Creatine is a naturally occurring nutrient that can be obtained in the diet from meat and fish. It can also be synthesized in the liver and pancreas from the amino acids arginine, glycine, and methionine. Approximately 95% of the body’s creatine is stored in muscle, mostly in the form of phosphocreatine. Phosphocreatine and creatine provide a vital reservoir of energy that is used to replenish ATP during high-intensity exercise. Since the 1990s creatine has become increasingly popular and to date is among the best-selling dietary supplements on the market.

During high-intensity anaerobic exercise lasting 5-15 seconds, muscles rely on stores of phosphocreatine to resynthesize ATP. Once these stores become depleted, the body is forced to rely on other forms of metabolism for ATP, and performance begins to decline. Supplementation with creatine increases stores of phosphocreatine, allowing muscles to work at higher intensities for a longer time. This is extremely beneficial for performance in high-intensity, strength, and power sports that rely heavily on phosphocreatine stores for energy. Creatine offers a number of performance benefits. It can produce small but immediate effects on maximum strength and power. This allows athletes to perform more high-intensity work in competition and training, resulting in improved performance and an enhanced training effect.

Scientific research has proven that supplementation with creatine results in 10%-40% increases in phosphocreatine stores within muscles. Athletes who consume diets low in meat and fish or who are vegetarian typically see the highest increases in phosphocreatine stores. Short-term supplementation has been shown to improve maximal strength and power by 5%-15%, single-effort sprint performance 1%-5%, and work performed during multiple sets of maximal strength training or sprinting 5%-15%. In addition, long-term creatine supplementation can improve the training effect by 5%-15%, improving gains in strength, power, and lean body mass.

A number of forms of creatine exist, including creatine salts (creatine citrate, maleate, fumarate, tartrate, pyruvate), creatine ethyl ester, and Kre-alkalyn. No forms of creatine are scientifically proven to be more effective than creatine monohydrate.

A 3-5 g maintenance dose can be consumed pre- or postworkout. FSSAI mandates a maximum consumption of 3 g per day.

Creatine is considered safe despite speculation that it negatively affects renal function. Creatine has also been scrutinized because of a lack of long-term research; however, long-term use has been studied up to 5 years. Creatine does not increase the risk of cramping nor cause dehydration. Interestingly, recent evidence suggests that creatine might have additional health benefits in the treatment of a broad range of diseases including neurodegenerative disorders, cancer, rheumatic diseases, and type 2 diabetes, in addition to improving cognitive function in the elderly.