Have you ever heard your gym buddies talking about taking creatine or seen them chuck some white powder in water and glug it down? Well what is creatine? And what does it do? Is it a useful, safe supplement?
Creatine is a compound your body creates and later uses during muscular contraction. Creatine is also found in seafood and meat. During exercise your body uses ATP (adenosine triphosphate) as energy. ATP is made from the food we ingest. In the first 5 seconds of strenuous exercise, your body will break down ATP already stored in the muscle to ADP (adenosine disphosphate) and a phosphate group. Then, in order to continue to have ATP for muscular contraction, the body must resynthesize ATP. Your cells do this by producing ATP from ADP and a phosphate group. To do this, creatine kinase is used. Essentially, creatine aids in helping muscles re-synthesize ATP during high intensity exercise, thereby increasing muscular power, repetitions, and volume. This increase in muscular power, repetitions, and volume can then lead to better muscle performance and greater hypertrophy [2]. So, if your goal is to get swoll, or simply to just perform better in your sport, creatine supplementation may just give you that extra edge.
Creatine is not a steroid. Anabolic steroids are drugs and can only be possessed with a physician’s prescription [2]. Creatine is not a drug and can be bought at your local nutrition supplement store or online.
The form of creatine that has been well studied and proven safe is creatine monohydrate. You may have seen other forms of creatine such as creatine salts, creatine dipeptides, or creatine mixed in with other nutrients. Some may purport to be more effective than creatine monohydrate. There are no peer reviewed published papers showing that ingesting equal amounts of other forms of creatine increases creatine storage in muscle more than taking creatine monohydrate [2].
So you’ve bought the creatine….now how much to take. The general recommendation is 3-5 grams (g) per day. The bottle or bag of creatine you purchase may have instructions for a ‘loading phase on it’. This isn’t necessary. Loading phases essentially have a person take about 20-25 g of creatine for 5-7 days. You can just go ahead and take 3-5 g per day. The only difference will be that at the lower dose it will take longer to accumulate the same amount of creatine in your muscles as compared to taking the ‘loading’ dose for 5-7 days [2].
It is also recommended to take creatine with carbohydrates or carbohydrates and protein. Taking creatine with carbohydrates/carbohydrates + protein has been shown to more consistently promote greater creatine retention. In a nutshell, take your creatine with a meal [5].
Research has shown that the potential benefits of creatine are numerous. Possible benefits include increased single and repetitive sprint performance, increased work performed during sets of maximal effort muscle contractions, increased muscle mass and strength adaptations during training, enhanced recovery, and greater training performance. Sporting events that may be enhanced by creatine supplementation include swim and track sprints, pursuit cycling, American football, volleyball, downhill skiing, combat events, bodybuilding, powerlifting, rugby, Olympic wrestling, etc [5]. The list goes on. Essentially, any sport with heavy, high-intensity exercise may benefit from creatine supplementation [2].
Other benefits beyond purely sport performance have also been identified. Creatine has been studied for its effect on the brain and protection of neurons within the spinal cord, ischemic heart disease (heart damage caused by narrowed heart arteries), and aging. For example, one particular study studied the effects of 3 days of 3 g/kg of creatine supplementation in neonatal rats where brain hypoxia (low levels of oxygen) and ischemia (restriction or blockage of blood flow) was induced. This study found that the group given creatine had a 25% reduction in the amount of fluid build-up in brain tissue following induction of hypoxic ischemia [1]. Extrapolation of these results to human brain injuries may be inappropriate as 3 g/kg of creatine for a 150 lb. person would be 204 grams of creatine. Mind you, this is well over the recommended amount of 3-5 grams per day. But, the concept is fascinating and may be an avenue for future research. Another article written by Zhu and colleagues found that oral creatine supplementation in rats where cerebral ischemia was induced found that the group supplemented with creatine for a month had a 56% reduction in cerebral ischemic stroke size and a decrease in neuronal cell death. Rats were fed a 2% creatine supplemented diet [7]. Again, how much this actually is and what this equates to in terms of how much creatine a human would have to take is unclear. Nonetheless, considering creatine has proven to be a safe supplement this could very well be an avenue for future research in brain injury patients.
Creatine supplementation has also been shown to have positive effects on a number of health-related issues typically seen as we age. Some studies have shown minimizations of bone loss as well as improvement of functional capacity in patients with knee osteoarthritis [3, 4, 6]. However, studies showing this outcome paired creatine with resistance training. So, we can’t necessarily say that creatine alone would help minimize bone loss or improve functional capacity. But we can say that creatine combined with resistance training may have beneficial effects on bone loss and functional capacity in individuals with knee osteoarthritis.
Is creatine safe? Generally speaking, yes. It is a well-researched supplement. However, the scientific community really only has research for up to five years. So, the safety of taking it in the long term, i.e. >5 years is unknown.
Who should be taking this: If your weekly exercise consists of low-intensity movement such as yoga, walking, or gardening, I would not recommend creatine monohydrate. However, if your weekly exercise includes multiple bouts of swimming, weight lifting, combat sports or you’re an athlete that does a high-intensity sport with multiple days of multi-hour training sessions per week, I would recommend taking creatine. You can get a pound of it for about $20.
Do’s, don’ts, and considerations: Do take your creatine with food. There is generally no need to creatine load unless you’re trying to prepare for some sporting event or need to maximize the effects of it in less than 30 days. Creatine monohydrate is the most well-known form of creatine and the most well studied and the one I’d recommend buying. So, don’t fall for gimmicky marketing and buy something other than creatine monohydrate.
If you’d like more info on creatine, see the reference page below. Specifically, I recommend articles 2 and 5. These references can be typed into google or PubMed and should be found easily with the reference info below. As always, don’t just take my word for it. Read more yourself to dive deeper. 😉
References
- Adcock, K. H., Nedelcu, J., Loenneker, T., Martin, E., Wallimann, T., & Wagner, B. P. (2003). Neuroprotection of creatine supplementation in neonatal rats with transient cerebral hypoxia-ischemia. Developmental Neuroscience, 24(5), 382–388. https://doi.org/10.1159/000069043
- Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: What does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18(1). https://doi.org/10.1186/s12970-021-00412-w
- Candow, D. G., Little , J. P., Chilibeck , P. D., Abeysekara, S., Zello , G. A., Kazachkov, M., Cornish , S. M., & Yu, P. H. (2008). Low-dose creatine combined with protein during resistance training in older men. Medicine & Science in Sports & Exercise, 40(9), 1645–1652. https://doi.org/10.1249/mss.0b013e318176b310
- Chilibeck , P. D., Candow , D. G., Landeryou, T., Kaviani, M., & Paus-Jenssen, L. (2015). Effects of creatine and resistance training on Bone Health in postmenopausal women. Medicine & Science in Sports & Exercise, 47(8), 1587–1595. https://doi.org/10.1249/mss.0000000000000571
- Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition Position Stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1). https://doi.org/10.1186/s12970-017-0173-z
- Neves, M., Gualano, B., Roschel, H., Fuller, R., Benatti, F. B., De Sá Pinto, A. L., Lima, F. R., Pereira, R. M., Lancha , A. H., & Bonfá, E. (2011). Beneficial effect of creatine supplementation in knee osteoarthritis. Med Sci Sports Exerc., 43(8), 1538–1543. https://doi.org/10.1249/mss.0b013e3182118592
- Zhu, S., Li, M., Figueroa, B. E., Liu, A., Stavrovskaya, I. G., Pasinelli, P., Beal, M. F., Brown, R. H., Kristal, B. S., Ferrante, R. J., & Friedlander, R. M. (2004). Prophylactic creatine administration mediates neuroprotection in cerebral ischemia in mice. The Journal of Neuroscience, 24(26), 5909–5912. https://doi.org/10.1523/jneurosci.1278-04.2004