Your Guide to Creatine Monohydrate: What It Is, How to Use It and Whether It's Right for You

By Benjamin David APD

Creatine is one of the most researched sports supplements. Unlike many of the supplements on the market, it has decades of rigorous research supporting its benefits for performance and metabolism. Here's a breakdown of how creatine works: 

What is Creatine?  

Creatine is a natural compound that is produced in the body from amino acids.

It is primarily stored in muscle cells, where it plays a critical role in producing energy during short, intense bursts of exercise.

It can also be found in foods like red meat and some fish.

Creatine provides energy to support short, maximal intensity exercise. The rate of energy production from creatine is very high, but the storage capacity in the muscle is limited.

Creatine monohydrate is a supplement that can increase creatine stores and subsequently improve high-intensity exercise performance. Creatine is mostly found in the muscles as ‘free’ creatine or as phosphocreatine, where it has an essential role in powering exercise and movement.

Here is the technical explanation of how Creatine works:

• During intense exercise, your muscles rely on a molecule called ATP, which is often referred to as the body's "energy currency", to power every contraction.  

• The problem is that ATP is broken down rapidly during high-intensity effort and while the body can produce more ATP from fuel sources like carbohydrate and fat, these processes are relatively slow. 

• Phosphocreatine is responsible for quickly restoring levels of ATP in the muscle.

• Phosphocreatine provides a quick pool of energy to allow rapid restoration of ATP and, therefore, fuel for high intensity exercise.  

• Creatine only exists in small amounts in the body, enough to fuel around 8-10 seconds of high intensity activity. 

• Creatine supplementation works by topping up those stores beyond what diet alone can achieve, allowing you to sustain higher-quality efforts for longer and recover faster between them. 

The Benefits of Creatine

• Evidence around increasing muscle strength, endurance and size 

  • Research consistently shows that creatine supplementation combined with resistance training leads to greater gains in muscle strength, the ability to perform more repetitions at a given weight, and improvements in lean muscle mass over time. 

• Maximal exercise performance  

  • Creatine improves performance during short, high-intensity efforts. Particularly when those efforts are repeated. Think sprint intervals, repeated sets in the gym, or back-to-back sprints in team sport. 

• Recovery 

  • Creatine has been shown to help maintain muscle mass and strength during periods of reduced activity, such as during injury rehabilitation or immobilisation.

• Brain health 

  • A small amount of creatine is stored in the brain, where it supports energy production. Supplementation can increase brain creatine levels and has been linked to improved cognitive processing, particularly under conditions of stress such as sleep deprivation, aging or following a concussion. 

When to consider using Creatine 

Creatine is useful for a much wider range of people than most realise. Research supports its use across a variety of sports, exercise types and even non-athletic health goals. 

Below is a breakdown of how creatine applies across different types of activity.

High-intensity single max efforts < 30 secs  e.g. sprint events, resistance training

Sports that involve repeated bursts of high intensity efforts e.g. team sports, racquet sports

To support recovery in periods of loss of muscle from disuse (e.g. injury, immobilisation)

To improve cognitive processing in the brain and potentially reduced damage and enhance recovery from mild traumatic brain injury/ concussion.

How to take Creatine

There are two loading approaches:  

Fast loading (5 days) 

Take 5g, four times per day (20g total daily) for 5 days, then drop to the maintenance dose.

Slow loading (28 days) 

Take 5g once per day for 28 days, then drop to the maintenance dose. This approach achieves the same result with smaller daily doses and is a good option if you experience any stomach discomfort with higher doses. 

Maintenance dose 

After either loading approach, take 3g per day to maintain your creatine stores. Take it with a meal that includes both protein and carbohydrates, as this helps maximise creatine uptake into the muscle. 

A few practical notes: 

1 teaspoon of creatine monohydrate powder is approximately 5 g 

The washout period (time for creatine levels to return to baseline after stopping) is approximately 28 days.

Getting Creatine from Food 

Food-first principles apply to all supplements - creatine is no different. However, diet alone is not enough to raise muscle creatine to the levels needed for a performance benefit, which is where supplementation comes in. 

Creatine uptake into muscle is enhanced by insulin, so taking it alongside a meal containing both protein and carbohydrates maximises absorption.

Early research used large amounts of simple sugar to achieve this effect, but more recent evidence shows the same result can be achieved with a balanced meal containing around 50 g of protein and 50 g of carbohydrate.

Concerns and Considerations

Temporary weight gain: Creatine draws water into muscle tissue, which can cause a small increase in body weight: Approx. 1–2 kg. This is fluid retention and is part of the mechanism by which creatine works. It resolves within 4–6 weeks of stopping supplementation. For athletes competing in weight-class sports, this is worth factoring into your planning.

Gastrointestinal discomfort: A small number of people experience mild stomach upset, particularly during a loading phase. To minimise this: skip the loading phase and use the lower daily dose from the outset, take creatine with meals rather than on an empty stomach, and avoid combining it with high-fibre foods or other supplements known to cause GI issues (such as sodium bicarbonate).

What about kidney damage? This is one of the most common concerns people raise about creatine. Despite decades of research and widespread use, there is no credible evidence linking creatine monohydrate supplementation to kidney damage in healthy individuals. If you have a pre-existing kidney condition, speak to your GP or an Accredited Practising Dietitian before starting supplementation.

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Ben is an Accredited Practising Dietitian (APD) with experience supporting athletes and active individuals to optimise their nutrition for performance, recovery and long-term health. He understands that navigating the world of sports supplements can be confusing and is here to help you make evidence-based decisions that work for your goals, your sport and lifestyle.

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