What’s New with Creatine?

Creatine is one of the top-selling supplement products on Amazon – we know consumers are using it. As we head into spring, work out regimens for summer start to ramp up. This is a good time to review the evidence. Here’s the latest from our recent creatine update.

It’s no surprise that creatine is popular in the sports arena – the most supportive evidence on its use is for athletic performance and muscle strength. When it comes to athletic performance, it seems to benefit some sports more than others. For example, research shows that taking creatine monohydrate by mouth somewhat improves rowing, jumping, and soccer performance. But evidence on whether it benefits other sports is unclear, including sprinting, cycling, swimming or tennis. A recent meta-analysis of randomized controlled trials in trained athletes is further contributing to these mixed findings. It shows that taking creatine up to 20 grams by mouth daily for 5-42 days doesn’t improve endurance running or cycling when compared with control.

As for muscle strength, the overall evidence is more consistent. Meta-analyses of research in the general adult population show that taking creatine by mouth with or without resistance training seems to improve upper limb strength and lower limb strength. There’s also been research on using topical creatine, but the evidence on this is more mixed.

If patients want to give it a try, advise them to keep loading doses (the first 5-7 days) under 25 grams daily. And to reduce the dose to 5 grams daily if they plan to use it longer-term. Also make sure they drink lots of water – dehydration is one of the biggest concerns with creatine use. Lastly, you might get questions about which form of creatine is best: creatine monohydrate or creatine nitrate. Tell patients that most research has been done on creatine monohydrate, so it’s best to stick with that for now. Creatine nitrate has been claimed to produce higher concentrations of creatine in the muscles at a lower dose than creatine monohydrate, but clinical evidence doesn't support this.

Check out our recently updated monograph to learn more.