, Derek’s views align well with the scientific evidence. The idea that some people “need” more than 5 g is plausible (muscle mass varies), but in practice randomized trials show that once muscle stores are saturated (~120→150 mmol/kg), extra creatine is simply excretedjissn.biomedcentral.com. Hultman’s classic study found that a modest dose (3 g/day) for 4 weeks produced the same muscle creatine increase (~20%) as a heavy 20 g/day loadingjissn.biomedcentral.com. This suggests that doubling the dose beyond 5 g/day usually offers no further storage or performance benefit, unless perhaps someone has unusually high muscle mass or malabsorption. In short, Derek’s general advice (monohydrate works, be consistent, don’t fear safety) is solid. But his suggestion of routinely taking 10+ g/day is not supported by trials – most people will fully saturate with 3–5 g/dayjissn.biomedcentral.com jissn.biomedcentral.com, so mega-dosing just increases waste (and cost). Current expert recommendations (Antonio 2021, ISSN 2017) hold that 3–5 g/day is enough for “maintenance” in almost everyonejissn.biomedcentral.com jissn.biomedcentral.com.