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The Complete Guide to Creatine


Creatine is a naturally occurring organic compound produced in the body and also found in meat and fish. It helps your muscles recover and can help you develop explosive strength by supplying energy to muscle and nerve cells.

jason.lengstorf / flickr

How Creatine Works

When a strength athlete supplements with creatine, he or she is simply maximizing their main fuel reserve in the form of muscle creatine and creatine phosphocreatine. Think of creatine supplementation as carbohydrate loading for the strength athlete.

A paper published in the Journal of Pharmacological Reviews defines creatine as, “a naturally occurring compound obtained in humans from endogenous production and consumption through the diet.” When we consume meat and fish we also consume creatine. Does this mean vegetarians have no creatine in their body? No. Our body can synthesize creatine within the liver and pancreas from several amino acids including glycine, arginine and methonine. Once creatine is consumed or synthesized, 95 percent is transported to the skeletal muscle. It is within the skeletal muscle that creatine aids in energy metabolism.

During short intense bouts of exercise, such as sprinting, jumping and weight lifting, our body primarily relies on the phosphagen energy system. The fuel provided by this energy system is named ATP or adenosine “tri” phosphate. The name indicates ATP contains a compound named adenosine and three phosphates. Think of these phosphates as the three stooges: Moe, Curly and Larry.

As a trio the stooges are extremely funny and effective at producing a laugh. However, as individuals their effectiveness diminishes. When ATP is utilized to fuel intense activity one of the phosphates (We will say “Moe”) is separated from the group. Now just imagine the three Stooges minus Moe. Without the ring leader giving a good head butt or strategic eye poke the comedy is extremely diminished along with the effectiveness of the comedic group. So how do we reunite the lost phosphate (Moe) with the group? This is where creatine comes into play. Creatine has the ability to bind with the lost phosphate (Moe) creating phosphocreatine. Then phosphocreatine, with the help of an enzymatic reaction, can deliver Moe back to Curly and Larry reuniting the group and re-synthesizing ATP.

Now we know that creatine is a naturally occurring compound which plays an integral role in energy metabolism. So why can’t we just eat meat and fish, not worry about supplementation, and revel in the performance enhancing effects of creatine? The average person, through their diet and endogenous synthesis, stores about 120 grams of creatine within their skeletal muscle. However, we have the capacity to store about 160 grams of creatine. By saturating the skeletal muscle, with supplemental creatine, Moe’s separation time from the group is greatly diminished. This ample supply of phosphocreatine results in an increased capacity to perform strength/power-based exercise.

The Impact of Creatine

Let’s dive deeper into the performance enhancing effects by examining a creatine review compiled by some of the leading researchers in the field and published in the Journal of the International Society of Sports Nutrition. Their review of the literature found that roughly 70 percent of all studies involving creatine produced a statistically significant improvement in exercise capacity. The remainder of the studies showed slight performance improvements that were not statistically significant. In fact, no study showed detrimental effects on performance. For short term supplementation they reported average increases of:

  • 5-15% in maximal power/strength
  • 5-15% in work performed during sets of maximal power/strength
  • 1-5% in single effort sprint performance
  • 5-15% in work performed during repetitive sprint performance
  • 1-2 kilogram weight gain most likely from increases in total body water

For long-term supplementation they reported:

  • 5-15% greater gains in strength and performance
  • Body mass/LBM gains two times that of placebo groups (evidence of lean body mass gains in addition to total body water gains)

Based on the aforementioned researchers’ extensive review of the literature, creatine supplementation improves both performance and capacity in strength/power based exercise. It also appears to aid in lean body mass gains.

This seems too good to be true, right? There have to be some side effects. On the contrary, to date there are no scientific based side effects of proper creatine supplementation aside from weight gain. For most this weight gain would not be considered a negative side effect because the research supports gains in lean body mass and no reduction in performance.

Is Creatine Right for You? 

Creating healthy eating habits will produce the best results, not relying on supplements. But if you’re training hard and seeing results, you may want to consider adding a little creatine to complement your healthy diet after the first 6 to 12 weeks of your training program. It’s similar to carbohydrate in that it’s stored in the muscles and its level fluctuates. We do not recommend creatine to athletes under the age of 18 due to the lack of peer-reviewed, scientific research on the substance in this age group.

It’s most effective to take create in 3-week cycles, alternating between three weeks of taking it and three weeks without. Take 3 to 5 grams of creatine per day, ideally first thing in the morning on an empty stomach. If you work out in the morning, you could add it to your pre-workout shake.

Vegetarians and Creatine

Since creatine is only found in animal products, vegetarians have lower levels of creatine than those who eat meat. Vegetarians should consider supplementing 5 grams of creatine a day. As a vegetarian, you will also have to pay special attention to make sure you are getting the protein that you need. You may want to consider using 6 grams of essential amino acids after your training sessions in conjunction with 35 to 70 grams of carbohydrate. Also, make sure to take some type of essential fatty acid supplement, calcium, and a multi-vitamin to make up for any other lacking vitamins and minerals.

Myths About Creatine

One of the most frequently asked questions we receive from athletes, coaches, and parents is: “Should I take creatine?” More often than not there is a hint of doubt and skepticism in their voice. Despite years of research including more than 200 peer reviewed studies supporting the safety and ergogenic effect of this supplement, there are still many creatine myths being perpetuated. These myths include but are not limited to: creatine causes dehydration, cramping, muscle strains/pulls, and kidney problems. Unfortunately, anecdotal evidence and the modern media have helped keep these myths alive and well. It is very disheartening to hear creatine supplementation vilified and even compared to the use of illegal anabolic agents.

A review article published online in the British Journal of Sports Medicine does an excellent job refuting the common myths associated with creatine. Their review of the literature resulted in no scientific based evidence for creatine supplementation leading to cramps, dehydration or renal stress. In fact, they cited research to support that creatine supplementation may aid in hydration and performance in hot/humid temperatures. Several of the reviewed studies showed that creatine increased total body water (proportionally among intra and extra cellular compartments) and aided in the maintenance of blood plasma volume. As a result, it can be argued that athletes supplementing with creatine are at no greater risk of dehydration or cramping than their counterparts, and in fact may be better prepared for performance.

Caffeine and Creatine

Most sports nutritionists would agree that there is strong support in the research for the ergogenic effects of both creatine and caffeine when used independently. But there have been several studies used to make the claim that coffee/caffeine negates the ergogenic effects of creatine. These studies showed no performance differences between placebo groups and creatine/caffeine loaded groups. Interestingly enough, the studies also showed that coffee/caffeine did not hinder the muscle absorption of creatine.

These two findings seem to conflict each other. If coffee/caffeine does not hinder the absorption of creatine, why don't both studies show increased performance in the caffeine/creatine trials? The answer could lie in the design of the studies. Both utilized a crossover design — meaning that the same subjects were used for all trials. There is nothing wrong with this design as long as there is adequate time between trials to eliminate the ergogenic effects of creatine (about four weeks).

Unfortunately, neither study provided an adequate time period between trials. This means that the ergogenic effects of creatine could have influenced both trials, which could explain the conflicting findings of both studies.

Some would also argue that caffeine containing beverages such as coffee cause dehydration, leading to decreased performance that could negate the positive effects of creatine. However, there is evidence in the research that caffeine containing beverages, when combined with water and used in moderation, do not impair hydration status.

The best way to address this potential problem is to go by how you individually respond to caffeine and to closely monitor your hydration status. If your urine resembles lemonade, then there is good chance that you are hydrated. If your urine resembles apple juice, then chances are you are not hydrated.

Creatine Supplementation Tips

  1. Look for a reliable and safe product that is NSF certified. 
  2. Choose products which provide creatine monohydrate. Be wary of other formulations such as creatine ethyl ester.
  3. Take 3-5g /day with about 30g of easily digested carbohydrate prior to strength/power based workouts.
  4. Younger athletes (<18) should focus on proper food and hydration choices and leave supplementation for the years to come.

Other Benefits  

To Battle Depression

Creatine may even help treat depression by speeding up and improving women's response to anti-depressants. In a small study published in the American Journal of Psychiatry, 52 women with major depressive disorder were given an antidepressant along with either creatine supplements or a placebo. Those who were given creatine supplements showed significantly higher improvement rates than those who were given a placebo.

Originally published January 29, 2009. Updated August 6, 2015.

Tags: Supplements, Health, Build Muscle


  1. Persky A, Brazeau G (2001) Clinical Pharmacology of the Dietary Supplement Creatine Monohydrate. Pharmacol Rev 53:161-176.
  2. Buford T, Kreider R, Stout J, Greenwood M, Campbell B, Spano M et. al (2007) "International Society of Sports Nutrition Position Stand: Creatine Supplementation and Exercise." J Int Soc Sports Nutr 4:6 doi:10.1186/1550-2783-4-6.
  3. Daldo V, Roberts M, Kerksick C, Stout J (2008) "Putting the Myth of Creatine Supplementation Leading to Muscle Cramps and Dehydration to Rest." Br J Sports Med doi:10.1136/bjsm.2007.042473.