creatine monohydrate

I recommend creatine for almost everyone because of the immense benefits it offers for your brain and body, and its overwhelming safety and few contraindications (aka: very few reasons a person cannot or should not take it). Many studies are emerging with more information about how creatine can help support you after a sleepless night, in concussion recovery, to build muscle and improve performance, and maybe even to prevent or delay dementia. Creatine is used in the body to maintain levels of ATP in your cells, so you can think of it like a battery reserve.

Creatine is safe for children, adults, pregnant women, and elderly people. It is a substance found naturally in foods – mostly animal foods, like red meat, poultry, and fish. Your body also produces it, in your liver and your brain.

Creatine has been, and continues to be, extensively studied. (If you want to check out the latest literature, search "Darren Candow" or "creatine" on PubMed; I like Dr Candow because he has been researching creatine for decades at the University of Regina in Canada, and he's one of the most published researchers on the topic!) I recommend supplementing creatine monohydrate because it is well absorbed and has been the most well-studied. Some brands advertise different forms of creatine as being superior, but often, this is a gimmick to charge more money for a form of creatine that isn't actually better than plain creatine monohydrate.

When shopping for a supplement, look for third party tested products, or NSF Certified for Sport (which means the supplement can be safely taken by athletes competing at elite levels, and are tested for drugs and additives); look for products made in the United States or Europe.

Brands I like:

anything with Creapure creatine, which is manufactured in Germany, and Dr. Candow sits on their advisory board
Thorne
Force Factor: I use this one
Momentous: they have powder and chewables that are apparently tasty
Create gummies which contain Creapure

how much should I supplement?

always talk to your doctor before starting to supplement. this is not medical advice! (also, make sure your doctor has done their homework about creatine supplementation, too! some doctors are uncomfortable with creatine because they interpret increases in creatinine as renal failure. creatine does not cause renal impairment or renal failure and is safe for persons without kidney disease.)

Generally, children can supplement 3-5 grams daily. Creatine has been studied in concussion recovery in children at doses as high as 20+ grams daily.

Adult women can supplement up to 20 grams daily, but could start with 5-10 g daily and see how they go.

Adult men can supplement up to 25 grams daily, with the same advice for starting as above for women.

You need to drink plenty of water when you are supplementing creatine. I personally supplement 15 grams daily and drink at least 2.5 liters of water every day. Some days I'll take another dose, like if I'm jet lagged, fatigued, working longer hours, or didn't sleep well.

why supplement?

creatine may increase bone mineral density
increase skeletal muscle mass, which improves your metabolic health and increases the number of calories you burn at rest
creatine MIGHT decrease total fat mass
improved upper/lower body strength
may increase HDL ("good" cholesterol) levels
may decrease total cholesterol and triglycerides
may improve A1c (average blood sugar levels)

supplementing at higher levels permits creatine to saturate your muscles and begin to get into other tissues, such as bone and brain tissue. generally, more benefits are seen at higher doses, and that is what current literature is supporting. if you aren't getting the benefits you want to see at 5 g, try increasing. consistency is also key. food is a slow medicine. give yourself 3 months on creatine before making any decisions about what is or isn't working. food does not work the way pharmaceuticals do - pills hijack a specific system, molecule, or process with a specific target end point that has been measured and validated in rigorous controlled trials. food (including herbs and supplements) is synergistic, and works on many systems simultaneously and subtly. it can be powerful over time, but is also much safer because it's not taking control over a specific single target. it's nourishing.

creatine makes my stomach hurt.

If you are taking it with water on an empty stomach, try taking it with food. You can mix into yogurt or soups/stews, and you can divide your dose throughout the day. This generally alleviates stomach upset.

does caffeine affect absorption? what about carbohydrates?

you have to drink a LOT of caffeine for it to affect your creatine absorption. 1-2 cups of coffee with creatine is not going to affect it dramatically. there is some research that suggests that taking creatine with 75+ grams of carbohydrates can improve absorption, but generally creatine is really well absorbed all by itself and you do not necessarily need to eat carbs to get the benefits. the best way to get it into your muscles is movement, hence the recommendation to take it before or after exercising (within 1-2 hrs).

to learn more and do a deeper dive, I recommend the following resources.