Do you need to do a loading phase with creatine?
A loading phase is not necessary, but it does speed up the build-up of creatine in your muscles. Choose a loading phase if you want fast results, or simply take 3 to 5 grams daily if you have more patience.
A loading phase is not required. You can simply start creatine at 3 to 5 grams per day, without a loading phase, for at least 8 to 12 weeks if you are training for muscular strength. The label should read 'creatine monohydrate': that is the only form you need, whether in powder or capsule form. More expensive variants such as HCl or citrate offer no proven advantage.
A loading phase of 20 grams per day for five days fills your muscles more quickly: creatine stores rise by between 16 and 25 percent. Those who also consume carbohydrates see the largest increase. After those five days, 3 to 5 grams per day is sufficient as a maintenance dose to sustain that level for six weeks. Choose a loading phase if you want fast results; if you have more patience, you can get there without one.
In older adults who do strength training, an analysis showed that creatine with a loading phase improved bench press performance significantly more than a placebo. Once studies that included a loading phase were excluded, that advantage for bench press and leg press performance disappeared. Whether a loading phase is truly necessary in older adults therefore remains an open question. If you are taking creatine as someone aged 55 or older, stick with it for at least 12 weeks. One thing that does not matter: whether you train on land or in water makes no difference to the effect.
Creatine monohydrate is safe at recommended doses. The most commonly reported complaint is temporary water retention at the start. At doses higher than recommended, or when combined with other supplements, liver and kidney problems have been reported in a small number of cases; do not exceed the recommended amount without consulting a doctor. How creatine behaves with years of continuous use has not yet been well studied. If you have kidney disease or are taking medications that place a burden on the kidneys, discuss use with your doctor first. Note: several authors of the studies on creatine are advisors to, or have received donations from, a creatine manufacturer; bear that in mind when reading their conclusions.
Based on a randomised study (PMID 12660409), a meta-analysis (PMID 34199420), two reviews (PMID 23851411, 33557850), and additional reviews on safety and performance (PMID 10609446, 15707376).
What is best not to combine with creatine?
Combining creatine with caffeine powder adds nothing to your performance and increases the risk of gastrointestinal complaints; ready-made pre-workout blends with many ingredients carry additional risks due to possible contamination and unknown long-term effects.
Does creatine cause hair loss?
Current research shows that creatine does not raise DHT and has no effect on hair follicle health. There is no need to avoid creatine out of fear of hair loss.
Why don't doctors always recommend creatine?
Creatine monohydrate is well supported for strength sports and its safety profile in healthy adults is reassuring, but safety data for children and teenagers are lacking and some proven applications are more limited than the marketing suggests.
Does creatine put a strain on your kidneys?
For healthy people without kidney disease, creatine monohydrate at normal doses is not harmful to the kidneys, although it can raise a blood marker that resembles signs of kidney problems. If you have diabetes, high blood pressure, already reduced kidney function, or are taking medications that are hard on the kidneys, discuss it with your doctor first.
What is the best way to use creatine?
Creatine works best in combination with strength training: optionally start with a loading phase of 20 grams per day for 5 days and then maintain with 2 to 5 grams per day. If you have a kidney condition, discuss it with your doctor first.
How many grams of creatine per day is worthwhile?
For muscle strength and explosive performance, 3 to 5 grams of creatine monohydrate per day has a clear effect; a loading phase is convenient but not obligatory. For other goals the evidence is thinner, but safety for healthy adults is reasonably well supported.