Creatine (sometimes referred to as creatine monohydrate) has been called a “phenomenon” in the bodybuilding community and is among the best-selling supplements to gain muscle. To date, well over 500 research studies have evaluated the effects of creatine supplementation on muscle growth, metabolism, exercise capacity and many other markers of health. According to researchers of the Exercise and Sport Nutrition Laboratory at Baylor University, “About 70% of these studies report statistically significant results, while remaining studies generally report non-significant gains in performance.” (1)
So most research shows that creatine works — but is creatine safe? Depending on whom you ask, creatine may be “remarkably safe for most people” or potentially capable of causing certain side effects. (2) Most researchers today, including Dr. Paul Greenhaff, feel that creatine can be safely consumed — and not only by athletes, but also by people looking to give their energy and metabolism a boost. (2b)
What are some of the benefits of taking creatine (if any) according to studies? People who take creatine supplements usually do so because it has been shown to offer help with physical performance, improving body composition, energy output and even cognitive enhancement. While it might be effective for building muscle and increasing strength, on the other hand there can also some negative effects that have been associated with creatine.
Most studies have found that not every person reacts to creatine in the same way: Some may experience more results and health improvements, while others deal with creatine side effects like indigestion and fluid retention. Below we’ll look a the pros and cons of using creatine, what to expect if you begin “creatine loading,” and how you can maximize your results while still using creatine safely.
What Is Creatine Monohydrate?
Creatine monohydrate is a small peptide that is made up of amino acids (the “building blocks of protein”). It is formed in the liver, pancreas and kidneys, mostly with the help of the amino acids called glycine, arginine and methionine. In supplement form, creatine was first introduced to the public in the 1990s after Olympic athletes were reported to be using it to improve performance. Today, creatine is one of the “most widely used nutritional supplements or ergogenic aids” available on the market. (3)
What does creatine do to your body exactly to cause the physical and mental changes described above? Despite what many people think, creatine is not a steroid, and it’s not an unnatural/man-made product.
Creatine monohydrate is a molecule that is naturally present in the human body, especially in the skeletal muscles. About 90 percent to 95 percent of creatine is stored in our muscles, with the rest found in the heart, brain, liver, kidneys, testes and almost every cell. Creatine is taken in supplement form to help boost the production of energy in the body. It has the job of storing phosphate groups in the form of phosphocreatine — aka creatine phosphate — which support the release of energy and therefore help build strength and the growth of muscle mass.
Taking creatine can be useful for boosting production of energy in the form of adenosine triphosphate (ATP). ATP is sometimes referred to as the “molecular currency” of the body, since it helps store and transport chemical energy within cells. ATP is needed for cellular functions and is the source of fuel for our muscles — especially when they are working hard, such as during exercise. (4) When we eat foods we acquire a mix of macronutrients (carbohydrates, fats and proteins) that are used to produce ATP, and creatine helps this process by donating a phosphate group that helps with ATP creation.
Creatine Nutrition Facts
Certain foods provide us with creatine, but creatine from food is digested more slowly than the creatine we get from taking supplements. Plus, creatine can be destroyed when the foods that provide it are cooked. The NHANES III survey found that on average, Americans adults get approximately 5 to 7.9 mmol (0.64 to 1.08 grams) of creatine from their diets per day.
What foods are high in creatine? You can some some creatine from eating foods that are high in protein, including meat (especially beef), poultry, fish and eggs. Consuming collagen protein and sources of collagen like bone broth is a great way to increase intake of the amino acids that form creatine (arginine and glycine). Organ meats like liver and kidneys have lower concentrations of creatine. Some can also be found in breast milk, dairy products and milk from cows/sheep/goats, along with the blood of both humans and animals. Because vegetarians/vegans avoid the highest sources of creatine, it’s been found that they have lower resting creatine concentrations. This may contribute to problems gaining muscle and strength when eating a low-protein diet.
In supplement form, a serving of unflavored micronized creatine monohydrate powder (about one rounded teaspoon that equals about 5.25 grams has approximately: (5)
- 5 grams of creatine monohydrate
- 0–15 calories
- 0 sugar or carbs
- 0 grams of fat
- 0 vitamin A, calcium, magnesium, potassium, etc.
Creatine Benefits vs. Creatine Side Effects
Before diving into using creatine powder, it’s important to understand what research says about creatine’s pros and cons.
Benefits associated with taking/consuming creatine may include:
- Helping with protein synthesis, which increased growth of lean muscle mass (creatine also increases body weight due to muscles filling with more water). Some research found that one week of taking creatine supplements increased body mass by about 0.9–2.2 kilograms (2.0–4.6 pounds). (6)
- Improved strength and power output. (7) Creatine storage capacity in our muscles is limited, but it increases as muscle mass increases. Creatine supplementation has the ability to regenerate ATP stores faster during intense physical activity, helping sustain effort and prevent fatigue.
- May help improve muscle recovery and recovery from exercise, such as maximizing results from strength training.
- Seems to help maximize performance during high-intensity interval training (HIIT). Studies have found that creatine improved work performed during sets of maximal effort muscle contractions, single-effort sprint performance and during repetitive sprint performance.
- Neuroprotective properties (creatine may help protect the brain). (8)
- Cognitive enhancement, such as improved alertness, concentration and attention.
- May help reduce severity of depression symptoms (according to animal studies and small pilot studies in humans). (9)
- Cardioprotective properties, as creatine may help protect the heart and blood vessels. It has also been shown to support increased endurance and anaerobic cardiovascular capacity. (10)
- May potentially reduce fatigue.
- May potentially help improve bone density when combined with resistance training. (11)
Due to the benefits that creatine may offer, it’s not hard to see why there’s a connection between creatine and bodybuilding. If you’re looking to gain muscle, you might be wondering if creatine or whey protein is better (or another type of protein powder)? Both have been shown to have similar benefits in terms of supporting muscle growth, however whey protein is not always easy for many people to digest if they have a sensitivity to dairy. Creatine also seems to have some unique benefits, such as improving heart health and bone density. If you do choose whey protein or creatine, I recommend consuming organic whey protein from grass-fed cows.
Creatine Side Effects
Is creatine dangerous? Generally speaking, it seems to be safe. However, some people might not react very well to taking higher doses, such as if they have an existing kidney problem or enzyme defect that makes digesting protein difficult. Certain studies suggest that side effects of creatine may include: (12)
- Weight gain due to water retention (sometimes up to three to five pounds of weight gain in a day due to fluid accumulation if taking high doses)
- Abdominal pain
Can creatine be used by women? Yes, it seems to be safe in women when used in moderate doses. Creatine is not only for athletes, but recommended for anyone who wants to improve energy and muscle mass (although it won’t make you look like a “bulky” bodybuilder!).
Can creatine damage the kidneys? Certain studies have looked at this question but not found much evidence that it will damage the kidneys of mostly healthy people without kidney disorders. (13) The kidneys do have the job of metabolizing creatine and breaking it down so it can eliminated from the body via urine, but in normal/moderate doses this does not seem to be dangerous for most people. However, if someone does have a kidney disorder or is being treated with diuretic medications in order to manage fluid levels in their body, he or she should discuss using creatine and similar supplements with a doctor before starting.
How to Use Creatine Safely
How and When to Take Creatine Supplements:
If you are going to use oral creatine supplements, you can reduce the potential for experiencing creatine side effects by:
- Making sure not to take too much at once. Avoid very high doses and always read directions for dosage/serving recommendations.
- Spacing out servings throughout the day. If you use creatine more than once daily, make sure to divide doses (take one early in the day and one at least several hours or more later). If you’re consuming between 20–30 grams of creatine daily during the initial five to seven loading phase, try to divide this amount up in four to five equal doses for the best absorption. Note that some people may experience mild restlessness if they use creatine too close to bedtime, so it might be best to have creatine earlier in the day.
- Take creatine with meals, rather than on an empty stomach.
- Drinking enough water. If you take creatine while dehydrated you’re more likely to deal with digestive symptoms and to lack energy.
How should you take creatine in order to maximize its effectiveness?
- Some studies have found that creatine works better when taken with meals, rather then taken alone on an empty stomach, because consuming carbohydrates and protein with creatine helps it work more effectively. (14)
- There’s also evidence that creatine may work better to improve muscle growth and strength when taken after exercise, rather than before. However, athletes have reported using creatine effectively at all times of day, so it may be an individual preference.
- The effects of creatine seem to diminish as the length of time spent exercising increases. Additionally, creatine may stop providing results if it’s used for a long period of time, such as many years. The most results might be experienced within the first several months or year of use (although people react differently).
Many athletes and bodybuilders choose to use creatine by following a “loading protocol,” meaning they start out by taking a higher dose of creatine in order to build their bodies’ stores quickly and then either abruptly or gradually decrease their dosage as time goes on. (15) Some people may also cycle their creatine intake, alternating between time periods of taking higher doses followed by time periods of taking lower doses. Cycling might continue for several months or go on indefinitely if it’s leading to results and not causing side effects.
- When just beginning to use creatine most experts recommend that if you’re “loading” you take about 0.3 grams of creatine per kilogram of bodyweight (or about 0.136 per pound) for the first five to seven days. During this phase you’ll take much higher amounts than during the weeks to follow. To give you an example, a man who weighs 175 pounds (79.4 kilograms) would take about 25 grams of creatine per day when loading.
- After the first five to seven days, take a lower dose of five to 10 grams of creatine per day for about three weeks. To be more precise, aim for about 0.03 grams of creatine per kilogram of bodyweight for about three weeks.
- Once the three weeks are over, you can either continue taking the lower dosage for as long you’d like to or can go back to loading. You might choose to cycle your creatine intake every three weeks or so.
The Best Creatine to Take:
Many experts feel that pure creatine monohydrate is the best type of creatine to take, since it’s typically the least expensive and has been shown to be effective. If you can find micronized creatine monohydrate, it is a good option, since in this form creatine tends to be easier to dissolve in liquid and potentially easier to digest.
Another type of creatine is creatine nitrate, which seems to have stronger effects than creatine monohydrate but not to be any more effective or well-tolerated. Then there is creatine ethyl ester, which ” is alleged to increase creatine bio-availability.” Creatine ethyl ester may be beneficial, but research has not confirmed it’s actually more bioavailable than creatine monohydrate. (15b)
Final Thoughts on Creatine Monohydrate
- Creatine is a small peptide that is made up of amino acids. It is found in the body naturally, consumed from certain high-protein foods, and taken by some people, such as athletes or bodybuilders, in supplement form.
- Benefits associated with creatine supplements include building lean muscle mass, improving strength and power output, reducing fatigue, improving cardiovascular capacity, improving bone density, and improving moods.
- Potential creatine side effects can include weight gain, water retention, diarrhea, cramping, stomach pains and restlessness.
- The best way to use creatine is follow dosage directions, space out intake, use it after exercise, take it with meals containing carbs and protein, and to drink plenty of water when using creatine.
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