Should You Be Using Creatine?

Creatine is hands down one of the most popular supplements ever. With that comes a massive amount of information, countless opinions, “bro science” and myths. We’re going to try to make it easy for you to figure out if creatine is right for you.

What exactly is creatine?

Creatine is a natural compound produced in the body from amino acids. It is mostly found in the muscle, with smaller amounts in the brain and other organs. Creatine regenerates adenosine triphosphate (ATP) in the muscle to produce short, powerful bursts of energy lasting around 10 seconds (think heavy lifts or 100m sprint).¹ The pool of available creatine determines the maximum energy output of your muscles. Think of creatine kind of like horsepower: the more you have, the more weight you can push and pull, and the faster you can go.

The average person uses 2-3 grams of creatine per day, with increased demands in high-performing athletes. While the body can synthesize small amounts of creatine from the amino acids found in high-protein foods, most people would have to consume almost two pounds of meat and fish per day to optimize creatine stores (100g of cooked chicken breast has only 0.4 grams of creatine)!²

What are the benefits of creatine supplementation?

We know creatine increases strength and performance by maximizing the energy capacity of the muscle, as described above. In practical terms, creatine supplementation can boost your max reps at any given weight as well as your one-rep max (1RM) by as much as 14%.² Creatine also appears to minimize fatigue during high-intensity interval training (HIIT) training,³ and increase endurance in exercise lasting up to two hours by sparing muscle glycogen.⁴

In addition, creatine supplementation can significantly augment muscle growth when combined with heavy lifting. A recent study reported an average of 1.6kg (3.5 pounds) more lean mass gained in the creatine-supplemented test group compared to the placebo group over just eight weeks.⁵ Creatine seems to enhance muscle hypertrophy several ways: improving hydration and nutrient delivery to muscle tissues, increasing satellite cells and muscle fiber size, upregulating genetic factors for muscle growth reducing levels muscle growth inhibitors, and protecting muscles against wasting and aging.²

Creatine supplementation also appears to improve neurological and cognitive function.^6-8 Scientists at the University of Sydney and Macquarie University in Australia found that taking creatine can give a significant boost to working memory (up to 20% improvement) and fluid intelligence (up to 40% improvement in IQ) in young adults.⁹

Even more exciting, creatine supplementation shows promise for preventing various mitochondrial DNA mutations. These mutations are partially responsible for neurodegeneration, aging, premature aging of the skin, and cancerous tumors affecting the colon, bladder, lung, breast, kidney, head, and neck.¹⁰

What are the side effects of taking creatine?

The only consistent side effect of creatine is weight gain, which comes from water retention in the muscle and increased muscle mass.¹¹ If you’re loading creatine, this can be as much as four pounds initially, but should level out after that. If you’re super worried about the number on the scale, this may cause alarm… but keep in mind, fuller, more-developed muscles will actually make you look leaner.

Do I need to worry about my kidneys or liver?

Years ago, the media hyped concern over kidney and liver damage with creatine supplementation based on isolated case studies. Yet over two decades, scientific research has thoroughly established that long-term creatine supplementation does not harm the kidneys or the liver in healthy adults.^16-18 Although consuming creatine can elevate urine levels of creatinine (a marker used to diagnose kidney problems), this is considered a “false positive” and is in no way harmful to the body.

Are there any other health risks to using creatine?

Anecdotal reports of dehydration, cramping, musculoskeletal injury, gastrointestinal distress, and “compartment syndrome” from creatine supplementation have been rare, and unsupported by current research. On the contrary, scientific literature indicates that those using creatine have no greater, and a possibly lower, risk of these issues than those who do not.^12-15

Who should take creatine (and who should not)?

Adults who are training at high-intensity or concerned with putting on as much lean muscle mass as possible should consider creatine supplementation to maximize performance and results. Mature athletes may also benefit from creatine supplementation to mitigate muscle aging and neurodegeneration.

Those with kidney disease, liver disease, or high blood pressure should not supplement with creatine without a doctor’s permission. Creatine supplementation is not recommended for those under 18 years of age, nor in women who are breastfeeding or pregnant, simply because it has not been sufficiently tested in these groups.

How much creatine should I use?

Research indicates that supplementing with 0.25 grams of creatine per kilogram of lean mass (2-5 grams of creatine per day for most people) is sufficient to increase muscle stores.¹⁹

Do I need to ”load” or “cycle” creatine?

While it’s not 100% necessary to load creatine, a loading period is beneficial for increasing creatine stores more quickly and achieving results sooner.^20,21 A standard loading protocol would be 20 grams of creatine per day the first 5-7 days, then 3-5 grams per day after that. There is no need to cycle off creatine (it’s naturally produced in the body), unless you are no longer training at high intensity to warrant it. Otherwise, it’s safe and beneficial to use continuously in healthy adults.

What’s the best form of creatine?

It seems everyday there’s a fancy new form of creatine: creatine phosphate, creatine HMB, creatine sodium bicarbonate, creatine magnesium-chelate, creatine glycerol, creatine glutamine, creatine beta-alanine, creatine ethyl ester, creatine with cinnulin extract, as well as micronized, effervescent, and serum formulations. Most of these new forms are no better than your standard creatine monohydrate in terms of increasing strength or performance, though often more expensive. Effervescent and serum formulations are actually less effective.

New research suggests that creatine monohydrate combined with beta-alanine may produce greater effects than creatine monohydrate alone, including more pronounced effects on strength, lean mass, and body fat percentage; in addition to delaying neuromuscular fatigue.^22,23 However, you can just as easily take creatine monohydrate with beta-alanine on the side. Those who experience discomfort or bloating with standard creatine formulations, may want to try a micronized creatine, or just choose a higher quality brand to start with!

All in all, creatine monohydrate is by far the most tested and trusted form of creatine.

Featured Creatine Monohydrate: MAN Sports Creatine 500g

Sources:

1. National Center for Biotechnology Information. PubChem Compound Database; CID=586, https://pubchem.ncbi.nlm.nih.gov/compound/586 (accessed July 6, 2018).
2. Cooper, Robert, et al. “Creatine Supplementation with Specific View to Exercise/Sports Performance: an Update.” Journal of the International Society of Sports Nutrition, vol. 9, no. 1, 2012, p. 33., doi:10.1186/1550-2783-9-33.
3. Branch J: Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab. 2003, 13: 198-226.
4. Hickner R, Dyck D, Sklar J, Hatley H, Byrd P: Effect of 28 days of creatine ingestion on muscle metabolism and performance of a simulated cycling road race. J Int Soc Sports Nutr. 2010, 7: 26-10.1186/1550-2783-7-26.
5. Burke DG, Candow DG, Chilibeck PD, MacNeil LG, Roy BD, Tarnopolsky MA, Ziegenfuss T: Effect of creatine supplementation. Int J Sport Nutr Exerc Metab. 2008, 18: 389-398.
6. Hammett S, Wall M, Edwards T, Smith A: Dietary supplementation of creatine monohydrate reduces the human fMRI BOLD signal. Neurosci Lett. 2010, 479: 201-205. 10.1016/j.neulet.2010.05.054.
7. D’Anci KE, Allen PJ, Kanarek RB: A potential role for creatine in drug abuse?. Mol Neurobiol. 2011, 44: 136-41. 10.1007/s12035-011-8176-2.
8. Rawson ES, Venezia AC: Use of creatine in the elderly and evidence for effects on cognitive function in young and old. Amino Acids. 2011, 40: 1349-1362. 10.1007/s00726-011-0855-9.
9. Oral creatine monohydrate supplementation improves brain performance: a double–blind, placebo–controlled, cross–over trial. Caroline Rae, Alison L. Digney, Sally R. McEwan, Timothy C. Bates. Proc. R. Soc. Lond. B 2003 270 2147-2150; DOI: 10.1098/rspb.2003.2492.
10. Berneburg, Mark, et al. “Creatine Supplementation Normalizes Mutagenesis of Mitochondrial DNA as Well as Functional Consequences.” Journal of Investigative Dermatology, vol. 125, no. 2, 2005, pp. 213–220., doi:10.1111/j.0022-202x.2005.23806.x.
11. Buford, Thomas W, et al. “International Society of Sports Nutrition Position Stand: Creatine Supplementation and Exercise.” Journal of the International Society of Sports Nutrition, vol. 4, no. 1, 2007, p. 6., doi:10.1186/1550-2783-4-6.
12. Greenwood M, Kreider RB, Melton C, Rasmussen C, Lancaster S, Cantler E, Milnor P, Almada A: Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003, 244: 83-88. 10.1023/A:1022413202549.
13. Kreider RB, Melton C, Rasmussen CJ, Greenwood M, Lancaster S, Cantler EC, Milnor P, Almada AL: Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003, 244: 95-104. 10.1023/A:1022469320296.
14. Greenwood M, Kreider RB, Greenwood L, Byars A: Cramping and injury incidence in collegiate football players are reduced by creatine supplementation. J Athl Train. 2003, 38: 216-219.
15. Greenwood M, Kreider RB, Greenwood L, Byars A: The effects of creatine supplementation on cramping and injury occurrence during college baseball training and competition. J Exerc Physiol Online. 2003, 6: 16-23.
16. Buford, T. W., Kreider, R. B., Stout, J. R., Greenwood, M., Campbell, B., Spano, M., … & Antonio, J. (2007). International Society of Sports Nutrition position stand: Creatine Supplementation and Exercise. Journal of the International Society of Sports Nutrition, 4 (6), 6.
17. Lugaresi R, Leme M, de Salles Painelli VT, et al. Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet? Journal of the International Society of Sports Nutrition. 2013;10(1):1-1.
18. Kim HJ, Kim CK, Carpentier A, Poortmans JR. Studies on the safety of creatine supplementation. Amino 2011;40(5):1409-1418.
19. Burke DG, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky M: Effect of creatine and weight training on muscle creatine and performance in vegetarians. Med Sci Sports Exerc. 2003, 35: 1946-55. 10.1249/01.MSS.0000093614.17517.79.
20. Williams MH, Kreider R, Branch JD: Creatine: The power supplement. 1999, Champaign, IL: Human Kinetics Publishers, 252-
21. Kreider RB, Leutholtz BC, Greenwood M: Creatine. Nutritional Ergogenic Aids. Edited by: Wolinsky I, Driskel J. 2004, CRC Press LLC: Boca Raton, FL, 81-104.
22. Hoffman J, Ramatess N, Kang J, Mangine G, Faigenbaum A, Stout J: Effect of creatine and beta-alaninesupplementation on performance and endocrine responses in strength/power athletes. Int J Sport Nutr Exerc Metab. 2006, 16: 430-446.

Sarah Wilkins, Nutritionist, B.S. Dietetics

IG: @no_excuses_Nutrition