How to Use Creatine for Muscle, Brain Power & Better Recovery

Sims traces the loading protocol back to 1980s bodybuilding, where the goal was to make muscles 'swole.' The original approach paired 5 g creatine with 20 g carbohydrate four times daily, which did enhance performance but also caused significant water retention and bloating — the source of the persistent myth that creatine causes a puffy look. She clarifies that the water retention from creatine alone is intracellular, contributing to muscle fullness and definition, not subcutaneous bloating. For those seeking muscle performance, this loading strategy remains effective, but she emphasizes that it takes about three weeks of consistent loading to achieve full saturation. She also notes that a washout period is typically used between cycles.

Sims distinguishes between performance and health dosing. For health, a modest daily intake is sufficient to top off the body's creatine pools without the need for loading or cycling. She notes that the liver endogenously produces about 3 grams per day, but that amount is often inadequate, especially for those under stress or with higher demands. The health dose is simple, flexible, and safe for long-term use. She particularly recommends starting low (1 gram) for those who are hesitant or sensitive, then gradually increasing to 5 grams as tolerated.

Sims explains that when the brain is sleep-deprived, its metabolic rate increases as it struggles to maintain function, burning through glucose rapidly. Creatine, as a key player in the phosphocreatine energy system, can help buffer this energy crisis. The research suggests a higher dose range of 10–20 grams daily, but it must be spread throughout the day to avoid GI distress and to facilitate gradual tissue saturation. She stresses that one large acute dose will not provide immediate cognitive rescue — the creatine must first accumulate in brain tissue. The question of whether pre-loading before a known period of sleep loss (e.g., a night shift) is effective remains unanswered, though logically it might help. This protocol is distinct from both muscle loading and general health dosing.

Sims and the host recount multiple instances where creatine users had blood tests return with creatinine levels in the 'red zone,' causing panic. The key is to preemptively tell the doctor about creatine supplementation so results are interpreted correctly. If a result is still concerning, the recommended step is to stop creatine for a couple of weeks and repeat the test. If levels normalize, it was the supplement; if not, further investigation is warranted. This is especially important for individuals taking multiple supplements or medications that can impact kidney function.

Sims started taking creatine about 10 years ago to rebuild muscle after surgeries and return to racing. While working with a women's rugby team, she noticed that male athletes were always advised to take creatine but the women were not — later learning it was simply because the women's team lacked budget. This prompted her to try it herself, and after experiencing benefits, she began recommending it to her female athletes. Now, based on the breadth of research and her own positive experience, she advocates for universal use. She emphasizes that the water retention myth (bloating) stemmed from old protocols that combined creatine loading with high-carb intake, not from creatine alone. The water retention is intracellular, contributing to muscle definition, not a puffy appearance.

Sims explains that a 'tired brain' — from lack of sleep, shift work, or jet lag — has a heightened metabolic rate and burns through glucose faster. Because creatine is integral to the fast energy system (phosphocreatine) in all tissues, including the brain, supplementation may help buffer this energy deficit. The research suggests a dose of 10–20 grams per day, but it must be split across the day, not taken as a single bolus. Crucially, one acute dose won't help; the brain and other tissues need time to become saturated. She notes that the question of using creatine prophylactically (loading before a known period of poor sleep) hasn't been studied yet, though logically it might help. The research is still emerging, led by scientists like Darren Kandow.

Sims distinguishes between creatine monohydrate made via a water wash (Creapure) and cheaper versions that may use formaldehyde and an acid wash, leaving residual chemicals that cause bloating and stomach pain. She notes that some individuals may be 'over-responders' who react even to pure creatine, but starting with a low dose (1 gram) and titrating up can help. She personally trusts and recommends only products bearing the Creapure seal, which is a B2B ingredient supplied to many brands. This purity factor, combined with appropriate dosing (avoiding the old carb-loading protocol), eliminates most side effects people fear.

Sims and the host both share anecdotes of blood tests coming back with alarmingly high creatinine, leading to panic until they disclosed creatine use. Sims advises always listing creatine on your supplement list before tests. If a result is flagged, the proper approach is to taper off creatine for a couple of weeks and retest to see if levels normalize, distinguishing between a true kidney issue and a supplement artifact. This is especially important for people taking multiple supplements or medications that can affect kidney function.