by Sophia Cassella
Are you looking to take your athletic performance to the next level, and wondering if creatine can help you get there?
Look no further than this article, where I will explore the science behind creatine, covering how it works, the benefits, how to take it, who can take it, and the most common misconceptions about the supplement.
Disclaimer: We’re about to dive head-first into the biochemistry of creatine.
But first, let’s start by defining this supernatural white powder.
What is creatine?
Creatine is one of the most effective, over-the-counter supplements on the market today, known for increasing strength, power, muscle mass, and improving recovery. It is a compound that is naturally-occurring in our muscles and its job is to produce energy for high-intensity exercise.
It can be consumed in small amounts through animal-based protein sources like meat or fish, but when supplemented, athletes can effectively increase their creatine stores, contributing to enhanced athletic performance and recovery benefits.
How does creatine work?
Our muscles require energy in the form of adenosine triphosphate (ATP) to perform in high-intensity, anaerobic activities such as weightlifting, sprinting, or BJJ (my personal favorite).
Creatine, in its phosphorylated form of phosphocreatine, plays a crucial role in the process of producing ATP, specifically by donating a phosphate group to an amino group called adenosine diphosphate (ADP) to produce ATP for energy:
Phosphocreatine + Adenosine Diphosphate (ADP) = Creatine + Adenosine Triphosphate (ATP), which serves as energy for high-intensity activities
In laymen’s terms: 1 phosphate + 2 phosphate = 3 phosphate
That’s all the science for today, don’t worry!
The process of ATP reproduction is vital to exercise performance in high-intensity activities. As ATP stores become depleted, performance rapidly declines.
Supplementing with creatine increases phosphocreatine stores, thus contributing to prolonged ATP production and improving your ability to train harder and recover faster between sets.
One example of how this increase in ATP might translate into your training would be: being able to perform more reps with a heavier weight than you previously could.
Over time, this increased workload will allow you to get stronger and build more muscle over a shorter period of time than if you weren’t supplementing with creatine.
Benefits of creatine supplementation
Creatine’s ability to increase ATP production contributes to increases in strength, speed, power output, and muscular hypertrophy (growth) in athletes.
Creatine has been shown to improve maximal strength and power output by 5-15%, maximal effort muscle contractions by 5-15%, single effort sprint performance by 1-5%, and repetitive sprint performance by 5-15% (9).
Supplementing with creatine has also been proven to improve recovery times.
After intense workouts, muscle soreness and fatigue can hinder subsequent training sessions. Creatine has been shown to reduce markers of muscle damage and inflammation, allowing for quicker recovery between workouts.
This means that athletes can train more frequently and with greater intensity, leading to enhanced results in the long run.
Additionally, there has been evidence to show that creatine reduces the likelihood of musculoskeletal injuries and accelerates the recovery time when they do occur (1).
New research even demonstrates that creatine supplementation can improve brain function during strenuous activities like exercise or mental exertion.
Creatine’s role in regenerating ATP for energy contributes to improved cognitive function, memory, and energy availability to brain cells (2). Studies also show that creatine supplementation can reduce the risk of damage from brain injuries and neurodegenerative diseases.
Recommended dosage and timing for creatine supplementation:
The recommended dosage for creatine is 3-5 grams per day. However, many people like to start with a loading phase of 20 grams per day for 5-7 days to jumpstart the ergogenic effects, but this is not necessary.
Be aware that some people experience gastrointestinal upset during the loading phase. To mitigate this, it’s recommended that you to split the 20g dose into four 5-gram doses throughout the day, and that you take it with a carbohydrate and protein-based meal to improve the absorption of the creatine (5).
After the 5-7 day loading phase, it is recommended to consume 3-5g of creatine daily to maintain high levels of creatine in your muscles and continue experiencing the ergogenic effects.
How long can you take creatine for?
The long-term effects of creatine remain unknown, but it has been proven to be safe to take continuously for up to 5 years in recommended doses.
Creatine levels can stay elevated for up to 4-6 weeks after stopping supplementation, meaning that you can still experience the ergogenic effects of creatine if you decide to cycle off for a few weeks.
Will creatine damage your kidneys?
No! This is one of the most common misconceptions concerning creatine supplementation.
After creatine gets broken down into creatinine to make ATP, creatinine accumulates in the blood and gets filtered through the kidneys. This means that your kidneys may have to filter through more creatinine than normal, which was once thought to be demanding on the kidneys, an idea that became the basis for this myth (1).
However, studies have shown that the kidneys are able to safely excrete creatine and its waste-product, creatinine, without damaging renal function in healthy individuals who are consuming the recommended dose.
Will creatine make you gain weight?
Maybe!
Creatine supplementation may cause temporary water-retention, which may slightly increase the number on the scale.
This is because creatine is an osmotically active substance, meaning that when it is stored in the muscle cells, it will bring water in with it to maintain equilibrium inside the cell.
However, creatine supplementation does not alter total body water relative to muscle mass over long periods of time (1).
Additionally, increased muscle mass is common amongst people who take creatine because they are able to train harder and more often with supplementation. Increased muscle mass will contribute to an increase in the number on the scale.
I personally did not experience any changes in the number on the scale for the first few months of taking creatine. However, it’s been four years since I started taking it, and I attribute any changes in my bodyweight since then to my diet and activity level.
Is creatine an anabolic steroid?
No!
Anabolic steroids are artificial versions of testosterone that are known for increasing strength and muscle mass by improving the rate of muscle protein synthesis. Anabolic steroids work by entering muscle cells and binding with receptors that increase the expression of muscle-specific genes (8).
Anabolic steroids are drugs and are illegal to take without a doctor’s prescription. They are a banned substance within all USADA and WADA-participating sports, and come with a long list of potentially health-threatening side effects.
Creatine, on the other hand, is a naturally-occurring compound that increases ATP production, leading to improved sports performance markers. Creatine is 100% safe, legal to buy and consume, and effective.
Will creatine make you go bald?
No!
This myth stems from a study performed on collegiate rugby players who experienced hair loss during the study back in 2009 (13). The study had these athletes supplement with 25g/day for 7 days, followed by 5g/day for 14 days.
These athletes experienced an increase in dihydrotestosterone (DHT), which is a metabolite of testosterone that is linked to hair loss. However, the researchers did not measure hair loss in their study; they measured DHT levels.
The “statistically significant” increase in DHT levels reported in the study were actually due to the athletes’ levels of DHT being lower to begin with (prior to supplementation) compared to the control group (the group that got a placebo) (13).
Additionally, the levels of DHT remained within normal clinical limits for males of that age group, as well as the DHT: testosterone ratio.
The results of this study have not been replicated and there is no further evidence to suggest that creatine causes hair loss.
Will creatine cause dehydration and muscle cramps?
No, quite the opposite actually!
This myth is predicated in the fact that creatine pulls water into your muscle cells, and it was once thought that the osmosis of water into the cells would disrupt the electrolyte balance in your body and lead to muscular cramps and extracellular (outside of the cell) dehydration.
However, there are multiple studies demonstrating that creatine can actually hyper-hydrate individuals who exercise in hot and humid environments, which can lead to increased resistance against cramping, dehydration, and heat-related illnesses.
In one study involving Division IA NCAA collegiate football players, participants chose between supplementing with creatine or a sports drink placebo throughout the season. Creatine users experienced less muscular tightness, strains, heat-related illnesses, dehydration, and total injuries compared with the participants who chose the placebo (6).
Can aerobic athletes benefit from taking creatine?
At this point, we know that creatine is a great supplement for strength and anaerobic athletes looking to improve their athletic performance, but what about aerobic athletes?
There is a study that looked at creatine supplementation for athletes running a 30km race, and the results demonstrated that the athletes who supplemented with creatine experienced less muscle damage, soreness, and inflammation (11).
Additionally, supplementing with creatine can benefit endurance athletes who train outside in hot and humid environments because creatine can prevent heat-related illnesses, muscle cramping, and dehydration.
However, there is no evidence suggesting that creatine will improve endurance performance in aerobic athletes (4).
Is creatine safe for children and older adults?
Yes and yes!
At this time, creatine supplementation is considered safe for older children and adolescents from a clinical perspective.
In a study where pediatric patients with systemic lupus erythematosus were given creatine for 12 weeks, conditions improved with no adverse changes in kidney function, liver function, inflammatory markers, or hematology (7).
In another study where pediatric patients with Duchenne muscular dystrophy were given creatine for 4 months, significant improvements were found in their fat-free mass and grip strength, along with no adverse changes in kidney function, oxidative stress, or bone health (12).
Another study reported significant improvements in children with traumatic brain injuries who were given 0.4g/kg/day of creatine for 6 months. Creatine may be a good supplement choice for athletes who participate in high-contact sports where brain injuries like concussions are common (10).
However, there is still no evidence to suggest that ergogenic benefits can be found in children and adolescents supplementing with creatine.
In older adults, creatine supplementation can improve the symptoms of many clinical conditions.
For example, sarcopenia, a common condition found in older adults that leads to significant losses in strength and muscle mass, contributes to many incidences of falls, fractures, and long-term physical disabilities.
Resistance training is the primary treatment for sarcopenia; however, there is increasing evidence to show that creatine supplementation in addition to resistance training can enhance the ergogenic effects of resistance training and improve strength, muscle mass, and bone density in older adults (3).
However, creatine without resistance training will not contribute significantly to increases in muscle mass. This means that the increases in muscle mass are likely due to the increased training load individuals supplementing with creatine are able to tolerate.
Conclusion:
Creatine is one of the safest, most effective, and most highly-researched nutritional supplements on the market.
It does not cause kidney damage, baldness, dehydration, or muscle cramping.
I’ve been taking it for almost 4 years now, and I’ve only gotten stronger, faster, and more conditioned from taking it. So, unless none of those things matter to you, I highly recommend ordering some today.
Sources:
- 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
- Avgerinos, K. I., Spyrou, N., Bougioukas, K. I., & Kapogiannis, D. (2018). Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Experimental Gerontology, 108, 166–173. https://doi.org/10.1016/j.exger.2018.04.013
- Candow, D. G., Forbes, S. C., Chilibeck, P. D., Cornish, S. M., Antonio, J., & Kreider, R. B. (2019). Effectiveness of creatine supplementation on aging muscle and bone: Focus on falls prevention and inflammation. Journal of Clinical Medicine, 8(4), 488. https://doi.org/10.3390/jcm8040488
- IZQUIERDO, M., IBA??EZ, J., GONZ??LEZ-BADILLO, J. J., & GOROSTIAGA, E. M. (2002). Effects of creatine supplementation on Muscle Power, endurance, and Sprint Performance. Medicine and Science in Sports and Exercise, 34(2), 332–343. https://doi.org/10.1097/00005768-200202000-00023
- Greenhaff, P. L. (1997). The nutritional biochemistry of creatine. The Journal of Nutritional Biochemistry, 8(11), 610–618. https://doi.org/10.1016/s0955-2863(97)00116-2
- Greenwood, M., Kreider, R. B., Melton, C., Rasmussen, C., Lancaster, S., Cantler, E., Milnor, P., & Almada, A. (2003). Creatine supplementation during college football training does not increase the incidence of cramping or injury. Guanidino Compounds in Biology and Medicine, 83–88. https://doi.org/10.1007/978-1-4615-0247-0_12
- Hayashi, A. P., Solis, M. Y., Sapienza, M. T., Otaduy, M. C., de Sá Pinto, A. L., Silva, C. A., Sallum, A. M., Pereira, R. M., & Gualano, B. (2014). Efficacy and safety of creatine supplementation in childhood-onset systemic lupus erythematosus: A randomized, double-blind, placebo-controlled, crossover trial. Lupus, 23(14), 1500–1511. https://doi.org/10.1177/0961203314546017
- Kersey, R. D., Elliot, D. L., Goldberg, L., Kanayama, G., Leone, J. E., Pavlovich, M., & Pope, H. G. (2012a). National Athletic Trainers’ Association position statement: Anabolic-androgenic steroids. Journal of Athletic Training, 47(5), 567–588. https://doi.org/10.4085/1062-6050-47.5.08
- Kreider, R. B. (2003). Effects of creatine supplementation on performance and training adaptations. Guanidino Compounds in Biology and Medicine, 89–94. https://doi.org/10.1007/978-1-4615-0247-0_13
- Sakellaris, G., Kotsiou, M., Tamiolaki, M., Kalostos, G., Tsapaki, E., Spanaki, M., Spilioti, M., Charissis, G., & Evangeliou, A. (2006). Prevention of complications related to traumatic brain injury in children and adolescents with Creatine Administration: An open label Randomized Pilot Study. The Journal of Trauma: Injury, Infection, and Critical Care, 61(2), 322–329. https://doi.org/10.1097/01.ta.0000230269.46108.d5
- Santos, R. V. T., Bassit, R. A., Caperuto, E. C., & Costa Rosa, L. F. B. P. (2004). The effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30km race. Life Sciences, 75(16), 1917–1924. https://doi.org/10.1016/j.lfs.2003.11.036
- Tarnopolsky, M. A., Mahoney, D. J., Vajsar, J., Rodriguez, C., Doherty, T. J., Roy, B. D., & Biggar, D. (2004). Creatine monohydrate enhances strength and body composition in Duchenne Muscular Dystrophy. Neurology, 62(10), 1771–1777. https://doi.org/10.1212/01.wnl.0000125178.18862.9d
- van der Merwe, J., Brooks, N. E., & Myburgh, K. H. (2009). Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clinical Journal of Sport Medicine, 19(5), 399–404. https://doi.org/10.1097/jsm.0b013e3181b8b52f