ISSN Position Stand on Creatine: Key Findings and Recommendations

The Gold Standard of Creatine Research

The International Society of Sports Nutrition (ISSN) published its updated position stand on creatine supplementation in 2017, authored by Kreider et al. This comprehensive document represents the most authoritative scientific consensus on creatine’s safety, efficacy, and practical applications. It reviewed hundreds of studies spanning decades of research (RB et al., 2017) .

The ISSN is one of the most respected organizations in sports nutrition research, and their position stands undergo rigorous peer review. When they make a statement about a supplement, it carries significant scientific weight.

The 12 Key Positions

The ISSN position stand includes 12 specific evidence-based conclusions. Here are the most important ones:

Position 1: Most Effective Ergogenic Supplement

The ISSN states that creatine monohydrate is the most effective ergogenic nutritional supplement currently available for increasing high-intensity exercise capacity and lean body mass during training.

Position 2: Safety Confirmed

There is no scientific evidence that short- or long-term use of creatine monohydrate has any detrimental effects on otherwise healthy individuals when used at recommended doses.

Position 3: Monohydrate is Superior

Creatine monohydrate is the most extensively studied and clinically effective form of creatine for use in nutritional supplements. No alternative form (HCl, ethyl ester, kre-alkalyn, etc.) has been shown to be superior.

Position 4: Beyond Athletic Performance

Creatine supplementation is not just an ergogenic aid — the ISSN recognizes it may have therapeutic applications in neurodegenerative diseases, diabetes, muscle-wasting conditions, and brain health.

Dosage Recommendations

The ISSN provides clear dosage guidelines:

Loading Protocol

• Dose: ~0.3g/kg/day (approximately 20g/day for a 70kg individual)
• Duration: 5-7 days
• Administration: Divided into 4 equal doses throughout the day
• Effect: Rapidly saturates muscle creatine stores within one week

Maintenance Protocol

• Dose: 3-5g/day
• Duration: Ongoing
• Effect: Maintains elevated muscle creatine stores
• Alternative: Can be used from the start without loading (saturation in ~4 weeks)

Safety Evidence Reviewed

The ISSN position stand specifically addresses common safety concerns:

Kidney Function

The position stand references studies including Poortmans & Francaux (2000), which monitored athletes taking creatine for up to 5 years and found no adverse effects on kidney function (JR & M, 2000) . The elevated creatinine from supplementation does not indicate kidney damage.

Dehydration and Cramping

The ISSN explicitly states that claims about creatine causing dehydration and muscle cramping are not supported by scientific evidence. Research actually suggests creatine may improve hydration status and reduce cramping incidence.

Liver Function

No adverse effects on liver function have been documented in any controlled study of creatine supplementation at recommended doses.

Weight Gain

Initial weight gain of 1-2kg during loading is attributed to increased intracellular water — a beneficial effect of cell volumization, not fat gain.

Performance Benefits Highlighted

The ISSN position stand documents extensive performance benefits:

These findings are consistent across the broader literature, including the earlier 2007 ISSN position stand (TW et al., 2007) and the landmark loading study by Harris et al. (1992) (RC et al., 1992) .

Therapeutic Applications

One of the most forward-thinking aspects of the 2017 position stand is its recognition of creatine’s potential therapeutic applications beyond sport:

• Neurodegenerative diseases — Potential benefits for Parkinson’s, Huntington’s, and ALS
• Traumatic brain injury — Creatine may reduce brain damage severity
• Depression — Preliminary evidence for mood benefits, particularly in women
• Type 2 diabetes — Improved glycemic control when combined with exercise
• Bone health — Potential benefits for bone mineral density, especially in older adults
• Sarcopenia — Significant benefits for age-related muscle loss when combined with resistance training

What This Means for Malaysian Consumers

The ISSN position stand provides strong reassurance for Malaysian creatine users:

• Scientific backing — Creatine monohydrate is the most studied supplement in history with clear evidence of safety and efficacy
• No need for expensive forms — The ISSN confirms monohydrate is superior; there is no scientific reason to pay premium prices for HCl, ethyl ester, or other forms
• Safe for long-term use — Studies up to 5 years confirm safety at recommended doses
• Malaysian-specific considerations — The ISSN’s dosage recommendations (3-5g/day) are universal and apply equally to Malaysian consumers. Halal-certified creatine monohydrate (Creapure, AGYM, PharmaNutri) provides the same compound reviewed in these studies.
• Inform your doctor — If undergoing medical tests in Malaysia, mention creatine use to avoid misinterpretation of elevated creatinine

Criticisms and Limitations

While the ISSN position stand is comprehensive, it is worth noting:

• Most studies were conducted on Western populations; more research on Asian/Malaysian populations is welcome
• Many studies focus on young, healthy, trained individuals; more research on diverse demographics continues
• The position stand acknowledges that individual responses vary (responders vs. non-responders)
• Ongoing research may reveal additional applications and mechanisms

Key Takeaways

• The ISSN confirms creatine monohydrate as the most effective ergogenic supplement available
• Recommended dose: 3-5g/day maintenance (with optional 20g/day loading for 5-7 days)
• Safety confirmed across hundreds of studies with no adverse effects in healthy individuals
• No alternative form is superior to creatine monohydrate
• Therapeutic applications beyond sport are increasingly recognized
• The ISSN position stand represents the strongest scientific consensus on any supplement

Sources & References

This article summarizes the ISSN Position Stand by Kreider et al. (2017) and references the earlier position stand by Buford et al. (2007), Harris et al. (1992), and Poortmans & Francaux (2000). Full citations are available in our Research Library.