Guest post by Madelyn Bourgeois, B.S., LSU, Wellness Workdays Dietetic Intern

WHAT IS CREATINE?

Creatine is an amino acid that is found within your muscles and in your brain. The levels of creatine storage in your body are specific to your age, race, gender, and body size. Creatine is stored as phosphocreatine, where it is used as energy. In the diet, creatine is found naturally in red meat and seafood, but it is difficult to get maximum creatine from a natural diet. Our body also produces small amount of creatine through the liver, pancreas, and kidneys – at about 1 gram per day. Although we do have creatine in our bodies, for those with limited red meat and seafood in their diet supplementing creatine can be very beneficial. Creatine is available in powder, tablets, energy bars, and drink mixes. When choosing the best creatine supplement for you, look for the purest form of Creatine monohydrate, as this is the most studied form of creatine. Taking other forms of creatine has not showed any added benefits.

WILL CREATINE SUPPLEMENTATION BENEFIT ME?

One of the largest benefits of creatine intake is enhanced energy production. ATP is our body’s main energy source, which runs out quickly during exercise, espeically during high intensity exercise. Creatine replaces the ATP storage as it gets depleted, and may give you the ability to produce additional energy during an exercise (ie: gives you an extra boost of energy to push through your workout!) This reduces fatigue and tiredness and allows for greater endurance performance. 

There is also evidence that creatine speeds up recovery time and aids in injury prevention, which might also contribute to reaching performance goals quicker. Injury prevention includes reduced frequency of dehydration and muscle cramps. This is especially important in high intensity endurance training performance goals.

DOES CREATINE IMPROVE STRENGTH TRAINING?

Creatine is also used for strength and muscle gain. In the same way that creatine benefits endurance training, energy from ATP is necessary in weightlifting and gaining muscle mass. In a study that focused on the long-term effects of Creatine Monohydrate use, they found significant differences in the bench press, squat, and power clean. Creatine was able to help increase output during all of these exercises. Creatine can help with this for several reasons, including:

• Creatine can alter cellular pathways that lead to new muscle growth. Studies show creatine can boost the formation of proteins that create new muscle fibers and increase lean muscle mass. 
• Potentially decreases myostatin, which is responsible for stunting muscle growth. 
• Potentially raise insulin growth factors that promote increases in muscle mass. 
• Speeds muscle growth. Just 5-7 days of taking it shows significant increase in lean body weight and muscle size. This is initially due to water content, but eventually contributes to real growth through muscle fibers signaling key biological pathways and boosting gym performance
• Studies show both increase in the amount of weight lifted, and the number of reps performed during a set. 
• Increase in ballistic power, which is “explosive power” during a workout.

DOES CREATINE IMPROVE LOW INTENSITY EXERCISE?

For athletes who perform lower intensity exercise such as walking, swimming, light jogging, and biking, creatine supplementation is less beneficial. This is because these exercises rely less on ATP regeneration and usually can be performed with ATP stores.

There is research that creatine can improve performance regardless of previous fitness level. While creatine cannot improve heart health, which also contributes to cardiovascular endurance, it can enhance performance and allow for better cardiovascular training, which might speed up performance goals. Bottom line: The more creatine you have – the more energy your muscles can produce during high intensity exercise!

SIDE EFFECTS OF CREATINE SUPPLEMENTS

Possible side effects include short term water retention, decreased urinary volume, bloating, temporary weight gain (due to water retention), and increased risk of muscle cramps. People have also become dehydrated from use, so ensure you are consuming the recommended amount of water for your age, gender, and activity level during use. There are no serious long-term effects that have been studied. In older people with kidney disfunction, a doctor should be consulted before taking creatine.

HOW MUCH CREATINE TO TAKE

If you have low stores of creatine, you might have more noticeable improvements than those who might consume creatine through their diet more frequently. Vegans and vegetarians will especially benefit due to their low creatine intake. In this case, a loading phase might be beneficial. In a loading phase, you consume larger doses for a few days then return to a more sustainable consumption regularly (20-25 g/day then 3-5g/day moving forward).

It will take seven to 28 days to see energy effects depending on how much creatine you already have in your body as stored creatine.

The best time to take creatine is 30 minutes before a workout, but it can be beneficial post-workout either in a shake or meal, when muscles are rebuilding. If you consume creatine after a workout, it is best to take with a combination of carbs and protein. Mixing straight creatine with water 30 minutes before a workout provides quick digestion and availability for the workout. Some research indicates that taking creatine with food helps absorption. Taking caffeine with creatine can lower the absorption of creatine supplementation. Consider this when deciding dosing and attempt to limit caffeine to see maximum results.

Creatine on rest days is beneficial if you want to ensure you are maintaining a high level of creatine in the muscles.

THE BENEFITS OF CREATINE SUPPLEMENTATION IN WOMEN

In women, creatine kinase levels decrease with age and pregnancy. Lowest CK levels are during the first trimester. Research indicates that creatine is an effective ergogenic aid for increasing strength, power, and athletic performance in females without changes in body weight. (The initial weight gain is more prevalent in men).

Women have about 70-80% lower endogenous creatine stores compared to males. Supplementation might be more important and beneficial during menses, pregnancy, post-partum, during and post-menopause due to hormonal changes. There is also evidence to suggest positive effects from creatine supplementation on mood and cognition (restoring homeostasis). 

Increased metabolic demand to grow the child during pregnancy is associated with a dip in creatine levels. Reduction in creatine stores during pregnancy has been linked to low birth weight and preterm birth. However, consuming creatine during pregnancy has not been heavily researched to date, but there is data that implies a potential positive relationship between creatine supplementation and increased mitochondrial integrity in the baby. Consult your doctor before making any supplementation changes during pregnancy.  

Creatine has been studied as a potential countermeasure to menopausal symptoms, such as decrease in muscle, bone, and strength, inflammation, oxidative stress, and bone reabsorption. In one study, a group of postmenopausal women with knee arthritis were given creatine. Those who were given creatine showed improvement in lower limb lean mass, quality of life, and reduction in pain.

IS CREATINE SAFE FOR PROFESSIONAL ATHELTES

Creatine is not currently banned through any athletic organization. However, the NCAA does not allow institutions to provide creatine monohydrate or other muscle building supplements to their athletes. According to the NCAA, products might be contaminated with banned substances and athletes do take a risk by incorporating any non-FDA approved supplement into their regime.

WHO CAN BENEFIT FROM CREATINE USE?

·       Athletes looking to improve strength training performance

·       Endurance runners looking to increase run length or increase speed

·       Anyone looking for a boost in energy and performance

·       Track athletes looking for increase speed during sprints and ballistic power

·       People experiencing brain fog and other brain function disorders (*consult a doctor before use)

·       Women looking to regulate hormonal changes surrounding pregnancy 

TOP RECOMMENDED CREATINE SUPPLEMENT BRANDS

Thorne Performance– Uses high-quality creatine, 3rd party tested to ensure safety for athletes looking to avoid banned substances, affordable, 5g per serving

Bare Performance- Creapure-based (highly refined form of CM), 3rd party tested, unflavored, 5g per serving

Genius Creatine- Creapure-based, 3rd party tested, contains Beta-alanine, which contributes to increased exercise performance, green apple or unflavored, 5g per serving

Optimum Nutrition (Capsules)- Best for those who do not want to drink their mixture and would rather take a pill, 2.5g per serving (less than powder)

 

REFERENCES:

Cooper, R. et al. (2012) Creatine supplementation with specific view to exercise and sports performance: an update. Journal of the International Society of Sports Nutrition. DOI: 10.1186/1550-2783-9-33

Saremi, A. et al. (2010) Effects of oral creatine and resistance training on serum myostatin and GASP-1. Molecular and cellular endocrinology. 317(1-2). p 25-30.

Smith-Ryan, A.E. et al. (2021) Creatine Supplementation in Women’s Health: A Lifespan Perspective. National Library of Medicine. DOI: 10.3390/nu13030877