Rankings / Essentials — Supplements

Creatine

Essentials · Supplement

Also known as: Creatine monohydrate ·CrM

Tier S

Reviewed by Read Off Label · Last reviewed · How we grade

creatinemitochondrialanti-inflammatoryotc
9.7 / 10
Tier S
Ev 10 Bn 8 Sf 10

Bottom line

Read Off Label grades Creatine as S (9.7/10) based on very strong evidence, high benefit magnitude, and a very low-risk safety profile.

Creatine has a large efficacy and safety evidence base across sports-nutrition trials.

Studied, labeled, or reported-use context: 3-5 g/day maintenance (no loading needed); up to 10 g/day explored for cognition — OTC; not individualized guidance.

If you were testing this on yourself

Two properties decide whether an n-of-1 experiment is readable and recoverable. These describe the experiment — they are not a judgment about whether to run it, and nothing here is a recommendation.

Can you undo it?

Reverses on stopping

Muscle creatine stores wash out over roughly 4–6 weeks after stopping, and the associated water weight goes with them. No lasting change.

Can you tell if it worked?

Readable — 2–4 weeks at 3–5 g/day; faster with a loading protocol

Reps at a fixed load, or total volume on a compound lift you already track. Body weight will rise 1–2 kg early from intracellular water — expect that and do not read it as fat gain.

What would fool you Training progression alone will improve your lifts over the same window, which is the single biggest trap here. Compare against your own trend line before starting, not against a standing start. The early water-weight gain also makes scale weight useless as a readout for the first month.

What the evidence says

Creatine has a large efficacy and safety evidence base across sports-nutrition trials. Kreider 2017 ISSN position stand is the canonical safety review. Cognitive benefits most apparent under sleep deprivation or in vegetarians/vegans. Alternative forms such as HCl, ethyl ester, and buffered creatine have not demonstrated superior outcomes over monohydrate.

Mechanism

Phosphocreatine buffers ATP regeneration during high-intensity work; muscle cell volumization via osmotic water; mitochondrial biogenesis; neuroprotection; anti-inflammatory at supraphysiological intake

Studied, labeled, or reported dose & route

3-5 g/day maintenance (no loading needed); up to 10 g/day explored for cognition

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about Creatine's effects?
Read Off Label rates the evidence for Creatine as Very Strong and the benefit magnitude as high, producing an overall grade of S (9.7/10). Creatine has a large efficacy and safety evidence base across sports-nutrition trials.
What safety findings are reported for Creatine?
Creatine has a very low risk profile in the database. Very Low (most-studied supplement; rare GI; older kidney concerns debunked in healthy adults; caution in preexisting renal disease) Legal status: OTC.
What doses or routes are reported for Creatine?
3-5 g/day maintenance (no loading needed); up to 10 g/day explored for cognition This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does Creatine work?
Phosphocreatine buffers ATP regeneration during high-intensity work; muscle cell volumization via osmotic water; mitochondrial biogenesis; neuroprotection; anti-inflammatory at supraphysiological intake

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.