What Creatine does for our Bodies

By now, I’m guessing that everyone has heard that creatine is an important supplement that can boost your body’s ability to build and maintain muscle mass.  But what is creatine and is it safe?  

Creatine is naturally produced in the body and is present in some of the foods we eat, like red meat and seafood. It is synthesised in the body, primarily in the liver, kidneys, and pancreas. Creatine works by expanding our energy reserve by increasing glycogen storage in the muscle. Glycogen can quickly convert into glucose, to fuel  muscle contraction, circulation of blood, and various body movements. That is why creatine has become so popular as a means to benefit athletic performance.

Creatine supplementation itself does not build muscle. But, with regular resistance training and a well-balanced diet it has been found to enhance athletic performance. It also expedites muscle recovery.  Creatine also offers benefits beyond the gym; in addition to the touted athletic performance-enhancing effects, recent studies have discovered that creatine can positively benefit cognition and cardiovascular health as well.  It is also becoming more popular as a means to offset age-related muscle loss. Another interesting finding, speculative at this point, is that creatine may promote changes in glucose metabolism that may improve insulin resistance for Type 2 diabetics– although more controlled studies need to be conducted before this claim can be relied upon.  

It is not just athletes who can benefit from the supplement — there’s a growing body of research that suggests it may be especially beneficial for pre- and post-menopausal women. Creatine supplementation among pre-menopausal females appears to be effective in improving strength and exercise performance. Post-menopausal females may also experience benefits in skeletal muscle size and function when consuming creatine, including favorable effects on bone density when combined with resistance training. Evidence also indicates positive effects on mood, cognitive processing, and memory.  Studies have shown that women tend to have lower levels of creatine in their brains, which can affect mood and other mental functions. Taking creatine supplements might help boost mood and reduce depression symptoms, possibly by restoring brain energy levels.  

Side effects

Creatine is actually one of the most studied supplements out there (according to ResearchGate, over 500 studies have been conducted on the effects of creatine and muscle physiology). It is consistently found to be a relatively safe and effective supplement.

So what are the known side effects?  Well, there is little documentation in the literature on the side effects of creatine. The lack of documentation for a supplement so extremely well studied indicates that side effects are uncommon and likely anecdotal based on a person’s unique response. What is known is that creatine increases water retention in muscle cells, so to avoid cramps or dehydration, stay hydrated.

The supplement industry is a huge business. The Dietary Supplement Health and Education Act restricts the FDA's ability to regulate products marketed as "dietary supplements" even though most people buy them for health. That means manufacturers can sell supplements without submitting evidence of their purity, potency, safety, or efficacy. There is no way of knowing what other ingredients may be included in the product you are buying, so there is always the potential that a creatine supplement contains less or more than the amount on the label because it is unregulated. A supplement has the potential to contain other ingredients that could potentially be harmful for you.  So only buy from a high-quality source.  

In reviewing the research, most studies have found no significant side effects on using the recommended dosage of creatine (5 mg/day). The potential for side effects appears to be very limited, but if one were searching for a negative side effect, it ‘might’ make kidney disease worse in people who already have kidney disease, or ‘mania’ worse in people with bipolar disorder.  For individuals with Parkinson’s, if caffeine and creatine are taken together, it may make symptoms of Parkinson's disease worse.    

When is the best time to take creatine?

The benefits of taking creatine before or after a workout have been well established.  Findings show creatine will boost your training sessions, assist in building muscle, and aid in your recovery. However, what is debated is when and how to take the supplement. Studies conflict on whether adding protein and/or carbs with the timing of creatine is essential; the research does indicate that it is better to time creatine shortly before or after you exercise, rather than long before or after. On your rest days, it may be beneficial to take it with food, but the timing is probably not as important as on exercise days.

The most well-researched and effective form is creatine monohydrate.  Other forms, like buffered creatine, have not shown superior benefits and tend to be more expensive.

Here are the Key Take Aways:

  1. Boosts Strengths and Power: by enhancing ATP resynthesis, creatine allows you to push harder during short, intense workouts.
  2. Enhance muscle growth:  Allows for greater training volume and improves cellular hydration.
  3. Improve recovery after exercise: Accelerates recovery by reducing inflammation and oxidative stress.
  4. Supports cognitive function (*9): May benefit brain health by improving energy supply to brain cells.
  5. May protect against neurodegenerative diseases: Emerging studies on animals have shown that creatine can reduce neuronal loss and improve motor function so may be preventative for neurodegenerative diseases.
  6. Supports Bone Health: A study in older adults found that creatine supplementation, combined with resistance training, improved bone mineral density and functional performance.  

Bottom line: Creatine use seems to provide many health benefits with very little to no side effects, particularly for women.  When used consistently, the effects demonstrate improvements in muscle and brain functionality (short-term memory and reasoning capabilities), and have been shown to result in improvements in strength and exercise capacity. When combined with resistance training, creatine further augments body composition and bone mineral density, particularly in post-menopausal females.  Common myths about creatine: There are many misconceptions about creatine. It’s been around for a long time and has been extensively studied. Here are some common myths:

  1. Water retention: Creatine might make you feel a little bloated at first as your muscles are absorbing water, but this is usually temporary and goes away quickly.  If you continue to experience bloating, be sure to add roughly 3 to 4 ounces of water for each gram of creatine consumed and make sure you are staying hydrated.  Consider your water intake may vary depending on your muscle mass, as well as your activity level and your climate.  
  2. Anabolic steroids: Creatine is not an anabolic steroid.
  3. Kidney damage: Creatine is generally safe for healthy individuals when taken at recommended doses. Studies have shown up to 5 g of creatine daily for 35 days had no impact on kidney function.
  4. Hair loss: There's no strong evidence linking creatine to hair loss.
  5. Fat gain: Creatine doesn't increase fat mass.
  6. Loading phase: Smaller, daily doses are effective, so a loading phase isn't necessary.
  7. Resistance training: Combining creatine with resistance training yields optimal results.
  8. Not just for men: Creatine offers various benefits for women of all ages.
  9. Other forms: Creatine monohydrate is generally the most effective and widely studied form.

Guidance:

  1. Consult with your doctor before taking any new supplements.
  2. Choose a reputable brand.
  3. Aim for 5 grams of creatine monohydrate every day. On exercise days, take it 30 to 90 minutes before or after exercise.
  4. Stay hydrated throughout the day!

Resources:

  1. Andres, R. H., Ducray, A. D., Schlattner, U., et al. (2005). Neuroprotection by creatine in neurodegenerative diseases: An evaluation of the evidence. Proceedings of the National Academy of Sciences, 102(17), 5954–5959.
  2. Branch, J. D. (2003). Effect of creatine supplementation on body composition and performance: A meta-analysis. Medicine & Science in Sports & Exercise, 35(2), 207-211.
  3. Chilibeck, P. D., Kaviani, M., Candow, D. G., & Zello, G. A. (2015). Effect of creatine supplementation during resistance training on bone health in older adults. Journal of Nutrition, Health & Aging, 19(5), 442-453.
  4. Greenwood, M., Kreider, R. B., Melton, C., Rasmussen, C., Lancaster, S., Cantler, E., & Milnor, P. (2003). Creatine supplementation during college football training does not increase the incidence of cramping or injury. Journal of Strength and Conditioning Research, 17(4), 641–646.
  5. Poortmans, J. R., & Francaux, M. (2000). Long-term oral creatine supplementation does not impair renal function in healthy athletes. Medicine & Science in Sports & Exercise, 32(5), 1106–1110.
  6. 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 of the Royal Society B: Biological Sciences, 270(1529), 2147–2150.
  7. Rawson, E. S., & Volek, J. S. (2003). Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. Amino Acids, 26(3), 213–221.
  8. Volek, J. S., Kraemer, W. J., Bush, J. A., et al. (1999). Creatine supplementation enhances muscular performance during high-intensity resistance exercise. Journal of Applied Physiology, 91(1), 116-127.
  9. Andres, R. H., Ducray, A.D., Schlattner, U., et al (2005). Neuroprotection by creatine in neurodegenerative diseases. An evaluation of the evidence. Proceedings of the National Academy of Sciences, 102(17), 5954-5959.
  10. Reference: Creatine Supplementation in Women’s Health: A Lifespan Perspective Abbie E Smith-Ryan 1,2,*, Hannah E Cabre 1,2, Joan M Eckerson 3, Darren G Candow 4
  11. Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials Konstantinos I Avgerinos a,b,*, Nikolaos Spyrou a,c, Konstantinos I Bougioukas b, Dimitrios Kapogiannis d
  12. Potential of Creatine in Glucose Management and Diabetes Marina Yazigi Solis 1, Guilherme Giannini Artioli 1, Bruno Gualano 1
  13. WebMD: side effects of Creatine

More Resources:

  1. https://pubmed.ncbi.nlm.nih.gov/33800439/
  2. https://pubmed.ncbi.nlm.nih.gov/31257405/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210857/
  4. https://journals.lww.com/acsm-msse/Fulltext/2015/08000/Effects_of_Creatine_and_Resistance_Training_on.5.aspx
  5. https://www.ncbi.nlm.nih.gov/books/NBK553175/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1691485/
  7. https://pubmed.ncbi.nlm.nih.gov/21394604/
  8. https://pubmed.ncbi.nlm.nih.gov/33578876/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998865/
  10. https://pubmed.ncbi.nlm.nih.gov/26457568/
  11. https://pubmed.ncbi.nlm.nih.gov/26907087/
  12. https://pubmed.ncbi.nlm.nih.gov/22864465/
  13. https://pubmed.ncbi.nlm.nih.gov/12850248/
  14. https://pubmed.ncbi.nlm.nih.gov/17988366/
  15. https://pubmed.ncbi.nlm.nih.gov/12660409/
  16. https://pubmed.ncbi.nlm.nih.gov/33557850/
  17. https://pubmed.ncbi.nlm.nih.gov/32670557/

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