Creatine: What the Research Shows
Overview:
Creatine is a compound that is made endogenously (inside the body) via reactions involving amino acids in the liver and kidney. 95% of creatine is stored in the muscles as phosphocreatine. Phosphocreatine is used as an energy source during exercise that involves short, high intensity intervals such as boxing, sprinting, or weight lifting. Exogenously, we can obtain creatine through meat and supplementation. Creatine supplementation has been one of the safest and most well-researched supplements (>20 years and over 500 peer reviewed studies) proven to enhance performance under anaerobic conditions (i.e. sprinting, weightlifting) by increasing muscular power and subsequently increasing repetitions, power output, and recovery from exercise.
Common Myths:
Common myths about creatine include: it always leads to water retention, it causes renal failure, it is not safe for women, it causes increased fat mass, it is an anabolic steroid, it causes hair loss/ baldness and a loading phase is required to saturate the muscles. According to the Journal of the International Society of Sports Medicine, all of these claims have been proven to be untrue.
Who Can Benefit:
Creatine supplementation is beneficial for any active person who engages in high intensity exercise/resistance training. It has also been proven to delay age-related sarcopenia and can increase functionality (strength, activities of daily living, delay fatigue) when combined with exercise in older adults. Creatine combined with resistance training in post-menopausal females showed to delay bone mineral loss, increase muscle mass, increase upper- and lower-body strength, and enhance ability to perform tasks of functionality. Vegans and vegetarians also naturally have lower endogenous creatine stores, so supplementation can especially benefit this population (most notably in pregnancy or if the female is unable to eat meat due to nausea).
Additionally, creatine has been shown to be more beneficial when combined with intake of carbohydrates and/or carbohydrates with protein to help replenish muscle glycogen stores. Creatine supplementation may lower the risk of heat related-illness when athletes train and/or compete in hot and humid environments due to it’s ability to hyper-hydrate muscles and enhance tolerance to heat. Lastly, animal studies have shown creatine’s neuroprotective abilities. The evidence has been so strong that the International Society of Sports Nutrition recommends that athletes engaged in sports that have a potential for concussion and/or spinal cord injury take creatine for its neuroprotective benefits.
What type is best, and what dosage?
Typically, the gold standard is creatine monohydrate. While other forms may be more soluble (e.g., creatine salts, creatine complexed with other nutrients, creatine dipeptides, etc.), creatine monohydrate appears to be the most optimal in eliciting favorable effects. If performance enhancement is a priority in a short period of time (i.e. a match or sporting event coming up), a loading phase is advisable: 20g/day x 1 week, followed by a maintenance phase of 3-5g/day thereafter. However, a loading phase is not necessary to gain beneficial effects. If there is not time constraint to obtain these effects, a general low dose of 3-5g/day x at least 4 weeks has been proven to be just as beneficial in saturating muscle stores.
Sources:
https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w
https://jissn.biomedcentral.com/track/pdf/10.1186/s12970-017-0173-z.pdf
