Do you need to do a loading phase with creatine?

A loading phase of 20 grams of creatine per day for five days rapidly and measurably increases the creatine stores in the muscles: the rise is between 16 and 25 percent. Those who add carbohydrates to that loading phase see the greatest increase. After those first five days, small maintenance doses of 2 to 5 grams per day are sufficient to sustain that level for six weeks.

A loading phase is not mandatory, however. Those who take 3 to 5 grams of creatine daily without a loading phase will ultimately reach a comparable saturation level in the muscles. It simply takes longer -- typically several weeks rather than five days. If you want quick results, a loading phase is worthwhile. If you have more patience, you will get there without one as well.

In older adults who engage in strength training, a meta-analysis found that creatine with a loading phase significantly improved bench press strength more than a placebo did. Once studies that included a loading phase were removed from that analysis, the benefit for bench press and leg press strength disappeared. Whether a loading phase is truly necessary in older adults therefore remains an open question; the results are not clear-cut.

Regarding side effects: creatine monohydrate is considered safe at recommended doses. Temporary water retention at the start of supplementation is the most commonly reported complaint. In some cases, liver and kidney problems have been reported at doses higher than recommended or when combined with other supplements. How creatine behaves with years of continuous use has not yet been thoroughly studied.