The supplement with the most accumulated human evidence (+700 RCTs). Universally recommended by Attia, Patrick, Huberman. Benefits in strength, muscle mass, bone density, cognitive function and sarcopenia prevention. Women appear to benefit more than men.
8Creatine appears in 8 protocols personalizable→Endogenous compound (hepatic synthesis) + dietary (1-2 g/day from meat/fish). 95% stored in muscle as phosphocreatine · rapid ATP reserve.
Creatine is a nitrogenous compound synthesized endogenously (1 g/day by liver and kidneys from arginine, glycine and methionine) and obtained from diet (meat and fish · ~1-2 g/day in omnivores · practically 0 in vegans).
95% of body pool (~120 g in 70 kg man) is in skeletal muscle as phosphocreatine. Function: phosphate donor to regenerate ATP in high-intensity/short-duration exercise (sprint, lifting, jumping). Also present in brain, supporting cognitive function under energetic stress (sleep deprivation, advanced age).
Supplementing creatine raises muscle pool 20-40% · effect: more reps at same load, faster recovery, greater lean mass. In elders: sarcopenia prevention + strength improvement + fall risk reduction. In post-menopausal women: significant bone effects.
5 pivotal studies · recent meta-analyses on cognition, sarcopenia and body composition.
| Study | Finding | Hallmarks |
|---|---|---|
Creatine and adult cognitive function Xu et al · Front Nutr 2024 | Meta 16 RCTs · n=492 adults · 5 g/day × 6-24 weeks · memory improvement (SMD 0.31), processing speed (SMD 0.28). Greater effect in elders 66-76 (SMD 0.88) and sleep deprivation. | CognitionMito |
Creatine + resistance training in sarcopenia Prokopidis et al · Nutr Rev 2023 | Meta 22 RCTs · n=721 adults ≥50 years · creatine + strength training 12+ weeks: +1.4 kg lean mass, +5.3 kg bench press, +12% walking speed vs exercise alone. | SarcopeniaMuscle |
Creatine and bone health in postmenopausal women Chilibeck et al · Med Sci Sports Exerc 2015 | 2-year RCT n=47 postmenopausal women · 0.1 g/kg creatine + strength training · preserved femoral mineral density, improved diaphyseal femur geometry (fracture predictor). | BoneWomen |
Safety review · 30 years clinical use Antonio et al · J Int Soc Sports Nutr 2021 | Qualitative review 685 studies · zero renal/hepatic/cardiac red flags at 3-30 g/day doses up to 5 years. Kidney damage myths NOT supported by literature. | SafetyLong-term |
Creatine and mild cognitive impairment Forbes et al · Nutrients 2022 | Analysis 14 MCI RCTs · 5-20 g/day creatine improves cognitive tests · especially robust effect in vegetarians (lower baseline muscle creatine) and elders >70 years. | MCIVegetarians |
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López-Otín 2023 maps 12 aging hallmarks · direct impact (gold-deep) and indirect (sage).
5 g/day sustained · no loading phase needed · no cycling · timing irrelevant (saturation matters, not within-day timing).
Complete muscle saturation in 28 days with sustained 5 g · no need for loading phase (20 g × 5 d) which causes GI distress in ~30%. Dissolve in water or smoothie. Timing irrelevant: post-workout, morning, evening · doesn't matter.
No cycling · no breaks · no need to increase. Body regulates and excretes excess. Men >90 kg may need 7 g/day.
0.1 g/kg covers higher baseline + reduced endogenous synthesis with age. For 70 kg = 7 g/day. Especially useful in sarcopenia + bone density (postmenopausal women).
Only under supervision · doses used in MCI cognition RCTs. Increasing brain pool requires 2-4 weeks · 30% brain PCr saturation with 20 g/d × 7 d (Dolan 2021). Return to maintenance after.
Only monohydrate has solid human evidence. Other forms are marketing without comparative RCTs.
Single relevant criterion: Creapure® certification (purity ≥99.95%). Creapure® brand is owned by AlzChem GmbH · licensed to final brands.
Dose: 5 g elemental/day (1 scoop)
Form: Creapure® pure monohydrate
Cert.: NSF Certified for Sport · GMP · third-party tested
Fillers: Zero · only creatine · no flavors
Dose: 5 g elemental/day (1 scoop)
Form: Creapure® monohydrate
Cert.: Informed Sport · GMP
Fillers: Zero · pure micronized powder
Dose: 5 g elemental/day
Form: Micronized monohydrate (not Creapure®)
Cert.: GMP · Informed Sport
Fillers: Zero · 100% monohydrate
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Biomarkers are indirect (muscle saturation requires biopsy · not practical). Indicators: mass gain, strength, cognitive performance.
Lean mass (DEXA). Typical increase +1-2 kg in 12 weeks with training + creatine vs training alone. DEXA available ~80-120 € in Spanish private clinics.
1RM in compound exercises. Increase +5-10% bench press, squat, deadlift in 12 weeks with training + creatine (Prokopidis 2023 meta).
Cognitive test (episodic memory). If taking for cognition · measure before/after with MMSE or specific tests · detectable change in 6-8 weeks in elders 60+ or sleep deprivation.
Serum creatinine (NOT toxicity marker). Creatinine may rise slightly with supplementation (it's the degradation byproduct) · DOES NOT indicate renal damage · if your doctor worries, request cystatin C instead (unaffected).
DEXA is the gold-standard for measuring lean mass · visceral fat · bone density. One pre-supplementation measurement + another at 12 weeks shows real effect. We verify clinics in-situ.
Excellent safety profile · contraindications limited to specific renal conditions.
4 combos with RCT or confirmed mechanism · creatine is a puzzle piece, not the sole solution.
Classic exercise combo · creatine (fast ATP) + beta-alanine (lactate buffer via carnosine) cover two complementary energetic systems. RCT Hoffman 2008 showed additivity.
HMB (β-hydroxy-β-methylbutyrate) reduces muscle catabolism · combo with creatine (anabolism) in elders sarcopenia improves lean mass +50% vs each alone (Wilson 2014).
Post-workout combo · creatine + 25-40 g whey maximizes muscle protein synthesis (MPS). Workout timing matters for whey · not for creatine.
Insulin improves muscle creatine uptake · taking with carbs (banana, date, smoothie) increases saturation 13% per Steenge 2000. Useful in loading phase, irrelevant in maintenance.
8 myths vs reality · answers based on literature, not gym folklore.
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