Creatine: The One Supplement That's Almost Always Justified

Out of hundreds of sports supplements on the market, creatine monohydrate is one of the very few with genuinely convincing evidence accumulated over three decades of research. The position of the International Society of Sports Nutrition (Kreider et al., 2017) is direct: creatine monohydrate is the most effective ergogenic supplement available for increasing high-intensity work capacity and muscle mass during training.

The mechanism involves no magic: creatine increases muscle stores of creatine phosphate — the fast fuel for ATP resynthesis during short, powerful efforts. In practice that means 1-2 extra reps in heavy sets and slightly faster recovery between them. Creatine doesn't grow muscle by itself — it lets you do more quality work, and the work drives the growth. Expecting results without training is pointless.

The dosage is simpler than it's sold: 3-5 grams of monohydrate per day, every day, regardless of training days or time of day. A loading phase (20 g/day for a week) speeds up muscle saturation from 3-4 weeks to one, but doesn't change the final level — it's an option for the impatient, not a requirement. No cycling needed either: there's no data supporting breaks.

The form — monohydrate only. Hydrochlorides, ethyl esters and "buffered" versions cost more and have never shown superiority over monohydrate in any quality comparison. Paying extra for the form means paying extra for marketing.

On water: creatine does increase water content in muscle cells — that's intracellular water, part of how the supplement works, not "bloat" under the skin. Gaining 1-2 kg in the first weeks is normal, and it isn't fat. For weight-class sports that's a planning factor; for everyone else it's neutral or positive.

On kidneys: in healthy people, long-term observations find no harm from standard doses. The myth grew from the fact that creatine raises creatinine — the marker used to assess kidney function. A creatine-driven rise in the marker doesn't mean kidney function is declining, but do tell whoever interprets your labs that you take it. With diagnosed kidney disease, the question goes to a doctor, not to internet articles.

A nuance that rarely gets airtime: the response to creatine is individual. People with naturally high creatine stores (usually from a meat- and fish-rich diet) will see a smaller effect, and 20-30% of people are low responders. A month of use with a training log will show your case: if heavy sets got 1-2 reps longer — it works; if after 6-8 weeks there's no difference in the numbers, your skepticism is earned.

Bottom line: if you train with weights and are considering supplements, the priority order is simple — first protein intake and sleep squared away, then creatine monohydrate at 3-5 g per day, and only then everything else. Most of the other jars on the store shelf don't deserve a place on that list at all.