Sport Nutrition

Creatine: Everything You Need to Know

Creatine is a popular nutrition supplement known for its muscle-building benefits. Over the years, it has also taken the title as one of the most extensively researched supplements on the market. Hence why you’re probably here to read about it! Today we’ll discuss what Creatine is, and what benefits it can provide. I’ll also share with you safety considerations and possible side effects to be aware of!

Likewise, I myself was a skeptic when I first heard about Creatine. When it comes to online health and fitness information it can be difficult to separate fact from fiction. Today, we’ll dive into the research behind creatine, and how to decide if it’s the right fit for you.

What can Creatine do for Athletes?

Let’s begin with two accepted claims by The International Society of Sports Nutrition (ISSN). The ISSN provides an objective and critical review of creatine based from scientifically researched studies and approval from their Research Committee [1].

  1. During training, Creatine monohydrate (the main type typically found in supplements) is the most effective ergogenic nutritional supplement for increasing lean body mass and increasing high-intensity exercise capacity.
  2. Creatine monohydrate potential benefits include with regards to preventing injury, an aid for post-exercise recovery, and used for management of select medical conditions when taken under recommended guidelines.

Several studies in this document also report users experiencing less muscle tightness and strain in comparison to non-users.

Before we continue, what is creatine?
(Beware a little bit of biochemistry ahead)

Creatine is a member of the guanidine phosphagen family. This is a naturally occurring compound primarily found in red meat and seafood [1]. It is made from three amino acids: arginine, glycine and methionine. We can make our own in our bodies, and store it in our muscles [2].

ATP is the energy currency of our cells.

For example, when you watch a movie in the theaters, you typically pay in order to receive a movie ticket. The act of actually being able to watch a movie is dependent on the fact that you first made that transaction using your money. Similarly, within the cells in our body, they require ATP in order for the body to perform any activity. ATP is the currency our cells use and Phosphocreatine is a key ingredient for energy metabolism.

Let’s break it down

If phosphocreatine is used in energy metabolism, then the availability of phosphocreatine in your muscle is an influential factor for energy generation during periods of high intensity exercise.

Theoretically, this is why people consume Creatine based supplements as part of their workout regime. By increasing phosphocreatine stores through supplementation, you are increasing the availability of phosphocreatine to partake in energy metabolism.

Which type of creatine should I use?

There are various forms of creatine that exist on the market. Here are a few forms you may recognize:

  • Creatine hydrochloride
  • Buffered creatine
  • Creatine magnesium chelate
  • Creatine monohydrate
  • Liquid Creatine
  • Creatine ethyl ester

Among the various forms mentioned, creatine monohydrate is the most studied and validated form of creatine. With hundreds of studies on the topic of, the benefits of creatine have shown to be the most effective in the monohydrate form [1] [2][14].

How much should I use?

Let’s do the math!

There are two phases: Creatine loading and the maintenance phase. These recommendations have been studied and reviewed by the ISSN.

Phase 1 – The Loading Phase

For 3 days consume 0.3 grams/kg/day.
For example, if you weighed 150 pounds (68 kg), then the math would be…

0.3 grams x 68 kg = 20.4 grams/ day

Split them up into 4 even portions of about 4-5 grams throughout your day.
The goal of the loading phase is to rapidly maximize your creatine muscle stores. Doing so in a short period with a high dosage will help saturate your muscles.

Phase 2 – the maintenance phase

After the 3 days, follow up with consuming just 3-5 g/day to maintain the elevated creatine stores [1] [2].

But is it safe? What are the side effects?

Creatine has been surrounded by controversy since it gained popularity during the early 1990’s. Both from the media and anecdotal reports have made claims that the usage of creatine was dangerous.

Purported Side Effects include:

  • Dehydration
  • Weight gain
  • Kidney damage
  • Bloating
  • Muscle cramps
  • Digestive distress

But before we jump to any conclusions, there are some myths we need to bust.

Despite the negative associations, according to the ISSN, Creatine has an exceptional safety profile [3] [1]. With over decades of research, Creatine is viewed as one of the safest supplements sold on the market.

In a study that examined 52 biomarkers for Creatine supplement users found that over a 21 month period, there were no adverse health effects[5]

In addition, a cohort study monitored patients consuming 1.5-3 grams per day of creatine monohydrate since 1981 found no serious or noteworthy side effects[8] [9]

I’m assuming that you’re probably still curious about the list of side effects mentioned, but I am happy to say that none of those claims have been scientifically supported by research, except weight gain [1] [6]  Therefore, from the list above, weight gain is the only clinically significant side effect.

A word about weight gain

Again, before we jump to conclusions, the weight gain isn’t as it seems.

In fact, the initial weight gain is due to the creatine loading phase, when the consumption is at a high of about 20 grams/day during the first week. The increase of about 1-3 kg comes from an increase of water in your muscles. Typically, the initial weight gain is due to water retention [1] [6]. When looking at long-term users, the weight gain associated with creatine has been due to muscle growth, not an increase in body fat. Therefore, the adaptation is seen to be favorable and one of the reasons why people consume creatine in the first place

Is creatine safe for children and adolescents?

Another controversial topic is the usage of creatine supplements in children and adolescents.  Opponents of creatine supplementation deem the usage in children unfavourable and potentially harmful. While the research conducted using younger participants is not as common as the extensive research targeting an adult population, no study done has presented any adverse effects.

The ISSN presents a list of conditions at which supplementation would be deemed acceptable for younger athletes [1]. Some conditions include:

  1. That the athlete has completed puberty
  2. The athlete is partaking in serious competitive training, and that the
  3. Supplementation is supervised by the athlete’s parents, coaches, and/or physician.

Outside of these conditions, creatine supplementation would not be considered appropriate for young athletes.

Is creatine safe for older adults?

Accumulating evidence confirms that creatine supplementation has a positive impact on aging muscle. Sarcopenia is an age-related condition characterized in a decrease in muscle mass, strength and overall physical performance. Associated with the aging population, studies have found that exogenous consumption of creatine supplements can combat issues related to Sarcopenia, and enhance bone mineral density [14].  While the research is promising, best practice would be to consult your doctor or a medical professional before implementing a creatine regime.

Emerging Research on Creatine

On top of the benefits mentioned previously including increasing lean muscle mass and increasing high intensity exercise capacities for athletes; Creatine monohydrate has been reported to showcase potential benefits for several other clinical applications.

Research has revealed a number of possible uses for creatine monohydrate including:

  • Heart arrhythmias,
  • An aid for patients with various neuromuscular diseases and those suffering from orthopedic injuries [1].
  • Continual research is ongoing with an expansion of research dedicated to topics related to creatine and spinal cord injuries [10],
  • muscular dystrophy [11],

While the benefits may extend beyond the gym, be sure to consult your physician before taking creatine for any of the above conditions.

The Bottom Line

Creatine is a safe, effective and an ethical nutritional supplement. Hundreds of studies have demonstrated that creatine can promote greater training adaptations by increasing lean body mass, improve strength and has shown promising results regarding its effectiveness with preventing injury.

That being said, Creatine is not a short cut to becoming a successful athlete! A nutritionally balanced diet and personalized training program are still the cornerstones of athletic performance, and should be optimized before starting any supplements. Work with a Sport Dietitian to learn how to fuel your best so you can perform your best, and decide which sport supplements are right for you!


About the Author:

“Adrienne is a Human Nutritional Science student from the University of Manitoba. Her goal is to one day become a Registered Dietician, specializing in Pediatric health. 

During her evenings and weekends Adrienne is a dance teacher! She also loves to bake, venture on hikes and enjoy the outdoors! She hopes to inspire others to live a balanced healthy lifestyle from the inside out!”

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