3–5 g/day of creatine monohydrate, every day (including rest days). The loading phase (20 g/day, 5–7 days) is optional and only speeds up saturation. With water; timing does not matter.
Increases maximal strength and power in short, intense efforts, especially alongside strength training.
See the study (ISSN position stand · hundreds of RCTs) →Added to training, it increases lean mass. Part of the initial weight is intramuscular water; in the medium term there is real muscle.
See the study (numerous RCTs and meta-analyses) →Greater benefit when the brain is under strain (sleep deprivation, older adults, meat-free diets); in rested young people the effect is small.
See the study (recent RCTs) →It is not a steroid, does not cause hair loss, does not damage the kidney or liver in healthy people, and does not dehydrate or cause cramps.
See the study (2024 review) →⏱ 8 min read
Creatine is one of the most studied compounds in the history of sports nutrition, and yet it remains profoundly misunderstood, reduced in the popular imagination to a powder taken by athletes who want bigger muscles, when in reality it is a molecule your body already makes, that is present in every cell that needs fast energy, and whose influence extends from muscle fibers to brain neurons, by way of the heart, the immune system, and the fundamental processes of pregnancy.
The human body produces creatine endogenously, mainly in the liver and kidneys, from the amino acids arginine, glycine, and methionine; and it also obtains it through the diet, mainly from animal muscle, which explains why vegetarians and vegans have significantly lower plasma and muscle creatine concentrations than omnivores, with consequences that go beyond physical performance.
Creatine is not, strictly speaking, a direct source of energy: it is rather a system for the storage and rapid transfer of energy that works like a reserve battery for the moments when metabolic demand exceeds the capacity of the aerobic system, which is slower but more sustainable, to generate ATP, the universal energy currency of the cell.
When muscle needs energy immediately, as in a sprint, a weightlifting set, or any intense short-duration effort, phosphocreatine donates its phosphate group to ADP to regenerate ATP in fractions of a second; this process, which the aerobic system would take seconds to complete, occurs almost instantaneously thanks to creatine kinase, the enzyme that catalyzes this reaction and that is present in especially high amounts in cardiac and skeletal muscle, and also in the brain.
Decades of research on creatine supplementation in the sports context reveal a consistent and replicable effect: it increases maximal strength, anaerobic power, and the capacity to perform repeated high-intensity efforts, with improvements typically ranging between 5 and 15 percent depending on the protocol, the dose, and the individual's characteristics; and this effect is especially relevant in older people, in whom sarcopenia, the progressive loss of muscle mass and function associated with aging, is one of the strongest predictors of disability, dependence, and mortality.
A meta-analysis that evaluated the effect of creatine supplementation in older adults doing resistance training found significantly greater gains in lean mass, bench press strength, and leg press strength compared with the placebo group, suggesting that creatine may be especially valuable precisely at the stage of life when muscle loss accelerates and cellular resources for regenerating tissue diminish.
The human brain is one of the most metabolically active tissues in the body, accounting for barely two percent of body weight but consuming approximately twenty percent of total energy; and neurons, the most energetically demanding cells, depend on the phosphocreatine-creatine kinase system in the same way as skeletal muscle, which explains why creatine has begun to accumulate evidence as a neuroprotective agent and cognitive enhancer.
A pilot study in patients with Alzheimer's disease found that supplementation with high doses of creatine, on the order of 20 grams daily for several months, increased brain creatine concentrations by approximately eleven percent as measured by magnetic resonance spectroscopy, and was associated with improvements in cognitive markers; although the evidence in humans is still emerging, animal models of neurodegenerative diseases consistently show that creatine delays disease progression and protects neurons from mitochondrial damage, which is one of the central mechanisms in conditions such as Alzheimer's, Parkinson's, and ALS.
One of the most surprising findings of recent research on creatine is its possible role as an adjunct in the treatment of depression, a condition that affects hundreds of millions of people worldwide and for which approximately one third of patients do not respond adequately to conventional antidepressants; studies that have combined creatine, typically four to five grams daily, with standard antidepressants have reported reductions in depressive symptoms of between 56 and 79 percent, a magnitude that frequently exceeds that of antidepressants alone.
The most plausible mechanistic hypothesis links creatine to brain energy metabolism: depression is associated with deficits in ATP production in the brain, particularly in regions such as the prefrontal cortex and the hippocampus, and creatine supplementation could restore neuronal energy availability, facilitating neurotransmitter synthesis and improving synaptic function in ways that conventional antidepressants do not directly address.
Cardiac muscle is one of the tissues with the highest concentration of creatine kinase in the body, and the phosphocreatine reserve in the heart plays a critical role in maintaining cardiac function during episodes of high metabolic demand or ischemic stress; clinical studies with creatine in the cardiovascular context have shown improvements in endothelial function, with increases in flow-mediated dilation of between 1.2 and 1.4 percent, as well as estimated reductions of 13 percent in the risk of cardiovascular events in some models.
Creatine monohydrate is the most studied form, the most economical, and the one with the strongest safety profile: decades of research in diverse populations, including children, older adults, elite athletes, and patients with chronic diseases, have not identified significant adverse effects in people with normal kidney function, with a transient increase in body weight from intracellular water retention being the most common side effect and, for most goals, actually a desirable one.
The standard supplementation protocol includes an initial loading phase of 20 grams daily divided into four doses for five to seven days, followed by a maintenance phase of three to five grams daily; although the loading phase speeds up muscle saturation, it is equally effective to start directly with three to five grams daily and reach saturation in three to four weeks.
⏱ 4 min read | Tags: Cardiovascular, Heart disease
Creatine is one of those compounds that most people associate exclusively with gyms and muscle gain, but science has been accumulating evidence for years that its range of action is much broader than was thought, reaching, unexpectedly, the cardiovascular system and the health of blood vessels.
The endothelial tissue lining the inside of our arteries and capillaries expresses creatine, phosphocreatine, specific creatine transporters, and creatine kinase enzymes, a whole molecular arsenal whose main function is to maintain vascular tone and regulate endothelial integrity through the continuous supply of high-energy phosphates to ion channels.
Creatine acts as a direct antioxidant, scavenging free radicals and reducing the oxidative stress that damages the endothelium; it increases nitric oxide bioavailability by decreasing the reactive oxygen species that hinder its synthesis; and it supports endothelium-derived hyperpolarizing factors, which are crucial for regulating vasodilation and blood flow.
In addition to its role as an antioxidant and nitric oxide modulator, creatine reduces neutrophil adhesion to endothelial cells, stabilizes cell membranes through interactions with phospholipids, and may lower serum levels of triglycerides, total cholesterol, and LDL while raising HDL, all of which translates into lower vascular permeability and better tissue perfusion.
An especially relevant aspect is creatine's ability to protect mitochondrial DNA from oxidative damage and mutagenesis, something that becomes important in cells with high energy demand such as endothelial cells, where mitochondrial deterioration is one of the first signs of vascular aging.
A randomized trial with twelve men and women about 59 years old evaluated the effect of creatine supplementation for 28 days, with a loading phase of 20 grams daily for five days followed by a maintenance phase of 5 grams a day, measuring endothelial function in both large arteries and smaller vessels using established vascular assessment techniques.
The results were significant: macrovascular endothelial function improved by 1.2% and microvascular by 1.4%, a magnitude of change that in the epidemiological literature is associated with a 13% reduction in the risk of a major cardiovascular event, such as a myocardial infarction or a stroke.
In the same trial, although creatine did not modify oxidative stress biomarkers, it did lower fasting glucose from 103 to 99 mg/dL, taking participants out of the prediabetes range, and lowered triglycerides from 100 to 84 mg/dL, two classic cardiovascular risk factors that do not usually improve with supplements other than those specifically lipid-lowering.
In another study in older men, supplementation with 20 grams daily of creatine for only seven days reduced the cardio-ankle vascular index, a measure of arterial stiffness, and produced a nonsignificant trend toward a reduction in systolic blood pressure of 8 mmHg, suggesting that both acute and prolonged supplementation may exert positive effects on vascular parameters.
Creatine is not a cardiovascular supplement in the traditional sense of the term, and there are variables it does not improve, such as blood pressure, arterial stiffness (consistently), or the complete lipid profile, but the magnitude of the effect observed on endothelial function is relevant enough that anyone who already takes creatine for its muscular or cognitive benefits should know they are probably getting an additional benefit for the heart.
The available evidence suggests that, in addition to making muscles stronger and maintaining cognitive function, creatine may have beneficial side effects on the heart and blood vessels without the adverse effects that accompany many cardiovascular drugs, something that deserves further investigation in larger and longer clinical trials.
Information, not medical advice. Scientific evidence reflects the quality of the studies.