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Supplemental Creatine - A Break Down


Supplemental Creatine

I can remember back to the early days of weight training in my high school gym wanting to get bigger, faster, stronger. The upperclassmen seemed to be doing things right - they were becoming all of those things and it made me wonder what they were doing that I wasn’t.


Then one day after gym class in the locker room, I see the upperclassmen passing around a tub of this white powder and mixing it into their plastic water bottles (the OG shaker bottle). Curious as any young, aspiring lifter would be, but too afraid to ask the question, I sat there wondering what it was they were taking and if it would be helpful. After quite some time mulling this substance over, I finally gathered up the courage to ask them what it was and if it would help me. 


Turns out that what they were taking was some form of creatine. That moment was one that has had quite a significant impact on my life in the gym and with strength training. That was my first introduction to arguably the most important sports nutrition supplement and the only supplement I use today aside from caffeine.


All that being said, this article intends to break down some of the myths and the science behind creatine and its various forms to allow you to form an educated opinion on whether this supplement is something that could be beneficial for you. First, we will discuss the benefits of using creatine, the safety of creatine, the different forms of creatine, the most recommended supplement regimen, and some of the myths about creatine.


The Benefits of Creatine


Creatine is most notably known as an ergogenic (performance-enhancing) supplement used mainly in the realms of sports and strength and conditioning. There are a few other suggested benefits such as neuroprotection against spinal cord injuries and traumatic brain injuries, improved rehabilitation from injury, enhanced clinical outcomes with neurodegenerative diseases (Parkinson’s, dementia, etc.), and aging to name a few. For the purposes of this article, we will be focused on the performance enhancement in exercise and sport and the few additional benefits that fall under that category such as improved recovery, heat tolerance, and injury prevention.


Ergogenic Aid

Creatine, which is naturally found in our bodies and in a lot of the foods we eat, plays a role in the phosphocreatine energy system which is responsible for a quick, powerful burst of energy lasting around 8-12 seconds. Many studies have shown that supplemental creatine increases the amount of creatine found in muscle and therefore can improve acute exercise capacity because it is more readily available for use in the phosphocreatine energy system. This allows the athlete to perform for a slightly longer duration using that quick and powerful energy and subsequently improves the quality of training leading to better gains over time.(1,2) 

Creatine performance enhancement

That being said, when you read “...a quick, powerful burst of energy lasting around 8-12 seconds,” what sort of sport or event can you think of that matches that description?


If you were thinking of a high-intensity set of weight training, you hit the nail on the head.

As we’ve discussed previously in other content most strength training programs live in the 5 reps or less range with heavy weights and a high-intensity. These sets don’t usually last much longer than 8-12 seconds unless you are doing tempo work (which we won’t be focusing on here) and primarily use the phosphocreatine energy system. If you can improve the efficiency of the phosphocreatine energy system, you can improve the quality of those sets. Which, in turn, leads to greater strength and muscle mass gains (most sets of exercises that are focused on building muscle take a little longer than 8-12 seconds but also utilize the phosphocreatine energy system).


Is it starting to make sense now how supplemental creatine can be used as an ergogenic aid?


Hopefully, you are starting to see the performance enhancement picture. But, the increased efficiency in the phosphocreatine energy system that supplemental creatine provides is not the only way that creatine enhances your performance.


Enhanced Recovery

Now, before we get into the additional benefits of creatine, it is important to understand that these additional benefits do not have as much evidence to back them up. However, there are suggestions that creatine can help with other things besides just ergogenic enhancement. The first that we will discuss is the potential that creatine supplementation helps with improving recovery by reducing muscle damage following intense exercise. 


In a handful of different studies where the majority of the protocols were comparing a group that supplemented with creatine and a group that didn’t, they found that creatine supplementation helped with some inflammatory markers following exercise and that the group taking creatine demonstrated greater isokinetic (same force applied to a shortening/lengthening muscle) and isometric (no change in muscle length as force is being applied) strength in the knee extensors during recovery of exercise-induced muscle damage (delayed onset muscle soreness - DOMS).(1) 


This benefit of creatine can be particularly helpful if you are someone that likes to maintain a regular routine of strength/resistance training as well as run, bike, or do other activities as you could possibly have less soreness affecting your running, biking, etc. after your lifting workout.


Reduced Injury

Although there are some reports of studies indicating that creatine helps with injury prevention, I think there needs to be more rigorous evidence to support these claims and that currently, they should be taken with a grain of salt. Nevertheless, the evidence points in a positive direction of reduced injury rates. 


Creatine and reduced injury risk

In multiple studies that were primarily performed in collegiate football players that were ingesting 10+ grams of creatine per day (a much larger dose than most people require to experience the benefits) showed less incidence of muscle cramping, heat illness/dehydration, muscle tightness, muscle strains/pulls, non-contact injuries, and total injuries/missed practices compared to those that were not taking creatine. It is important to note that along with those findings, there were no significant changes in renal function, blood panel findings, muscle and liver enzymes, clinical urinalysis, and others.(1)




The mechanism as to how creatine improved injury risk was not specified. So the question is, does this only apply to collegiate football players? Or can it be assumed in other populations? As I said, more research is needed to substantiate these claims but in the meantime, this is what we have so far.


Improved Heat Tolerance

One of the common things you hear about taking creatine is that it helps retain water and that’s the reason why you look bigger and more muscular while on creatine. I hope that by now, you can see that water retention is not the only reason that you look bigger or more muscular if you are taking creatine appropriately and for an appropriate period of time. However, the idea that creatine retains water is accurate, though it has a different benefit than just increasing how big you look. Creatine has osmotic properties that cause slight water retention. There are many studies that have shown this property of creatine and how it can have a positive effect on hydration and subsequently heat tolerance.(1) 


How this osmotic property of creatine works to improve heat tolerance is by increasing intracellular water and decreasing thermoregulatory and cardiovascular responses (heart rate, sweat rate, temperature, etc.). Most of the studies performed on this subject showed significant differences between the groups supplementing with creatine and those that didn’t in favor of creatine improving heat tolerance and allowing the athletes to perform better and for longer periods of time.(1)


Safety

If you have heard about creatine prior to reading this article, I’m sure you have heard about many proposed side effects and reasons why you shouldn’t take creatine. I can anecdotally tell you that for as long as I have taken creatine I have never experienced any significant side effects. The same goes for any clients, friends, or acquaintances that I have recommended creatine to.


Of the vast amount of studies performed on creatine and specifically looking at the safety of this supplement, there has only been one consistently reported “side effect” - weight gain.(1) Which if you’re looking to get bigger and stronger, I would not think that this would be a negative side effect and would actually be a positive side effect. 


One of the biggest and scariest potential side effects that you hear about with creatine is kidney function. There are many rumors and stigmas that say that creatine decreases your kidney function and poses a really big risk to your kidneys. Again, anecdotally, I have had multiple blood panels throughout my life of taking creatine with all values within normal limits and no adverse reactions. With that, there have been many studies that have extensively studied creatine and kidney function and have determined that creatine is, in fact, safe and not harmful for your kidneys.(1) If you have a pre-existing kidney condition, it would be wise to consult with your medical doctor before beginning to supplement with creatine (this is good practice even if you don’t have a pre-existing kidney condition with creatine and any other supplement). Ultimately, it has been determined that creatine is a safe supplement for pretty much all ages.(1, 2) 


The Different Forms of Creatine

There are many different forms of creatine available on the market today with creatine monohydrate being the most popular and most studied form of creatine. All of the information mentioned above was in reference to creatine monohydrate. Many of these different forms of creatine claim to be more effective and efficient than creatine monohydrate. These forms of creatine may be something like micronized creatine, creatine HCl, and other formulas mixed with additional supplements. 


As I mentioned, many of these different forms of creatine claim to be more effective and produce greater results than creatine monohydrate. Since many of these forms of creatine are newer, they are not as studied as creatine monohydrate and therefore, don’t have as much evidence advocating for their use. 


In a couple of different studies that were conducted to compare these different forms of creatine vs. creatine monohydrate, they found no significant differences in the performance outcomes such as muscle creatine content, body composition, strength, or anaerobic capacity.(3, 4) 


A lot of the companies that make these different forms of creatine claim that their form of creatine produces better results and has fewer side effects. Usually along with those claims comes a higher price tag. Based on the evidence that supports the use and effectiveness of creatine monohydrate and the lack of evidence that supports these different forms of creatine, creatine monohydrate proves to be the supplement of choice for myself and many of the top-performing athletes across the board. Plus, creatine monohydrate is usually inexpensive and easy to consume.


Recommended Supplement Regimen

When taking supplemental creatine, there are many different camps that recommend different supplement regimens. The most recommended and most effective way to increase muscle creatine stores (the goal with consuming supplemental creatine) is to perform a “loading phase” where you consume ~5g of creatine monohydrate four times daily for 5-7 days.(1) This helps increase the concentration of creatine within the muscle cells the fastest. Following the loading phase, there is a maintenance phase where you consume 3-5g of creatine monohydrate per day. Keeping in mind that larger athletes require more creatine to have the same effect.


How to take creatine

This is the most researched and supported supplement regimen when consuming creatine. Some studies suggest consuming creatine monohydrate with carbohydrates or protein to promote greater creatine retention. However, the difference between consuming creatine with or without carbohydrates or protein will not make or break the effectiveness of the supplemental creatine. 


Lastly, I want to mention that generally, creatine muscle stores return to baseline following creatine supplementation termination in approximately 4-6 weeks.(1) 


The Last Myth About Creatine Debunked

If you are familiar with supplemental creatine, you have probably heard many different myths about it. Such as you have to cycle on-and-off of creatine, creatine is bad for your kidney function, and creatine only causes water retention that makes you look bigger. We have already debunked the last two myths within the contents of this article, so, therefore, our focus here will be on cycling on and off of creatine.


Cycling On-And-Off

As far as cycling on-and-off creatine, this is one of the oldest myths about creatine. There is no evidence supporting the claim that you have to cycle on-and-off creatine for it to be effective. The thinking here is that once you take creatine for a long enough period of time, your body gets used to it and then the supplemental creatine becomes essentially ineffective. This is far from the truth as supplemental creatine is purely used to increase muscle creatine concentration to help the efficiency of the phosphocreatine energy system. Therefore, as long as you are supplementing creatine, the percentage of muscle creatine concentration will remain higher than if you were not supplementing with creatine. 


So don’t worry so much about taking it for 2 weeks and then taking a week off. My recommendation and how I have personally consumed creatine supplements in my life is to take it consistently until my container runs out. Then I take some time off from taking it (mainly because I will forget to get more when I go to the store) and don’t think anything of it. Remember, the higher concentration of creatine in your muscles takes approximately 4-6 weeks before it returns to baseline. This means that you don’t have to worry about cycling off for a set amount of time and to not overthink taking your creatine supplement. The main thing is to just be consistent with it.


Summary

Creatine is one of the safest and most effective supplements to help with your performance in the gym and in sports. There is a vast amount of research that proves the effectiveness of creatine monohydrate and the aim of this article was to incorporate some of that here to provide you with a clear picture of the truth about creatine monohydrate. I hope that you have learned about the benefits of creatine, the safety of it, different forms of the supplement, and how to consume the supplement for maximum benefit. 


This has been one of the most fun articles to research and write as we get a lot of questions from clients and gym members regarding creatine - I hope you enjoyed it. Please, give this a share as that helps us get the word out!


 

References

  1. Kreider RB, Kalman DS, Antonio J, 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. 2017;14(1). doi:10.1186/s12970-017-0173-z 

  2. Dorrell HF, Gee TI, Middleton G. An Update on Effects of Creatine Supplementation on Performance: A Review. Sports Nutrition and Therapy. 2016;1(1). doi:10.4172/2473-6449.1000107 

  3. Jagim AR, Oliver JM, Sanchez A, et al. A buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate. Journal of the International Society of Sports Nutrition. 2012;9(1):43. doi:10.1186/1550-2783-9-43 

  4. Jäger R, Purpura M, Shao A, Inoue T, Kreider RB. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids. 2011;40(5):1369-1383. doi:10.1007/s00726-011-0874-6 

  5. Dash AK, Mo Y, Pyne A. Solid‐state Properties of Creatine Monohydrate. Journal of Pharmaceutical Sciences. 2002;91(3):708-718. doi:10.1002/jps.10073

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