If you are trying to optimize your workouts, on a GLP-1 agonist like semaglutide or tirzepatide, or are a menopausal woman or a man over 50, building muscle is a thing you should focus on. Creatine is the way to do so. But how?
For those who just want to know the take-home points:
- You do not need to do a loading dose for a week. You can go straight to maintenance.
- Maintenance for most is 3-5 grams/day
- The best form of creatine is creatine monohydrate.
More detailed information:
Creatine monohydrate powder is the most commonly used form of creatine, used since the early 1990s. This was studied to find out the dosages, looking at how it reacts and the changes in the blood when taken orally, when you see the blood concentration rise, etc. What they found is that when you take 3-5 grams/day, you see the blood concentration go up for 3-4 hours after you take it. Almost all of this is either 1. taken up in your tissue, or 2. excreted in your urine.
It is made by drying it out into a powder. Creatine monohydrate gives the highest percentage of creatine at 87.9%. In the article, they state German manufacturers have created a process that makes 99.9% pure creatine monohydrate with no contaminants. They warn against products from China, which start with different materials and are found to be contaminated with heavy metals and other contaminants. They strongly recommend German-produced creatinine.
The powder is very stable. It does not need to be mixed in hot tea. Though that makes the creatine more soluble, studies show the solubility has no influence on tissue uptake. Due to its lack of solubility and that it is unstable in solution, creatine is marketed in powder form. Beverages are unsuccessful in developing a stable, physiological effective dose.
When taken at the recommended dosing, intramuscular creatine stores increase by 20-40% and exercise performance capacity increases by 5-10%. You see increase in muscle mass, strength, and exercise capacity.
There are other forms of creatine on the market: creatine salts, dipeptides, effervescent creatine, creatine ethyl ester, buffered creatine, and others. There are not good studies on these other forms. What studies are there show they have less impact than the well-studied traditional creatine monohydrate.
Summary?
- No loading dose is needed. 3-5 grams/day. Safe for men and women.
- Creatine monohydrate powder is the gold standard. (German-made is best)
- It needs to be paired with resistance training to see muscle changes (see blog on creatine in older adults for the science behind that)
- Other forms (beverages, other types of creatine) are not ideal.
