Jagim et al. 2012: Buffered Creatine vs Monohydrate — No Advantage Found

TL;DR — Jagim et al. 2012

Jagim and colleagues published a double-blind RCT comparing buffered creatine (Kre-Alkalyn) against creatine monohydrate. The study found no advantage for the buffered form in any measured outcome — muscle creatine content, body composition, strength, or endurance were equivalent between groups. These results reinforced the ISSN position that creatine monohydrate remains the gold standard form with no evidence supporting the superiority of alternative formulations.

Background

Buffered creatine, marketed as Kre-Alkalyn, claims to have a higher pH that prevents conversion to creatinine in the stomach, theoretically improving absorption and reducing side effects. These marketing claims suggested that lower doses of buffered creatine could match or exceed the effects of standard monohydrate doses.

However, both the 2007 ISSN position stand by Buford et al. (TW et al., 2007) and the 2017 update by Kreider et al. (RB et al., 2017) concluded that no alternative form of creatine has been shown to be superior to monohydrate. Jagim et al. designed this study to directly test the buffered creatine claims.

Study Design

• Type: Double-blind, randomized controlled trial
• Groups:
  • Creatine monohydrate: 20 g/day loading for 7 days, then 5 g/day maintenance
  • Buffered creatine (manufacturer dose): as directed on label
  • Buffered creatine (equivalent dose): matched to monohydrate group dosing
• Duration: 28 days
• Measurements: Muscle creatine via muscle biopsy, body composition via DXA, strength tests, endurance tests, blood chemistry, reported side effects

Key Findings

1. Muscle creatine content was equivalent

Muscle biopsy analysis showed that all three groups achieved similar increases in intramuscular creatine content. The buffered form did not produce superior muscle loading despite marketing claims of better absorption.

2. Performance outcomes were identical

No significant differences were observed between groups for:

• Bench press 1RM
• Leg press 1RM
• Muscular endurance
• Sprint performance

3. Side effects were comparable

Both forms were well tolerated. Reports of bloating, cramping, and gastrointestinal discomfort were minimal and not significantly different between groups. This contradicted the marketing claim that buffered creatine eliminates the side effects associated with monohydrate.

4. Creatinine levels were similar

Blood creatinine levels did not differ significantly between groups, challenging the claim that buffered creatine prevents the conversion of creatine to creatinine.

Practical Implications

1. Stick with monohydrate: No evidence supports paying a premium for buffered or pH-adjusted creatine formulations
2. Marketing claims are unsubstantiated: Buffered creatine’s purported advantages in absorption and side effect reduction were not confirmed by direct scientific comparison
3. The ISSN position is supported: Monohydrate remains the most researched, most effective, and most cost-effective form of creatine
4. Cost matters: Monohydrate is typically 3-5 times cheaper per serving than proprietary formulations

Malaysian Relevance

Malaysian consumers encounter numerous creatine forms on Shopee, Lazada, and in supplement shops. Buffered creatine products are often marketed with premium pricing and claims of superior absorption. This study provides clear evidence that standard creatine monohydrate — available for as little as RM 0.50 per serving — performs identically to more expensive alternatives. As Harris et al. (1992) first demonstrated, the monohydrate form reliably increases muscle creatine stores (RC et al., 1992) .

Limitations

• 28-day study may not capture long-term differences
• Relatively small sample size per group
• Only compared one alternative form (Kre-Alkalyn)
• Single manufacturer’s product tested

Full Citation

Jagim AR, Oliver JM, Sanchez A, et al. A buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate. Journal of the International Society of Sports Nutrition. 2012;9(1):43. doi:10.1186/1550-2783-9-43

Study Design and Methodology

Understanding how a study was designed helps assess the strength of its conclusions. Key methodological factors to evaluate include:

• Sample size — larger studies (n=50+) provide more reliable results than small studies (n=10-15). Small sample sizes increase the risk of false positives and limit the ability to detect moderate effect sizes
• Study duration — creatine research requires adequate duration for muscle saturation (minimum 4 weeks for maintenance dosing, 1 week for loading). Studies shorter than this may miss the full effect
• Blinding — double-blind, placebo-controlled designs (where neither researchers nor participants know who receives creatine) are the gold standard for minimising bias
• Population studied — results from trained athletes may not fully apply to untrained individuals, and vice versa. Age, sex, and dietary habits (particularly vegetarian status) also influence creatine response
• Outcome measures — direct measures (muscle biopsy, MRS imaging) are more informative than indirect proxies (blood markers, performance tests) for assessing creatine uptake and metabolism

Clinical Implications and Practical Relevance

This research contributes to our understanding of creatine in several practical ways:

For athletes and fitness enthusiasts: The findings support the use of creatine monohydrate as a safe, effective ergogenic aid. The standard dosing protocol of 3-5g daily remains well-supported by the cumulative evidence base including this study.

For healthcare professionals: Understanding the specific mechanisms and safety data from studies like this helps clinicians provide evidence-based guidance to patients who ask about creatine supplementation. The research consistently shows a favourable safety profile at recommended doses.

For the Malaysian context: While most creatine research is conducted in Western populations, the fundamental biochemistry (ATP-phosphocreatine system) is universal. Malaysian consumers can apply these findings with confidence, adjusting for local factors like tropical climate (increased hydration needs) and halal dietary requirements (synthetic creatine monohydrate is permissible).

How This Fits Into the Broader Evidence

No single study should be used to make definitive claims about creatine supplementation. Instead, this research should be viewed as one piece of a much larger evidence base:

• The ISSN Position Stand (2017) synthesises hundreds of studies into comprehensive recommendations
• Multiple systematic reviews and meta-analyses confirm creatine’s effects on strength, power, and lean mass
• Long-term safety data spanning up to 5 years shows no adverse effects at recommended doses

For a complete overview of the evidence, explore our Research Library which covers 60+ landmark creatine studies.

Sources & References

This article is based on the RCT by Jagim et al. published in JISSN (2012) and contextualized with Buford et al. (2007), Kreider et al. (2017), and Harris et al. (1992). All citations reference PubMed-indexed publications.

Further Reading

• creatine dosage guide
• creatine safety profile
• creatine monohydrate
• creatine for muscle building
• buying creatine in Malaysia
• creatine research library