Creatine 101
Creatine is one of the most researched supplements on the market with decades of research behind it. What is it and does it work?
What is creatine?
Creatine is naturally found in the body. In the case of exercise, it provides an extremely quick source of energy, although our storage capacity is extremely low.
If you go sprint for 5 to 10 seconds right now, where did that energy come from? You aren’t breathing heavy until after the sprint, so it can’t all be from oxygen. You got that energy from creatine! Well, sort of, but creatine played a huge role in that energy production.
In nerd terms, this is called the phosphocreatine system, or the ATP-PC system. ATP is final product that gives us energy. The phosphocreatine system is very quick to provide ATP, but our storage is very limited. Once depleted, other systems start to contribute more like the glycolytic system (used heavily during maximal exercise ranging from 30-90 seconds), and the oxidative system (used heavily during exercise durations of 90 seconds or longer).
Still awake? Let’s go over what creatine can (or can’t) do for you.
What are the claimed benefits of creatine supplementation?
Creatine supplementation has claimed benefits of:
Improved muscle size, strength, and performance
Enhanced recovery
Injury prevention
Bone health
Cognitive benefits and brain health
Skin health
Many others!
That’s quite an impressive list, but that’s also why we should be skeptical about these claims. I did not study neuroscience or dermatology, so I will not speak on the claims of cognitive benefits or skin health. However, I would like to take a look at the other benefits.
I will be getting most of my information from the article, “International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine”.1 If you would like to read this article for yourself, use this link. For the rest of this publication, I will refer to this article as the “ISSN”
Muscle size, strength, and performance
By taking a creatine supplement, we can increase our intramuscular creatine stores. As mentioned above, creatine provides rapid energy to the working muscles, making this extremely appealing to power and speed athletes, lifters, body builders, and anyone looking to improve their muscle strength and size.
Below is table from the ISSN creatine position stand. There is a lot of research to support these potential benefits of creatine supplementation.
The data is clear, and it has been for a long time. Creatine is an effective ergogenic aid. This data is more commonly known and more established, but what about the other claims?
Enhanced recovery
Interestingly, consuming creatine alongside large amounts of glucose (carbs) following intense exercise enhances both creatine and carbohydrate absorption2 . Maximizing carbohydrate absorption is important to those with high levels of physical activity since it allows them to be properly fueled for following exercise bouts.
Research also shows that those supplementing with creatine are better able to perform while still sore and recovering from a previous exercise bout.
Creatine supplementation has evidence that it can aide in recovery by increasing carbohydrate ingestion, decreasing inflammation following exercise, and increasing the tolerance for more strenuous bouts of exercise.
Injury Prevention
As mentioned in the ISSN position stand, the results are mixed on whether or not creatine supplementation prevents injury. It seems clear that it does not increase injury risk, but there is some evidence that it may be an effective injury prevention tool.
It is worth mentioning that injuries are extremely difficult to study, as it would be unethical to take a group of subjects and put them at risk of injury. Most of the data and research we have on injuries is observational.
Creatine supplementation might have an effect on injury prevention, but that could be due to the variables previously mentioned above like increased muscle size, strength, and recovery benefits.
Bone Health
The ISSN highlights several studies that demonstrate creatine supplementation being beneficial for bone health. These studies are mostly conducted with older subjects and postmenopausal women (those who are at higher risk for osteopenia, osteoporosis, and general bone health issues). The research shows better improvements in bone health and/or a slower decline in bone health in those supplementing with creatine.
I am not sure whether creatine supplementation directly results in better bone health or if this is a result of the increase in muscle strength and size. Either way, creatine seems beneficial for bone health.
Safety
If you are concerned with the safety of creatine, there are over 1,000 studies to back it up. The only reported side effect of creatine is weight gain, and it is likely due to the increased water weight and lean mass, rather than fat gain.
Short studies, long studies, youth, elderly, small and large doses, etc. have all been examined. Creatine is safe to use! The research has looked at incidence of injuries, dehydration, cramping, GI distress, and renal dysfunction.
You may see claims that creatine is deemed safe to use for “up to 5 years”, but don’t let that worry you. It is simply because long duration studies are extremely difficult to conduct. Creatine won’t suddenly turn on you after 5 years of using it.
Summary
This is not just a supplement for athletes. Creatine is safe to use, and it is effective for improving muscle strength and size, recovery, and it has evidence that it can reduce injury prevelance and improve bone health.
Will creatine supplementation make you an indestructible superhuman and double your lifting numbers? I wouldn’t count on it. Think of it as a way to marginally improve in these areas (which is still a huge deal). Creatine is safe, effective, and cheap, making it one of the best supplements and ergogenic aids available.
Recommendations
I am directly quoting the recommendations from the ISSN position stand.
“The quickest method of increasing muscle creatine stores may be to consume ~0.3g/kg/day of creatine monohydrate for 5–7-days followed by 3–5g/day thereafter to maintain elevated stores. Initially, ingesting smaller amounts of creatine monohydrate (e.g., 3–5g/day) will increase muscle creatine stores over a 3–4-week period, however, the initial performance effects of this method of supplementation are less supported.”
It is more effective to do a high dose loading period for 5-7 days since using lower doses to start can take 3-4 weeks to start seeing results.
As for picking an actual supplement, pick a popular brand. While creatine is safe, I guarantee there are some sketchy brands out there that have more than just creatine in it. Popular brands that have been around for a while are more likely to have had rigorous testing to their product.
I also recommend choosing creatine monohydrate. Other common forms of creatine supplements are buffered creatine, creatine HCL, creatine ethyl-ester, and micronized creatine. There are many forms of creatine supplements, but the specific compound, creatine monohydrate, is the cheapest and still gives you all of the benefits.
What’s Next? Myth busting 5 Common Health, Fitness, and Nutrition Myths.
References:
International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.
Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans.