Does Creatine Actually Work? I Tested It for 6 Months (With Before/After Data)

Creatine is the most researched supplement in sports science history. There are over 500 peer-reviewed studies on it. The evidence is clear: it works.

But there's still a lot of confusion about how it works, who it works for, the best type, loading vs. not loading, and whether it causes hair loss (we'll get to that one).

I've been using creatine for years, but for this review I took a proper 6-month controlled approach. DEXA scan before and after. Strength numbers tracked weekly. Bloodwork at months 0, 3, and 6.

Here's everything you need to know.

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What Is Creatine and How Does It Work?

Creatine is a naturally occurring compound found primarily in red meat and fish. Your body also makes it in the liver and kidneys from amino acids.

Stored in your muscles as phosphocreatine, it helps rapidly regenerate ATP — the energy currency your cells use for high-intensity work like lifting weights or sprinting. When your phosphocreatine stores are depleted (typically within 8-10 seconds of max effort), you fatigue.

Supplementing creatine increases your phosphocreatine stores by 10-40%, which means:

• More reps before muscle failure
• Faster recovery between sets
• Slightly more power output during intense efforts
• Better muscle hydration and cell volumization

Over time, those extra reps compound into real muscle and strength gains. That's the mechanism.

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My 6-Month Results

Starting stats:

• Body weight: 183 lbs
• Lean mass (DEXA): 156 lbs
• Body fat: 14.8%
• Bench press 1RM: 265 lbs
• Squat 1RM: 345 lbs

6-month stats (on 5g creatine monohydrate daily):

• Body weight: 188 lbs (+5 lbs)
• Lean mass (DEXA): 160.5 lbs (+4.5 lbs)
• Body fat: 14.2% (-0.6%)
• Bench press 1RM: 295 lbs (+30 lbs, 11%)
• Squat 1RM: 385 lbs (+40 lbs, 12%)

Worth noting: the first 1-2 weeks saw a rapid 2-3 lb weight gain from increased water retention in the muscles. This is normal and expected — creatine pulls water into muscle cells.

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Which Type of Creatine Should You Take?

Walk into any supplement store and you'll see 15 types of creatine. Here's the honest breakdown:

Creatine Monohydrate — Just Use This

Creatine monohydrate is the most studied form. It's what every major clinical trial used. It works. It's cheap. Period.

Any supplement company trying to sell you "superior" creatine HCL, Kre-Alkalyn, creatine ethyl ester, or buffered creatine is either misinformed or trying to charge you a premium for no meaningful benefit. The science doesn't support these claims.

Recommended brands:

• Thorne Creatine — pharmaceutical-grade, Creapure certified, no fillers. ~$40 for 180 servings.
• Optimum Nutrition Micronized Creatine — industry standard, mixes well. ~$25 for 120 servings.
• Bulk Supplements Creatine Monohydrate — absolute cheapest per gram option. No flavor, mixes ok. ~$20 for 200 servings.

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Do You Need to "Load" Creatine?

The classic loading protocol is 20g/day for 5-7 days, then 3-5g/day maintenance.

Short answer: No, you don't have to.

Loading gets you to saturation faster (~1 week vs. ~4 weeks), but you end up in the same place either way. If you have an event coming up and want faster results, load. If you're playing the long game, just take 5g/day and you'll be fully saturated within a month.

Loading can cause some GI discomfort for sensitive people. If your stomach doesn't love it, stick to 3-5g/day.

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Does Creatine Cause Hair Loss?

This one comes up constantly so let me address it.

One 2009 study in rugby players found that creatine increased DHT (dihydrotestosterone) levels by about 56%. DHT is the hormone responsible for male pattern baldness in genetically predisposed men.

Here's the nuance: that study showed DHT within normal range and has never been replicated. The existing evidence does NOT show creatine causes hair loss.

Reality check: If you're genetically predisposed to male pattern baldness, it's going to happen. Creatine might accelerate it marginally in some people, though the evidence is weak. If you're already on finasteride or minoxidil for hair loss, creatine supplementation is probably fine. Talk to your doctor if you're concerned.

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Who Benefits Most from Creatine?

High responders:

• People with naturally low muscle creatine stores (often vegetarians/vegans, since creatine comes mainly from meat)
• People doing strength training, HIIT, sprint-based sports
• Older adults (some evidence for cognitive benefits and preserving muscle mass)

Low responders:

• People who eat a lot of red meat (already have higher stores)
• Endurance athletes (less relevant for long, steady-state efforts)

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Bloodwork — Is Creatine Safe?

My creatinine levels (a kidney function marker) went up slightly, which is completely normal and expected with creatine supplementation. Creatine metabolizes to creatinine, so your numbers will be elevated. This is NOT a sign of kidney damage.

All other markers (liver enzymes, BUN, electrolytes) were within normal range at all three tests.

The bottom line on safety: Creatine monohydrate is one of the safest sports supplements studied. Unless you have pre-existing kidney disease, there's no evidence it's harmful at normal doses.

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My Recommendation

Just take it. 5g/day, creatine monohydrate, with water or mixed into your protein shake. It doesn't matter when you take it (before or after training is fine). Consistency over time is what matters.

If you haven't been taking it, start today. It's cheap, safe, and it works. There's no supplement category with stronger evidence.

For the brand: Thorne if you want the cleanest option, Optimum Nutrition if you want the best value, Bulk Supplements if you want the cheapest.