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Asian J Sports Med. In Press(In Press):e62739.
Published online 2018 July 23.
doi: 10.5812/asjsm.62739.
Research Article
Effects of Low-Dose Creatine Monohydrate on Muscle Strength and
Endurance
Jose de Oliveira Vilar Neto,1,2,3,* Carlos Alberto da Silva,2,3 Antonio Barroso Lima,2,3 Francisco Jose Rosa
de Souza,3Daniel Vieira Pinto,1Jocasta de Sousa Araujo,1Claudio de Oliveira Assumpcao,2,3 and
Elizabeth de Francesco Daher1
1Federal University of Ceara, Fortaleza CE, Brazil
2Research Group in Biodynamic Human Movement, Physical Education and Sports Institute, Federal University of Ceara, Fortaleza CE, Brazil
3Physical Education and Sports Institute, Federal University of Ceara, Fortaleza CE, Brazil
*Corresponding author: Laboratory of Force Applied to Sport and Health, Physical Education and Sports Institute, Federal University of Ceara (UFC), Mister Hull Ave., Sports
Park, Block 320, Pici Campus, Fortaleza CE, Brezil. Tel: +55-8533669533, Email: jvilarr@gmail.com
Received 2017 October 10; Revised 2018 April 10; Accepted 2018 May 04.
Abstract
To investigate the effect of low-dose supplementation of creatine monohydrate without the use of the saturation phase, 36 male
university students engaged in resistance training (age 22.5 ±4.3 years, height 1.76 ±0.08 m, weight 77.0 ±11.0 kg, and body mass
index 24.6 ±2.5 kg/m2) were randomly divided into three groups: group placebo (GP), group supplemented with creatine 3 g/day
(3G), and group supplemented with 5 g/day creatine (5G). The subjects were tested for maximum muscle strength (1RM), upper body
muscle endurance (MPU), and abdominal muscle endurance (MSU) before and after 7, 14, 21, 28, and 35 days of creatine supplementa-
tion or placebo and performing standardized resistance training. After 35 days of supplementation and training, all groups showed
a significant improvement in the 1RM test; however, the percentages of strength increase were significantly higher (P < 0.05) in the
groups supplemented with creatine (G3, ∆% 1RM = 20.0 ±4.0; G5, ∆% 1RM = 19.9 ±1.5) than in the placebo group (GP, ∆% 1RM = 10.3
±1.9). Upper limb muscle endurance showed a significant improvement only in 5G, ranging from 39.9 ±7.9 MPU/min to 50.7 ±11.0
MPU/min after 35 days of supplementation. Interestingly, abdominal muscle endurance showed no increase in any of the groups
(GP, P > 0.528; G3, P > 0.076; G5, P > 0.148). These results support a number of earlier studies that demonstrated that creatine sup-
plementation at low doses and without the use of the loading phase are effective for increasing maximal strength and endurance
of upper limbs.
Keywords: Nutritional Supplementation, Maximal Strength, Ergogenic Aids, Fatigue Resistance
1. Background
For at least 50 years, creatine is already well known
to scientists and professional athletes (1). However, crea-
tine supplementation with athletic intent began to gain
popularity in the 1992 Olympics in Barcelona, when British
sprinter Linford Christie won the 100-m dash and linked
his gold medal to creatine intake (2).
Creatine is a natural nutrient mainly found, in small
amounts, in foods of animal origin (e.g., 2 g in 500 g of
raw beef) (1) and is also endogenously synthesized in small
amounts (1 g/day) by the liver, kidneys, and pancreas from
the amino acids glycine, methionine, and arginine (3,4).
In a standard omnivorous diet with an intake of 1 - 2 g of
creatine per day, the intramuscular creatine stores are be-
tween 60 and 80% saturated. Therefore, creatine monohy-
drate supplementation aims to saturate the remaining 20
to 40% (5). Oral creatine monohydrate supplementation
could increase the total amount of muscle creatine, which
in turn could also increase free creatine and phosphocrea-
tine (PCr) (1,6).
Previous studies showed that administration of 20
g/day of creatine for 5 - 6 days could significantly in-
crease performance at maximal exercise and increase body
weight by 0.5 - 1.0 kg (7-11). When this high dose of crea-
tine was sustained for 28 days, body weight gain reached
1.7 kg (12). The suggested dose of 20 g/day for 5 days, com-
monly called the “loading phase,” followed by the “mainte-
nance phase,” with doses between 5 and 10 g/day make up
the most popular creatine administration protocol among
athletes (12,13).
Burk et al. investigated the effect of low and contin-
uous doses of creatine and demonstrated that adminis-
tration of a low dose (7.7 g/day) for 21 days is sufficient
to increase strength, potency, and fatigue resistance in
male college athletes compared with the control group
(14). However, the efficacy of low-dose creatine mono-
hydrate supplementation has no absolute consensus in
the scientific world. Some studies failed to demonstrate
any improvement in maximal strength, potency, or mus-
Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License
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Vilar Neto JO et al.
cle endurance in subjects on low-dose creatine monohy-
drate supplementation (15-19). For example, no increase in
muscle creatine concentration and no anaerobic muscle
metabolism improvement were found in swimmers sup-
plemented with 2 g of creatine per day for a period of 6
weeks (18). Similarly, 6 g/day of creatine administered for
6 days was also not sufficient to improve muscle power
(Wingate test) in 40 active men (20). Moreover, Lobo et al.
investigated the effects of 1-year creatine supplementation
(1 g/day) on bone health, lean mass, and muscle function
in 109 older postmenopausal women using a double-blind,
placebo-controlled, parallel-group study design. Muscle
function was measured by timed up and go and timed-
stands tests. No improvement was found after 1 year of sup-
plementation (17).
Thus, unlike the saturation protocol, the ergogenic
benefits of low and continuous dose supplementation of
creatine have not yet been fully elucidated, and issues such
as dose, minimum time of use, and influence of resistance
training during supplementation remain the subjects of
doubt and questions in the scientific and sports field.
2. Methods
2.1. Experimental Approach to the Problem
This is a randomized, double-blind, placebo-controlled
clinical trial involving 36 healthy men engaged in resis-
tance training. All participants were informed about the
risks and benefits involved in this study and signed a writ-
ten informed consent before participating in the study.
The subjects were divided into three groups in a ran-
domized, double-blind fashion as follows: group G3 (3
g/day creatine supplementation), group G5 (5 g/day crea-
tine supplementation); and group GP (supplementation
with placebo, a compound of inert substance with color,
solubility, and taste similar to those of creatine, using a
dose of 5 g/day).
During the study period, all subjects performed a stan-
dardized resistance training program and were advised to
avoid alcohol consumption and not to change their food
intake habits.
2.2. Subjects
Thirty-six male students engaged in resistance train-
ing participated in this study. Mean age was 22.5 ±4.3
years, height 1.76 ±0.08 meters, weight 77.0 ±11.0 kg, and
body mass index (BMI) 24.6 ±2.5 kg/m2. The participants
performed the resistance training in a systematic and as-
siduous manner at least 6 months before the commence-
ment of the study. Inclusion criteria included the follow-
ing: not using any central nervous system stimulants; no
personal history of cardiovascular, kidney, or liver disease;
no injuries or pain in the shoulders or elbows; and not tak-
ing any supplements that contained creatine in the last 60
days. Six participants who did not fully observe the train-
ing protocol or perform all required tests were excluded.
This study was registered with the certificate of presen-
tation for ethical appreciation (no. 52825816.9.0000.5045)
and was approved by the Ethics and Research Committee
(appraisement report number 1690479). All the determi-
nations of resolution 466/12 of the National Health Coun-
cil, which deals with the guidelines and norms regulating
research involving humans in Brazil, were verified.
2.3. Procedures
The total intervention time was 6 weeks, with the first
week being aimed at familiarizing the physical tests and
the adaptation to the resistance training program. Over
the next 5 weeks (35 days), the participants underwent a
standardized resistance training and had a daily intake of
creatine or placebo. All study participants were instructed
to maintain their food intake habits and not to consume
any type of dietary supplements during the study period.
To establish a baseline, physical tests were performed
shortly after the week of familiarization and before the be-
ginning of creatine supplementation or placebo. The tests
were repeated at the end of each week (7 days) for 5 weeks
to evaluate the effect of creatine supplementation on max-
imal strength and fatigue resistance over time.
2.4. Creatine Supplementation Protocol
A supplement in the form of powder containing 100%
of micronized creatine monohydrate, supplied by a com-
pany of notoriety in Brazil, was used. The supplier guaran-
tees the purity of the product based on high-performance
liquid chromatography test.
Creatine and placebo were prepared (36 kits with 35 sa-
chets each). The kits and sachets were identical and were
subsequently coded. The relationship between the code
and the composition of the sachets in each kit were known
only by the pharmacy school.
All groups had the supplementation for 35 days (one sa-
chet per day, taken at their convenience). The participants
were instructed to mix and dissolve the contents of the sa-
chet in 200 mL of water before drinking the solution. Re-
peating the process to ensure intake of remnants that were
still impregnated in the glass.
2.5. Performance Measures
All subjects were tested for strength (one maximal
bench press repetition, 1RM), upper body resistance (max-
imal push-ups in 1 minutes, MPU), and abdominal resis-
tance (maximal sit-ups in 1 minutes, MSU).
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Vilar Neto JO et al.
The tests were performed after the familiarization
week, i.e., before the beginning of supplementation and at
the end of each week (7 days) for 5 weeks (POST 7D, POST
14D, POST 21D, POST 28D, and POST 35D).
All tests were performed under the supervision of a
trainer with a degree in Physical Education, with special-
ization in Biomechanics and Physiology and over 20 years
of experience in resistance training.
2.5.1. Muscular Strength
Subjects performed the 1RM test, wherein the maxi-
mum amount of weight (in kilograms) that can be lifted
during the performance of a standardized exercise, with
the perfect technique of execution, is determined. In this
study, we used bench press.
Bench press exercises were performed on an articu-
lated machine, which was set for maximum range of move-
ment. After the warm-up for the muscles and joints in-
volved in the exercise, the subject was properly positioned
on the equipment, and after receiving a lift-off from two
spotters, the subject lowered the machine towards his
chest, paused briefly, and pressed the machine to full fore-
arm extension.
The loads were identified during the familiarization
week; however, for the 1RM test, we applied increasing
loads until the subject could not complete a repetition
with full range of motion. When necessary, the trials
were performed with lighter loads until the 1RM was deter-
mined (maximum of five trials). Five minutes of rest was
allowed between trials.
2.5.2. Upper Body Muscle Endurance
Upper body muscle endurance was assessed by the
MPU test. The subjects completed as many push-ups as
they could in 60 second. After 5 minutes of warm-up, the
subjects started with the standard “up” position, with the
body taut and straight, the hands positioned shoulder-
width apart, the fingers pointed forward, and the elbows
extended. At the “attention, go!” command, the subjects
flexed their elbows, bringing the thorax about 5 cm close to
the ground; the body should not come in contact with the
ground, except the palms of the hands and feet. Moreover,
the elbow joint should form a minimum angle of 90° and,
subsequently, fully extend again. The body should remain
straight during the test. The subjects were allowed to rest;
however, only full and perfect repetitions were recorded.
2.5.3. Abdominal Muscle Endurance
The maximal sit-up (MSU) test was used to assess the
endurance of the abdominal muscles. After 5 minutes of
warm-up, the subjects were in the dorsal decubitus posi-
tion, with the elbows, shoulders, trunk, hip, and knees ex-
tended (initial position). At the “attention, go!” command,
the subjects flexed their trunk, hip, and knees, assuming a
sitting position, and touched their knees with their elbows
(final position). Thereafter, the subject assumes the initial
position. They completed as many repetitions as possible
within 60 seconds. Rest was allowed in the down position.
Similar to the push-up test, only full and perfect repetitions
were counted.
2.6. Resistance Training Program
To avoid any uncontrolled variables in the resistance
training during the 35 days of supplementation, all sub-
jects had an identical resistance training program, i.e., a
standardized resistance training was provided to the sub-
jects to ensure that they receive the same exercise stimulus.
Moreover, the training sessions were performed within the
same facility and were supervised by an experienced coach.
For all exercises, the subjects performed 2 sets of 20 repe-
titions as localized warm-up, followed by 4 sets of 8 to 10
repetitions. The subjects were also instructed to select a
load that would enable them to perform a minimum of 7
repetitions; when the repetitions exceed 10, the load was
increased.
2.7. Statistical Analyses
Normal data distribution was confirmed using the
Kolmogorov-Smirnov test. A simple one-way analy-
sis of variance (ANOVA) between groups for the pre-
supplementation scores indicated that all dependent
variables in the GP, G3 and G5 groups were statistically
equal (P > 0.05) at baseline, thereby suggesting that the
group randomization was effective in providing equiva-
lent baseline scores across the groups.
Paired samples t-tests were used to identify significant
differences between pre- and post-supplementation scores
for 1RM, MPU, and MSU. 1RM test was analyzed using the
percent change (%∆). The values were compared between
groups using Student’s t-test. P < 0.05 was considered sta-
tistically significant for all comparisons. Statistical analy-
ses were performed using SPSS v. 20.0 (SPSS Inc., Chicago,
IL).
3. Results
Table 1 shows the characteristics of the groups prior to
supplementation. Weight, age, height, BMI, maximal mus-
cle strength, fatigue resistance of the upper limbs, and re-
sistance to abdominal muscle fatigue showed no signifi-
cant differences between the groups (P > 0.05).
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Vilar Neto JO et al.
Table1. Physical Characteristics of the Groupsa
Variables Placebo 3G 5G Hom
Age 21.6 ±3.0 24.4 ±6.1 21.4 ±2.8 0.327
Weight, kg 77.4 ±10.4 79.4 ±13.3 74.1 ±9.5 0.558
Height, m 1.78 ±0.1 1.75 ±0.1 1.76 ±0.1 0.452
BMI, kg/m224.2 ±1.5 25.7 ±3.0 24.0 ±2.4 0.085
1RM, kg 114.2 ±18.9 127.6 ±17.8 114.9 ±18.2 0.895
MSU, rep/min 34.5 ±6.4 35.5 ±7.5 36.9 ±6.8 0.733
MPU, rep/min 32.7 ±6.8 40.1 ±10.7 39.9 ±7.9 0.102
Abbreviations: Hom, test of homogeneity of variances; MPU, maximum push-up; MSU, maximum sit-up; RM, repetition maximum.
aValues are expressed as mean ±SD.
3.1. Maximal Strength
Figure 1 shows the values obtained in the 1RM test (pre-
supplementation and after 35 days of supplementation).
Paired t-test showed that the maximal muscle strength in-
creased significantly in all groups (P < 0.05); thus, the re-
sults in the supplemented groups were not different from
those of the placebo group. However, when we evaluated
the percentage increase of strength (Figure 2), groups 3G
and 5G had a significantly higher percentage of strength
increase than the placebo group (G3, ∆% 1RM = 20.0 ±4.0
and G5, ∆% 1RM = 19.9 ±1.5 vs. GP, ∆% 1RM = 10.3 ±1.9;
GP vs. 3G and GP vs. 5G, P < 0.05). Nevertheless, no signif-
icant difference in the percentage of strength increase be-
tween the groups supplemented with creatine was found
(3G vs. 5G, P > 0.05). When assessing the increase in maxi-
mal strength over time (Table 2), we found that unlike the
placebo group, which only showed a significant increase
after 14 days, the groups supplemented with creatine (5
and 3 g/day) showed significant increases in the expression
of maximal strength shortly after 7 days of supplementa-
tion.
3.2. Upper Body Muscle Endurance
Based on the MPU values described in Figure 1, no
significant difference between the pre-supplementation
and after 35 days of supplementation in GP and 3G exists;
however, in 5G, significant differences were observed (pre-
supplementation, 39.9 ±7.9 vs. after 35 days of supplemen-
tation, 50.7 ±11.0) (one-way ANOVA, P < 0.05). Interest-
ingly, different from maximal strength evaluation, the 5G
group was only able to show significant increases in upper
limb muscle resistance after 14 days of supplementation
versus 7 days for 1 RM. (Table 2).
3.3. Abdominal Muscle Endurance
Paired t-test showed no significant difference in the val-
ues before and after 35 days of supplementation in any of
the groups (Figure 1). Creatine supplementation did not re-
sult in any improvement in abdominal muscle endurance.
4. Discussion
Creatine supplementation using the standard proto-
col, i.e., 5 days of saturation phase followed by mainte-
nance phase, is effective for the improvement of perfor-
mance related to anaerobic power, strength, and mus-
cular endurance (9,11,21-23). However, conflicting data
with regard to the effect of creatine supplementation
without a “loading phase” and using low doses exist (15-
19). Aedma et al., in a double-blind, placebo-controlled,
parallel-group study, showed that in 20 trained wrestlers
whose age, weight, height, and body fat percentage were
25.6 ±3.8 years, 82.7 ±8.6 kg, 185.1 ±6.5 cm, and 16.1 ±
2.4 % (mean ±SD), respectively, no improvement in up-
per body anaerobic power in anaerobic tests mimicking
wrestling matches was observed after creatine supplemen-
tation (0.3 g/kg of body weight/day for 5 days) (19) Simi-
larly, Wilder et al. investigated creatine ergogenic effects
in 25 highly trained male collegiate football players (age,
19 ±1.02 years; height, 185.8 ±5.27 cm; weight, 100.89 ±
21.79 kg) with at least 1 year of playing experience. The
maximal strength of the supplemented group (3 g/day of
creatine) was assessed using the 1RM test (back-squat exer-
cises); the subjects were evaluated before (week 0), during
(week 5), and after supplementation (week 10), and the re-
sults showed no improvement in maximal strength (15).
Our results demonstrated that creatine supplementa-
tion in low doses (i.e., 3 and 5 g/day), even without the use
of saturation phase (i.e., 20 g/day for 5 - 7 days), could be ef-
fective in increasing maximal muscle strength and fatigue
resistance. Although the placebo group also showed a sig-
nificant increase in maximal strength, the percentage of
increase in strength was significantly greater in the sup-
plemented groups than in the placebo group. Consider-
4Asian J Sports Med. In Press(In Press):e62739.
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Vilar Neto JO et al.
Table2. Muscular Strength Over Timea
Variables Pre Post 7 Days Post 14 Days Post 21 Days Post 28 Days Post 35 Days
1RM
Placebo 114.2 ±18.9 118.8 ±21.15 119.8 ±21.13b123.8 ±22.05b124.6 ±20.7b125.6 ±19.4b
3G 127.6 ±17.8 136.2 ±16.45b144.2 ±17.3b148.0 ±17.0b151.2 ±19.6b152.4 ±21.4b
5G 114.9 ±18.2 118.8 ±18.6b124.0 ±20.4b127.0 ±20.5b130.8 ±22.0b136.8 ±20.4b
MPU
5G 39.9 ±7.9 41.8 ±11.0 45.9 ±11.3b49.2 ±11.7b47.6 ±12.1b49.8 ±11.2b
Abbreviations: MPU, maximum push-up; RM, repetition maximum.
aValues are expressed as mean ±SD.
bSignificantly different from Pre.
Placebo 3G 5G
Pre Post 35
Days Pre Post 35
Days Pre Post 35
Days
1RM (kg)
114 ± 18.9 125 ± 19.4* 127 ±
17.8
152 ±
21.3* 114 ± 18.2 137 ± 19.7*
MSU
(rep/min)
34.5 ± 6.4 36.2 ± 4.0 35.5 ± 7.5 38.6 ± 6.6 36.9 ± 6.8 41 ± 11.8
MPU
(rep/min)
32.7 ± 6.8 36.3 ± 5.0 40.1 ±
10.7
45.2 ±
15.8 39.9 ± 7.9 50.7 ± 11.0*
*
* *
*
PLACEBO 3G 5G
PLACEBO 3G 5G
PLACEBO 3G 5G
180
150
120
90
60
30
0
70
60
50
40
30
20
10
0
70
60
50
40
30
20
10
0
70
60
50
40
30
20
10
0
70
60
50
40
30
20
10
0
70
60
50
40
30
20
10
0
70
60
50
40
30
20
10
0
Pre Post Pre Post Pre Post
Pre Post Pre Post Pre Post
Pre Post Pre Post Pre Post
1RM (kg)
MSU (rep/min)
MSU (rep/min)
MSU (rep/min)
MPU (rep/min)
MPU (rep/min)
MPU (rep/min)
180
150
120
90
60
30
0
1RM (kg)
180
150
120
90
60
30
0
1RM (kg)
Figure 1. Effect of creatine supplementation. RM, repetition maximum; MSU, maximum sit-up; MPU, maximum push-up. *Significantly different from Pre. No difference
between the groups (one-way ANOVA). Values are express as mean ±SD.
Asian J Sports Med. In Press(In Press):e62739. 5
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Vilar Neto JO et al.
Placebo 3G 5G
Placebo vs. 3G*
Placebo vs. 5G* 3G vs. 5G
∆%
∆%
Pre
vs.
35
Days
* *
10.3 ± 1.9 vs. 20.0 ± 4.0 10.3 ± 1.9 vs. 19.9 ± 1.5 20.0 ± 4.0 vs. 19.9 ± 1.5
10.3 ± 1.9 20.0 ± 4.0 19.9 ± 1.5
PLACEBO
Placebo vs. 3g Placebo vs. 5g 3g vs. 5g
3g 5g
Placebo
Placebo
3g
3g 3gPlacebo 5g 5g
5g
50
40
30
20
10
0
50
40
30
20
10
0
50
40
30
20
10
0
∆% 1RM∆% 1RM
∆% 1RM
∆% 1RM
∆% 1RM
∆% 1RM
50
40
30
20
10
0
50
40
30
20
10
0
50
40
30
20
10
0
Figure 2. ∆% 1RM test. *Significantly different from the other group. Values are express as mean ±SD. ∆% were calculated as follows: (Post/Pre) - 1.
ing the time variable, the supplemented groups showed
significant results after 7 days, whereas the placebo group
showed significant results after 14 days. Moreover, the max-
imal strength increase in the placebo group, which could
be lower than that in the supplemented groups, could be
attributed to the natural and physiological adaptation to
resistance training (24,25). For the upper limb resistance
to fatigue, significant results were found only in the group
supplemented with 5 g/day of creatine (P < 0.05) and only
after 14 days. Similar results were found by Camic et al.,
who investigated the maximal strength and endurance us-
ing bench press in 77 university men (mean age, 22.1 ±
2.5 years; weight, 81.7 ±8.4 kg) in a double-blind, placebo-
controlled, randomized clinical trial. However, unlike our
study, the participants were untrained and used a crea-
tine supplement with a polyethylene glycol compound
(1.25 and 2.50 g/day for >30 days). They also found that
the placebo group had a significant increase in maximum
strength; however, only the groups supplemented with
creatine showed improvement in resistance to upper limb
fatigue (26).
Furthermore, it is interesting to note that no statisti-
cal difference in the maximum force between the supple-
mented groups was noted. However, improvement in the
6Asian J Sports Med. In Press(In Press):e62739.
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Vilar Neto JO et al.
resistance to upper limb fatigue was observed only in the
group supplemented with 5 g/day and only after 14 days.
We could speculate that for activities with a longer du-
ration, a higher dose and longer supplementation dura-
tion are required to obtain a significant increase in perfor-
mance.
Interestingly, abdominal muscle endurance showed
no improvement in any of the groups (GP, P > 0.528; G3,
P > 0.076; G5, P > 0.148). This finding could be attributed
to the characteristics of the muscle group, mainly consist-
ing of type 2 muscle fibers, which are naturally oxidative
and resistant to fatigue (27,28). Moreover, our sample was
composed of individuals with at least 6 months of previ-
ous training; thus, most likely, the muscle group already
had high fatigue resistance.
From a biochemical and physiological point of view,
the ergogenic effect of creatine could be explained by the
fact that the energy required for muscle contraction is pro-
vided by the breakdown of adenosine triphosphate (ATP)
from the enzyme ATPase. The result of the reaction, which
is extremely fast, is adenosine diphosphate (ADP), which is
rapidly regenerated by the phosphocreatine (PCr) through
another enzyme, i.e., creatine kinase (5,29). Thus, creatine
is a vital source of chemical energy for muscle contraction
because of its capacity for phosphorylation, with the con-
sequent formation of PCr and reversion and with the do-
nation of the phosphate group to ADP, which in turn gives
rise to a new ATP. Moreover, creatine is a fast source of en-
ergy for the synthesis and re-synthesis of ATP and is thus
extremely important for high-intensity and short-duration
activities (1).
In terms of administration protocols, a loading phase
of 20 g/day for 5 days followed by a maintenance phase of 2
or 3 g/day is common for creatine monohydrate (5,16). The
saturation phase is used to achieve an adequate increase
in muscle creatine stores. In this sense, Hultman et al. in-
vestigated the effect of two oral creatine supplementation
protocols on muscle tissue saturation. The typical satura-
tion protocol (20 g/day for 6 days) increased the amount
of creatine in muscle tissue by 20%. The low and contin-
uous dose protocol (3 g/day for 28 days) also provided an
approximately 20% increase in muscle creatine stores. The
elevated levels of muscle creatine were sustained in both
cases with a maintenance dose of 2 g/day (30).
Therefore, our results corroborate other findings (14,
20,21,31-35), i.e., low doses of creatine monohydrate sup-
plementation, regardless of the use of saturation phase,
could significantly increase maximum muscle strength
and resistance to fatigue. Furthermore, no subjects in any
of the groups reported any discomfort or side effects dur-
ing the study period.
4.1. Practical Applications
The results of this study indicate that creatine supple-
mentation in low doses could also provide its ergogenic
benefits without the need of the saturation phase. More-
over, doses of 3 and 5 g/day are sufficient and do not differ
from each other in terms of maximal strength increment
after 7, 14, 21, 28, and 35 days of supplementation. However,
for fatigue resistance, a higher dose (5 g/day) for a mini-
mum of 14 days seems to be necessary for a significant im-
provement.
These findings are particularly significant for athletes
with little preparation time for a competition or for those
who have some contraindication to prolonged use and
high doses of creatine, thereby benefitting from low-dose
creatine supplementation at 7 or 14 days before competi-
tions.
Acknowledgments
We would like to thank Editage (www.editage.com) for
English language editing.
Footnotes
Conflicts of Interests: No conflicts of interest are declared
by the authors.
Funding/Support: No funding was received for the study.
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