Pros & Cons: Creatine Supplements

Creatine supplementation has become a hot topic in the fitness world as of late, due to its well-studied effects on exercise performance and body composition. Most recently, there has been strong evidence supporting its therapeutic benefits for various diseases.(1) And while creatine is one of the most researched supplements on the market, with significant data that demonstrates the efficacy of creatine supplementation, there are also many myths surrounding creatine and how it affects your body’s physiology. In this article we debunk many of these misconceptions, so you know exactly what you can expect if you decide you want to supplement with creatine.

What is Creatine?

Creatine is an endogenous amino acid (protein building block), meaning it is naturally produced in your liver and kidneys. It is found primarily in muscle cells, but is also present in the brain, central nervous system, and heart. This tiny but mighty amino acid is easily converted to Phosphocreatine, which then becomes available to use as a fuel source for quick, powerful movements that last about 4-15 seconds (think short sprints, power lifting, jumping, etc.). Because of how useful it is for explosive and fast movements creatine is traditionally used by athletes or those who exercise at very high workloads. However, its therapeutic benefits (especially in muscle wasting diseases, vascular disease, and improvement of brain health) are becoming more apparent, expanding its use to more people.

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While your body can produce this molecule on its own, creatine is also found exogenously, meaning you can get it from dietary sources such as meat and supplements. Because it is produced endogenously, it is not necessary to get it in your diet, so fear not if you are vegetarian or vegan. However, research shows that exogenous sources increase the amount of creatine stored in your muscles and other tissues, therefore making it easily available to use when needed.(2) Essentially, it makes your body more efficient when exercising at high intensity. In a diet that includes meat, muscle creatine stores are about 60-80% full, so supplementing with creatine aims to increase muscle creatine levels by 20-40%. Therefore, your dietary preferences could be one indication of whether you might consider taking a creatine supplement.

What are the benefits of supplementation?

There are many benefits to taking creatine, and the body of research touting its usefulness continues to grow. Below are some of the top reasons you might consider using this dietary supplement:

1. Improves Exercise/Sports Performance

One of the primary reasons most people decide to add creatine into their dietary regimen is for its performance enhancing benefits. It has a vast amount of scientific evidence backing its effectiveness in power sports/exercise and has traditionally been used in this setting for decades.(3) If this is the type of exercise you enjoy most, you might consider looking into supplementation for this reason.

2. Increases Lean Muscle Mass

Studies have observed a significant increase in lean muscle mass in individuals who take creatine.(4) Creatine supplements top off intramuscular stores, and thus a readily available fuel source for muscle contraction required for powerful, explosive movements. If you are able to perform these movements more frequently and with more ease, your muscles will have a better opportunity to hypertrophy (get bigger in size) and thereby improving overall lean mass and body composition.

3. Improves Brain Health

Creatine supplements are thought to benefit your brain in the same way it does your muscles.(5) In addition to glucose, your brain uses creatine as a fuel source for its various functions throughout the day. Having enough fuel ensures your brain is operating as it should and is not deprived of any necessary nutrients. Scientists have also observed improvements in neuropsychological performance in the form of cognitive functioning. In other words, creatine can potentially help improve your ability to learn, think, remember, problem solve, make decisions, and hold attention. A benefit for anyone!

4. Reduces Inflammation

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If one of your goals is to improve heart health, this is one for you. Some studies suggest that creatine may help improve vascular health by reducing inflammation and reactive oxygen species (ROS), both of which are known to be damaging to your heart and vasculature. Even beyond heart health, an overall reduction in inflammation can help with recovery after workouts, better sleep, and a stronger immune system.(6)

5. Potential Therapeutic Benefits

There is emerging evidence that demonstrates the benefits of creatine supplementation on various atrophic (muscle wasting) conditions, weakness, and metabolic disturbances.(1) If this is something that affects you, ask your doctor about potentially using creatine as an additive to your diet.

How to supplement

When taking a creatine supplement, there are a few things to consider. Here we will discuss the best type of creatine, recommended dosage, when to take it, and response level.

Dosage

Different studies recommend different levels of creatine, depending on the overall goal, but the most agreed upon dosage level is 3-5 g/day or 0.1 g/kg of body weight/day. This seems to be an optimal level and is safe to take for at least up to 5 years.(3)

Type

Creatine monohydrate is observed to have the greatest benefits. Many supplement companies will push a proprietary blend, or different forms of creatine, but research proves that other types of creatine are less bioavailable and therefore not as useful in your body.(7) If it isn’t creatine monohydrate, don’t bother.

Timing

Taking creatine with carbs or a mix of carbs and protein causes an increase in creatine retention in comparison to taking creatine alone. Consider taking your supplement with a meal or adding it to a smoothie to get the greatest benefit possible.(3)

Level of Response

The amount of creatine you get naturally through your diet will determine how your body responds to a supplement. Those who have lower levels of dietary creatine will typically have a stronger, more significant response than those who ingest a lot of creatine naturally. For example, vegetarians/vegans usually have a more dramatic response to supplementation since they do not have as much creatine in their daily dietary intake. Therefore, they typically have lower intramuscular creatine storage and more room for change. Those whose diets are high in animal protein are likely to see less of a change.(3)

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There are also individuals that are simply “non-responders,” meaning their body doesn’t react to the increased dosage of creatine. In those cases, supplementation is unnecessary, and they can rely on dietary and endogenous sources of creatine to meet their needs.(3)

Are there any side effects of supplementing creatine?

Overall, creatine is a reasonably safe supplement, and its effects and side-effects have been well studied over the past few decades. Of course, as with any supplement, there are things to be aware of if you are thinking about adding creatine to your daily dietary intake. Always consult with your doctor before you start taking creatine.

Kidney Damage, Hair Loss, & Dehydration?

There is some discussion about creatine causing water retention, kidney damage, hair loss, and dehydration. However, these claims have been largely disproven in numerous scientific studies.(7) As long as it is taken as directed, there is no robust evidence to support these claims. However, if you have a pre-existing health condition, specifically if you have a kidney disorder, make sure to consult with your doctor before initiating supplementation.

Avoid GI Distress

Another thing to consider is how much creatine you take. Some individuals may experience GI distress, bloat, or weight gain if taking it in large quantities; if you know you are predisposed to GI distress, skip the loading phase, and take the minimum recommended amount.(3) Once you feel confident and comfortable with the amount you are taking, you can scale up as needed.

Do Some Brand Research

As with all dietary supplements, creatine is not tested by the FDA, so be sure the supplement brand you choose has been tested by a few different third-party companies. This will ensure you’re getting exactly what the supplement company claims you’re getting.

One last, important point to remember is that creatine isn’t a magic supplement. This is a supplement with great results and can enhance your training if you take it as directed. However, don’t forget you still have to put in work and combine supplementation with exercise to see results.

1. Exploring the therapeutic role of creatine supplementation, Amino Acids, 2010. Exploring the therapeutic role of creatine supplementation | SpringerLink Accessed 4 January 2023.2. 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, 2017. Full article: International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (tandfonline.com) Accessed 4 January 2023.3. Common questions and misconceptions about creatine supplementation: what does scientific evidence really show? Journal of the international society of sports nutrition, 2021. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? | Journal of the International Society of Sports Nutrition | Full Text (biomedcentral.com) Accessed 3 January 2023.4. What does creatine do and why you should use it for muscle growth, NASM. What Does Creatine Do & Why You Should Use It For Muscle Growth (nasm.org) Accessed 3 January 2023.5. Creatine supplementation and brain health, Nutrients, 2021. Nutrients | Free Full-Text | Creatine Supplementation and Brain Health (mdpi.com) Accessed 4 January 2023.6. The evolving applications of creatine supplementation: could creatine improve vascular health? Nutrients, 2020. Nutrients | Free Full-Text | The Evolving Applications of Creatine Supplementation: Could Creatine Improve Vascular Health? (mdpi.com) Accessed 4 January 2023.7. Creatine won’t magically give you abs. Here’s what it might do, The New York times, 2022. What is Creatine? Understanding its Benefits and Side Effects – The New York Times (nytimes.com) Accessed 3 January 2023.8. Effects of creatine supplementation on brain function and health, Nutrients, 2022. Nutrients | Free Full-Text | Effects of Creatine Supplementation on Brain Function and Health (mdpi.com) Accessed 4 January 2023.

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