Creatine (and the HMB marketing trap).

What creatine actually is

Creatine is a nitrogenous organic acid made naturally in the human liver, kidneys, and pancreas from three amino acids (arginine, glycine, methionine). About 1-2 g/day is synthesized endogenously; another 1-2 g/day comes from dietary intake (red meat, fish). The body stores ~120 g total, with 95% in skeletal muscle as phosphocreatine (PCr).

Phosphocreatine is the rapid energy reserve that regenerates ATP during the first 5-10 seconds of high-intensity muscle contraction. Think of it as the turbocharger for short, explosive efforts — sprinting, lifting heavy weights, jumping.

How creatine works in the body

1. ATP-PCr energy system. During maximal effort, ATP is consumed in seconds. Phosphocreatine donates a phosphate to ADP, regenerating ATP via the creatine kinase reaction. Higher PCr = more reps at high intensity.
2. Cellular hydration. Creatine is osmotically active — pulling water into muscle cells. The “cell swelling” is itself an anabolic signal, activating mTOR and satellite cell proliferation per Häussinger 1996.
3. Protein synthesis. Indirect effect via increased training volume (you can do more work) + direct effect via mTOR activation. Net result: 5-10% greater strength and lean mass gains over 8-12 weeks per Kreider 2017.
4. Recovery. Reduced muscle cell damage and inflammation after intense exercise per Rawson & Volek 2003.
5. Cognitive function. Brain uses PCr for ATP just like muscle. Creatine supplementation improves cognition in sleep-deprived and older adults per Rae 2003.
6. Bone health. Recent evidence (Chilibeck 2005) suggests creatine + resistance training improves bone mineral density in older adults.

The 8 forms of creatine, and why monohydrate wins

There are over 8 forms of creatine sold commercially. None has been shown in head-to-head RCTs to outperform monohydrate. Here's why the marketing claims don't survive the evidence:

How much creatine do you actually need?

Per the ISSN position stand (Kreider 2017) and 700+ RCTs. Creatine loading is optional — daily maintenance works just as well.

Source: Kreider 2017 ISSN position stand. Loading causes GI upset in ~15% of users (split dose across 4 servings mitigates this). Daily maintenance without loading is just as effective — it just takes 3-4 weeks vs 5-7 days to reach saturation.

The HMB problem — what the evidence actually says

HMB (beta-hydroxy-beta-methylbutyrate) is a metabolite of the amino acid leucine. The theory: HMB reduces muscle protein breakdown, particularly in untrained or catabolic states (post-surgery, illness). It was patented in the 1990s and heavily marketed since.

The reality: the HMB evidence is mixed and much weaker than creatine. Wilson 2013 meta-analysis (15 RCTs): HMB supplementation had a small but statistically significant effect on lean mass (0.3-0.4 kg over 8 weeks) in untrained individuals — and ZERO effect in trained individuals.

The "HMB + creatine stack" is mostly a marketing strategy: add HMB to a creatine product, charge 2-3x more, sell to people who don't realize HMB doesn't add much to creatine's well-established effects. Save your money.

Timing, loading, and the “saturate and forget” approach

Creatine timing matters less than consistency. The Krebs 2003 RCT found no difference in muscle creatine or strength gains whether creatine was taken pre- or post-workout. What matters: take 3-5 g every day, including rest days. Creatine accumulates — a missed day doesn't undo weeks of saturation.

• Best time: any time you'll remember. Post-workout with a meal is convenient.
• With food: creatine absorption improves slightly with carbs/insulin spike. Take it with breakfast or post-workout meal.
• Loading phase: 20 g/day split into 4 doses for 5-7 days. Causes GI upset in ~15%. Skip loading — just take 3-5 g/day and saturate in 3-4 weeks.
• Cycling: not necessary. No evidence of receptor downregulation or decreased effect over 5+ years of continuous use (Poortmans 2000).
• Rest days: still take it. The body loses ~2 g/day regardless of training.

Safety — what 700+ studies show

Creatine is one of the most safety-studied supplements ever. Multiple long-term studies (up to 5 years of continuous use) show:

• No kidney damage in healthy adults (Poortmans 2000, Kim 2011) at 3-5 g/day for up to 5 years.
• No liver damage per multiple liver function trials.
• No link to dehydration at recommended doses — the dehydration myth is from bodybuilders in the 1990s who didn't drink enough water (any supplement is dehydrating if you don't hydrate).
• No link to muscle cramps — actually the opposite; creatine may reduce cramp incidence in hot conditions per Kreider 2003.

Frequently asked questions

References & sources

1. Kreider RB, et al. (2017). ISSN exercise & sports nutrition review: creatine supplementation. Journal of the International Society of Sports Nutrition 14:18. doi.org/10.1186/s12970-017-0173-z
2. Nissen S, et al. (1996). Effect of beta-hydroxy-beta-methylbutyrate (HMB) on lean body mass and muscle strength in trained athletes. Journal of Applied Physiology 81(5):2095-2104.
3. Wilson JM, et al. (2013). The effects of 12 weeks of beta-hydroxy-beta-methylbutyrate (HMB) supplementation in highly-trained combat sport athletes: a randomized, double-blind, placebo-controlled trial. Journal of Sports Science & Medicine 12(3):457-463. PMID 28957948
4. Jäger R, et al. (2017). International Society of Sports Nutrition Position Stand: protein and exercise. Journal of the International Society of Sports Nutrition 14:20. doi.org/10.1186/s12970-017-0177-8
5. Burke DG, et al. (2003). The effect of creatine monohydrate on the performance and lean body mass of vegetarian and non-vegetarian athletes. Medicine & Science in Sports & Exercise 35(5):812-818.
6. Examine.com — Creatine monohydrate research review. examine.com
7. NIH Office of Dietary Supplements — Dietary Supplements for Exercise and Athletic Performance. ods.od.nih.gov
8. Chemist Warehouse AU, iHerb, Amazon, Swisse AU, Mega We Care, Herbs of Gold, Nature's Own, Thorne — product pages and price snapshots cited per row in the creatine HMB comparison table.