Vitamins & Supplements · Creatine form
Buffered Creatine (Kre-Alkalyn)
Buffered creatine monohydrate · also called Kre-Alkalyn (brand), pH-correct creatine, alkaline creatine, creatina tamponada
Buffered creatine is creatine monohydrate mixed with an alkaline ingredient and sold as a powder or capsule. Sellers say it is better absorbed, works in a smaller amount and causes fewer side effects. The one head-to-head trial, in 36 people over 28 days, found no advantage over plain monohydrate. Like other creatine, it can raise blood creatinine, so tell your doctor before kidney tests.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Buffered Creatine (Kre-Alkalyn)
Buffered creatine is creatine monohydrate with an alkaline ingredient added. The one trial found no advantage over plain monohydrate, and no trial compares it with placebo. Like other creatine it can raise a kidney blood test.
What buffered creatine is
Creatine is a compound your muscles use for quick bursts of energy. Buffered creatine is creatine monohydrate mixed with an alkaline ingredient, sold as a powder or capsule, and sometimes as part of a blend. Kre-Alkalyn is one trademarked brand.
The seller's patent describes adding an alkaline powder to raise the product's pH. The reasoning is that this would stop creatine breaking down into creatinine before it is used.
Food versus pills
Creatine is found in meat and fish, and your body also makes some. Amounts in foods were not read from USDA or NIH sources, so none are stated here. Buffered creatine is a made powder, not a food.
See the pages on creatine in food and on creatine monohydrate for what is known about those.
What the research shows
There is one head-to-head trial, from 2012: 36 resistance-trained people for 28 days. Muscle creatine, body make-up, strength and sprint power did not differ between buffered creatine and monohydrate. The group using the maker's small label amount tended to gain less muscle creatine. There was no placebo group, so it cannot show buffered creatine works better than a dummy powder.
A 2022 review says no other form of creatine has been shown to beat monohydrate. The trial was paid for by a company that makes monohydrate raw material, and the reviews that support monohydrate come from authors with creatine-industry ties. That does not make them wrong, but it is worth knowing.
At a glance
Traditional uses history, not proof
- Creatine itself is found in meat and fish and made by the body
- Buffered creatine has been sold as a supplement since the early 2010s
Studied for research
- Muscle creatine compared with monohydrate, insufficient evidence
- Strength, lean mass and sprint power compared with monohydrate, insufficient evidence
- Stability in the stomach, insufficient evidence
- A smaller amount working as well, evidence against
- Fewer side effects, insufficient evidence
Main compounds
- Creatine monohydrate
- Alkaline ingredient (varies by product)
- Creatinine (breakdown product)
Common forms
- Powder
- Capsules
- Ingredient in blended products
Research links: 2012 trial: buffered creatine versus monohydrate · 2022 review: bioavailability and safety of creatine forms · 2022 review: alternative creatine forms and performance · 2026 review: creatine and kidney health (26 trials) · 2025 study: adulteration of creatine supplements · Research Library · Genes & Biomarkers Library
What it is and its history
- Accepted scientific name
- Buffered creatine (Kre-Alkalyn is a trademarked brand)
- Common names
- Buffered creatine (English); pH-correct creatine (English); Alkaline creatine (English); Creatina tamponada (Spanish)
- Family or group
- Creatine product. The 2012 trial calls it a buffered creatine monohydrate; the seller's patent (per the 2022 review) adds an alkaline powder to raise pH.
- Classification
- None > None > None > None > None > None > None
- Harvest and processing
- Per the 2022 review, the patent describes adding an alkaline powder (examples named: soda ash, magnesium glycerol phosphate, bicarbonate) to creatine to raise pH to between 7 and 14; the product was described as made to a pH of 12. The exact ingredients of any product were not read from a label.
- Look-alikes and adulterants
- Name: Creatine monohydrate; Note: The standard, best-studied form. Has its own page.; Name: Creatine hydrochloride (HCl); Note: A different salt marketed for better dissolving. Has its own page.; Name: Magnesium creatine chelate; Note: Creatine bound to magnesium. Has its own page.
- Sustainability and conservation
- Not assessed.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| 2002: US patent | A US patent titled 'Oral Creatine Supplement and Method for Making Same' (listed in the 2022 review's references) describes adding an alkaline powder to creatine. | p35268011 |
| Early 2010s: heavy marketing | The 2022 review says a buffered or pH-correct form was heavily marketed as more bioavailable than monohydrate. | p35268011 |
| 2012: first head-to-head trial | The only trial of buffered creatine against monohydrate was published; it did not support the claims. | p22971354 |
Traditional use shows how it was used. It does not show that it works or is safe today.
What is inside, and how it may work
What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Creatine monohydrate (the creatine in the product) PubChem None | guanidino compound | Not read from a label. | The compound behind the training results seen with creatine in general. 3 4 | Human data |
| Alkaline ingredient (varies by product) PubChem None | alkaline salts | Not read from a label. | Added to raise the product's pH; no benefit after swallowing was shown. 6 | Claim |
| Creatinine PubChem None | breakdown product | Not applicable | Waste product measured in blood and urine; rises with creatine supplements. 4 10 | Human data |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Alkaline pH to slow conversion of creatine to creatinine | Not applicable | A seller claim based on a patent. Reviews say monohydrate is not broken down in normal digestion, and the one trial found no extra muscle creatine from buffering. 6 3 4 | Claim, not established in people |
| Muscle creatine and phosphocreatine stores (for monohydrate) | Not specified in the sources read | The 2011 review states monohydrate raises muscle creatine and phosphocreatine by about 15 to 40%. This was not shown for the buffered form. 3 | Review of human studies |
Absorption, metabolism and elimination
- Absorption
- Not compared directly for buffered creatine. For monohydrate, a 2011 review says nearly 99% of what is swallowed is either taken up by muscle or leaves in urine.
- Distribution
- Not found.
- Metabolism
- Creatine slowly turns into creatinine; creatinine rose with buffered creatine in the trial.
- Elimination
- Creatinine leaves in urine (general physiology).
- Bioavailability
- The seller's claim of up to 10 times better bioavailability is not supported by the trial.
Isolated compounds versus whole extracts
Buffered creatine is a manufactured powder. Creatine in meat and fish is a separate topic and has its own page.
Nutritional composition
Creatine occurs in meat and fish. No USDA or NIH amounts were read for this page, so none are stated. Buffered creatine is a supplement, not a food.
4 not enough evidence1 evidence against
What was looked at
The 5 benefits and uses checked for Buffered Creatine (Kre-Alkalyn), each with how strong the evidence is. Tap one to open it.
- Raising creatine stored in muscle (compared with monohydrate)Not enough evidence
- Strength, body composition and sprint power with trainingNot enough evidence
- Stability in the stomach and less conversion to creatinineNot enough evidence
- A much smaller amount working as well as a larger monohydrate amountEvidence against
- Fewer side effects than monohydrateNot enough evidence
Lab markers tracked in the studies
Muscle free creatineBench press and leg press strength (1RM)Fat-free mass and fat massWingate sprint powerBlood creatinineLDL cholesterol
What is Buffered Creatine (Kre-Alkalyn) good for?
The claims made for buffered creatine and what the research found. Only one small head-to-head trial exists, so no claim has more than insufficient evidence in its favour.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Raising creatine stored in muscle (compared with monohydrate)
Not enough evidenceIn the one head-to-head trial, buffered creatine did not raise muscle creatine more than plain creatine monohydrate. The maker's label-amount group tended to rise less.
2 studiesOne buffered product (Kre-Alkalyn) at the maker's label amount and at…
Studies, doses and limits
What the trials found
One 28-day randomised trial in 36 resistance-trained people took muscle samples from 25 of them. Muscle creatine rose over time in every group with no significant difference between groups. The label-amount buffered group tended to rise less than monohydrate (p = 0.053). A 2022 review that read the trial also found no peer-reviewed paper showing a buffered form raises muscle creatine more than monohydrate.
Results
No advantage over monohydrate was shown. The claim of better uptake is not supported by the one trial.
Effect sizes as reported
Group difference in muscle creatine p = 0.46; label-amount buffered vs monohydrate p = 0.053.
Why this rating
One small trial, a muscle-sample subgroup of 25 and very wide person-to-person spread, so it cannot rule out a small difference either way. It tested no placebo group.
Form and dose studied
One buffered product (Kre-Alkalyn) at the maker's label amount and at monohydrate-equivalent amounts, against monohydrate. Other buffered products were not tested.
Who was studied
Young resistance-trained people with no recent creatine use.
Limits
One trial; paid for by a monohydrate raw-material maker; no placebo group.
Why researchers looked
Sellers say the alkaline ingredient helps more creatine reach the muscle. Muscle creatine is what is thought to drive the training benefits of creatine.
Traditional use
Creatine is a compound found in meat and fish and made by the body. Buffered creatine is creatine monohydrate mixed with an alkaline ingredient, sold since the early 2010s as a better-absorbed version.
Proposed mechanism Not established
The seller's patent says adding an alkaline powder keeps creatine stable. Whether that changes how much reaches muscle is not shown in people.
A proposed mechanism does not show that the effect happens in people.
No side effects were reported. See the Safety tab for creatinine blood-test changes.
Strength, body composition and sprint power with training
Not enough evidenceIn the same trial, buffered creatine and monohydrate groups did not differ in strength, lean mass, fat mass or sprint power. There is no trial of buffered creatine against placebo.
3 studiesSame product and amounts as above, for 28 days.
Studies, doses and limits
What the trials found
In the 28-day trial of 36 resistance-trained people, there were no significant group-by-time differences in body mass, fat-free mass, fat mass, body fat, bench press or leg press strength, or sprint cycling power, between buffered creatine and monohydrate. Some measures changed over time in all groups. A 2022 systematic review of 17 trials of other creatine forms did not include buffered creatine, found no consistent gains over placebo for the forms it covered, and said monohydrate stays the best-studied choice.
Results
No difference from monohydrate in the one head-to-head trial. Whether buffered creatine beats placebo has not been tested.
Effect sizes as reported
No significant group-by-time differences (p > 0.05) for strength, body composition or sprint power.
Why this rating
Insufficient: one small, short trial without a placebo group, funded by a monohydrate maker.
Form and dose studied
Same product and amounts as above, for 28 days.
Who was studied
Young resistance-trained people who kept their own training.
Limits
Short; 36 people; no placebo; training was not controlled.
Why researchers looked
Creatine monohydrate is known to add small gains in strength and lean mass with weight training, so researchers asked whether the buffered form does the same or better.
Traditional use
Creatine is a compound found in meat and fish and made by the body. Buffered creatine is creatine monohydrate mixed with an alkaline ingredient, sold since the early 2010s as a better-absorbed version.
Proposed mechanism Not established
Not tested for this form. For monohydrate, the role is helping muscles remake quick energy (phosphocreatine).
A proposed mechanism does not show that the effect happens in people.
No side effects were reported by anyone.
Stability in the stomach and less conversion to creatinine
Not enough evidenceSellers say the alkaline mix stops creatine turning into creatinine in the stomach. Reviews say plain monohydrate already survives digestion, and blood creatinine rose with buffered creatine too.
3 studiesNot applicable: this is a claim about the product, not a studied amou…
Studies, doses and limits
What the trials found
A 2011 review reported that monohydrate is not degraded during normal digestion and that nearly 99% of swallowed monohydrate is either taken up by muscle or leaves in urine. In the 2012 trial, blood creatinine rose in all groups, including buffered ones, by 0.1 to 0.2 mg/dl, with higher amounts giving bigger rises. No test measured breakdown in the stomach directly.
Results
No benefit of buffering was shown. The creatinine rise seen with buffered creatine is similar in kind to monohydrate.
Effect sizes as reported
Blood creatinine up 0.1 to 0.2 mg/dl in all groups (p < 0.001 over time).
Why this rating
Insufficient: the claim was tested only indirectly, in one trial; the supporting reviews are by authors with industry ties and the 2011 review pre-dates the trial.
Who was studied
Resistance-trained young adults (one trial).
Limits
No direct stomach or blood-level test of buffered creatine was found.
Why researchers looked
The main selling point is that buffering keeps creatine from breaking down before it reaches the muscle.
Traditional use
Creatine is a compound found in meat and fish and made by the body. Buffered creatine is creatine monohydrate mixed with an alkaline ingredient, sold since the early 2010s as a better-absorbed version.
Proposed mechanism Not established
The patent describes an alkaline powder that raises the pH of creatine. Reviews report monohydrate is not broken down in normal digestion.
A proposed mechanism does not show that the effect happens in people.
See the Safety tab for creatinine and kidney blood tests.
A much smaller amount working as well as a larger monohydrate amount
Evidence againstThe maker says a small label amount of buffered creatine matches a much larger monohydrate amount. In the one trial, the label-amount group did not raise muscle creatine significantly and tended to rise less than monohydrate.
2 studiesThe label amount of the tested product versus monohydrate loading and…
Studies, doses and limits
What the trials found
The 2012 trial compared the label-amount buffered group, a buffered group given the same larger amounts as monohydrate, and a monohydrate group. The label-amount group did not significantly raise muscle creatine and tended to rise less than monohydrate (p = 0.053). The 2022 review describes a Bulgarian report of 24 soccer players that the seller cites; it did no statistical tests and the review says it does not support the claim.
Results
The smaller-amount claim was not supported.
Effect sizes as reported
Label-amount buffered group tended to gain less muscle creatine than monohydrate (p = 0.053).
Why this rating
Evidence against the claim, but weak: one small trial with wide variation, and the difference was not statistically significant.
Form and dose studied
The label amount of the tested product versus monohydrate loading and maintenance amounts; studied amounts appear in the studies table only.
Who was studied
Resistance-trained young adults.
Limits
One trial; not significant; the seller report was not available to read directly.
Why researchers looked
A smaller amount would be a main reason to pay for the buffered form, so the claim was tested head to head.
Traditional use
Creatine is a compound found in meat and fish and made by the body. Buffered creatine is creatine monohydrate mixed with an alkaline ingredient, sold since the early 2010s as a better-absorbed version.
Proposed mechanism Not established
The seller's claim of up to 10 times better uptake rests on a patent and a non-peer-reviewed report.
A proposed mechanism does not show that the effect happens in people.
No side effects reported in the trial.
Fewer side effects than monohydrate
Not enough evidenceNo side effects were reported by anyone in the one trial, so it could not show that buffered creatine is gentler.
1 studiesNot applicable.
Studies, doses and limits
What the trials found
In the 36-person, 28-day trial, side effects were self-reported and none were reported in any group, including monohydrate. The authors said there was no evidence that buffered creatine caused fewer side effects.
Results
No safety advantage was shown. With no side effects in any group, the trial could not test the claim.
Effect sizes as reported
No side effects reported in any group.
Why this rating
Insufficient: small, short trial with self-reported side effects.
Who was studied
Resistance-trained young adults.
Limits
Short, small; no long-term data for buffered creatine.
Why researchers looked
Sellers say a smaller amount means fewer stomach complaints.
Traditional use
Creatine is a compound found in meat and fish and made by the body. Buffered creatine is creatine monohydrate mixed with an alkaline ingredient, sold since the early 2010s as a better-absorbed version.
Proposed mechanism Not established
Not tested beyond self-reported side effects.
A proposed mechanism does not show that the effect happens in people.
See the Safety tab.
Connections to the rest of health
How Buffered Creatine (Kre-Alkalyn) connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Peak Performance | Not enough evidence | Raising creatine stored in muscle (compared with monohydrate): In the one head-to-head trial, buffered creatine did not raise muscle creatine more than plain creatine monohydrate. The maker's label-amount group tended to rise less. Strength, body composition and sprint power with training: In the same trial, buffered creatine and monohydrate groups did not differ in strength, lean mass, fat mass or sprint power. There is no trial of buffered creatine against placebo. | 4 6 2 | |
| Physical Stamina | Not enough evidence | Strength, body composition and sprint power with training: In the same trial, buffered creatine and monohydrate groups did not differ in strength, lean mass, fat mass or sprint power. There is no trial of buffered creatine against placebo. | 4 2 6 | |
| Peak Performance | Not enough evidence | Stability in the stomach and less conversion to creatinine: Sellers say the alkaline mix stops creatine turning into creatinine in the stomach. Reviews say plain monohydrate already survives digestion, and blood creatinine rose with buffered creatine too. Fewer side effects than monohydrate: No side effects were reported by anyone in the one trial, so it could not show that buffered creatine is gentler. | 4 3 6 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Bones Joints Muscles | Biological association | Not enough evidence | Studied for: Raising creatine stored in muscle (compared with monohydrate) Studied for: Strength, body composition and sprint power with training | 4 6 2 3 |
E. Health conditions
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Chronic kidney disease | Narrative review | Reviews say concerns persist about creatine in people with impaired kidney function; no buffered-specific study was found. Preparation or compound: Creatine in general |
9 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Muscle free creatine | Biological association | Not enough evidence | Measured in trials: rose in every group; no clear difference between buffered and monohydrate. A lab change is not the same as a health benefit. | 4 |
| Bench press and leg press strength (1RM) | Biological association | Not enough evidence | Measured in trials: no group difference. A lab change is not the same as a health benefit. | 4 |
| Fat-free mass and fat mass | Biological association | Not enough evidence | Measured in trials: no group difference. A lab change is not the same as a health benefit. | 4 |
| Wingate sprint power | Biological association | Not enough evidence | Measured in trials: no group difference. A lab change is not the same as a health benefit. | 4 |
| Blood creatinine | Biological association | Moderate certainty | Measured in trials: rose slightly with buffered and monohydrate groups. A lab change is not the same as a health benefit. | 4 10 |
| LDL cholesterol | Biological association | Not enough evidence | Measured in trials: fell during monohydrate loading, then returned to baseline. A lab change is not the same as a health benefit. | 4 |
K. Biological pathways
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Creatine | Preliminary mechanism | Summary | Buffered creatine is creatine monohydrate plus an alkaline ingredient; the evidence base is on the creatine page. | 11 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Creatine monohydrate (the creatine in the product) | Biological association | Human | The compound behind the training results seen with creatine in general. | 3 4 |
| Alkaline ingredient (varies by product) | Biological association | Claim | Added to raise the product's pH; no benefit after swallowing was shown. | 6 |
| Creatinine | Biological association | Human | Waste product measured in blood and urine; rises with creatine supplements. | 4 10 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 26, 2026).
Evidence at a glance: what the research found for 5 outcomes
Each outcome below is one thing researchers measured. Certainty is how far the evidence can be trusted, not how well it works. The full studies are on the next tab.
The evidence
The research centre for Buffered Creatine (Kre-Alkalyn). Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing buffered-creatine summary, then re-read PubMed abstracts for every study and review cited, and the full text of the 2012 trial (funding) and the 2022 review (its buffered-creatine section). Regulator pages were not read and are marked unverified.
Study library: every study we checked 11
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Escalante 2022 Analysis of the efficacy, safety, and cost of alternative forms of creatine available for purchase on Amazon.com Heliyon · PMID 36544833 · DOI |
Product survey n/a |
None 175 creatine products listed on one online store |
Creatine products with monohydrate or 16 other forms Oral |
Products contained 16 forms of creatine other than monohydrate. Only 8% were third-party certified. Products with only non-monohydrate forms cost on average more than twice as much per gram as products with only monohydrate. About 88% of the alternative-form products were rated as having limited to no evidence for bioavailability, efficacy and safety. Mean price per gram: $0.12 monohydrate-only vs $0.26 other-forms-only (Not applicable) Methods, limits and fundingOutcomes: Creatine content, forms, claims, third-party certification, price per gram Limitations: A snapshot of one store at one time; the abstract does not say how many products were buffered creatine. Funding and conflicts: Several authors report ties to supplement companies, including a sports-supplement maker and an expert-witness role in creatine cases. Registration: None Read: abstract |
| Fazio 2022 Efficacy of Alternative Forms of Creatine Supplementation on Improving Performance and Body Composition in Healthy Subjects: A Systematic Review J Strength Cond Res · PMID 36000773 · DOI |
Systematic review |
None 17 randomised placebo-controlled trials of alternative creatine forms (healthy people) |
Magnesium-creatine chelate, creatine citrate, malate, ethyl ester, nitrate and pyruvate Oral Varied Varied · vs Placebo or creatine monohydrate |
Only 3 of the 17 trials compared an alternative form with monohydrate. No consistent performance gains for alternative forms over placebo. Monohydrate was the cheapest form. Buffered creatine is not on the list of forms the review found trials for. No consistent finding (Not given in the abstract) Methods, limits and fundingOutcomes: Exercise performance, body composition, price Limitations: Did not cover buffered creatine, so it shows how thin the research on alternative forms is rather than testing this one. Funding and conflicts: No conflict statement in the record read. Registration: None Read: abstract |
| Jager 2011 Analysis of the efficacy, safety, and regulatory status of novel forms of creatine Amino Acids · PMID 21424716 · DOI |
Narrative review n/a |
None Review of marketed creatine forms |
Creatine monohydrate and newer forms Oral · vs Creatine monohydrate |
Reported that studies show monohydrate is not broken down in normal digestion and that nearly 99% of swallowed monohydrate is taken up by muscle or leaves in urine. Found little to no evidence that any newer form is more effective or safer, and said the safety and regulatory status of newer forms is less clear. Not a pooled analysis (Not applicable) Methods, limits and fundingOutcomes: Efficacy, safety and regulatory status of newer creatine forms Limitations: Narrative review from 2011, before the 2012 buffered-creatine trial, so it did not weigh that trial. Funding and conflicts: No conflict statement in the record read. The same research group later declared creatine-industry ties (see the 2022 review). Registration: None Read: abstract |
| Jagim 2012 A buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate J Int Soc Sports Nutr · PMID 22971354 · DOI |
Randomised controlled trial |
36 36 resistance-trained people (average age about 20, body fat about 15%) who kept their own training for 28 days; muscle samples taken in a subgroup of 25 |
Buffered creatine monohydrate (Kre-Alkalyn brand) or creatine monohydrate (Creapure brand) Oral powder Studied in the trial: buffered creatine at the maker's label amount (1.5 g a day) for 28 days; buffered creatine at the same loading then maintenance amounts as monohydrate; monohydrate at 4 x 5 g a day for 7 days then 5 g a day for 21 days 28 days · vs Creatine monohydrate (no placebo group) |
Muscle creatine rose over time in all groups with no significant difference between groups. The label-amount buffered group tended to rise less than monohydrate (p = 0.053). No group differences in body mass, fat-free mass, fat mass, strength or sprint power. Blood creatinine rose in all groups (0.1 to 0.2 mg/dl), within normal values for active people. No side effects were reported by anyone. Group x time differences not significant (p > 0.05) for body composition, strength and power; muscle creatine group difference p = 0.46; label-amount buffered vs monohydrate p = 0.053 (Not given in the abstract) Methods, limits and fundingOutcomes: Muscle creatine (biopsy), body composition (DEXA), 1RM bench and leg press, Wingate sprint power, blood tests, self-reported side effects Limitations: Only 36 people for 28 days; muscle samples in 25; wide person-to-person spread in muscle creatine; no placebo group so it cannot show whether buffered creatine beats placebo; side effects were self-reported; resistance-trained young adults only. Funding and conflicts: Funded by AlzChem AG, a maker of creatine monohydrate raw material, through a grant to the university (funding and competing-interest sections of the full text, read via Europe PMC). The authors state they collected and analysed the data independently. One author reports consulting for a supplement company. The 'monohydrate maker' funding is therefore verified. Registration: None Read: abstract and full text (Europe PMC open copy) for funding |
| Kreider 2017 International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine J Int Soc Sports Nutr · PMID 28615996 · DOI |
Position stand review n/a |
None Position stand and review |
Creatine (mainly monohydrate) Oral |
Concluded that short and long-term creatine supplementation (studied up to 5 years) is safe and well tolerated in healthy people and in several patient groups from infants to older adults. The evidence base is mainly for creatine monohydrate. Not a pooled analysis (Not applicable) Methods, limits and fundingOutcomes: Safety and efficacy of creatine Limitations: Mostly creatine monohydrate, so it does not show safety of the added alkaline ingredients in buffered products. A professional society whose authors have creatine-industry links. Funding and conflicts: The lead author declares creatine-industry ties in a 2022 review (see that entry); no conflict statement in the record read for this paper. Registration: None Read: abstract |
| Kreider 2022 Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review Nutrients · PMID 35268011 · DOI |
Narrative review n/a |
None Review of creatine forms sold as supplements |
Creatine monohydrate and other marketed forms, including buffered creatine Oral Varied; the review describes claims and trials Varied · vs Creatine monohydrate |
Concluded that creatine monohydrate is the only form with substantial evidence for bioavailability, efficacy and safety. In its buffered-creatine section the review describes the seller's patent (an alkaline powder added to raise pH), a seller claim of up to 10 times better absorption, a non-peer-reviewed Bulgarian report in 24 soccer players with no statistical tests, and the 2012 trial. It places buffered creatine in a 'some evidence' group but says there is no evidence it is better than monohydrate. Not a pooled analysis (Not applicable) Methods, limits and fundingOutcomes: Bioavailability, efficacy, safety and regulatory status of creatine forms Limitations: Narrative review by authors with industry ties; the buffered section rests on one trial and on a seller report the authors could not check statistically. Funding and conflicts: Authors report ties to creatine industry: two are principals of a research firm that consults with industry on raw ingredients and have patents from earlier work at a creatine manufacturer (now AlzChem); one chairs a creatine scientific advisory board for AlzChem and has received industry-sponsored research funding. Registration: None Read: abstract and full text (Europe PMC open copy) for the buffered-creatine section |
| Muccini 2021 Creatine Metabolism in Female Reproduction, Pregnancy and Newborn Health Nutrients · PMID 33540766 · DOI |
Narrative review mixed (mostly animal and lab) |
None Narrative review |
Creatine in pregnancy (mostly lab and animal studies of supplements) Oral |
Notes that creatine supplementation in pregnancy has been studied mostly in lab and small-animal models, and that there is still no consensus on whether creatine is essential for successful reproduction. Not a pooled analysis (Not applicable) Methods, limits and fundingOutcomes: Creatine and reproduction, pregnancy and newborns Limitations: Mostly animal and lab work; not about buffered creatine. Funding and conflicts: One author sits on a creatine scientific advisory board (AlzChem); the review says the company had no oversight of its content. Registration: None Read: abstract |
| Oliveira 2025 Assessing the authenticity of the sport supplement creatine using spectroscopic techniques and multivariate analysis Food Chem · PMID 40306235 · DOI |
Laboratory analysis n/a |
None 149 creatine supplement samples |
Creatine supplements (all forms) Oral |
HPLC found 117 pure samples and 32 adulterated samples. Infrared methods with computer models sorted pure from adulterated samples with over 95% accuracy. 32 of 149 adulterated (about 21%) (Not applicable) Methods, limits and fundingOutcomes: Purity by HPLC and infrared spectroscopy Limitations: The abstract does not say which forms were tested or whether any were buffered, or what the adulterants were. Funding and conflicts: Authors declare no competing interests. Registration: None Read: abstract |
| Pereira 2026 Creatine supplementation in patients with kidney disease - harm or benefit? Nephrol Dial Transplant · PMID 42545747 · DOI |
Narrative review n/a |
None Narrative review |
Creatine supplementation in kidney disease Oral |
States that concerns persist about the kidney safety of creatine in people with impaired kidney function, and discusses possible benefits for muscle loss, thinking and gut function in chronic kidney disease. Not a pooled analysis (Not applicable) Methods, limits and fundingOutcomes: Kidney safety, sarcopenia, cognition, gut effects Limitations: Narrative review, not a trial; not about buffered creatine specifically. Funding and conflicts: No conflict statement in the record read. Registration: None Read: abstract |
| de Souza Almeida 2026 Impact of creatine supplementation on kidney health: a systematic review and meta-analysis Int Urol Nephrol · PMID 42507286 · DOI |
Systematic review meta analysis |
1036 26 randomised trials, 1,036 people, healthy people and people with chronic kidney disease |
Creatine supplementation (forms not split out; buffered creatine not singled out) Oral Varied by trial Varied · vs Placebo |
Creatine was linked with higher blood creatinine and lower creatinine-based GFR, but not with a change when GFR was measured by Cr-EDTA or in urea, albumin or protein in urine. The authors say this likely reflects altered creatinine handling, not kidney injury. Serum creatinine mean difference 0.14 mg/dL; creatinine-based GFR mean difference -10.75 mL/min; Cr-EDTA GFR 5.89 mL/min (p = 0.06) (Serum creatinine 0.05 to 0.22; creatinine-based GFR -17.48 to -4.02; Cr-EDTA -0.30 to 12.08) Methods, limits and fundingOutcomes: Serum creatinine, kidney filtering (GFR) by creatinine-based and Cr-EDTA methods, urea, albumin and protein in urine Limitations: Very high variation between trials for creatinine (I2 about 94%); trials mostly used creatine monohydrate or unspecified creatine, not buffered creatine. Funding and conflicts: No conflict statement in the record read. Registration: PROSPERO CRD420251015042 Read: abstract (PubMed record, via Europe PMC copy because efetch returned it empty) |
| s-site-summary Existing AlternativeMed buffered-creatine summary (read 2026-10-26) |
Internal summary n/a |
Methods, limits and fundingRead: summary-only |
What we do not know yet
- No trial compared buffered creatine with placebo.
- Only one head-to-head trial exists, and it has not been repeated.
- The safety of the alkaline ingredients was not found.
- No kidney, pregnancy, breastfeeding or children data for buffered creatine.
- No regulator statement on buffered creatine was read.
- Creatine amounts in foods were not read.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue before the page changes.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Metabolic 1
LDL cholesterol
Fell during monohydrate loading, then returned to baseline in trials
A blood fat marker linked to heart disease risk.
Not enough evidenceResults and what it means
Why it was measured
Checked as part of routine blood safety tests.
Statistical vs. clinical meaning
A short-lived change in one group; not a health outcome.
Safety implication
None reported.
| Study | Result | People | Product |
|---|---|---|---|
| 4 | LDL fell more with monohydrate loading than with the other groups, then returned to baseline during the maintenance phase | 36 resistance-trained people | Monohydrate loading vs buffered creatine groups |
Other 5
Muscle free creatine
Rose in every group; no clear difference between buffered and monohydrate in trials
The amount of creatine sitting free in muscle fibres, measured from a small muscle sample (biopsy).
Not enough evidenceResults and what it means
Why it was measured
To see whether the buffered form loads muscle with creatine as well as monohydrate.
Statistical vs. clinical meaning
Wide spread between people; the trial was small.
Safety implication
None reported.
| Study | Result | People | Product |
|---|---|---|---|
| 4 | Rose in all groups; no overall group difference (p = 0.46); label-amount buffered group tended to rise less than monohydrate (p = 0.053) | 25 resistance-trained people (subgroup) | Buffered creatine or monohydrate for 28 days |
Bench press and leg press strength (1RM)
No group difference in trials
The heaviest weight a person can lift once.
Not enough evidenceResults and what it means
Why it was measured
To see whether buffered creatine adds strength.
Statistical vs. clinical meaning
Same strength change as monohydrate; placebo not tested.
Safety implication
None reported.
| Study | Result | People | Product |
|---|---|---|---|
| 4 | No significant group-by-time differences | 36 resistance-trained people | Buffered creatine or monohydrate for 28 days |
Fat-free mass and fat mass
No group difference in trials
Lean tissue and fat measured by a DEXA body scan.
Not enough evidenceResults and what it means
Why it was measured
To see whether the buffered form changes body make-up.
Statistical vs. clinical meaning
No difference from monohydrate.
Safety implication
None reported.
| Study | Result | People | Product |
|---|---|---|---|
| 4 | No significant group-by-time differences in body mass, fat-free mass, fat mass, percent body fat or total body water | 36 resistance-trained people | Buffered creatine or monohydrate for 28 days |
Wingate sprint power
No group difference in trials
A 30-second all-out cycling test of anaerobic power.
Not enough evidenceResults and what it means
Why it was measured
To see whether the buffered form improves short, hard efforts.
Statistical vs. clinical meaning
No difference from monohydrate.
Safety implication
None reported.
| Study | Result | People | Product |
|---|---|---|---|
| 4 | No significant group-by-time differences in mean power, peak power or total work | 36 resistance-trained people | Buffered creatine or monohydrate for 28 days |
Blood creatinine
Rose slightly with buffered and monohydrate groups in trials
A waste product from muscle creatine. Doctors use it to estimate how well the kidneys filter blood.
Moderate certaintyResults and what it means
Why it was measured
Creatine supplements raise it, which can confuse a routine kidney test.
Statistical vs. clinical meaning
A rise of this size reflects how creatine is handled, and the review authors say it likely does not mean kidney injury.
Safety implication
Tell the doctor you take creatine before kidney blood tests.
| Study | Result | People | Product |
|---|---|---|---|
| 4 | Rose 0.1 to 0.2 mg/dl in all groups; higher amounts gave bigger rises; still within normal values for active people | 36 resistance-trained people | Buffered creatine or monohydrate for 28 days |
| 10 | Across 26 trials of creatine in general, blood creatinine was higher by 0.14 mg/dL on average | 1,036 people, healthy and with kidney disease | Creatine supplements (buffered not singled out) |
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 2
- Creatine can raise a routine kidney blood test without kidney damage, and caution is still advised in kidney disease. Creatine raises blood creatinine, and it did with buffered creatine too (up 0.1 to 0.2 mg/dl, within normal values for active people). A 2026 pooled review of 26 trials found creatine raised creatinine and lowered creatinine-based filtering estimates but not when filtering was measured by a different method, which the authors read as altered creatinine handling rather than kidney injury. A 2026 review still says concerns persist for people with impaired kidney function. No kidney study of buffered creatine was found. If you have kidney disease or take medicines that affect the kidneys, ask a doctor first, and tell your doctor you take creatine before kidney blood tests. Randomised trial, meta analysis and narrative review (creatine in general) 4 10 9
- Product quality: adulteration is documented in creatine powders, and buffered products add alkaline ingredients. A 2025 laboratory study found 32 of 149 creatine supplement samples were adulterated. A 2022 survey of 175 creatine products found only 8% were third-party certified. The abstracts do not say how many were buffered. The safety of the added alkaline ingredients in buffered products was not assessed in any source read. Laboratory analysis and product survey 8 1
Side effects 3
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| No side effects reported in the only head-to-head trial The trial was small and short. It could not show whether buffered creatine is safer or less safe than monohydrate. | None reported in 36 people over 28 days (self-reported) | Not applicable Not applicable | Randomised trial 4 |
| Higher blood creatinine The authors of the pooled review say this likely reflects how creatine is handled by the body, not kidney injury. | Rose in all groups in the trial; 0.14 mg/dL on average across 26 trials of creatine in general | Mild; a lab value Not studied in the sources read | Randomised trial and meta analysis 4 10 |
| Stomach upset, cramps or weight gain Reports of stomach complaints, cramps and weight gain with creatine in general were not read for this page; none were reported for buffered creatine in the one trial. | Not given | Not given Not given | Not found for buffered creatine |
Liver
No liver injury from buffered creatine was found in the sources read. This is not proof of safety.
How often. No frequency was found.
Monitoring. No agency monitoring advice was found.
This is a safety connection. It is not evidence that Buffered Creatine (Kre-Alkalyn) supports liver health.
Medicines and supplements 3
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Kidney blood tests (creatinine, estimated filtering rate) laboratory test | Creatine supplements raise blood creatinine, which is used to estimate kidney function. | A routine test can look worse than it is. A different measure (Cr-EDTA) did not change in the pooled review. | Meta analysis (creatine in general) and randomised trial Moderate certainty 4 10 | Tell your doctor you take creatine before kidney tests. |
| Medicines that affect the kidneys prescription | Not studied for buffered creatine. The concern is general caution about creatine and impaired kidney function. | No interaction study of buffered creatine with any medicine was found. | Narrative review Not enough evidence 9 | Absence of a study is not proof of safety. Ask a doctor or pharmacist if you take medicines that affect the kidneys. |
| Other medicines and supplements (general) prescription and supplements | No mechanism found. | No interaction study of buffered creatine was found, including for its alkaline ingredients. | Absence of evidence Not enough evidence | Tell a doctor or pharmacist about every supplement you use. |
Who should check first 3
| Situation | Advice | Evidence |
|---|---|---|
| Kidney disease or reduced kidney function | Ask a doctor before using any creatine product; reviews say concerns persist for people with impaired kidney function. | Narrative review (creatine in general) 9 |
| Pregnancy and breastfeeding | No human safety data for buffered creatine were found. A review says pregnancy studies of creatine supplements are mostly lab and animal work and that there is no consensus. Ask a doctor first. | Narrative review 7 |
| Children and teenagers | No data on buffered creatine for children were found. The review that covers creatine in children could not be read for its abstract. Ask a doctor first. | Absence of evidence |
Overdose, product quality and regulators
Summary. No poisoning or overdose reports for buffered creatine were found in the sources read. A 2017 position stand reports that creatine (mainly monohydrate) was studied for up to 5 years in healthy people and several patient groups and was well tolerated.
Animal. Not reviewed.
High dose or long term signals. The one buffered-creatine trial lasted 28 days. Long-term safety of the buffered form, and of its added alkaline ingredients, was not found.
Overdose response. Not found.
Genotoxicity. Not researched.
Quality varies by product. A laboratory study and a product survey found adulteration and little independent testing among creatine products in general.
Adulteration of creatine powders. 32 of 149 samples were adulterated; 117 were pure (the abstract does not say how many were buffered). 8
Third-party testing and price. Among 175 products on one store, 8% were third-party certified; products with only forms other than monohydrate cost more than twice as much per gram on average. 1
Hidden amounts in blends. A buffered form is sometimes one ingredient in a blend, where amounts can be hidden in a proprietary mix. This comes from the existing summary and was not re-checked in a study. 11
| Body | Action | Date |
|---|---|---|
| NIH Office of Dietary Supplements, NCCIH, EFSA, FDA (United States and European Union) | No fact sheet or statement specific to buffered creatine was read. No regulator page was opened for this page, so no regulator position is stated. source | None |
When to get medical help
- Swelling of the face, lips or tongue, hives, wheezing or trouble breathing after taking any supplement: get emergency help.
- Passing much less urine, new swelling of the legs or face, or severe back or side pain: contact a doctor promptly, especially with kidney disease.
Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is buffered creatine?
Is buffered creatine better absorbed than regular creatine?
Does buffered creatine build more muscle than monohydrate?
In the one trial, 36 trained people for 28 days showed no difference in lean mass, strength or sprint power. No trial compared it with placebo.
Does buffering stop creatine turning into creatinine?
Does buffered creatine cause fewer side effects?
This has not been shown. Nobody in the trial reported side effects, including the monohydrate group, so it could not test the claim.
Can a small label amount match a larger monohydrate amount?
Can buffered creatine affect kidney blood tests?
Is buffered creatine safe for people with kidney disease?
Unknown. No kidney study of buffered creatine was found, and a 2026 review says concerns persist about creatine in people with impaired kidney function. Ask a doctor first.
Was the trial independent?
It was paid for by AlzChem, a company that makes monohydrate raw material, through a university grant. The authors say they collected and analysed the data independently. It is the only trial, so it has not been repeated by anyone else.
Is it safe in pregnancy, breastfeeding or for children?
No data on buffered creatine were found. A review says creatine pregnancy research is mostly lab and animal work. Ask a doctor first.
Are creatine supplements always what the label says?
Explore by health goal
Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against the sources listed.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-26
- Last substantive update
- 2026-10-26
- How we research
- We started from our existing buffered-creatine summary, then re-read PubMed abstracts for every study and review cited, and the full text of the 2012 trial (funding) and the 2022 review (its buffered-creatine section). Regulator pages were not read and are marked unverified.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown. The only trial was paid for by a monohydrate maker, and several reviews are by authors with creatine-industry ties; this is flagged where the sources show it.
Sources 11
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Escalante G, Gonzalez AM, St Mart D, and colleagues. Analysis of the efficacy, safety, and cost of alternative forms of creatine available for purchase on Amazon.com. Heliyon. 2022. PMID 36544833. DOI 10.1016/j.heliyon.2022.e12113. (abstract)
- Fazio C, Elder CL, Harris MM. Efficacy of Alternative Forms of Creatine Supplementation on Improving Performance and Body Composition in Healthy Subjects: A Systematic Review. J Strength Cond Res. 2022. PMID 36000773. DOI 10.1519/JSC.0000000000003873. (abstract)
- Jager R, Purpura M, Shao A, and colleagues. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids. 2011. PMID 21424716. DOI 10.1007/s00726-011-0874-6. (abstract)
- Jagim AR, Oliver JM, Sanchez A, and colleagues. A buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate. J Int Soc Sports Nutr. 2012. PMID 22971354. DOI 10.1186/1550-2783-9-43. (abstract and full text (Europe PMC open copy) for funding)
- Kreider RB, Kalman DS, Antonio J, and colleagues. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017. PMID 28615996. DOI 10.1186/s12970-017-0173-z. (abstract)
- Kreider RB, Jager R, Purpura M. Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review. Nutrients. 2022. PMID 35268011. DOI 10.3390/nu14051035. (abstract and full text (Europe PMC open copy) for the buffered-creatine section)
- Muccini AM, Tran NT, de Guingand DL, Philip M, Della Gatta PA, Galinsky R. Creatine Metabolism in Female Reproduction, Pregnancy and Newborn Health. Nutrients. 2021. PMID 33540766. DOI 10.3390/nu13020490. (abstract)
- Oliveira TF, Santos GR, de Jesus JC, and colleagues. Assessing the authenticity of the sport supplement creatine using spectroscopic techniques and multivariate analysis. Food Chem. 2025. PMID 40306235. DOI 10.1016/j.foodchem.2025.144282. (abstract)
- Pereira JP, Leal VO, Trigueira P, and colleagues. Creatine supplementation in patients with kidney disease - harm or benefit?. Nephrol Dial Transplant. 2026. PMID 42545747. DOI 10.1093/ndt/gfag169. (abstract)
- de Souza Almeida A, da Silva LOD, Takahasi BNA, and colleagues. Impact of creatine supplementation on kidney health: a systematic review and meta-analysis. Int Urol Nephrol. 2026. PMID 42507286. DOI 10.1007/s11255-026-05287-x. (abstract (PubMed record, via Europe PMC copy because efetch returned it empty))
- . Existing AlternativeMed buffered-creatine summary (read 2026-10-26). . . (summary-only)
Where to buy
Check the label first. Whatever you buy, look for these:
- The amount of the active ingredient per serving, not just the front-label claim
- A third-party testing mark (USP, NSF or ConsumerLab)
- Other ingredients and allergens
- Ask a pharmacist about interactions with your medicines
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
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