How Does Creatine Monohydrate Supplementation Work?

January 22, 2019

Creatine monohydrate is one of the most well-researched supplements in the sport nutrition supplement industry.

Multiple training studies have shown that groups who supplemented creatine monohydrate gained more muscle and/or strength than groups who didn’t.

Volek et. Al, 1999
Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training.

So, how does creatine monohydrate supplementation work?

Muscular work requires the use of energy in the form of adenosine triphosphate (ATP). Since only enough ATP is stored at rest for a few seconds of muscular work, various bioenergetic pathways which utilize energy-rich substrates are utilized by muscle cells to produce/replenish ATP for muscular work.

One of the substrates used during muscular work to replenish ATP is phosphocreatine (PCr). PCr can donate its phosphate to an ADP molecule to form ATP. This reaction occurs nearly immediately coincident with the onset of exercise. This reaction is vital to high power production between 1- ~30 seconds of muscular work. Thus, this bioenergy system is very important for strength athletes.

However, PCr is stored to a limited extent in muscle cells.

Creatine monohydrate supplementation can increase muscle PCr stores to maximal levels if completed regularly. This can prolong the amount of time that maximal or near maximal forces can be produced utilizing the ADP-PCr reaction, thereby potentiating an individual’s ability to produce high power output for longer.

For example, instead of doing 5-6 reps with 85 % 1RM during a set, one might be able to do 7-8 reps after saturating muscle PCr stores, thereby allowing someone to train with higher volumes over time by comparison.

Also, creatine monohydrate supplementation has been shown to enhance the expression of muscle proteins involved in signaling satellite cell proliferation and differentiation which may potentiate one’s ability to recover from resistance training and hypertrophy.

A general recommended dosing strategy is to load creatine monohydrate for 5-7 days at ~20g per day separated into 3-4 doses of ~4-5 grams, followed by a maintenance dose of ~5g/day, while also ensuring appropriate fluid intake.

However, Buford et al. proposed a 3 day loading phase of 0.3 g/kg body mass/day followed by 3-5 g/day as a maintenance dose in the International Society of Sport Nutrition’s Position Stand in 2007.