Creatine is one of the most commonly used, studied and scientifically endorsed athletic nutritional supplements in existence today. It is not a protein, but rather a nitrogen based compound that is synthesized in the liver and pancreas from arginine, glycine and methionine (references 6, 7, 8). Most creatine is found in skeletal muscle as phosphocreatine, but small traces are found in the brain and testes, stored as free creatine (references 5, 9). As far as natural supplementation goes, meat and fish carry small amounts of creatine.
Creatine gained popularity in the early 1990’s. All scientific research to date perpetuates the claim that creatine is not only clinically safe, but it is also beneficial for athletic performance and a multitude of medical conditions. Hundreds of these studies have been completed to assess the supplement’s impact on anaerobic capacity, strength and lean body mass. Each of the studies supports creatine’s effectiveness in such capacities. The International Society of Sports Nutrition claims creatine use as a nutritional supplement is safe, effective and ethical. Most forms of creatine have been reported to provide no excess benefit over that of creatine monohydrate; so don't be duped into paying more for creatine in another form.
As touched upon briefly above, creatine has many benefits in regards to muscle endurance and anaerobic performance. The benefits include increase of lean mass, increased exercise capacity during training and injury prevention (references 1, 2, 3, 4). Roughly 70% of studies have reported significant improvement in exercise capacity, averaging roughly a 10-15% increase (reference 17). Long term consumption appears to enhance overall strength and athletic performance as well as lean body mass gains of 1-2kg given proper dosing (reference 11).
The following list represents a few athletic benefits supported by research done on cycling power, total work performed on the bench press and jump squat, sprinting, swimming and soccer.
1. Increased strength
2. Increased fat-free mass
3. Increased sprinting power
4. Increased power/force development
5. Increased muscle diameter
Creatine is also used in the treatment of Alzheimer’s and Parkinson’s diseases due to its benefits for brain activity (references 18, 19, 20, 21, 22).
The only significant side effect reported in literature is “weight gain” (references 3, 10, 12), but people have also associated the supplement with dehydration, cramping, kidney and liver damage and gastrointestinal distress. Studies have been conducted extensively to find that these occur in rare instances and usually under improper use (i.e. excessive dosing of creatine with limited hydration). Adequate hydration is crucial as creatine requires water for effective absorption.
Using creatine monohydrate in concert with Beta-Alanine will produce greater effects on strength, lean mass, body fat percentage and delaying neuromuscular fatigue than creatine monohydrate in isolation (references 15, 16).
Recommended amounts of creatine vary by the athlete’s goals. In general, recommended doses are between 3g and 5g of creatine monohydrate daily taken around the time of exercise (references 13, 14). There are various strategies such as a “loading” cycle involving 10g of creatine taken daily every other month with the smaller doses taken throughout the months in between (references 10, 12).
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3. Kreider RB, Melton C, Rasmussen CJ, Greenwood M, Lancaster S, Cantler EC, Milnor P, Almada AL: Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003, 244: 95-104. 10.1023/A:1022469320296.View ArticlePubMed
4. Poortmans JR, Francaux M: Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc. 1999, 31: 1108-1110. 10.1097/00005768-199908000-00005.View ArticlePubMed
6. Greenhaff P: The nutritional biochemistry of creatine. J Nutrit Biochem. 1997, 11: 610-618. 10.1016/S0955-2863(97)00116-2.View Article
7. Brunzel NA: Renal function: Nonprotein nitrogen compounds, function tests, and renal disease. Clinical Chemistry. Edited by: Scardiglia J, Brown M, McCullough K, Davis K. 2003, McGraw-Hill: New York, NY, 373-399.
8. Paddon-Jones D, Borsheim E, Wolfe RR: Potential ergogenic effects of arginine and creatine supplementation. J Nutr. 2004, 134: 2888S-2894S.PubMed
9. Hultman E, Soderlund K, Timmons JA, Cederblad G, Greenhaff PL: Muscle creatine loading in men. J Appl Physiol. 1996, 81: 232-237.PubMed
10. Williams MH, Kreider R, Branch JD: Creatine: The power supplement. 1999, Champaign, IL: Human Kinetics Publishers, 252-
11. Kreider RB: Creatine in Sports. Essentials of Sport Nutrition & Supplements. Edited by: Antonio J, Kalman D, Stout J, et al. 2007, Humana Press Inc., Totowa, NJ,
12. Kreider RB, Leutholtz BC, Greenwood M: Creatine. Nutritional Ergogenic Aids. Edited by: Wolinsky I, Driskel J. 2004, CRC Press LLC: Boca Raton, FL, 81-104.
13. Willoughby DS, Rosene J: Effects of oral creatine and resistance training on myosin heavy chain expression. Med Sci Sports Exerc. 2001, 33: 1674-81. 10.1097/00005768-200105001-00170.View ArticlePubMed
14. Willoughby DS, Rosene JM: Effects of oral creatine and resistance training on myogenic regulatory factor expression. Med Sci Sports Exerc. 2003, 35: 923-929. 10.1249/01.MSS.0000069746.05241.F0.View ArticlePubMed
15. Stout JR, Cramer JT, Mielke M, O'Kroy J, Torok DJ, Zoeller RF: Effects of twenty-eight days of beta-alanine and creatine monohydrate supplementation on the physical working capacity at neuromuscular fatigue threshold. J Strength Cond Res. 2006, 20: 938-931. 10.1519/R-19655.1.
16. Hoffman J, Ramatess N, Kang J, Mangine G, Faigenbaum A, Stout J: Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes. Int J Sport Nutr Exerc Metab. 2006, 16: 430-446.PubMed
18. Zhu S, Li M, Figueroa BE, Liu A, Stavrovskaya IG, Pasinelli P, Beal MF, Brown RH, Kristal BS, Ferrante RJ, Friedlander RM: Prophylactic creatine administration mediates neuroprotection in cerebral ischemia in mice. J Neurosci. 2004, 24: 5909-12. 10.1523/JNEUROSCI.1278-04.2004.View ArticlePubMed
19. Hausmann ON, Fouad K, Wallimann T, Schwab ME: Protective effects of oral creatine supplementation on spinal cord injury in rats. Spinal Cord. 2002, 40: 449-56. 10.1038/sj.sc.3101330.View ArticlePubMed
20. Brustovetsky N, Brustovetsky T, Dubinsky JM: On the mechanisms of neuroprotection by creatine and phosphocreatine. J Neurochem. 2001, 76: 425-34. 10.1046/j.1471-4159.2001.00052.x.View ArticlePubMed
21. Sullivan PG, Geiger JD, Mattson MP, Scheff SW: Dietary supplement creatine protects against traumatic brain injury. Ann Neurol. 2000, 48: 723-9. 10.1002/1531-8249(200011)48:5<723::AID-ANA5>3.0.CO;2-W.View ArticlePubMed
22. Jacobs PL, Mahoney ET, Cohn KA, Sheradsky LF, Green BA: Oral creatine supplementation enhances upper extremity work capacity in persons with cervical-level spinal cord injury. Arch Phys Med Rehabil. 2002, 83: 19-23. 10.1053/apmr.2002.26829.View ArticlePubMed