Are there any safety concerns with creatine supplementation in women?

The available evidence indicates creatine supplementation is well tolerated in women. A comprehensive systematic review concluded that short and longer-term creatine use does not adversely affect the gastrointestinal, renal, hepatic, or cardiovascular systems in women. The CONCRET-MENOPA trial (Forbes et al., 2025) reported that all interventions were well tolerated, with no severe adverse effects in any group including the 1,500 mg creatine HCl arm. As with any supplement, individuals with pre-existing kidney conditions should consult their GP before use.

Does creatine cause water retention in women?

Q: Does creatine cause water retention?

Creatine is an osmotically active compound. When it enters muscle cells, it draws water with it to maintain osmotic balance — this is intracellular water retention. The effect is dose- and form-dependent. Standard creatine monohydrate loading protocols (20–25 g per day for 5–7 days) have been shown to increase total body water by approximately 1 litre, reflected as around 1 kg of scale weight change. Lower daily maintenance doses, and particularly creatine HCl at 1,500 mg per day (as used in the CONCRET-MENOPA trial), are associated with substantially smaller or negligible changes in total body water.

Q: Is the scale weight change from creatine fat gain?

No. Any scale weight increase associated with creatine supplementation is attributable to intracellular water retention — water drawn into muscle cells by the osmotic activity of creatine. Fat tissue is not involved in this mechanism. Creatine loading protocols that produce a 0.75–1 kg scale weight increase achieve this within 7 days — a timeframe far too short for meaningful changes in fat mass. The CONCRET-MENOPA trial (Forbes et al., 2025) reported no adverse effects including no body composition changes in any treatment group, including the 1,500 mg creatine HCl group.

Q: Why does creatine HCl cause less water retention than monohydrate?

The mechanism is linked to solubility and dose. Creatine monohydrate loading protocols require high doses (20–25 g/day) that rapidly saturate muscle creatine stores, drawing a significant volume of water intracellularly in a short period. Creatine HCl has substantially greater solubility in water than monohydrate, and research supports effective muscle and brain creatine elevation at a much lower dose — 1,500 mg per day — without a loading phase. At this lower dose, the osmotic load on muscle cells is smaller, and the associated intracellular water shift is correspondingly less pronounced.

Q: Do I need a loading phase with Krevie's Creatine Companion?

No. Creatine Companion uses creatine HCl at 1,500 mg per day — the dose and form used in the CONCRET-MENOPA trial (Forbes et al., 2025). This trial used a daily maintenance approach without a loading phase and demonstrated improvements in reaction time and frontal brain creatine levels over eight weeks. loading phases (typically 20–25 g/day for 5–7 days) are a regimen designed for creatine monohydrate at higher doses. They are not part of the research basis for creatine HCl at 1,500 mg.

By The Krevie Team | Last reviewed: May 2026

Creatine can cause water retention — but the extent depends entirely on the dose, the form, and whether a loading phase is used. Standard creatine monohydrate loading (20–25 g per day for 5–7 days) produces measurable intracellular water retention, typically reflected as 0.75–1 kg of scale weight change in the first week. Creatine HCl at 1,500 mg per day — the dose and form used in the CONCRET-MENOPA trial — operates at a far lower osmotic load, and the CONCRET-MENOPA trial reported no adverse body composition changes in any group. Understanding the mechanism explains why these differences exist.

What creatine is

Creatine is a naturally occurring compound synthesised primarily in the liver, kidneys, and pancreas from the amino acids arginine, glycine, and methionine. It is also consumed through meat and fish in the diet. The body stores approximately 95% of its total creatine in skeletal muscle, with the remainder distributed in the brain, heart, and other tissues.

Creatine's primary function is in cellular energy metabolism. It is stored in muscle and brain tissue as phosphocreatine (PCr) — a high-energy molecule that donates its phosphate group to adenosine diphosphate (ADP) to regenerate adenosine triphosphate (ATP), the cell's primary energy currency. This reaction happens in milliseconds and is the mechanism by which creatine supports high-intensity muscle contractions and, increasingly in the research, brain energy metabolism.

Two forms dominate the supplement market: creatine monohydrate (creatine attached to one water molecule) and creatine hydrochloride (creatine HCl, creatine combined with a hydrochloride group). These forms differ substantially in solubility — a difference with practical consequences for dosing, water retention, and gastrointestinal tolerance.

Women have been historically under-represented in creatine research. A comprehensive review by Smith-Ryan et al. (2021) in Nutrients noted that females exhibit 70–80% lower endogenous creatine stores compared to males, suggesting that supplementation may be of particular relevance for women — a finding with direct implications for dose-response considerations.

What the research shows

The osmotic mechanism: why creatine draws water

Creatine is an osmotically active substance. This means it has an inherent tendency to attract water molecules. When supplemental creatine enters muscle cells and is converted to phosphocreatine, it increases intracellular solute concentration — and water follows by osmosis to restore balance. This is intracellular hydration, not subcutaneous or extracellular fluid accumulation.

The volume of water drawn in is proportional to the creatine accumulation. A study by Ziegenfuss et al. (published in the Journal of Athletic Training), using a regimen of 25 g/day for seven days then 5 g/day for 21 days in both men and women, found a significant time-by-group interaction for total body water (TBW): the creatine group experienced a TBW increase of 1.37 litres in the first week of loading, with the total increase at 28 days approximately 2.04 litres. Body mass in the creatine group increased by a non-significant 0.75 kg after the loading phase, reaching significance at day 28. Importantly, the study found no change in fluid distribution — the water was retained across fluid compartments consistently, with no disproportionate subcutaneous pooling.

Loading phase vs maintenance dose: the dose-response difference

The scale weight changes associated with creatine supplementation are strongly linked to loading protocols. Standard creatine monohydrate loading — 20–25 g/day for 5–7 days — rapidly saturates muscle creatine stores, triggering the largest osmotic water shift. Research published in the Journal of Applied Physiology confirms that this loading achieves intramuscular phosphocreatine increases of 10–40% within that window, depending on baseline creatine status.

A maintenance dose (3–5 g/day of creatine monohydrate, reaching saturation over 3–4 weeks) produces the same final muscle creatine saturation but does so gradually, with a smaller and more gradual intracellular water shift. The total body water increase at endpoint is comparable; the rate and magnitude of any associated scale weight change at any given early timepoint is smaller.

Creatine HCl at 1,500 mg: the CONCRET-MENOPA trial findings

The CONCRET-MENOPA trial (Forbes, Korovljev, Ostojic et al., 2025), published in the Journal of the American Nutrition Association, is the primary trial supporting Krevie's Creatine Companion dose. This randomised, double-blind, placebo-controlled trial enrolled 36 perimenopausal and menopausal women (mean age 50.1 ± 5.7 years) and assigned them to one of four groups: low-dose creatine HCl (750 mg/day), medium-dose creatine HCl (1,500 mg/day), a creatine HCl plus creatine ethyl ester combination (800 mg/day), or placebo, for eight weeks. No loading phase was used.

The key safety finding: all interventions were well tolerated, with no severe adverse effects reported in any group. This includes the 1,500 mg creatine HCl arm. No adverse body composition changes — including scale weight or body mass change — were reported in any treatment group. The medium-dose creatine HCl group showed improvements in reaction time (6.6% improvement versus 1.2% in placebo, p<0.01) and a 16.4% increase in frontal brain creatine levels versus 0.9% in placebo (p<0.01). Serum lipid profiles were also favourably modulated (p<0.05) in the 1,500 mg group.

Why creatine HCl produces less water retention than monohydrate

Creatine HCl is formed by attaching a hydrochloride group to the creatine molecule. This lowers the pH of solutions containing it and substantially increases solubility. Research indicates creatine HCl is significantly more soluble in water than creatine monohydrate — this means it dissolves and is absorbed more readily at lower doses.

Pharmacokinetic modelling work (Dash et al., 2018 in Biopharmaceutics & Drug Disposition) found oral bioavailability of creatine monohydrate was dose-dependent and less than complete at higher doses (53% at low dose, 16% at high dose), whereas simulated creatine HCl showed predicted bioavailability of approximately 66% at an equivalent dose — reflecting improved absorption. This means a lower dose of creatine HCl can achieve comparable muscle and brain creatine elevation to a higher dose of monohydrate.

The practical consequence: the osmotic load entering muscle cells is smaller, because less creatine is being delivered and accumulated at any single point. The intracellular water shift is proportionally smaller. This is why research and user reports consistently associate creatine HCl with less noticeable scale weight change compared to monohydrate loading protocols.

How creatine HCl is used in Krevie

Creatine Companion provides 1,500 mg of creatine hydrochloride per daily serving — one scoop of the unflavoured powder, mixed in water or any cold beverage. This is the exact dose and form used in the CONCRET-MENOPA trial, which reported a 6.6% improvement in reaction time and a 16.4% increase in frontal brain creatine levels at eight weeks, with no severe adverse effects in any group.

No loading phase is required or recommended. The 1,500 mg daily maintenance approach achieves creatine saturation progressively over several weeks — the same endpoint as a loading regimen, without the higher osmotic load in the first week. This design choice reflects the CONCRET-MENOPA trial methodology directly: the trial used this dose without loading and demonstrated meaningful cognitive and neurological outcomes in perimenopausal and menopausal women.

The choice of creatine HCl rather than monohydrate is deliberate. Because the CONCRET-MENOPA trial specifically studied creatine HCl at 1,500 mg in this population, Krevie uses the same form and dose — matching the trial conditions precisely. Monohydrate at 5 g per day is a different compound form, at a different dose, with different pharmacokinetics, and was not the subject of this trial.

Frequently asked questions

Does creatine cause water retention?

Creatine is an osmotically active compound. When it accumulates in muscle cells, it draws water inward to maintain osmotic balance — intracellular water retention. This effect is dose- and form-dependent. Loading protocols with creatine monohydrate (20–25 g/day) produce measurable total body water increases, typically around 1 litre reflected as ~1 kg of scale weight change. Creatine HCl at 1,500 mg/day, with no loading phase, is associated with substantially smaller intracellular water shifts.

Is the scale weight change from creatine fat gain?

No. Any scale weight increase from creatine supplementation reflects intracellular water retention — water drawn into muscle cells by osmosis as creatine accumulates. Fat tissue is not involved. This change can occur within 7 days — a timeframe far too short for meaningful fat accumulation. The CONCRET-MENOPA trial reported no adverse body composition changes in any group, including at 1,500 mg creatine HCl.

Why does creatine HCl cause less water retention than monohydrate?

The mechanism is linked to solubility and dose. Creatine monohydrate loading protocols require high doses (20–25 g/day) that rapidly saturate muscle stores, drawing a larger volume of water intracellularly. Creatine HCl is substantially more soluble, allowing effective creatine elevation at a much lower dose (1,500 mg/day) without a loading phase. At this lower dose, the osmotic load on muscle cells is smaller.

Do I need a loading phase with Creatine Companion?

No. Creatine Companion uses creatine HCl at 1,500 mg per day — the dose and form used in the CONCRET-MENOPA trial, which used a daily maintenance approach without loading. This trial demonstrated improvements in reaction time and frontal brain creatine levels over eight weeks. loading phases are a regimen designed for creatine monohydrate at higher doses.

Are there safety concerns with creatine supplementation in women?

The evidence indicates creatine is well tolerated in women. A comprehensive systematic review found no adverse effects on gastrointestinal, renal, hepatic, or cardiovascular systems. The CONCRET-MENOPA trial reported no severe adverse effects in any group. As with any supplement, those with pre-existing kidney conditions should consult their GP before use.

References

Forbes SC, Korovljev D, Ostojic J, et al. The Effects of 8-Week Creatine Hydrochloride and Creatine Ethyl Ester Supplementation on Cognition, Clinical Outcomes, and Brain Creatine Levels in Perimenopausal and Menopausal Women (CONCRET-MENOPA). J Am Nutr Assoc. 2026;45(3):199–210. PubMed 40854087
Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients. 2021;13(3):877. PubMed 33800439
Ziegenfuss TN, Lowery LM, Lemon PWR. Acute fluid volume changes in men during three days of creatine supplementation. J Exerc Physiol Online. 1998. PMID not available — as referenced in Smith-Ryan 2021 review.
Dash AK, Miller WI, Bhatt S, Misra M, Mandal S. Absolute oral bioavailability of creatine monohydrate in rats: formulation and transportability. Biopharm Drug Dispos. 2018. PubMed 29518030
Candow DG, Forbes SC, Chilibeck PD, et al. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J Clin Med. 2019;8(4):488. PMC6518405

Food supplement notice: Creatine Companion is a food supplement, not a medicine. Food supplements should not be used as a substitute for a varied and balanced diet and a healthy lifestyle. If you are pregnant, breastfeeding, taking any medications, or have a medical condition — particularly kidney-related conditions — consult your GP or healthcare professional before use. The information on this page is for educational purposes and does not constitute medical advice.