Creatine
Creatine is a small molecule built from three amino acids (glycine, arginine, methionine). Around 95% of the body's creatine sits in skeletal muscle as phosphocreatine, where it acts as a rapid energy buffer for short, high-effort contractions. Sold in the UK as a food supplement — typically as creatine monohydrate powder. There is one UK-authorised health claim covering short-bout high-intensity exercise performance, conditional on a 3 g/day intake. Cognitive and lifespan-marketing claims are not authorised.
Camden Medicals editorial · Last reviewed 12 June 2026 · Next review December 2026
- Cross-checked against
- NHS
- NICE
- BNF
- EFSA
- FSA
Camden's editorial team independently graded each health claim below on the strength of the published evidence — see the grade beside every condition.
- Class
- Amino acid
- Typical daily dose
- Standard maintenance: 3–5 g/day creatine monohydrate. Optional loading: ~20 g/day (split into four 5 g doses with food/drink) for 5–7 days, then 3–5 g/day maintenance. The UK-authorised health claim applies at 3 g/day intake.
- Top use evidence
- Strong
On this page
What it is
Creatine is endogenously synthesised in the liver, kidneys and pancreas from glycine, arginine and methionine, and is also obtained from the diet — primarily from red meat and fish (around 1–2 g per day in a typical omnivorous UK diet). Roughly 95% of total body creatine sits in skeletal muscle, with smaller pools in the brain, heart and testes. The majority is stored phosphorylated as phosphocreatine, which donates a phosphate group to ADP to regenerate ATP during the first ~10 seconds of high-intensity work — sprints, single repetitions of heavy lifts, jumps, repeated short contractions.
Creatine monohydrate is the form that has been used in the overwhelming majority of trials over four decades. It is a white, odourless, water-soluble powder; research-grade material from licensed European producers (Creapure® is the most-cited research-grade preparation, made in Germany) is the standard reference. Other marketed forms — creatine HCl, ethyl ester, buffered ("Kre-Alkalyn"), magnesium chelate, citrate, malate, nitrate — are more expensive and have not shown improved muscle uptake or performance versus monohydrate in head-to-head trials.
At a glance
- A naturally-occurring compound the body makes from three amino acids and stores mostly in muscle as phosphocreatine.
- One UK-authorised health claim, conditional on 3 g/day intake: it improves physical performance in short, high-intensity, repeated bouts of exercise.
- Creatine monohydrate is the most-studied form and remains the reference standard. "HCl", "ethyl ester", "buffered", and "magnesium chelate" forms are more expensive and not better-evidenced.
- Loading is optional. 3–5 g/day reaches saturation in about 4 weeks; loading reaches it in about 1 week. Either way, the steady-state effect is the same.
- Modest weight gain (1–2 kg) early on is intracellular water retention, not fat. This is normal and reversible on stopping.
What people use it for
Adults doing resistance training, sprinting, or repeated short high-effort sport (football, rugby, tennis, HIIT)
The UK-authorised health claim applies: creatine improves physical performance in successive bursts of short-term high-intensity exercise. The claim is conditional on at least 3 g/day intake. [1]
Some evidenceStrongVegans and vegetarians
Lower baseline muscle creatine stores than omnivores; supplementation typically produces a larger relative increase. The same authorised claim and conditions apply. [6,7,8]
Some evidenceStrongOlder adults engaged in resistance training
A growing literature on creatine in older adults paired with resistance training; the existing UK claim applies to the performance outcome. Specific sarcopenia, cognitive, or fall-prevention claims are not authorised in the UK. [9,10,11,12]
Some evidenceModeratePeople not training
The authorised claim is for performance during exercise bouts. Without training, the supplement primarily increases intracellular water content. The authorised performance benefit is conditional on the exercise stimulus.
Some evidenceLimitedPeople with kidney disease or significant kidney risk
Talk to your GP first. Creatine raises serum creatinine (the metabolite, not the substance) by a small amount through normal turnover, which can mislead routine kidney-function tests if the test is interpreted without context. This is not the same as kidney injury, but you and your clinician need to know. [13]
Popular, not provenInsufficient
How it works
Creatine supplementation increases intramuscular total creatine and phosphocreatine by typically 10–40%, depending on baseline status (vegans and vegetarians, who consume little dietary creatine, generally have lower baseline stores and respond more strongly). Higher phosphocreatine stores extend the duration of the ATP-PCr energy system during very-short high-effort bouts and accelerate phosphocreatine resynthesis between repeated bouts. The net effect on training is a small but reliable improvement in repeated sprint output, total volume of repetitions in resistance training, and lean-mass accrual over weeks-to-months when paired with a training stimulus.
Creatine also crosses into the brain, more slowly than into muscle. Brain effects are an active research area but the clinical translation in healthy adults is uncertain and EFSA cognitive claims for creatine are on hold.
Common myths
Myth"Creatine is a steroid"
RealityIt is not. Creatine is a small molecule the body synthesises from three amino acids and obtains from meat and fish. It is structurally and pharmacologically unrelated to anabolic-androgenic steroids (testosterone analogues) and does not affect circulating testosterone or oestrogen at supplemented doses. UK regulation classifies it as a food substance, not a medicine.
Myth"Loading is essential to "fill" the muscles"
RealityIt is not. The two standard protocols (loading vs steady 3–5 g/day) reach the same muscle saturation, only on different timelines. Loading is faster but more likely to cause GI complaints. The steady protocol is what most consumers should default to.
Myth"Creatine causes hair loss"
RealityThis claim traces to a single small 2009 rugby-player study that reported a transient rise in dihydrotestosterone (DHT) ratio after loading. The result has not replicated in larger or longer trials, no causal link between creatine supplementation and androgenetic alopecia has been established in the broader literature, and the DHT change in the original study did not exceed normal range. The claim is widely repeated in fitness media and weakly supported by data.
Myth""Advanced" forms (HCl / Kre-Alkalyn / ethyl ester) work better than monohydrate"
RealityNot at equivalent doses. Multiple head-to-head trials have failed to show greater muscle creatine elevation, greater performance gain, or meaningfully different side-effect profiles versus monohydrate. These forms cost more without delivering more.
Myth"Creatine works as soon as you take it"
RealityCreatine builds up in muscle over time. The performance benefit depends on reaching and maintaining elevated muscle creatine stores — about 1 week with a loading protocol, about 4 weeks with a steady 3–5 g/day. A single dose before training does not meaningfully change muscle creatine concentration in someone who is not already saturated.
Common online questions
Synthesised from the questions UK shoppers most often ask online about Creatine. Each answer is editorial and links to its evidence in the Sources list below.
Do I need to "load" creatine?
Loading is optional, not necessary. The two standard protocols both end at the same steady-state muscle creatine concentration. Loading (around 20 g/day split into four 5 g doses for 5–7 days, then 3–5 g/day maintenance) reaches saturation in about a week. Steady 3–5 g/day with no loading reaches saturation in roughly four weeks. Picking the slower protocol avoids the GI complaints that some people get with loading.
Is creatine HCl better absorbed than monohydrate?
Head-to-head trials have not shown improved muscle uptake or performance for HCl, ethyl ester, buffered, or chelated forms over monohydrate at equivalent doses. Monohydrate is the cheapest and the most-studied form. The marketing premium for "advanced" forms is not matched by superior performance evidence.
Will creatine make me retain water and look puffy?
Creatine increases intracellular water in muscle cells (not subcutaneous water) which manifests as a small initial weight gain of typically 1–2 kg in the first weeks. This is normal, expected, reversible on stopping the supplement, and not the same as the bloated subcutaneous appearance that some people associate with salt or carbohydrate loading.
Does creatine damage the kidneys?
In healthy adults, multi-year studies of creatine supplementation have not shown clinically meaningful changes in kidney function. Creatine does cause a small predictable rise in serum creatinine — the metabolite, not the substance — through normal phosphocreatine turnover; this can mislead a routine kidney-function test (estimated GFR) if the lab does not know you are supplementing. Tell your GP or pharmacist before any blood test. If you have existing kidney disease, talk to your GP before starting creatine. [13]
Is creatine safe for women / for older adults / for teenagers?
The bulk of the evidence base is in adult men, but trials in women and in older adults exist and the safety profile is similar across groups studied. Use in under-18s sits in a more cautious position: the UK-authorised health claim does not specify age, but the evidence base in adolescents is thinner and many sport governing bodies steer young athletes towards food-first approaches first. If a young person is asking, talk to their GP and a registered sports nutritionist.
Why does the label say I need to take 3 g/day?
The UK-authorised health claim for creatine is conditional on the consumer obtaining a daily intake of 3 g of creatine. That number is the threshold the GB NHC Register requires for the performance claim to apply on a label, and it is also a sensible practical maintenance dose. [1]
⚖️ The official position
What may lawfully be claimed about Creatine in Great Britain. This is a regulatory position, not an evidence grade.
A health claim is authorised in Great Britain.
“Creatine increases physical performance in successive bursts of short-term, high-intensity exercise”
This claim is authorised for use in Great Britain under the GB Nutrition and Health Claims regulation. A product may carry it when it provides at least 15% of the UK NRV per recommended daily portion.
Authorised UK health claims
Verbatim from the GB Nutrition and Health Claims Register (Reg 432/2012 as assimilated in GB). A product can carry these claims when it provides at least 15% of the UK NRV per recommended daily portion.
1 authorised claim — show / hide
- "Creatine increases physical performance in successive bursts of short-term, high-intensity exercise"
🔬 Camden’s evidence review
The research Camden reviewed, graded on its strength. This is our own appraisal — it sits beneath the official guidance above, never above it.
Short-burst high-intensity exercise performance
StrongEvidencestrongUK guidance leads on this use: the GB Nutrition and Health Claims Register holds an authorised performance claim and EFSA's 2011 opinion judged the cause-and-effect relationship established (see the guidance section). Beneath that, the research Camden reviewed: decades of randomised trials, multiple meta-analyses, and the International Society of Sports Nutrition position stand have consistently reported small-to-moderate improvements in maximal strength, repeated-sprint output, training volume and lean mass when creatine monohydrate is supplemented at 3–5 g/day alongside resistance training. Effect sizes are typically larger in previously untrained or vegetarian populations and in shorter higher-intensity protocols than in long endurance work. The strong grade here rests on the regulator-assessed authorised claim, not on a single appraiser's reading of the trials. [1]
Cognitive function in healthy adults
LimitedEvidencelimitedSeveral small trials have explored creatine for cognitive outcomes (working memory, mental fatigue, sleep deprivation), with effect sizes that vary by population and task. The literature is heterogeneous; EFSA cognitive claims for creatine remain on hold. UK NHS pathways for cognitive concerns do not list creatine.
Sarcopenia / age-related muscle loss
ModerateEvidencemoderateTrials in older adults pairing creatine with resistance training report greater gains in lean mass and strength than training alone. The UK-authorised claim covers the performance outcome; sarcopenia as a clinical condition is managed via NHS pathways including physiotherapy, nutrition, and treatment of underlying conditions. [9,10,11,12]
Cardiac, neurological, or rare metabolic conditions
InsufficientEvidenceinsufficientCreatine is studied in several rare conditions (e.g. creatine deficiency syndromes) under specialist care. Self-supplementation is not appropriate in this context; talk to your specialist team.
Safety
Creatine monohydrate is one of the most-studied sports supplements in nutrition science. At 3–5 g/day in healthy adults, multi-year trials have not shown major safety signals. A small initial weight gain (1–2 kg) is normal — it is intracellular water in muscle, not fat.
Talk to your pharmacist or GP first if you:
- You have any kidney condition or are at higher risk of kidney problems (diabetes with poor control, prior acute kidney injury, single functioning kidney).
- You take prescribed medicines that need stable kidney-function monitoring (lithium, methotrexate, NSAIDs at high dose, certain antibiotics).
- You are due any blood test that includes serum creatinine or eGFR — disclose creatine supplementation to your clinician for accurate interpretation.
- You are pregnant, breastfeeding, or trying to conceive — safety data is limited.
- You are under 18 — talk to your GP and ideally a registered sports nutritionist before supplementing.
Common side effects: Mild GI complaints (stomach discomfort, mild diarrhoea) most commonly reported during loading at high doses; rare on 3–5 g/day. Initial weight gain of 1–2 kg from intracellular water retention is normal and reversible.
Pregnancy and breastfeeding
Limited safety data in pregnancy. Creatine is found in the diet and synthesised endogenously, but the higher exposure from supplementation has not been studied at scale in pregnancy. Talk to your pharmacist or GP before supplementing during pregnancy.
Limited safety data — talk to your pharmacist or GP.
Talk to your GP, midwife, or pharmacist before starting any supplement during pregnancy or breastfeeding.
More clinical detail (for clinicians and informed readers)
Contraindications
- Significant pre-existing kidney disease — discuss with your GP before starting.
- Known hypersensitivity to creatine or any constituent of the supplement.
Drug interactions
- Drugs that affect kidney function or are nephrotoxic (NSAIDs at high dose, certain antibiotics, some chemotherapy agents) — combination is not contraindicated but flag to pharmacist.
- Creatine raises serum creatinine through normal turnover, which can mislead routine eGFR-based dosing of renally-cleared drugs (e.g. metformin, gabapentin) if the prescriber is unaware of supplementation.
This is not an exhaustive list. Always tell your prescriber and pharmacist about every supplement you take.
Common side effects
- Mild GI complaints — particularly with loading doses; reduce dose or split across the day.
- Initial weight gain (~1–2 kg) from intracellular muscle water; reversible on stopping.
- Muscle cramping is occasionally reported but multiple trials have not shown a higher cramp rate vs placebo.
Rare side effects
- Allergic reactions — uncommon; some users react to fillers in flavoured products rather than creatine itself.
- Symptomatic kidney complaints in healthy adults at standard doses — not characterised in long trials.
How to take it
- Typical supplemental range
- Standard maintenance: 3–5 g/day creatine monohydrate. Optional loading: ~20 g/day (split into four 5 g doses with food/drink) for 5–7 days, then 3–5 g/day maintenance. The UK-authorised health claim applies at 3 g/day intake.
- Timing
- Daily timing is not critical for steady-state effect. Some trials report marginally better outcomes when taken close to training (with carbohydrate or a meal), but the consistent daily dose matters more than the timing.
How to spot quality
Look for
- Creatine monohydrate explicitly stated as the form. Creapure® is the European research-grade reference preparation.
- Powder format with no fillers, sweeteners or "proprietary blends" hiding dose. A teaspoon of pure powder is the cleanest delivery.
- Mesh size / micronisation declared if relevant — not a quality marker on its own but signals attention to dispersion.
- GMP-certified manufacture and a clear country of origin.
- Pack size that delivers ≥3 g per serving with a calibrated scoop.
Red flags
- Multi-ingredient pre-workout blends that hide creatine in a "proprietary matrix" without per-serving dose.
- "Advanced" or "next-generation" forms (HCl, ethyl ester, buffered, chelated) sold at significant premium without head-to-head evidence.
- Capsules at high price-per-gram — capsules typically deliver less per serving and cost more than equivalent powder.
- Performance claims beyond the UK-authorised wording: e.g. age-related marketing, "boosts brain function", lifespan-stack positioning.
- Lack of country-of-manufacture transparency — bulk creatine commodity quality varies significantly by source.
Commonly combined with
Other ingredients that share a biological pathway, cofactor relationship, or evidence-backed protocol with this one. Mechanisms below cite primary physiology — not folk pairing. Doses are literature ranges, not recommendations. Talk to your pharmacist or GP before changing your stack, especially if you take prescription medication.
Magnesium
Moderate evidenceEnergy + recovery cluster — creatine ATP regeneration + magnesium ATP-Mg cofactor.
Creatine phosphate ATP-buffer system + magnesium ATP-Mg complex. Mechanism complementary on energy-metabolism axis.
Evidence: UK Article 13.1 creatine performance claim + magnesium energy claim. [1]
Doses studied: 3 g/day creatine monohydrate + 200-400 mg magnesium daily.
Found in Camden: Aurifera™ Magnesium Complex 120 Capsules · Purifera™ Creatine Monohydrate Powder 500g (200 mesh micronised)
Vitamin D3
Moderate evidenceActive-living cluster — creatine performance + vitamin D3 muscle function.
Creatine ATP buffering + vitamin D3 muscle UK Article 13.1 maintenance claim. Mechanism complementary.
Evidence: UK Article 13.1 vitamin D3 muscle claim. [1]
Doses studied: 3 g/day creatine + 10-25 µg vitamin D3 daily.
Found in Camden: Purifera™ Creatine Monohydrate Powder 500g (200 mesh micronised)
L-Glutamine
Limited evidenceRecovery cluster — creatine + glutamine in active-living / sports context.
Creatine ATP buffering; glutamine intestinal-mucosa / immune / recovery. Different mechanisms; common active-living co-formulation.
Evidence: Common active-living combination.
Doses studied: 3 g/day creatine + 5-10 g/day l-glutamine.
Found in Camden: Purifera™ Creatine Monohydrate Powder 500g (200 mesh micronised)