If you’re a supplement enthusiast then chances are you know all about creatine and its plethora of research-supported benefits. Even if you’re not much a supplement user, odds are you know a decent amount about the beneficial properties of creatine, specifically with regards to enhancing athletic performance and muscular development. But don’t worry, if you have no clue what creatine is or how it works, this article will give an abridged flow of how it works.
That being said, the main this article is going to tackle is what forms of creatine are actually efficacious according to literature. It seems like supplement companies will do anything these days to gain an edge, and sadly this often results in them using bunk ingredients just because they’re different and sound flashy. Without further ado, let’s jump into how creatine works physiologically.
Abridged Overview of How Creatine Works
Structure of Creatine
Every cell in the body requires energy in the form of a molecule known as adenosine triphosphate (ATP) to carry out physiological processes. Muscle cells, in particular, are repeatedly exhausting and restoring ATP levels in order to perform work (i.e. contract). Thus, any way to bolster the cell’s restoration process of ATP is conducive to increasing a muscle’s capacity to perform work. Pretty simple, right?
The good news is that the phosphocreatine energy system found in skeletal muscle tissue is meant for precisely this. When ATP is broken down to adenosine diphosphate (ADP), phosphocreatine comes into action to donate a highly energetic phosphate molecule to ADP, thus forming a new ATP molecule. Phosphocreatine, as you may have derived already, is a creatine molecule bound to phosphate. Bear in mind this is a highly truncated overview of how creatine works to boost cell energy and athletic performance.
Hands-down the most available and research-backed form of creatine is creatine monohydrate, which is simply creatine bound to water. Creatine monohydrate has 1000’s of studies supporting its benefits and safety, eclipsing any other form as far as research validation goes. Moreover, creatine monohydrate is one of the most effective supplements to consider when looking at its cost-to-benefit ratio and tolerability. Many creatine monohydrate products come in “micronized” powders, such as that of the trademarked Creapure product, which is an unadulterated form of creatine produced made from select raw materials in Germany that are tested for purity and safety.
Creatine researchers hypothesize that binding creatine to various salts will produce a product that is more bioavailable in the body and soluble in liquid than creatine monohydrate. Below we will take a look at the popular forms of creatine salts and the research findings (or lack thereof) behind them.
NO-Generation in the body
A popular salt of creatine is the nitrate salt. The research is still somewhat scarce on creatine nitrate, but preliminary findings show that dietary nitrate may enhance oxygen uptake and enhance athletic performance. The concern, however, is that dietary nitrate is broken down to nitrite which reacts with creatine to form N-nitrososarcosine, which is a strong carcinogen. More studies will be needed to investigate the ramifications of this reaction in vivo.
Recent research has found that this citric acid-bound form of creatine is not more absorbable (nor effective) than creatine monohydrate. It is however suggested to be more soluble in liquid solution (but doesn’t mean much in the grand scheme of things).
The malic acid-bound form of creatine has yet to be studied (at least as far as its effects on athletic performance). However, malic acid on its own has demonstrated performance-enhancing benefits, suggesting it could be useful without synergistic creatine actions (similar to the added benefits of L-citrulline-malate vs. L-citrulline).
At this time, the most promising salt of creatine is the pyruvate form. Research indicates that it is more effective than creatine citrate and produces high plasma levels of creatine. However, it is yet to be seen in literature that creatine pyruvate is any more effective than creatine monohydrate.
Similar to creatine malate, creatine orotate has little scientific research behind it at the time of this writing. However, orotic acid is a crucial organic acid in the biosynthesis of pyrimidines, and also spare vitamin B12 and folate in animals. That being said, it’s much more expensive than creatine monohydrate and the added benefits of orotic acid are nothing to write home about.
Magnesium Creatine Chelate
Magnesium Creatine Chelate
It appears that magnesium creatine chelate enhances the uptake of creatine into muscle tissue, which in turn increases intracellular water levels in muscle. However, the significance of this enhanced uptake on athletic performance is still up for debate, and hasn’t been compared directly to creatine monohydrate. 
Buffered Creatine (Kre Alkalyn)
This is a form of creatine purported to be buffered at a basic pH and more absorbable than creatine monohydrate. The buffer used is simply baking soda, but the irony here (as below with esterified creatine) is that studies show it to be no more (or even less) effective than creatine monohydrate in terms of performance enhancement. 
Steer clear of this…
It’s a bit disconcerting that supplement companies even go down this route with creatine products given that creatine monohydrate is not stable in aqueous solutions. Essentially, these products are rendered into the useless byproduct creatinine long before they even hit store shelves. Main point—stick to powdered creatine supplements.
Esterified creatine is somewhat ironic in that supplement companies claim it has “enhanced uptake” over creatine monohydrate, but the research has shown it is actually less bioavailable .  Upon ingestion, creatine esters are readily converted to the creatine byproduct creatinine.
Given the unstable nature of creatine in liquid solutions, some manufacturers created an effervescent form of creatine which is comprised of creatine monohydrate, citric acid and bicarbonate. However, studies show that this form of creatine ultimately becomes unstable in solution just like other forms of liquid creatine monohydrate supplements. 
This is actually one of the more intriguing “new” forms of creatine due to the absorption-enhancing effect polyethylene glycol (PEG) produces. In fact, studies seem to suggest that polyethylene glycosylated creatine is just as effective as creatine monohydrate at doses 75% less than that of monohydrate treatments. [9,10] This suggests that PEG acts as a highly efficient vehicle for oral creatine supplements. However, this is still a somewhat scarce creatine form in the supplement industry.
Creatine Monohydrate is still the King
So Which Form of Creatine is Best?
Given its vast catalog of research, it’s rather hard to argue against creatine monohydrate powders as being the most effective and safe form of creatine available. Make no mistake, some of the salt forms of creatine (particularly creatine pyruvate and magnesium creatine chelate) may present decent alternatives with other performance-enhancing benefits, while glycosylated creatine does appear to have some potential as well. At the end of the day, though, your best bet is to go with what works and what has stood the test of time, and that is plain old creatine monohydrate.
Top Supplement Review Lists:
The Top 11 Best Pre-Workout Supplements for 2016
The Best 15 Natural Testosterone Booster Supplements for Men – 2016 Rankings
The Best 11 Post Workout Supplements for Recovery & Muscle Building – 2016 Rankings
- Derave, W., & Taes, Y. (2009). Beware of the pickle: health effects of nitrate intake. Journal of Applied Physiology, 107(5), 1677-1677.
- Jäger R, Harris RC, Purpura M, Francaux M: Comparison of new forms of creatine in raising plasma creatine levels. J Int Soc Sports Nutr 2007, 4:17
- Wu, J., Wu, Q., Huang, J., Chen, R., Cai, M., & Tan, J. (2007). Effects of L-malate on physical stamina and activities of enzymes related to the malate-aspartate shuttle in liver of mice. Physiological research, 56(2), 213.
- Jäger R, Metzger J, Lautmann K, Shushakov V, Purpura M, Geiss K, Maassen N: The effects of creatine pyruvate and creatine citrate on performance during high intensity exercise. J Int Soc Sports Nutr 2008, 5:4
- Abraham, Sal, and Shengli Jiang. “Process for preparing a creatine heterocyclic acid salt and method of use.” U.S. Patent No. 6,838,562. 4 Jan. 2005.
- Brilla, L. R., et al. “Magnesium-creatine supplementation effects on body water.” Metabolism9 (2003): 1136-1140.
- Jagim, A. R., Oliver, J. M., Sanchez, A., Galvan, E., Fluckey, J., Reichman, S., … & Kreider, R. B. (2012). Kre-Alkalyn® supplementation does not promote greater changes in muscle creatine content, body composition, or training adaptations in comparison to creatine monohydrate. Journal of the International Society of Sports Nutrition, 9(Suppl 1), P11.
- Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DS:The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. J Int Soc Sports Nutr 2009, 6:
- Ganguly S, Jayappa S, Dash AK:Evaluation of the stability of creatine in solution prepared from effervescent creatine formulations. AAPS PharmSciTech 2003, 4:
- Herda TJ, Beck TW, Ryan ED, Smith AE, Walter AA, Hartman MJ, Stout JR, Cramer JT:Effects of creatine monohydrate and polyethylene glycosylated creatine supplementation on muscular strength, endurance, and power output. J Strength Cond Res2009, 23:818-826.
- Camic CL, Hendrix CR, Housh TJ, Zuniga JM, Mielke M, Johnson GO, Schmidt RJ, Housh DJ:The effects of polyethylene glycosylated creatine supplementation on muscular strength and power. J Strength Cond Res2010, 24:3343-3351