Creatine is one of the most popular and is among the most well-researched supplements in the fitness industry! (1)
In this article, we will go over what is creatine, why we supplement with it, its safety and efficacy, the types of creatine supplements available, and the proper dosages.
What is creatine?
About half of our body's creatine stores come from food that we eat, specifically from red meat and seafood. While the rest are made in the liver and kidneys. (1)
Naturally, creatine is a molecule that is produced in the body from amino acids, methionine, glycine, and arginine. (1)
It is synthesized mostly in the liver and to a lesser extent in the kidney and pancreas assisting in the reformation of ADP to ATP (adenosine triphosphate), the primary energy carrier in the body. (2)
Muscle tissues have enough stored ATP to last a few seconds. To synthesize more ATP as quickly as possible, muscles turn to phosphocreatine. This process provides an instant source of energy but is quickly depleted.
The combination of a muscle’s stored ATP plus its phosphocreatine is collectively known as the phosphagen system. This system however is limited by the supply of phosphocreatine in the body.
So why supplement creatine?
Creatine supplementation has been shown to improve power output, muscle strength, and muscle size. (1)
The effect on muscle strength is promoted by increasing body stores of phosphocreatine which is then used during high-intensity exercise to generate more ATP. (3)
Normally, after ten seconds of high-intense activity, ATP becomes depleted. However, creatine supplementation help produce more ATP where optimal performance can be maintained for a few seconds longer! (4)
The creatine’s effect on body size is facilitated by drawing water into the muscle through osmosis leading to an increase in body weight and muscle size. (5)
Also, with the increased strength creatine provides; heavier weights can be used in the gym and will lead to more stimulus for growth. This enables more total volume and working sets in a single training session. (6)
In addition, it appears creatine supplementation increases the number of myonuclei that satellite cells will donate to the damaged muscle fiber. This will then increase the potential for the growth of those muscle fibers. (7)
Moreover, numerous studies show creatine raises anabolic hormones such as IGF-1 (insulin-like growth factor 1). This is beneficial as IGF-1 is a hormone that manages the effects of growth hormones in the body. (8)
The study concluded that creatine supplementation which increases lean body mass could be mediated by signaling pathways involving IGF. (8)
Furthermore, like muscles the brain stores phosphocreatine as well. For optimal function, the brain requires a good deal of ATP. (9)
However, creatine supplementation has been researched far less for the benefits it has on cognitive performance.
It appears it reduces mental fatigue in situations of high mental demand or improves working memory. Although, it may be only beneficial to those who aren't getting enough creatine from their diet. (10)
Any drawbacks in taking creatine?
Creatine is one of the world's most tested supplements and has been one the most well-researched supplements with an outstanding safety profile. (1)
There are common misconceptions and some things to be aware of about creatine supplementation.
Water retention typically results in weight gain, partly due to an increase in total body water in the short term. (11)
Nonetheless, water will be taken up into the muscle to help maintain intracellular osmolality. However, it does not alter total body water relative to muscle mass over long periods and it is not likely to be dramatically affected by the creatine supplement. (12)
In regards to kidney damage or renal dysfunction, when ingested at recommended dosages, it does not result in any kidney damage or renal dysfunction in healthy individuals. (12)
There is also speculation regarding the relationship between hair loss. This is due to a single study that has yet to be replicated which concluded the increase in serum dihydrotestosterone (DHT). (13)
Nonetheless, the current evidence doesn't indicate that creatine supplementation causes hair loss.
Minor side effects may occur typically involved with an upset stomach or cramping which is more often linked to excessive dosages. (14)
Fortunately, there are over 500 peer-reviewed publications involving creatine supplementation which suggest a variety of beneficial effects in the adult population. (12)
A large amount of research indicates that creatine is safe to consume while no serious side effects have ever been reported.
What types of creatine supplements are available?
The most common and well-researched form of creatine supplementation is creatine monohydrate. This is typically the form of creatine that is used or has been observed almost exclusively in most peer-reviewed studies.
Creatine monohydrate is made up of a creatine molecule and a water molecule and is about 90% creatine by weight.
Whereas, creatine anhydrous removes the water molecule resulting in 100% creatine by weight. Despite that, it is rarely seen in the supplement market.
Sometimes, the creatine monohydrate is micronized to improve water solubility. Regardless, each of these forms is equally effective in equal doses.
One form of creatine that has recently gained popularity is creatine hydrochloride (HCL).
There have been reports indicating superior solubility in water and is speculated that a lower dose can be used. A study even found that it was 38 times more soluble than creatine monohydrate. (15)
Unfortunately, there have been no published experiments done on humans.
Ultimately, based on numerous well-researched evidence, we recommend creatine monohydrate.
How much should I take?
Generally, people start with a loading phase leading to accelerated creatine muscle stores.
Typically, the loading phase entails around 20 grams of creatine per day for about five to seven days, split into four servings of 5 grams throughout the day. Following the loading phase, take 3 to 5 grams to stay saturated. (1)
Sometimes, people choose not to do the loading phase and start with 3 to 5 grams per day. In turn, it will take longer to maximize creatine stores which are said to take around 28 days. (16)
Now, regarding specific protocols for each individual. Start with 0.3 grams per kilogram of body weight for 5 to 7 days. Following the loading phase, take at least 0.03 grams per kilogram of body weight.
For example, in terms of a 180lbs (82kg) person. This translates to about 25 grams per day for the loading phase, followed by about 2.5 grams per day to maintain saturation. Higher doses of 3 to 5 grams per day are recommended for those with high amounts of muscle mass and high activity levels to maintain muscle stores of creatine.
These dosages can be taken every three weeks to a month if cycling or indefinitely without additional loading phases.
Numerous studies reveal no negative effects if taken for long periods lasting up to four years. (17)
One comprehensive study showed no adverse effect after 21 months measuring 52 blood markers. (18)
Other studies have shown creatine supplements in doses of up to 4 grams per day for 2 years resulted in no detrimental health effects. (19)
How much do we take?
We have been taking creatine in some form for about a decade staying saturated with about 3 - 5 grams per day.
We take this dosage amount of 3 - 5 grams to stay saturated due to our high activity level and high amounts of muscle mass.
Ultimately, we have yet to experience any negative side effects.
Although, sufficient water intake is essential in avoiding minor side effects like stomach pains or cramping. So make sure you stay hydrated!
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Also, all content contained within this article is for informational purposes only and is not intended to substitute the advice, diagnosis, or treatment from a qualified medical professional.
References
1. Kreider, Richard B et al. “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 vol. 14 18. 13 Jun. 2017, doi:10.1186/s12970-017-0173-z
2. Cohen S, Buckley P. The synthesis of creatine by preparations of the liver from embryos and adults of various species. J Biol Chem. 1951;193(2):851-858.
3. Rawson, E S et al. “Differential response of muscle phosphocreatine to creatine supplementation in young and old subjects.” Acta physiologica Scandinavica vol. 174,1 (2002): 57-65. doi:10.1046/j.1365-201x.2002.00924.x
4. Butts, Jessica et al. “Creatine Use in Sports.” Sports health vol. 10,1 (2018): 31-34. doi:10.1177/1941738117737248
5. Häussinger, D et al. “Cellular hydration state: an important determinant of protein catabolism in health and disease.” Lancet (London, England) vol. 341,8856 (1993): 1330-2. doi:10.1016/0140-6736(93)90828-5
6. Becque, M D et al. “Effects of oral creatine supplementation on muscular strength and body composition.” Medicine and science in sports and exercise vol. 32,3 (2000): 654-8. doi:10.1097/00005768-200003000-00016
7. Dangott, B et al. “Dietary creatine monohydrate supplementation increases satellite cell mitotic activity during compensatory hypertrophy.” International journal of sports medicine vol. 21,1 (2000): 13-6. doi:10.1055/s-2000-8848
8. Deldicque, Louise et al. “Increased IGF mRNA in human skeletal muscle after creatine supplementation.” Medicine and science in sports and exercise vol. 37,5 (2005): 731-6. doi:10.1249/01.mss.0000162690.39830.27
9. Rae, Caroline et al. “Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial.” Proceedings. Biological sciences vol. 270,1529 (2003): 2147-50. doi:10.1098/rspb.2003.2492
10. Avgerinos, Konstantinos I et al. “Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials.” Experimental gerontology vol. 108 (2018): 166-173. doi:10.1016/j.exger.2018.04.013
11. Kutz, Matthew R, and Michael J Gunter. “Creatine monohydrate supplementation on body weight and percent body fat.” Journal of strength and conditioning research vol. 17,4 (2003): 817-21. doi:10.1519/1533-4287(2003)017<0817:cmsobw>2.0.co;2
12. Antonio, Jose et al. “Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?.” Journal of the International Society of Sports Nutrition vol. 18,1 13. 8 Feb. 2021, doi:10.1186/s12970-021-00412-w
13. Van der Merwe, Johann et al. “Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players.” Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine vol. 19,5 (2009): 399-404. doi:10.1097/JSM.0b013e3181b8b52f
14. Groeneveld, G J et al. “Few adverse effects of long-term creatine supplementation in a placebo-controlled trial.” International journal of sports medicine vol. 26,4 (2005): 307-13. doi:10.1055/s-2004-817917
15. Gufford, Brandon T et al. “Physicochemical characterization of creatine N-methylguanidinium salts.” Journal of dietary supplements vol. 7,3 (2010): 240-52. doi:10.3109/19390211.2010.491507
16. Preen, David et al. “Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle.” International journal of sport nutrition and exercise metabolism vol. 13,1 (2003): 97-111. doi:10.1123/ijsnem.13.1.97
17. Schilling, B K et al. “Creatine supplementation and health variables: a retrospective study.” Medicine and science in sports and exercise vol. 33,2 (2001): 183-8. doi:10.1097/00005768-200102000-00002
18. Kreider, Richard B et al. “Long-term creatine supplementation does not significantly affect clinical markers of health in athletes.” Molecular and cellular biochemistry vol. 244,1-2 (2003): 95-104.
19. Bender, Andreas et al. “Long-term creatine supplementation is safe in aged patients with Parkinson disease.” Nutrition research (New York, N.Y.) vol. 28,3 (2008): 172-8. doi:10.1016/j.nutres.2008.01.001
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