What’s the best form of creatine? Original paper

This systematic review of 17 clinical trials compared 7 creatine formulations in terms of effects on body composition and exercise performance and concluded that creatine monohydrate is still the lowest-cost and best-studied form of creatine.

This Study Summary was published on November 7, 2022.

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Background

In recent years, novel forms of creatine have appeared in the marketplace, each claiming to be superior to the gold standard of creatine monohydrate. These claims are often based on superior properties such as higher solubility, better bioavailability, and superior uptake mechanisms. However, few human intervention trials had investigated these claims. This study investigated whether novel forms of creatine have any supporting scientific evidence.

The study

This systematic review of 17 randomized controlled trials in a total of 548 healthy adult participants (ages 20–75) examined the safety and efficacy of different creatine formulations, as compared to creatine monohydrate, on exercise performance and body composition. The study populations included men (9 studies), men and women (5 studies), and women (2 studies).

Creatine formulations included citrate (9 studies), malate (2 studies), ethyl ester (1 study), nitrate (1 study), pyruvate (2 studies), and magnesium-chelated creatine (2 studies). The daily doses ranged from 1.5 to 20 grams, and some studies gave equal amounts to all participants, whereas others received amounts based on body weight.

For body composition, the researchers assessed BMI, body weight, lean body mass, and body fat percentage. To assess exercise performance, they looked at parameters of strength performance (e.g., one-repetition maximum), aerobic performance (e.g., oxygen uptake kinetics), and anaerobic performance (e.g., maximum oxygen uptake). Additionally, the researchers compared the monetary costs of third-party-certified products for the different creatine formulations.

The results

The researchers found no evidence supporting the use of any alternative creatine formulations in place of creatine monohydrate. Of the 17 included studies, only 3 studies compared the creatine formulation to creatine monohydrate.

All forms of creatine were found to be safe in existing studies. When comparing the costs per serving (5 grams of product), creatine monohydrate had the lowest cost (US$0.29), whereas alternative creatine formulations such as magnesium-chelated creatine (US$1.50) were much more expensive.

Note

Given the scarcity of evidence to support the claims of novel creatine formulations, this study supports the use of creatine monohydrate as the best-studied and lowest-cost form of creatine.

However, one major limitation is the lack of studies with head-to-head comparisons, which makes it difficult to prove the alleged superiority of other creatine formulations over creatine monohydrate. As such, it’s not completely impossible that a superior creatine formulation other than creatine monohydrate might exist. However, given the low cost and strong body of evidence supporting the use of creatine monohydrate, it’s very unlikely that another creatine formulation will challenge its position as the gold standard any time soon.

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This Study Summary was published on November 7, 2022.