Creatine monohydrate
Summary
Creatine monohydrate is the most studied form of creatine. In meta-analyses of randomized trials, adding it to resistance training produced larger gains in strength and lean mass than placebo (grade A), with a smaller memory signal (grade B). Two-year trials found no effect on bone density. Creatine HCl has only two small trials.
Key facts
- Strength with resistance training ↑ (A); lean mass with resistance training ↑ (A); memory ↑ (B); bone mineral density ↔ (no effect)[4][5][8][10]
- 3–20 g/day creatine monohydrate (≈2.6–17.6 g creatine); 20 g/day only in 5–7 day loading phases[1][11]
- None set. The body makes about 1 g/day; meat and fish supply some[1]
- None found in our sources (NIH ODS)[1]
- Evidence table: 5 meta-analyses and 3 randomized trials, plus 1 meta-analysis and 1 trial cited as supporting evidence[4][5][6][7][8][9][10][11][13][14]
- Weight gain of about 1–2 kg in the first month, mostly water[1]
- 8 graded human outcomes on this page
- October 9, 2026
How it works
EstablishedSupplementation raises muscle creatine and phosphocreatine stores, which buffer ATP during short bursts of high-intensity work; this is the established explanation for performance effects. Proposed additional mechanisms include faster phosphocreatine resynthesis after exercise and greater training volume over time. Effects on the brain are proposed and less well characterized.[1][3][2]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Performance | Grade A | Improved | Meta-analysis · n = 1,937 · 2025 | 5 rows |
| Healthy aging | Grade B | Improved | Meta-analysis · n = 608 · 2026 | 1 row |
| Focus | Grade B | Improved | Meta-analysis · n = 492 · 2024 | 1 row |
| Bones & joints | No effect | No effect | RCT · n = 237 · 2023 | 1 row |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Muscular power and strength across lifts | Improved | Grade A | Meta-analysis · n = 1,937 · 2025 69 RCTs in adults, with various exercise programs or none Form: creatine (form not specified in abstract) · Dose: Varied across trials · Duration: Varied across trials With resistance training: bench/chest press +1.43 kg, squat +5.64 kg, vertical jump +1.48 cm, Wingate peak power +47.8 W vs placebo. No significant effect on handgrip or leg press. Benefits were clearer in younger adults and men. | 40944139 (opens PubMed)Source [6] |
| Lean body mass | Improved | Grade A | Meta-analysis · n = 1,192 · 2022 35 RCTs in adults without specific diseases, with or without exercise programs Form: creatine (form not specified in abstract) · Dose: Varied across trials · Duration: Varied across trials Overall +0.68 kg lean mass vs placebo; +1.10 kg when combined with resistance training (any age). No significant effect without exercise (+0.03 kg) or with mixed exercise. Men +1.46 kg; women +0.29 kg (not significant). | 35986981 (opens PubMed)Source [5] |
| Muscle strength with resistance training | Improved | Grade A | Meta-analysis · n = 509 · 2024 Adults under 50 doing resistance training; 23 RCTs, mostly men (447 men, 40 women, 22 mixed) Form: creatine (form not specified in abstract) · Dose: Varied across trials; a non-significant trend toward larger lower-body gains at higher doses · Duration: Varied across trials Versus placebo, upper-body strength +4.43 kg and lower-body strength +11.35 kg. Gains were significant in men; women showed no significant gains, but only 2 trials (40 women) were female-only. | 39519498 (opens PubMed)Source [4] |
| Lean mass and strength in postmenopausal women | Improved | Grade B | Meta-analysis · n = 608 · 2026 7 placebo-controlled RCTs in postmenopausal women (mean age ≈62) Form: creatine monohydrate · Dose: Benefits seen at ≥5 g/day with resistance training; ≤3 g/day without training showed no measurable effect · Duration: 12–104 weeks (median 38) Lean mass +0.37 kg (5 trials, n=338) and leg-press 1RM +7.5 kg (3 trials, n=111) vs placebo. Bone density unchanged. Adverse events similar to placebo; renal indices unchanged. | 42141930 (opens PubMed)Source [7] |
| Memory | Improved | Grade B | Meta-analysis · n = 492 · 2024 16 RCTs in adults aged 20.8–76.4, healthy people and people with specific diseases Form: creatine monohydrate (all included trials) · Dose: Varied across trials · Duration: Under 4 weeks to over 4 weeks (no difference by duration) Memory improved vs placebo (SMD 0.31; moderate certainty). Attention time and processing speed also improved (low certainty). No significant effect on overall cognitive function or executive function. | 39070254 (opens PubMed)Source [8] |
| Strength and muscle size with creatine HCl | Improved | Grade D | RCT · n = 40 · 2024 Adults aged 18–25 doing 8 weeks of resistance training; 4 groups of 10 Form: creatine hydrochloride vs creatine monohydrate vs placebo · Dose: HCl 0.03 g/kg/day; monohydrate 0.03 g/kg/day with or without a 5-day 0.3 g/kg/day loading phase · Duration: 8 weeks Both HCl and monohydrate increased strength, muscle cross-sectional area and skeletal muscle mass more than placebo. Creatine HCl showed no benefit over monohydrate. | 39545789 (opens PubMed)Source [13] |
| Sprint and jump performance with creatine HCl | Improved | Grade D | RCT · n = 40 · 2026 Male collegiate soccer players doing 4 weeks of repeated-sprint training; 4 groups of 10 Form: creatine hydrochloride vs ethyl ester vs monohydrate vs placebo · Dose: Not stated in abstract · Duration: 4 weeks All creatine groups improved physical performance, peak power and fatigue index more than placebo. HCl and ethyl ester groups gained more than monohydrate on jump, 20-m sprint, L-run agility and peak power; no differences in mean power or VO2max. | 42720250 (opens PubMed)Source [14] |
| Bone mineral density | No effect | No effect | RCT · n = 237 · 2023 Postmenopausal women (mean age 59) in a resistance training and walking program Form: creatine monohydrate · Dose: 0.14 g/kg body weight/day · Duration: 2 years No effect on femoral neck, total hip or lumbar spine bone mineral density vs placebo. Some femoral-neck geometry measures (section modulus, buckling ratio) were better maintained. | 37144634 (opens PubMed)Source [10] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Creatine monohydrate | 88%[1][15] | Reference form in nearly all trials. Studies indicate it is not broken down in normal digestion and nearly all of an oral dose is taken up by muscle or excreted in urine.[3] | No consistent side effects in trials apart from weight gain (about 1–2 kg in a month, mostly water). Anecdotal reports include nausea, diarrhea, cramps and heat intolerance.[1] | Strength, lean mass, power, memory, bone density (no effect), kidney markers |
| Creatine hydrochloride (HCl) | 78%[15] | No head-to-head human data on absorption or muscle creatine levels versus monohydrate in our sources. Reviews find little to no evidence that newer forms outperform monohydrate.[3][1] | No published human comparison of stomach tolerance versus monohydrate in our sources.[3] | Strength, muscle size and sprint performance in two small trials (40 people each) |
- Creatine monohydrate880 mg
- Creatine hydrochloride (HCl)780 mg
Compound weight → elemental active
500 mg creatine monohydrate ≈ 440 mg elemental active
Studied doses
Doses studied in human trials ranged from 3 to 20 g/day of creatine monohydrate (about 2.6 to 17.6 g of creatine), for 5 days to 2 years. The 20 g/day amounts were loading phases of 5–7 days, usually followed by 3–5 g/day; some trials scaled amounts to body weight (0.03 to 0.3 g/kg/day).[1][11][10][13]
Intake reference: No RDA, AI or UL has been set for creatine. The liver and kidneys make about 1 g/day, and beef, pork and salmon provide about 2 g per pound.[1][2] No UL. The ISSN reports short- and long-term intakes up to 30 g/day for 5 years were well tolerated in healthy people (expert review, not an official limit). NIH ODS fact sheet (updated April 1, 2024).
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
None found in our sources.
Who should be careful
- Medicines
- Our sources (NIH ODS) document no drug interactions for creatine. That means none are published in these sources, not that creatine is safe with every medicine.[1]
- Kidney
- A 2025 meta-analysis found a small rise in serum creatinine (significant at follow-ups under 1 week and over 12 weeks, not at 1–12 weeks) with no significant change in glomerular filtration rate. Because creatinine is a routine kidney test, this can complicate lab results. Trials mostly enrolled healthy people, so anyone with kidney disease or reduced kidney function should discuss creatine with their clinician first.[12]
- Pregnancy and breastfeeding
- Insufficient human safety data in our sources.[1]
- Liver
- No liver-specific human safety data in our sources.[1]
- Children and teens
- ODS describes creatine as safe for short-term use by healthy adults; most trials were in adults.[1]
- Athletes (anti-doping)
- USADA states creatine is not prohibited in sport. Supplements can still be contaminated with prohibited substances, so tested athletes often choose third-party certified products.[16]
- Endurance athletes
- ODS notes little benefit for endurance events, and the weight gain could be a drawback there.[1]
- Before you start
- Talk to your pharmacist or clinician before adding this supplement, especially if you take prescription medicines, are pregnant or breastfeeding, or have a chronic health condition.[1]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
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Articles about Creatine monohydrate
Plain-English answers to common questions, built on the evidence above.
- Creatine After 50: What It Does for Muscle, Memory and Bone (and What It Doesn’t)
- Creatine Loading Phase: Do You Need It, and Why Did the Scale Just Jump?
- Does Creatine Cause Hair Loss? The One Study Behind the Fear, and the Trial That Finally Checked Hair
- Beta-Alanine vs Creatine: Different Jobs, Different Time Frames
- HMB vs Creatine: In Young Lifters, Creatine Has the Data and HMB Mostly Does Not
Frequently asked questions
Is creatine HCl better than creatine monohydrate?
Not on current evidence. In an 8-week trial of 40 young adults, HCl and monohydrate both improved strength and muscle size versus placebo, with no advantage for HCl. A 4-week soccer trial reported larger sprint and jump gains with HCl, but both trials were tiny. HCl is about 78% creatine by weight versus 88% for monohydrate.[13][14][15][1]
Does creatine cause water retention or weight gain?
Often, yes. ODS reports a 1–2 kg rise in body weight in the first month of strength training with creatine, mostly from water held in muscle. Part of the lean-mass gain seen in trials may reflect this.[1]
Is creatine bad for your kidneys?
In a 2025 meta-analysis of trials mostly in healthy people, creatine produced a small rise in serum creatinine (a breakdown product of creatine) without a significant change in kidney filtration rate. The authors attribute it to creatine turnover rather than kidney harm. Because creatinine is a standard kidney test, tell your clinician you use creatine before blood work. People with kidney disease were largely not studied.[12]
Do you need a loading phase?
Trials have used both approaches: 20 g/day for 5–7 days followed by 3–5 g/day, or 3–6 g/day with no loading. ODS describes both approaches as producing ergogenic effects.[1]
Does creatine help memory or brain function?
A 2024 meta-analysis of 16 trials (n=492) found a moderate-certainty improvement in memory and low-certainty improvements in attention and processing speed, but no change in overall cognition. A 2023 analysis suggested the memory effect is concentrated in older adults.[8][9]
Does creatine work for women?
The evidence is thinner. Meta-analyses found clearer gains in men; in postmenopausal women, a 2026 meta-analysis of 7 trials found small gains in lean mass and leg strength when at least 5 g/day was combined with resistance training.[4][7]
Is creatine banned in sport?
No. USADA states creatine is not prohibited. Because supplements can be contaminated, tested athletes often choose products certified by a third-party sport program.[16]
Sources
- [1]Dietary Supplements for Exercise and Athletic Performance: Fact Sheet for Health Professionals (creatine section). NIH Office of Dietary Supplements, 2024. fact-sheet
- [2]International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.. J Int Soc Sports Nutr, 2017. review
- [3]Analysis of the efficacy, safety, and regulatory status of novel forms of creatine.. Amino Acids, 2011. review
- [4]Effects of Creatine Supplementation and Resistance Training on Muscle Strength Gains in Adults <50 Years of Age: A Systematic Review and Meta-Analysis.. Nutrients, 2024. meta-analysis
- [5]Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: A systematic review and meta-analysis of randomized clinical trials.. Nutrition, 2022. meta-analysis
- [6]The Effects of Creatine Supplementation on Upper- and Lower-Body Strength and Power: A Systematic Review and Meta-Analysis.. Nutrients, 2025. meta-analysis
- [7]Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: a systematic review and meta-analysis.. J Int Soc Sports Nutr, 2026. meta-analysis
- [8]The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis.. Front Nutr, 2024. meta-analysis
- [9]Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials.. Nutr Rev, 2023. meta-analysis
- [10]A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health.. Med Sci Sports Exerc, 2023. RCT
- [11]Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial.. J Gerontol A Biol Sci Med Sci, 2020. RCT
- [12]Effect of creatine supplementation on kidney function: a systematic review and meta-analysis.. BMC Nephrol, 2025. meta-analysis
- [13]Supplementing With Which Form of Creatine (Hydrochloride or Monohydrate) Alongside Resistance Training Can Have More Impacts on Anabolic/Catabolic Hormones, Strength and Body Composition?. Physiol Res, 2024. RCT
- [14]Creatine formulations and repeated sprint training: effects on physical and physiological adaptations in soccer players during the short-term preparation phase.. J Int Soc Sports Nutr, 2026. RCT
- [15]Creatine hydrochloride (CID 134732), creatine (CID 586) and creatine monohydrate (CID 80116): molecular weights. PubChem, NCBI, 2026. database
- [16]What Do Athletes Need to Know About Creatine? (anti-doping status). U.S. Anti-Doping Agency (USADA), 2021. guideline
What changed
- First draft. Every evidence-row PMID checked with NCBI E-utilities (esummary + efetch abstract) and re-read in an independent adversarial pass.
- Added cost-per-studied-dose method, labeled analysis derived from cited rows.