Creatine Monohydrate is a naturally occurring organic acid. It is the original and likely the most effective form of supplemental creatine on a gram-for-gram basis compared to creatine malate, creatine hydrochloride, creatine ethyl-ester and others. Those other forms are sexy though, huh? Ethel and Esther were the best looking ladies at the senior strip tease last week. Creatine is stored primarily in muscle tissue, and it is used for rephosphorylating ADP into ATP [1, 2]. This means that when our muscles use up our energy stores, creatine helps to replenish those stores in a fairly rapid manner. Obviously, you can imagine the benefits creatine may present for athletes just from that information alone.
From that mechanism of action (how we nerdy scientists like to complicate the phrase “this is how this works”), it is no surprise that creatine improves repeated sprint performance, strength, and relative lifting volume . This increased strength and training volume leads athletes to not only use creatine for quick performance enhancement but also to aid their off-season training. In addition to performance benefits, creatine supplementation increases muscle mass [4-6]. Whether creatine increases muscle mass via increased strength and training volume or increases strength and training volume via increased muscle mass can be debated. It cannot be debated, however, that creatine positively augmenting anabolic hormone status  increases muscle gain. Following 8 weeks of resistance training, Saremi and colleagues confirmed creatine’s beneficial effects on body composition, and they also determined that creatine contributed to decreased levels of myostatin . Have you ever seen dogs or bulls deficient in myostatin? They are legitimate genetic freaks.
Clearly, one side effect of creatine is weight gain. That is, if you consider weight gain a side effect as opposed to a primary or desired effect. Apart from that, the claims that creatine is unsafe are largely fallacious. A connection between creatine and kidney, liver, and/or heart complications has not been affirmed . However as creatine may cause muscles to retain water, appropriate water consumption is encouraged, just as it would be in the absence of creatine supplementation. Although, even water retention has been contested in the research .
Thus, athletes in weight restricted sports may desire to be selective in timing their creatine relative to weigh-ins. For pretty much all other athletes, creatine is going to be the number one to number four choice for supplementation depending upon whether or not protein powder is classified as supplement or food and the endurance component of the sport. If we consider protein powder a food, creatine would be my first recommendation for supplementation for athletes such as football players, hockey players, body builders, sprinters, powerlifters, baseball players, and others performing activity in short bursts. For more endurance oriented athletes, I would recommend creatine after caffeine, nitrates, and maybe beta-alanine in some cases; these athletes would be soccer players, cyclists, runners, and others performing exercise in prolonged bouts.
Standard dosing for creatine is 5g/day following a loading phase of anywhere from 10-20g per day for 1-2 weeks. In actuality, creatine doesn’t need to be front loaded, as it will accumulate over time with the 5g/day dose, but loading will get your muscles to the “saturation point” faster. The saturation point is when the muscles are full with creatine and cannot hold any more of it, and the saturation point is different for different people. For example, your 130lb younger brother needs less than 250lb linebacker Clay Matthews. Timing of creatine ingestion is unclear, but it may be best consumed post-workout  with some protein and carbohydrate . Additionally, creatine does not need to be cycled. Previously, it was believed that it must be cycled to ensure the recuperation of the body’s own natural, endogenous production. Since, new information has emerged confirming that creatine supplementation will not interfere with the body’s maintenance of creatine levels, so once you’re on it, you can stay on for life. Or not, without consequence.
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