*RR : REM RECOMMENDED

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What is Creatine?

Creatine is a nitrogenous organic compound synthesized from arginine, glycine, and methionine. It is stored mainly in skeletal muscle, cardiac muscle, and neurons where it plays a vital role in rapid ATP regeneration during high-intensity activities. Supplementation with creatine monohydrate enhances muscle phosphocreatine stores, improving performance and lean mass development.

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How Does Creatine Work?

Creatine increases intramuscular phosphocreatine levels, enhancing ATP resynthesis via the bidirectional creatine kinase reaction. This supports muscular contractions, particularly during anaerobic, high-intensity activities (e.g., weight training, sprints, etc.), during which your muscle cells are rapidly utilizing and diminishing their ATP. The extra phosphocreatine stored in muscles, brain, and heart can be used to rapidly generate extra ATP in physiologic situations that require more energy, like exercise or sports. Think of phosphocreatine as an energy reservoir or buffer to maintain sufficient ATP levels to meet the cell's energy demands. ​

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Key Benefits

• According to the International Society of Sports Nutrition (ISSN) and numerous peer-reviewed scientific sources, creatine monohydrate is the most extensively studied and validated dietary supplement. It is recognized as the most effective and safe ergogenic nutritional aid available for athletes, with a well-established ability to enhance high-intensity exercise capacity and performance (Kreider et al., 2017).

• Creatine can be used by athletes in various sports to improve exercise capacity and support muscular physiologic adaptations such as muscle hypertrophy and strength gains.

• Over time, consistent creatine supplementation can lead to:

  • Increased physical strength

  • Enhanced lean muscle mass

  • Improved exercise capacity and performance

• These benefits are supported by consistent evidence from randomized controlled trials (RCTs) and meta-analyses.

• Enhanced recovery: Creatine can help reduce muscle damage and post-workout inflammation 

• Emerging evidence: New studies are beginning to show that creatine may also have positive impacts on certain medical conditions, and may offer some cognitive, neurological, and psychological benefits. (Nima Norbu Sherpa et al., 2025; Avgerinos et al., 2018; Rawson & Venezia, 2011)

• Long-term safety: Long-term creatine use has been shown to be safe even in older patients with underlying medical conditions. (Bender et al., 2008)

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Recommended Forms

• Creatine Monohydrate: Extensively studied form. Gold standard form due to known bioavailability, efficacy, and safety. (Krieder et al., 2022) * RR

• Micronized Monohydrate: Improved solubility in fluid, same effectiveness as creatine monohydrate.

• Creatine HCl: Enhanced solubility but less validated efficacy and safety.

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Dosage Protocols

Loading Strategy

• Dose: 20 g per day, divided into 4 doses (or approximately 0.3 g/kg/day)

• Duration: 5 to 7 days

• This approach has been shown to rapidly increase muscle creatine concentrations by up to 20% within 6 days (Hultman et al., 1985).

• Alternatively, the same 20% increase in muscle creatine can be achieved by taking 3–5 g per day for 28 days.

• After the loading phase, 2–5 g per day is sufficient to maintain elevated creatine levels (Preen et al., 2003).

 

Daily Maintenance Strategy

• Dose: 3–5 g per day (or 0.03 g/kg/day)

• Duration: Minimum of 28 days if skipping the loading phase

• Consistent use of 3–5 g daily can increase total muscle creatine stores by about 20% after 28 days (Hultman et al., 1985).

• This dose can be continued indefinitely to maintain elevated creatine concentrations after a loading phase.

Notes on Strategy

• Loading is not required for all individuals—it depends on personal goals.

• Athletes needing rapid ergogenic effects (<30 days) may benefit from a loading protocol.

• For those using creatine long-term (>30 days), starting with the maintenance dose may be more practical and equally effective over time.

• No cycling is required. Creatine monohydrate is considered safe for continuous use (NIH Office of Dietary Supplements).

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⚠️ Safety and Considerations

• Creatine is the most validated supplement in terms of safety. Since its introduction to the supplement market in the early 1990s, vast research has demonstrated no significant adverse effects in healthy individuals and even in certain patient populations.

• Creatine may also be safe for use in both pediatric and geriatric populations. Several studies have shown no negative impact on kidney function in healthy individuals, as well as in people with select medical conditions.

• While the existing body of evidence suggests that creatine is likely safe for individuals with pre-existing kidney disease, pregnant or lactating women, and adolescents under 18, it is always advised to consult with a licensed healthcare provider before starting any supplement regimen

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The following evidence-based conclusions were published by the Journal of the International Society of Sports Nutrition (ISSN) regarding the safety, effectiveness, and common misconceptions of creatine supplementation:

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• "Creatine supplementation does not always lead to water retention.

• Creatine is not an anabolic steroid.

• When taken at recommended dosages, creatine does not result in kidney damage or renal dysfunction in healthy individuals.

• Most available evidence does not support a link between creatine supplementation and hair loss or baldness.

• Creatine does not cause dehydration or muscle cramping.

• Creatine appears to be generally safe and may be beneficial for children and adolescents.

• Creatine supplementation does not increase fat mass.

• Daily low-dose supplementation (3–5 g/day or ~0.1 g/kg body weight) is effective, and a loading phase is not required.

• Creatine paired with resistance training yields the greatest musculoskeletal and performance benefits in older adults, though creatine alone still provides some benefit.

• Creatine is beneficial across a wide range of athletic and sporting activities.

• Females also benefit from creatine supplementation throughout various life stages.

• No alternative form of creatine has been shown to be superior to creatine monohydrate." (Antonio et al., 2021)

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Final Remarks

• At REM Fitness, we believe that supplementation—like training and nutrition—should be informed, intentional, and individualized. Creatine monohydrate stands out as one of the most effective and well-researched supplements available today. It has a strong safety profile, a proven track record in enhancing performance, and growing evidence for broader health benefits.

• That said, no supplement is one-size-fits-all. Before starting any new supplement, it’s important to consider your personal health status, goals, and lifestyle.

• Always consult with a licensed healthcare provider before beginning any supplementation regimen, especially if you have a medical condition, are under 18, pregnant, or breastfeeding. Stay informed. Stay consistent. And make decisions that align with your long-term health and performance.

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Disclaimer

This information is intended for educational purposes only and is derived exclusively from peer-reviewed sources and government databases. It should not replace individualized medical advice. Consult a qualified healthcare provider before initiating creatine supplementation, especially in the presence of pre-existing health conditions.