Relatively few sports supplements have an abundance of nearly undeniable research supporting their effectiveness. Many fall into the vague category of “probably works for most individuals more often than not.” Creatine is considered one of the rare standouts.

The International Society of Sports Nutrition (ISSN) concluded creatine is probably the most effective performance complement available for supporting high intensity exercise and muscle mass. (1)(2) The American College of Sports Medicine (ACSM) has published an identical stance. (3)

Despite favorable position stances within the scientific community, a long time of research, and greater than 500 peer-reviewed publications, creatine supplementation continues to be misunderstood. (4) This misunderstanding is basically limited to the uninitiated public, which is a shame because a wide selection of individuals (even non-lifters) might profit from creatine supplementation. (5)

Credit: PintoArt / Shutterstock

When you are unfamiliar with creatine, or if you happen to could use a science-based refresher, it’s best to begin with the fundamentals. No, creatine shouldn’t be a steroid. And, no, it won’t melt your kidneys. Actually, creatine monohydrate, probably the most common type of supplemental creatine, is mostly recognized as secure (G.R.A.S) — an official designation which might only be applied to foods and products which have undergone stringent examination and important review. (1)(6)(7)

Creatine’s potential advantages extend beyond athletic competition and the gym. Take a look at the advantages, potential uncomfortable side effects, and customary dosing protocols below. 

Editor’s Note: The content on Breaking Muscle is supposed to be informative in nature, nevertheless it mustn’t be taken as medical advice. When starting a recent training regimen, weight-reduction plan plan, and/or complement protocol, it’s at all times a very good idea to seek the advice of with a trusted medical skilled. We will not be a medical resource. The opinions and articles on this site will not be intended to be used as diagnosis, prevention, and/or treatment of health problems. They will not be substitutes for individualized consulting with a professional medical skilled.

Creatine Advantages 

7 Advantages of Creatine

Creatine supplementation has been studied amongst individuals young and old, athletes and non-athletes, healthy and injured. Creatine exerts effects on the musculoskeletal system, nervous system (e.g. brain), and endocrine system (e.g. hormones).

A few of these effects are immediate — higher lifts, higher work capability, and cognitive advantages. Others take a bit longer to register — increased muscularity, higher recovery between workouts, and potentially increased performance during injury rehabilitation. Discover a summary of among the most enjoyable advantages of creatine below.

Supercharged Strength

In training studies, creatine supplementation is consistently shown to enhance strength. (1) For instance, in only six weeks, lifters taking creatine showed greater improvements in chest press and leg press strength in comparison with those taking a placebo. (8) Strength improvements have been documented with creatine supplementation across the lifespan — from young to very old. (5)(9)

Without getting too deep into biochemistry, creatine supports energy production via the phosphagen system — that is the system that supplies energy for transient high-intensity efforts resembling short sprints, jumps, and heavy, low repetition lifts. Creatine is present in foods like meat and seafood, and our bodies are in a position to synthesize it from other amino acids. Nevertheless, supplemental creatine appears to be obligatory to “top off” or saturate our muscles with creatine. 

Recharged Repeated Efforts

Anyone who has ever sprinted 50-meter repeats or hit high-effort cluster sets knows the phosphagen system takes time to replenish before you’re able to go again. Creatine supplementation may reduce the time needed to revive energy for the following high intensity set.

Credit: PeopleImages.com – Yuri A / Shutterstock

The mass motion from having extra creatine available drives more rapid re-synthesis of phosphocreatine, the lively type of creatine used for quick energy. Along with benefiting training performance, this potential effect of creatine supplementation can have performance implications in sports like basketball, hockey, football, and volleyball. (1)

More Muscle Mass

Because creatine promotes the power to maneuver more weight and better performance across repeated efforts, it should come as no surprise that it ultimately supports gains in muscle mass and improvement in body composition.

Once more, this effect is seen amongst individuals starting from young to very old. (1)(9) Bodybuilders, athletes, folks who need to look higher on the beach, aging adults wishing to stay independent, and more may profit from the muscle-building effects of creatine. 

Increased Training Tolerance

Creatine supplementation is understood to assist improve recovery from a single session of hard exercise. (10)(11) Perhaps surprisingly, some studies show increases in exercise-induced muscle damage following consistent use of creatine. (10)

Researchers attribute this to the opposite useful effects of creatine supplementation — More strength, more muscle, and more high-intensity sets and reps following consistent supplementation intuitively result in the potential for more muscle damage during workouts. (10)

Altogether, creatine appears to be an amazing tool for recovery from isolated bouts of exercise, particularly the form of workouts that involve high-load eccentric (“lengthening”) muscle contractions or novel exercises.

Credit: Merrick Lincoln, DPT, CSCS / YouTube

Are you a lifter training for an area 5k, half marathon, or triathlon? Or, perhaps you’re a trail runner or cyclist dedicated to constructing some extra strength? Athletes who train for aerobic- and strength performance in the identical workouts may struggle to take care of their strength as aerobic training ramps up. Creatine might help. A study on strength-trained men taking either creatine monohydrate or placebo were put through running workouts prior to leg resistance training.

Only individuals taking creatine were able to take care of their leg press strength-endurance (i.e. repetitions to failure at 80%), while the boys taking the placebo showed reduced leg press performance. (12) Concurrent training for aerobic and strength- or physique goals is rarely going to be easy, but supplemental creatine might play a supporting role. 

Ramped Up Recovery Following Injury

Injured individuals are likely to drop or dial back their complement regimes, often planning to resume once healthy again. But there’s a powerful case for creatine supplementation during times of injury. (13) As a consequence of the aforementioned antioxidant-like effect of creatine, its well-established advantages to muscle mass and strength, and other potential effects, supplemental creatine can have promise for those rehabilitating injuries.

Immediately following injury, affected body parts could also be rested and even immobilized. Studies assessing the consequences of creatine supplementation amongst individuals experiencing immobilization show protective effects on muscle protein composition and accelerated recovery of strength and size during their return to exercise. (14)(15)

It must be noted, current evidence for creatine during post-surgical rehabilitation is currently not as strong because the evidence to be used during true immobilization. (16) While creatine will not be a panacea, banged up athletes, wrecked weekend warriors, and the clinicians who manage their care should consider the potential role of creatine supplementation post-injury.

Free Radicals Scavenged and Scrubbed Out

Free radicals are highly reactive chemicals related to cell damage, aging, and variety of disease processes. For higher or worse, free radicals are produced during normal metabolism. Fortunately, creatine acts to scavenge and scrub out a sort of free radical called reactive oxygen species (ROS). (1)

While more research is required to substantiate the potential role of creatine in systemic health, cellular aging, and disease, the antioxidant-like role of creatine points to applications for general health and wellness.

Boosted Brain Power

Just as creatine supplementation increases creatine concentrations in muscle, it also increases levels in brain tissue. (5) Just as muscle runs on creatine-based substrate, so to does the brain. Research is mounting in support of a creatine’s potential role as a nootropic, or brain-booster.

Credit: WeStudio / Shutterstock

Vegetarians on a six-week “maintenance dose” of creatine monohydrate (five grams per day) performed higher on tests of working memory and intelligence than they did on a placebo complement. (17)

Now, one could argue that since a typical source of dietary creatine is meat, the vegetarian subjects were simply correcting a deficiency, however the demonstrated link between creatine and brain power stays relevant. 

In two separate studies on sleep-deprived kids and rested elderly individuals, McMorris and colleagues reported positive effects of creatine supplementation on working memory and long-term recall. (18)(19) In each studies, “loading doses” of creatine monohydrate were used — 20 grams per day for seven and 14 days, respectively.

Since update of creatine in brain tissue could also be less efficient than skeletal muscle, more research needed to determine dosing parameters that best elicit creatine’s cognitive effects. 

Potential Side Effects

Quite a few studies have failed to indicate clinically-relevant uncomfortable side effects of creatine monohydrate supplementation across a wide selection of populations (athletes, children, adults, older adults) and using a wide selection of doses (three to 30 grams per day). (1)(20)

Other than the advantages discussed above, one potentially relevant side effect is increased body mass, which might occur early as a consequence of increased water content within the body. 

Early Water Retention

Essentially the most commonly reported side effect of creatine is water retention. Studies have reported early increases in body mass through the initial days of creatine supplementation too rapid to be attributed to muscle gain. (4) As a substitute, these increases look like primarily driven by increases in intracellular water, or water found throughout the cells which plays a key role in cellular health and performance. (21)

Credit: Olena Yakobchuk / Shutterstock

In the primary three days or so of creatine supplementation (loading dose), it’s common to see gains of two to 4 kilos of water weight. (21) Fortunately, there may be probably no reason to fret about medium- or long-term bloating when supplementing with creatine. Intracellular water levels are shown to normalize after weeks to months of use. (4)

Find out how to Use Creatine 

Creatine monohydrate mixes reasonably well with liquid, particularly if you happen to purchase “micronized” powder, which is milled or sifted to smaller particles. Creatine supplementation needn’t be complicated — standard practices and considerations are provided below.

Regular Supplementation

Essentially the most common supplementation protocols involve three to 5 grams creatine monohydrate per day, or 0.1 gram per kilogram body weight. (4)(22) Step by step, creatine levels in muscle cells will increase above baseline and individuals will likely begin to appreciate the advantages discussed above.

This dosing protocol is known as a “maintenance dose,” because once muscle tissues reach creatine saturation, ongoing supplementation at this dose is probably going to take care of high or maximum levels. Although about one-third of studies on creatine supplementation involve only a maintenance dose, just as many incorporate a loading dose to “jumpstart” the advantages. 

Consider a Loading Dose

With typical creatine doses (i.e. three to 5 grams per day), it could take weeks before muscles are saturated. Due to this fact, a “loading dose” is usually really useful to speed up this process. (1)(22) Essentially the most common creatine monohydrate loading protocol involves 20 grams per day for five to seven days. (1)(22)

The day by day 20-gram loading dose is usually divided into 4 equal servings throughout the day (five grams each). The loading dose is usually followed by a maintenance dose of three to 5 grams per day (or 0.1 gram per kilogram body weight). 

Take with Food

Although creatine taken without other foods has been shown to effectively increase total muscle creatine levels, taking either with carbohydrates or with carbohydrates and protein appear to enhance retention. (23)(24) Shoot for about 95 grams of carbohydrate or 45 to 48 grams each carbohydrate and protein. (25)

Credit: MDV Edwards / Shutterstock

Common carbohydrate sources utilized in creatine studies are dextrose and glucose. Although studies commonly use powdered dextrose or glucose, these carbs are present in starchy foods and non-fruit sugars (i.e. corn flour, pastas, rice). A convenient protein source could also be a post-workout protein powder.

Consistent Use vs. Cycling

Little scholarly evidence currently informs whether creatine must be cycled (e.g. eight to 12 weeks “on,” followed by 4 to 6 weeks “off”) or taken consistently at a maintenance dose. Mechanistically, there doesn’t appear to be a powerful rationale behind cycling creatine — Again, creatine shouldn’t be a steroid, so there shouldn’t be a risk of “resistance” in consequence of prolonged use. 

Long-term studies illustrate the security of consistent creatine supplementation for so long as five years of consistent use. (1) Furthermore, since excess creatine is ultimately excreted within the urine (just like vitamin C), the chance of “overdose” appears low. (25) 

Should one resolve to “cycle off” creatine, they’re still more likely to experience advantages for weeks, even months following your last dose.

FAQs

Isn’t creatine related to hair loss, muscle cramps, and kidney damage?

These commonly claimed downsides of creatine will not be present in the “Side Effects” section, because none have been substantiated by high-quality studies (i.e. randomized and placebo-matched trials). 
The claim to hair loss comes from a 2009 creatine study amongst rugby players who showed a rise in dihydrotestosterone, a hormone occasionally linked to hair loss. (4)(26) To be clear, not one of the rugby players were reported to lose hair or go bald, and follow-up studies assessing the consequences of creatine on testosterone and related hormones are equivocal. (4)
The kidney damage claim appears to stem largely from anecdote and confusion. Creatinine is usually used as a marker of kidney damage when present in high concentrations within the urine. While it’s true that some excess creatine could also be discarded in the shape of creatinine within the urine, it doesn’t necessarily indicate the kidneys are being damaged or overloaded. (4)
Despite creatine getting used in some trials as a treatment for the sequelae of kidney disease, Kim and colleagues conservatively really useful individuals at increased risk of kidney issues (e.g. diabetics, those with hypertension, pre-existing kidney dysfunction) avoid creatine supplementation. (1)(20) As at all times, check together with your doctor.

Can I pre-mix my creatine powder in protein or meal substitute shakes?

Busy lifters commonly prepare their food and supplements upfront. Whether you’re facing a busy day or setting yourself up for a successful week, pre-mixing creatine into your meal substitute drink, pre-workout complement, or post-workout protein shake could also be a convenient approach to sticking to your supplementation schedule. 
But you wouldn’t need to sacrifice the efficacy of the complement for convenience. Fortunately, the U.S. Food and Drug Administration (FDA) has measured the steadiness of creatine monohydrate powder under various conditions. Minimal degradation occurs when creatine is mixed and stored in neutral pH liquids. (6). Milk-based drinks are included on this category.
Because the pH of the liquid is lowered, stability of creatine decreases, with losses of 12% reported following 72-hours storage at 4.5 pH. (6) When you want to pre-mix your creatine in liquid in a non-neutral pH beverage resembling fruit juice or a fruit smoothie, refrigeration likely slows degradation. (6) 
Take note: some manufacturers add creatine monohydrate to energy drinks. Nevertheless, since creatine is understood to degrade in low pH solutions, chances are you’ll want to avoid creatine/energy drink combos, because the low pH (e.g. pH 2.5- 4.0) paired with long durations non-refrigerated storage has likely reduced the potency of the creatine complement. Due to this fact, creatine in acidic shelf-stable energy drinks or pre-workout concoctions appears to be more gimmick than gains.

Can I “stack” creatine with other supplements? 

Creatine and caffeine are amongst probably the most studied (and most supported) performance-enhancing supplements. Naturally, it follows that many might wish to mix the 2. A recent systematic review reported mixed results of co-supplementation protocols of creatine and caffeine. (27) Two studies showed blunted advantages and one study showed synergistic effects of concurrent supplementation. (27) 
Now, when creatine and caffeine are co-ingested — taken together or in an in depth timeframe of each other — anecdotal and scholarly evidence suggests the very real possibility of gastrointestinal distress. (28)
Altogether, logical recommendations for those wishing to mix creatine and caffeine are to: 1 — separate consumption throughout the day, and a pair of — limit caffeine consumption to moderate or low intake through the initial “loading phase” of creatine supplementation. 
One other study checked out creatine together with beta-alanine regarding cycling performance and reported no apparent synergistic effects. (29) More research is required on the potential effects of mixing creatine with other common sports supplements.

I ran out of creatine. Am I gonna lose all my gains?

At times, supply chain disruptions have occasionally made it difficult to take care of consistency with creatine monohydrate supplementation. Next time you run out and your favorite retailer is sold out, don’t panic. You likely have 4 to 6 weeks before your supplemented and fully-saturated creatine levels in your muscle return to baseline. (1)(30)
Even after muscle creatine concentrations return to baseline, you might be more likely to enjoy a protracted twilight period where gains made during supplementation persist.

Are other types of creatine higher than creatine monohydrate?

Creatine monohydrate is way and away probably the most studied type of creatine. Although other forms often claim superiority of their promoting materials for “higher retention” or “increased uptake,” these claims are unsubstantiated by the present body of research (or patently false). (1)
Not only do other types of creatine are likely to be similar or inferior to monohydrate in effectiveness, in addition they are likely to be dearer. On the time of this writing, only creatine monohydrate has achieved the FDA status of “generally recognized as secure” (G.R.A.S). (7) Until convincing data on other formulations is presented, stick to tried-and-true monohydrate.

G.R.A.S. for Mass (with a Disclaimer)

Few, if any, supplements are as well-studied as creatine monohydrate. The scientific research is virtually overwhelming, but if you happen to’re still trying to find an anecdote, I’ve taken a creatine monohydrate maintenance dose for over 10 years with minimal interruptions. My wife, my mother, and, occasionally, even my dog complement with creatine monohydrate — it’s unlikely many lifters could be comfortable giving other sports supplements to any considered one of those three case studies, let alone all three.

But this text mustn’t be considered an endorsement or dietary advice — it is just a transient review of relevant literature. Seek the advice of your physician, sports dietician, or veterinarian for individualized advice.

References

1. Kreider, R. B., et al. (2017). 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, 14(1), 18.
2. Kerksick, C. M., et al. (2018). ISSN exercise & sports nutrition review update: research & recommendations. Journal of the International Society of Sports Nutrition, 15(1), 38.
3. Thomas, D. T., et al. (2016). Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. Journal of the Academy of Nutrition and Dietetics, 116(3), 501-528.
4. Antonio, J., et al. (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), 13.
5. Rawson, E. S., & Venezia, A. C. (2011). Use of creatine within the elderly and evidence for effects on cognitive function in young and old. Amino Acids, 40, 1349-1362.
6. U.S. Food & Drug Administration. GRAS Notices. Available online: https://www.fda.gov/media/143525/download (Accessed April 17, 2023).
7. Kreider, R. B.,et al. (2022). Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: A critical review. Nutrients, 14(5), 1035.
8. Mills, S., et al. (2020). Effects of creatine supplementation during resistance training sessions in physically lively young adults. Nutrients, 12(6), 1880.
9. Devries, M. C., & Phillips, S. M. (2014). Creatine supplementation during resistance training in older adults—a meta-analysis. Medicine & Science in Sports & Exercise, 46(6), 1194-1203.
10. Doma, K., et al. (2022). The paradoxical effect of creatine monohydrate on muscle damage markers: A scientific review and meta-analysis. Sports Medicine, 52(7), 1623-1645.
11. Cooke, M. B., et al. (2009). Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals. Journal of the International Society of Sports Nutrition, 6(1), 13.
12. de Salles Painelli, V., et al. (2014). Creatine supplementation prevents acute strength loss induced by concurrent exercise. European Journal of Applied Physiology, 114(8), 1749-1755.
13. Tack, C. (2016). Dietary supplementation during musculoskeletal injury: Protein and creatine. Strength & Conditioning Journal, 38(1), 22-26.
14. Elosegui, S., et al. (2022). Interaction between caffeine and creatine when used as concurrent ergogenic supplements: a scientific review. International Journal of Sport Nutrition and Exercise Metabolism, 32(4), 285-295.
15. Hespel, P., et al. (2001). Oral creatine supplementation facilitates the rehabilitation of disuse atrophy and alters the expression of muscle myogenic aspects in humans. The Journal of Physiology, 536(2), 625-633.
16. Mistry, D., Lee, P., & Gee, T. (2022). Systematic review for protein and creatine supplements in peri-operative period in elective musculoskeletal surgery-knee and hip substitute. Journal of Arthritis, 11(1), 6-10.
17. Rae, C., et al. (2003). Oral creatine monohydrate supplementation improves brain performance: a double–blind, placebo–controlled, cross–over trial. Proceedings of the Royal Society of London. Series B: Biological Sciences, 270(1529), 2147-2150.
18. McMorris, T., et al. (2007). Creatine supplementation, sleep deprivation, cortisol, melatonin and behavior. Physiology & Behavior, 90(1), 21-28.
19. McMorris, T., et al. (2007). Creatine supplementation and cognitive performance in elderly individuals. Aging, Neuropsychology, and Cognition, 14(5), 517-528.
20. Kim, H. J., et al. (2011). Studies on the security of creatine supplementation. Amino acids, 40, 1409-1418.
21. Ziegenfuss, T. N., et al. (1998). Acute fluid volume changes in men during three days of creatine supplementation. Journal of Exercise Physiology, 1(3), 1-9.
22. de Guingand, D. L., et al. (2020). Risk of adversarial outcomes in females taking oral creatine monohydrate: A scientific review and meta-analysis. Nutrients, 12(6), 1780.
23. Greenwood, M., et al. (2003). Differences in creatine retention amongst three dietary formulations of oral creatine supplements. Journal of Exercise Physiology Online, 6(2), 37-43.
24. Preen, D., et al. (2003). Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle. International journal of sport nutrition and exercise metabolism, 13(1), 97-111.
25. Naderi, A., et al. (2016). Timing, optimal dose and intake duration of dietary supplements with evidence-based use in sports nutrition. Journal of Exercise Nutrition & Biochemistry, 20(4), 1.
26. Van der Merwe, J., et al. (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.
27. Elosegui, S., et al. (2022). Interaction between caffeine and creatine when used as concurrent ergogenic supplements: a scientific review. International Journal of Sport Nutrition and Exercise Metabolism, 32(4), 285-295.
28. Trexler, E. T., & Smith-Ryan, A. E. (2015). Creatine and caffeine: considerations for concurrent supplementation. International Journal of Sport Nutrition and Exercise Metabolism, 25(6), 607-623.
29. Stout, J. R. (2006). Effects of twenty-eight days of beta-alanine and creatine monohydrate supplementation on the physical working capability at neuromuscular fatigue threshold. The Journal of Strength & Conditioning Research, 20(4), 928-931.
30. Preen, D., et al. (2003). Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle. International Journal of Sport Nutrition and Exercise Metabolism, 13(1), 97-111.

Featured Image: Enfoca y dispara / Shutterstock