Creatine Monohydrate Supplementation: Myths, Facts, and Useful Advice

Key Points of Creatine Monohydrate Supplementation

• Creatine monohydrate supplementation is scientifically confirmed as one of the safest and most powerful dietary supplements for enhancing physical performance and muscle growth.
• Although many people feel that creatine monohydrate supplementation is unsafe, studies bust false ideas about creatine causing negative effects, including renal damage, hair loss, and dehydration.
• For groups like vegetarians, senior citizens, and those healing from injuries, certain advantages of creatine monohydrate are clear-cut.

Among the most investigated and often utilized supplements available in the field of fitness and health is creatine monohydrate. Still, its reputation suffers from myths and misunderstandings, even with its obvious advantages. Published in the Journal of the International Society of Sports Nutrition, two recent studies—”Common Questions and Misconceptions about Creatine Supplementation“¹ and its follow-up, “Part II: Common Questions and Misconceptions about Creatine Supplementation, “² seek to clear the record. Here is a list of the most common questions covered in both review articles. Furthermore, the studies included going over more than 500 peer-reviewed publications. Examining data on creatine’s safety and efficacy, a team of worldwide experts dispelled prevalent misconceptions. For example, some of these subjects were:

Does a creatine monohydrate supplementation cause water retention?

Early research indicated that creatine causes brief water retention in loading periods. Because it attracts water into muscle cells, creatine is an osmotically active chemical that can increase muscle volume and body weight.³ Furthermore, weight gain is primarily due to increased water retention in muscle cells, which can improve muscle hydration and performance!^4,5 Although this water retention may seem undesirable, it is a natural physiological reaction that can help improve recovery and sports performance.

Does creatine monohydrate supplementation damage kidneys or induce hair loss?

Because of rising creatinine levels—a normal consequence of creatine metabolism—creatine has been erroneously blamed for kidney injury. However,  studies involving healthy people find no adverse renal effects.⁶ This indicates that although isolated instances of renal complications may occur, the general risk for healthy persons seems minimal when creatine is utilized correctly. However, before beginning a creatine monohydrate supplementation, people with pre-existing kidney issues should speak with medical professionals. Similarly, the fallacy about hair loss originates from one study showing creatine seemed to raise dihydrotestosterone (DHT), a hormone associated with hair thinning. Later studies notably failed to demonstrate a direct causative link between creatine monohydrate supplementation and hair loss.⁷

Does monohydrate supplementation timing or co-ingestion improve creatine absorption?

Unlike common wisdom, the time of creatine intake—before or after exercise—has little bearing on anything. The key to achieving the best results is regular daily dosing. In sum, for those already eating a balanced diet, combining creatine with carbohydrates or protein may improve absorption because of insulin surges; these advantages are rather slight.^8,9

Special populations: Older adults and vegetarians.

First, because they have few food sources, vegetarians usually have lower baseline creatine levels.¹⁰ Second, they might thus benefit more from supplements in performance terms. Finally, older persons also gain from creatine’s capacity to increase functional strength and offset age-related muscle loss.^11,12

Does Creatine Address Inflammation and Recovery?

Emerging data points to creatine’s anti-inflammatory qualities helping in injury or surgical recovery. Interestingly, the anti-inflammatory effect may be ascribed to creatine’s capacity to maintain cell membranes and regulate intracellular calcium levels, hence alleviating oxidative stress and proteolysis linked to muscle injury.¹³ Furthermore, Barranco-Gil et al. observed that creatine’s antioxidant qualities may enhance its anti-inflammatory effects, indicating its potential to mitigate oxidative stress during recovery from strenuous exercise.¹⁴ This is especially pertinent for athletes who endure significant oxidative stress from intense exercise, since it may result in extended inflammation and delayed recovery. Additionally, its capacity to restore cellular energy levels has shown promise in reversing muscular atrophy following immobilization.

Practical Applications: How to Optimize Creatine’s Effects

Avoid the Myths and Emphasize Facts.

Regarding creatine, data rules out anecdotes. Follow scientifically based recommendations:

1. Most people will find enough daily dosage between 3 and 5 grams.
2. Cycling or loading is not necessary.
3. Older persons and vegetarians could need somewhat greater dosages to get complete saturation.
4. Creatine can help muscles heal post-operative or injury and shorten recovery timeframes.

FAQs About Creatine Monohydrate Supplement

Can supplements containing creatine monohydrates lead to dehydration?

No. Studies indicate creatine might increase heat tolerance during exercise and does not affect hydration levels.

Are teens safe using creatine?

Indeed, even for teenagers involved in athletics, creatine is usually safe when consumed at advised levels.

Is caffeine interacted with by creatine?

While some research indicates coffee might lower the efficacy of creatine, most data supports their independent effects.

Notes

1               Antonio, J. et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition 18, 13 (2021). https://doi.org/10.1186/s12970-021-00412-w

2               Antonio, J. et al. Part II. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 22, 2441760 (2025). https://doi.org/10.1080/15502783.2024.2441760

3               Marini, A. C. B., Schincaglia, R. M., Candow, D. G. & Pimentel, G. D. Effect of Creatine Supplementation on Body Composition and Malnutrition-Inflammation Score in Hemodialysis Patients: An Exploratory 1-Year, Balanced, Double-Blind Design. Nutrients 16, 615 (2024). https://doi.org/10.3390/nu16050615

4               Peeters, B. M., Lantz, C. D. & Mayhew, J. L. Effect of Oral Creatine Monohydrate and Creatine Phosphate Supplementation on Maximal Strength Indices, Body Composition, and Blood Pressure. The Journal of Strength and Conditioning Research 13, 3-9 (1999). https://doi.org/10.1519/00124278-199902000-00001

5               Ziegenfuss, T. N. et al. Effects of a Dietary Supplement on Golf Drive Distance and Functional Indices of Golf Performance. Journal of the International Society of Sports Nutrition 12 (2015). https://doi.org/10.1186/s12970-014-0065-4

6               Baştürk, T., Ozagari, A. & Ünsal, A. The Effects of the Recommended Dose of Creatine Monohydrate on Kidney Function. Clinical Kidney Journal 4, 23-24 (2010). https://doi.org/10.1093/ndtplus/sfq177

7               Andres, S. et al. Creatine and Creatine Forms Intended for Sports Nutrition. Molecular Nutrition & Food Research 61 (2017). https://doi.org/10.1002/mnfr.201600772

8               Candow, D. G. et al. Creatine O’Clock: Does Timing of Ingestion Really Influence Muscle Mass and Performance? Frontiers in Sports and Active Living 4 (2022). https://doi.org/10.3389/fspor.2022.893714

Notes

9               Stecker, R. A., Harty, P. S., Jagim, A. R., Candow, D. G. & Kerksick, C. M. Timing of Ergogenic Aids and Micronutrients on Muscle and Exercise Performance. Journal of the International Society of Sports Nutrition 16 (2019). https://doi.org/10.1186/s12970-019-0304-9

10            Blancquaert, L. et al. Changing to a Vegetarian Diet Reduces the Body Creatine Pool in Omnivorous Women, but Appears Not to Affect Carnitine and Carnosine Homeostasis: A Randomised Trial. British Journal of Nutrition 119, 759-770 (2018). https://doi.org/10.1017/s000711451800017x

11            Davies, T. W. et al. Creatine Supplementation for Optimization of Physical Function in the Patient at Risk of Functional Disability: A Systematic Review and Meta‐analysis. Journal of Parenteral and Enteral Nutrition 48, 389-405 (2024). https://doi.org/10.1002/jpen.2607

12            Candow, D. G., Vogt, E., Johannsmeyer, S., Forbes, S. C. & Farthing, J. P. Strategic Creatine Supplementation and Resistance Training in Healthy Older Adults. Applied Physiology Nutrition and Metabolism 40, 689-694 (2015). https://doi.org/10.1139/apnm-2014-0498

13            Northeast, B. & Clifford, T. The Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention Trials. International Journal of Sport Nutrition and Exercise Metabolism 31, 276-291 (2021). https://doi.org/10.1123/ijsnem.2020-0282

14            Barranco-Gil, D. et al. High-Dose Short-Term Creatine Supplementation Without Beneficial Effects in Professional Cyclists: A Randomized Controlled Trial. Journal of the International Society of Sports Nutrition 21 (2024). https://doi.org/10.1080/15502783.2024.2340574