Why You (and Your Grandpa) Should Take Creatine

You may have heard that creatine gets you huge. You may have also heard it makes you grouchy, or can even mess up your kidneys. Today, we’re going to dispel the myths and decipher the truth about this sometimes controversial, yet quintessential supplement.

What Exactly is Creatine?

Creatine is a nitrogenous (referring to nitrogen) that occurs naturally in vertebrates and supplies muscle cells with ATP (adenosine triphosphate—check out issues one and two for more on how this works). It is naturally produced in our bodies (when we eat meat) from the amino acids glycine and arginine. For athletes this supplement is of particular importance as it can convert ADP back into ATP, keeping the muscles readily supplied with fuel for increased energy demands.

What are the Benefits of Taking Creatine and Why Should You Take it?

Creatine:

(1) improves the body’s capacity for high intensity work,

(2) enhances recovery,

(3) increase muscles volume,

(4) enhances brain function [can even offer protection from neurological diseases],

(5) improves bone healing,

(6) increases tolerances of glucose, and

(7) most importantly for bodybuilders and those looking to increase lean muscle mass can raise anabolic hormones.

Creatine acts by increasing cellular hydration, leading to a “fuller” muscle look, and because it increases the body’s ability to cycle through ADP and ATP, it increases the duration you can produce your maximum effort (up to 30 seconds).

Most sources report that ATP is deleted from cells after 8-10 seconds, but supplementing buffers that to 30 seconds. Creatine in this respect would be ideal for people who sprint, or have intervals in their training with periods of all-out effort, and short periods of rest in between.

Therefore, many sources report that putting on 5-10 pounds of muscle in a matter of weeks is not unrealistic.

In one 12-week long study, weight lifters found that athletes who supplemented creatine had increased muscle fiber growth up to three times than those athletes who just trained (Volek et al. 1999). The athletes who supplemented creatine also enjoyed double the increase in body mass, as well as they were able to increase their 1-RM (one repetition maximum—the amount an athlete can lift in one attempt) by 43% compared to those who didn’t supplement it. (1)

In the elderly population, individuals who supplemented creatine for 14 weeks were able to increase lower body strength and mass (Brose, Parise, and Tarnopolsky 2003).

Neurological Benefits

Creatine has significant research for improvement in cognitive and neurological health. It has been proven to increase memory, delay aging and cognitive decline that comes with aging, and even help those suffering with epilepsy. One study reported, “therapeutic strategies that buffer intracellular energy levels may prevent or impede the neurodegenerative process.

Recent studies suggest that "impaired energy production promotes neurological disease onset and progression.” What this means is that when your body cannot produce energy effectively, it can speed up the process of disease, further it stated,

“Creatine is a critical component in maintaining cellular energy homeostasis, and its administration has been reported to be neuroprotective in a wide number of both acute and chronic experimental models of neurological disease…including Huntington's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Alzheimer's disease, as well as in ischemic stroke, brain and spinal cord trauma, and epilepsy.”(Klein and Ferrante 2007).

Yes. You read that right, creatine can protect your brain and neurons from long-term and short-term disease that affect movement and thinking.

According to Alzheimer’s.org, AD is the 6th leading cause of death, more than 5 million Americans have it, and every 66 seconds, someone develops it.

“By 2050, the number of people age 65 and older with Alzheimer's disease may nearly triple, from 5.2 million to a projected 13.8 million, barring the development of medical breakthroughs to prevent or cure the disease. Previous estimates based on high range projections of population growth provided by the U.S. Census suggest that this number may be as high as 16 million.” (Alzheimer’s A 2016)

Creatine can help those who don’t have AD by preventing and even slowing it, while those who do have it, it can prevent it from getting worse(Bürklen et al. 2006) (Brose, Parise, and Tarnopolsky 2003).

Some scientists and fitness experts who have studied this say the best thing you can do with creatine is make sure your parents [especially those prone to developing those kinds of diseases] take it daily!

Creatine has also been found to help Parkinson’s disease (Matthews et al. 1999), Huntington’s Disease (Kaemmerer et al. 2001), Ischemic Stroke (Prass et al. 2007), Epilepsy (Rambo et al. 2009), brain and spinal cord injuries (Hausmann et al. 2002), motor neuron disease (Klivenyi et al. 1999), and memory and brain function in elderly people (McMorris et al. 2007).

Another interesting study considered the benefit supplementing creatine could have on those who don’t eat meat [as it is the main source for creatine], therefore, it studied the benefits it on vegetarians and vegans.

Vegetarians and vegans tend to have lower creatine stores in their bodies (95% of creatine is stored in muscles, and the remaining 5 is stored in the brain) because they don’t eat meat. They were able to improve their memory and brain function on memory tests by 50% when creatine was supplemented into their diets (Rae et al. 2003).

Creatine can also lower blood sugar levels, especially when taken with carbohydrates, (which is why many supplement manufacturers recommend taking it with juice as it will help shuffle the glucose directly into the muscle cells, as well as help to treat non-alcoholic fatty liver disease.

Clearly, the benefits of creatine extend past that of just hurling iron around in the gym.

Which Type of Creatine Should You Take?

There are quite a few types of creatine on the shelves, and you don’t want to be swindled, thrown for a loop, or throw money at a supplement that can’t help you perform. Creatine Monohydrate (comes in micronized and standard) is the most common form, is the most studied and is the standard other types of creatine compares to.

A few of the other types are Creatine Citrate (this has citric acid in it, which makes it more water soluble), but it doesn’t perform or absorb better.

Creatine Ethyl Ester is one of the most ineffective types of creatine you can purchase for the reason that once it enters your body, it is converted into creatine, which is an inactive substance.

Liquid Creatine is exactly what is sounds like, monohydrate in liquid. It has show to be less effective that creatine monohydrate because as it sits in the liquid for several days, it also breaks down to creatine—an inactive substance.

Generally, it’s just better to stick with the pure stuff and avoid paying for the brand name when it comes to effectiveness, price, and absorption of creatine.

How and When to Take it?

Many people who start taking creatine do so with what is called a “loading phase.” The reason for implementing a loading phase is to wash creatine through the cells and gain a rapid increase of it in muscle store. To do a loading phase, most athletes take 20 grams of creatine (5 grams throughout the day 4 times) per day for 7 days.

However, according to Dr. Layne Norton, it is not necessary to load (Norton 2016).

He states:

“it is not necessary to load but it can help you see results faster. You see to get the full benefit of creating you must saturate your muscle cells with it. Using a small dose (5g), this will take up to thirty days depending on the individual's lean body mass. However using a loading dosage of 15-25g per day for 5 days, one can quickly saturate the muscle cells in this time period and then use a maintenance dosage (3-5g) for the remainder of their time taking creatine.”

Many athletes also recommend cycling creatine, taking it for 8-12 weeks, and then taking an 8-12 hiatus, and then going back on it again, but scientists disagree about this one, and most sources state there is no benefit to cycling it.

There may be a benefit to it, but again, “taking excess creatine for a short period of time (4-8 weeks) may temporarily increase your creatine phosphate stores but after awhile your body's feedback mechanisms will likely place some type of control on creatine phosphate storage to bring the levels back down to normal.

This mechanism may be to decrease your body's own production of creatine or to downgrade the number receptors that admit creatine into the cell. Taking time off from creatine can help bring your body's equilibrium back into a state where in taking excess creatine will be beneficial again.

I would like to make clear at this point that I know of no studies to back this theory up with, it could be right or wrong, I am just merely applying my knowledge of biochemistry to a frequently asked question to which there is no good answer to yet.

To increase absorption of creatine, most scientists recommend taking it with a carbohydrate rich meal because of the insulin. Insulin helps drive creatine into muscle cells, and keep in mind that as it pulls water into the cells (cellular hydration), it is advisable to take it with water, and stay well hydrated throughout the time you supplement with it.

FAQs About Creatine

Can pregnant women take creatine?

While there are many experimental studies still considering this, there are many potential benefits that can be passed on to the fetus.

“The importance of creatine may extend beyond protecting the brain to preventing damage to other organs. In pregnancy, hypoxia, inflammation, and oxidative stress are reasonably common events that lead to compromise of not only the brain, but other important organ systems, rendering them particularly vulnerable to hypoxic-ischemic damage that can occur at birth, particularly preterm birth,” (Dickinson, Ellery, et al. 2014)

However, as it hasn’t been studied enough in pregnant women, it is definitely something to discuss with your doctor and determine if and how creatine can benefit your pregnancy (Dickinson, Bain, et al. 2014). If after discussing it with your doctor and completing your own research if you are in doubt, it’s always safer not to!

Can the elderly take creatine?

As demonstrated above, creatine is neuroprotective and can help preserve and create lean muscle mass; and as both of these are of critical importance in the elderly, I believe that they can and should supplement creatine.

Can sedentary people take creatine and still receive benefits?

Depending on what sedentary people desire as a benefit, it would be beneficial for them to take it. To gain an edge on memorial and neurological disease, or even cellular hydration, a sedentary individual taking creatine would in fact see benefits. But if they are looking to get ripped without working out or eating healthfully, it’s not going to happen.

What about all the negative media about creatine causing bloat, moodiness, kidney failure, compartment syndrome, and dehydration?

There are a lot of horror stories about creatine, but a well-done article on T-Nation asked Dr. Richard Kreider, a professor, department chair, and director at Texas A& M University a few questions (Shugart 2016):

T Nation: Aren't there some studies that show creatine may be able to improve an athlete's ability to tolerate intense exercise in the heat?

Richard Kreider, PhD: We did several studies back in the mid-90's that measured and monitored injuries, cramping issues, heat illness, fluid shifts, etc. The studies generally showed that there was no negative effect at all from creatine usage or there was a slight hyper -hydration where you have some fluid retention, so core temperature is lower when exercising — a benefit. Athletes using creatine actually had lower instances of cramping.

T Nation: What about that newer study showing that creatine is also protective when it comes to concussions?

Richard Kreider, PhD: From a neurological perspective, there are good reasons athletes, especially those in contact sports, should be taking creatine. Data was presented this summer showing that kids with traumatic brain injury have better outcomes and survival rates when put on a course of creatine than kids who don't get creatine. It's amazing how much neuroprotection occurs when these kids get creatine.

Same with concussions. People who have higher creatine concentrations in the brain show a neuroprotective effect. In contact sports like football, it makes sense that they should be taking creatine.

You could actually make the case that not allowing football players to take creatine would put them at higher risk than if they did. Creatine would help with concussions, temperature regulation, and recovery.

There you have it. As concerned parents, and even mistaken physicians have seen increased levels of creatine in athletes who weren’t even taking creatine, it’s understandable that there is some misinformation out there.

Should young athletes take it? If they do, will they get benefits? Is it detrimental to the health of young athletes?

There is a lot of anecdotal evidence calling for adolescents not to take it.

Clearly, the safest thing to do is wait until the onset of puberty and then, according to the International Society of Sports Nutrition,

“If proper precautions and supervision are provided, supplementation in young athletes is acceptable and may provide a nutritional alternative to potentially dangerous anabolic drugs.” (Buford et al. 2007)

Isn’t creatine a steroid?

Creatine is NOT a steroid. It is naturally occurring in your body and as made from amino acids (the same building blocks that make protein).

Is creatine illegal?

Creatine is NOT illegal, and is deemed a safe and effective supplement.

Further Reading

• Alzheimer’s A. 2016. “2016 ALZHEIMER’S DISEASE FACTS AND FIGURES.” http://www.alz.org/facts/.

• Brose, Andrea, Gianni Parise, and Mark A Tarnopolsky. 2003. “Creatine Supplementation Enhances Isometric Strength and Body Composition Improvements Following Strength Exercise Training in Older Adults.” The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 58 (1). United States: 11–19.

• Buford, Thomas W, Richard B Kreider, Jeffrey R Stout, Mike Greenwood, Bill Campbell, Marie Spano, Tim Ziegenfuss, Hector Lopez, Jamie Landis, and Jose Antonio. 2007. “International Society of Sports Nutrition Position Stand: Creatine Supplementation and Exercise.” Journal of the International Society of Sports Nutrition 4 (1): 6. doi:10.1186/1550-2783-4-6.

• Bürklen, Tanja S, Uwe Schlattner, Ramin Homayouni, Kathleen Gough, Margaret Rak, Adriana Szeghalmi, and Theo Wallimann. 2006. “The Creatine Kinase/Creatine Connection to Alzheimer’s Disease: CK Inactivation, APP-CK Complexes, and Focal Creatine Deposits.” Journal of Biomedicine and Biotechnology 2006 (December). Hindawi Publishing Corporation: 35936. doi:10.1155/JBB/2006/35936.

• Dickinson, Hayley, Emily Bain, Dominic Wilkinson, Philippa Middleton, Caroline A Crowther, and David W Walker. 2014. “Creatine for Women in Pregnancy for Neuroprotection of the Fetus.” The Cochrane Database of Systematic Reviews, no. 12 (December). England: CD010846. doi:10.1002/14651858.CD010846.pub2.

• Dickinson, Hayley, Stacey Ellery, Zoe Ireland, Domenic LaRosa, Rodney Snow, and David W Walker. 2014. “Creatine Supplementation during Pregnancy: Summary of Experimental Studies Suggesting a Treatment to Improve Fetal and Neonatal Morbidity and Reduce Mortality in High-Risk Human Pregnancy.” BMC Pregnancy and Childbirth 14 (1): 150. doi:10.1186/1471-2393-14-150.

• Hausmann, O N, K Fouad, T Wallimann, and M E Schwab. 2002. “Protective Effects of Oral Creatine Supplementation on Spinal Cord Injury in Rats.” Spinal Cord 40 (9). England: 449–56. doi:10.1038/sj.sc.3101330.

• Kaemmerer, W F, C M Rodrigues, C J Steer, and W C Low. 2001. “Creatine-Supplemented Diet Extends Purkinje Cell Survival in Spinocerebellar Ataxia Type 1 Transgenic Mice but Does Not Prevent the Ataxic Phenotype.” Neuroscience 103 (3). United States: 713–24.

• Klein, Autumn M, and Robert J Ferrante. 2007. “The Neuroprotective Role of Creatine.” Sub-Cellular Biochemistry 46. United States: 205–43.

• Klivenyi, P, R J Ferrante, R T Matthews, M B Bogdanov, A M Klein, O A Andreassen, G Mueller, M Wermer, R Kaddurah-Daouk, and M F Beal. 1999. “Neuroprotective Effects of Creatine in a Transgenic Animal Model of Amyotrophic Lateral Sclerosis.” Nature Medicine 5 (3). United States: 347–50. doi:10.1038/6568.

• Matthews, R T, R J Ferrante, P Klivenyi, L Yang, A M Klein, G Mueller, R Kaddurah-Daouk, and M F Beal. 1999. “Creatine and Cyclocreatine Attenuate MPTP Neurotoxicity.” Experimental Neurology 157 (1). United States: 142–49. doi:10.1006/exnr.1999.7049.

• McMorris, Terry, Gregorsz Mielcarz, Roger C Harris, Jonathan P Swain, and Alan Howard. 2007. “Creatine Supplementation and Cognitive Performance in Elderly Individuals.” Neuropsychology, Development, and Cognition. Section B, Aging, Neuropsychology and Cognition 14 (5). United States: 517–28. doi:10.1080/13825580600788100.

• Norton, Layne. 2016. “Creatine: Fact And Fiction!” http://www.bodybuilding.com/fun/layne13.htm.

• Prass, Konstantin, Georg Royl, Ute Lindauer, Dorette Freyer, Dirk Megow, Ulrich Dirnagl, Gerda Stockler-Ipsiroglu, Theo Wallimann, and Josef Priller. 2007. “Improved Reperfusion and Neuroprotection by Creatine in a Mouse Model of Stroke.” Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism 27 (3). United States: 452–59. doi:10.1038/sj.jcbfm.9600351.

• Rae, Caroline, Alison L Digney, Sally R McEwan, and Timothy C Bates. 2003. “Oral Creatine Monohydrate Supplementation Improves Brain Performance: A Double-Blind, Placebo-Controlled, Cross-over Trial.” Proceedings of the Royal Society B: Biological Sciences 270 (1529): 2147–50. doi:10.1098/rspb.2003.2492.

• Rambo, Leonardo Magno, Leandro Rodrigo Ribeiro, Mauro Schneider Oliveira, Ana Flavia Furian, Frederico Diniz Lima, Mauren Assis Souza, Luiz Fernando Almeida Silva, et al. 2009. “Additive Anticonvulsant Effects of Creatine Supplementation and Physical Exercise against Pentylenetetrazol-Induced Seizures.” Neurochemistry International 55 (5). England: 333–40. doi:10.1016/j.neuint.2009.04.007.

• Shugart, Chris. 2016. “The Truth About the Media Creatine Scare.” https://www.t-nation.com/supplements/truth-about-the-media-creatine-scare.

• Volek, J S, N D Duncan, S A Mazzetti, R S Staron, M Putukian, A L Gomez, D R Pearson, W J Fink, and W J Kraemer. 1999. “Performance and Muscle Fiber Adaptations to Creatine Supplementation and Heavy Resistance Training.” Medicine and Science in Sports and Exercise 31 (8). United States: 1147–56.