Tier 4 — mechanistic

International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine

Richard B. Kreider, Douglas S. Kalman, Jose Antonio, Tim N. Ziegenfuss, Robert Wildman, Rick Collins, Darren G. Candow, Susan M. Kleiner, Anthony L. Almada, Hector L. Lopez
Journal of the International Society of Sports Nutrition 2017 Volume 14, article 18

Bibliography

PubMed
PMID 28615996
DOI
10.1186/s12970-017-0173-z
Funding
Support to prepare the manuscript was provided by the Council for Responsible Nutrition.
Competing interests
Multiple authors disclosed creatine- and supplement-industry relationships, including externally funded research, consulting, advisory roles, employment, patents and other commercial ties. Richard B. Kreider disclosed industry-funded creatine research and consulting; Douglas Kalman, Tim Ziegenfuss, Robert Wildman, Anthony Almada and Hector Lopez disclosed relevant industry affiliations or relationships. The full paper contains the author-by-author statement.

Study snapshot

DesignExpert consensus position stand and narrative evidence review, published by the International Society of Sports Nutrition.
ModelHuman evidence base across athletic, clinical and older adult populations.
SampleNot applicable — expert position stand and narrative evidence review
InterventionCreatine monohydrate supplementation across loading, maintenance and low-dose-without-loading protocols.
DurationNot applicable — evidence review
EndpointsMuscle creatine store saturation; Exercise performance and training adaptation; Safety and adverse event profile across populations

What the study showed, in plain terms

This is the reference document the sports nutrition field uses for creatine dosing. A panel assembled by the International Society of Sports Nutrition reviewed the human creatine literature and set out, in one place, how much creatine it takes to actually saturate muscle stores and what the safety record looks like.

Two dosing routes are described. The fast route is a loading phase of roughly 5 g four times a day, or about 0.3 g per kilogram of body weight, for five to seven days, followed by a maintenance dose. The slow route skips loading entirely and takes 3 g a day for 28 days to reach the same place.

The number that matters most for reading a supplement label is the maintenance figure: 3 to 5 g a day, with the panel noting that larger athletes may need as much as 5 to 10 g a day. Any product supplying less than that, without a loading phase, is delivering less creatine than the protocols the evidence base was built on.

Key findings

  • Loading protocol: approximately 5 g of creatine monohydrate, or about 0.3 g per kg body weight, four times daily for 5 to 7 days.
  • Maintenance: muscle creatine stores can generally be maintained by ingesting 3 to 5 g per day, and the position stand notes that larger athletes may need as much as 5 to 10 g per day.
  • Alternative protocol without loading: 3 g per day for 28 days is required to saturate muscle creatine stores.
  • Creatine monohydrate is identified as the most extensively studied and clinically effective form for increasing intramuscular creatine and supporting exercise capacity and training adaptations.
  • The position stand finds no compelling scientific evidence that short or long-term creatine monohydrate use at recommended doses is harmful in healthy individuals.

What this study can and cannot tell us

A position stand is a consensus synthesis, not a primary trial. Its dosing figures describe the protocols used across the literature; they are not the output of a single head-to-head dose-ranging study, and the panel itself is drawn from a society with commercial links across the sports nutrition industry.

The dosing guidance also describes creatine taken as an isolated supplement at a stated daily amount. It does not establish what happens when a smaller creatine dose is delivered inside a multi-ingredient powder alongside two dozen other actives, and it does not speak to any finished consumer product.

Readers should also note that dose and outcome are not a simple ladder. Meta-analytic work published since, including Zhang 2025, reports that lower daily doses can produce strength gains at least as large as much higher ones — so a dose below the maintenance range is best described as under the studied protocol rather than as inert.

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