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Creatine 101: The science behind its benefits

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In recent years, creatine has gained a lot of hype in the fitness industry – and with good reason. This supplement is the most researched fitness supplement on the market. And no, it’s not just for bodybuilders. Creatine has been the supplement of choice for many athletes looking to boost their strength, enhance performance, or support their brain health. But what is creatine, and should you be supplementing it?

Get the lowdown on everything you need to know about this popular supplement in our comprehensive guide below.

What is creatine?

You’ve probably heard creatine referenced over and over again, but just what the heck is it?

Creatine, also known as creatine phosphate, is an organic compound that is naturally produced by the human body from three amino acids:

  • Arginine
  • Glycine
  • Methionine

Creatine is produced in the liver from three amino acids, with about 95% stored in skeletal muscle. The rest is distributed across other tissues, including the blood and the brain. Put simply, creatine is an amino acid stored in your muscles, brain, and gut.

What does creatine do?

Creatine is a natural energy source for muscles, aiding in contractions and maintaining performance, especially during exercise. It’s the main constituent of phosphocreatine, essential for generating adenosine triphosphate (ATP), the body's immediate energy source or fuel.

Creatine and performance - What’s the connection?
Now that we’ve covered what creatine is, what’s its connection to performance? The secret to creatine’s powers lies in its ability to quickly replenish ATP. This quick energy release can enhance performance in short-duration, high-intensity activities such as sprinting or weightlifting.

In fact, over 70% of studies investigating the ergogenic effects of creatine on high-intensity exercise have reported statistically significant results.1 For example, short-term creatine supplementation has been shown to increase maximal power or strength by 5 to 15%.1

And while this impact on HIIT activities is truly incredible, it doesn’t transfer 1:1 to low-intensity endurance exercise. A 2003 study revealed that creatine supplementation had no impact on running or swimming performance.2

Benefits of creatine

As mentioned above, creatine is a natural supplement that’s used by athletes to improve performance, but that’s not its only superpower – it has other advantages as well. Here, we’ll explore some of those science-backed benefits.

Creatine and muscle growth
Creatine is the go-to choice for increasing muscle mass among healthy, young individuals.3 It ramps up protein production, fueling muscle fiber growth.4

Creatine also increases levels of insulin-like growth factor 1 (IGF-1). IGF-1 regulates the effects of growth hormone in the body, and together they support the normal development of bones and tissues, including muscles.5

Creatine and cognition
Your brain is the highest energy-consuming organ in your body, using around 20% of metabolic energy each day. Therefore, creatine’s impact on the production of ATP means it could play a significant role in brain health and function.

In one study, creatine supplementation in 45 young adult vegetarians demonstrated significant positive effects on working memory and intelligence.6 Creatine might boost cognition as brain cells utilize it for extra energy during times of high demand.

One study published in 2023 tested the effect of creatine supplementation over a six-week period where participants received 5 g of creatine daily. The researchers found that daily supplementation of creatine did have a small effect on cognition.7

Busting the creatine myths

Now we know what creatine is, how it works, and some of its benefits, it’s time to bust some of the myths.

Creatine is only for bodybuilders

The image of creatine has become that of pumped-up bodybuilders looking to get their “flex” on. And there is a kernel of truth to this image – it’s a popular sports supplement often used to improve muscle mass. But you don’t need to be looking to get swole to benefit from creatine.

Creatine’s benefits go far beyond just increasing muscle. If you want to boost your high-intensity performance, improve your mood and cognition, you might want to add some creatine supplementation into your well-balanced diet.

Creatine causes kidney damage

Currently, there is no scientific evidence to support the claim that creatine causes kidney damage.8 If you have a kidney condition or are concerned, you should consult with your physician before taking creatine.

Creatine leads to excessive water retention

While creatine does increase water retention, most of the water is stored in your muscles. This effect is often short-lived and more common during creatine loading.9 Stick to the recommended dosage of  3 to 5 g/day of creatine, and this unwanted effect can easily be avoided. Water retention isn’t a long-term side effect of creatine supplementation and in some cases, may not lead to an increase in the storage of water at all.10

Creatine is a steroid

That’s a resounding no, creatine is not a steroid. Creatine is a legal and natural substance found in the body and actually found in many high-protein foods, like meat and fish. Anabolic steroids are synthetic drugs that mimic the effects of testosterone and are commonly used to increase muscle mass and sports performance. Anabolic steroids for personal use are illegal in many countries.

Creatine only works for men, not women

The use of creatine among women has sparked debate due to hormonal and physiological disparities between the two sexes. But let’s bust this myth once and for all – there’s no evidence that creatine, in recommended doses, is not suitable for women.

In fact, research from 2021 found that creatine supplementation can be beneficial for women of all ages by supporting muscle and brain health.11

What’s more, just as with men, creatine supplementation can help women build muscle and maintain their energy levels. It has also been shown to have a therapeutic effect on mood in women12 and can reduce mental fatigue.13

Do you need creatine?

As with all things health and wellness, it’s 100% individual. It depends on you and your training goals (and intensity!). The science is there — if you’re someone who goes full throttle with lots of high-intensity training, creatine supplementation could prove beneficial.

It’s important to emphasize here again that individual factors also play a key role in creatine substitution. While some individuals respond positively to creatine supplementation, others do not. This differentiation leads to two categories: responders and nonresponders. Various factors such as your gender, diet, muscular composition as well as the creatine concentration within your muscles (before supplementation) affect your body’s responsiveness to creatine supplements.

How much creatine should I take?

For most people, natural consumption of creatine is 1 to 2 g/day, meaning that muscle creatine stores are 60 to 80% saturated. Therefore, by supplementing creatine, you’ll be looking to increase your stores by 20-40%.14

The most effective way to do this is to start with a loading phase and supplement 5 g of creatine monohydrate, four times per day for 5 to 7 days in combination with carbohydrates and protein.15 Following this, creatine supplementation can be reduced to 3 to 5 g per day to help maintain the optimal levels of creatine in your muscles.

Alternatively, you can choose to skip the loading phase and just consume 3 to 5 g/day, but it can take 4 weeks to gain maximum benefit.14

Let’s recap

Creatine is a well-researched, versatile supplement that offers a wide range of benefits. It’s so much more than the stereotypical body-builder image – helping to increase your capacity for high-intensity exercise, muscle growth, and improve your mood and cognition. The research speaks volumes, and creatine stands as a valuable tool for both men and women, no matter their fitness level.

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Sources

[1] Kreider R. B. (2003). Effects of creatine supplementation on performance and training adaptations. Molecular and cellular biochemistry, 244(1-2), 89–94.

[2] Branch J. D. (2003). Effect of creatine supplementation on body composition and performance: a meta-analysis. International journal of sport nutrition and exercise metabolism, 13(2), 198–226. https://doi.org/10.1123/ijsnem.13.2.198

[3] Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (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, 18. https://doi.org/10.1186/s12970-017-0173-z

[4] Naderi, A., de Oliveira, E. P., Ziegenfuss, T. N., & Willems, M. T. (2016). Timing, Optimal Dose and Intake Duration of Dietary Supplements with Evidence-Based Use in Sports Nutrition. Journal of exercise nutrition & biochemistry, 20(4), 1–12. https://doi.org/10.20463/jenb.2016.0031

[5] Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients, 13(3), 877. https://doi.org/10.3390/nu13030877

[6] Lyoo, I, K et al. (2012). A Randomized, Double-Blind Placebo-Controlled Trial of Oral Creatine Monohydrate Augmentation for Enhanced Response to a Selective Serotonin Reuptake Inhibitor in Women With Major Depressive Disorder. The American Journal of Psychiatry.

[7] Watanabe, A., Kato, N., & Kato, T. (2002). Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation. Neuroscience research, 42(4), 279–285. https://doi.org/10.1016/s0168-0102(02)00007-x

[8] Wu, S. H., Chen, K. L., Hsu, C., Chen, H. C., Chen, J. Y., Yu, S. Y., & Shiu, Y. J. (2022). Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021. Nutrients, 14(6), 1255. https://doi.org/10.3390/nu14061255

[9] Deldicque, L., Theisen, D., Bertrand, L., Hespel, P., Hue, L., & Francaux, M. (2007). Creatine enhances differentiation of myogenic C2C12 cells by activating both p38 and Akt/PKB pathways. American journal of physiology. Cell physiology, 293(4), C1263–C1271. https://doi.org/10.1152/ajpcell.00162.2007

[10] Laron Z. (2001). Insulin-like growth factor 1 (IGF-1): a growth hormone. Molecular pathology : MP, 54(5), 311–316. https://doi.org/10.1136/mp.54.5.311

[11] Rae, C., Digney, A. L., McEwan, S. R., & Bates, T. C. (2003). Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proceedings. Biological sciences, 270(1529), 2147–2150. https://doi.org/10.1098/rspb.2003.2492

[12] Sandkühler, J.F., Kersting, X., Faust, A. et al.  (2023). The effects of creatine supplementation on cognitive performance—a randomised controlled study. BMC Med 21, 440. https://doi.org/10.1186/s12916-023-03146-5

[13] Vega, J., & Huidobro E, J. P. (2019). Efectos en la función renal de la suplementación de creatina con fines deportivos [Effects of creatine supplementation on renal function]. Revista medica de Chile, 147(5), 628–633. https://doi.org/10.4067/S0034-98872019000500628

[14] Kutz, M. R., & Gunter, M. J. (2003). Creatine monohydrate supplementation on body weight and percent body fat. Journal of strength and conditioning research, 17(4), 817–821. https://doi.org/10.1519/1533-4287(2003)017<0817:cmsobw>2.0.co;2

[15] Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (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. https://doi.org/10.1186/s12970-021-00412-w