Creatine is most commonly used in power sports where athletes are looking for supplements that give them extra boosts of strength over a short period of time. It has been reported that 75% of powerlifters, track and field athletes and weightlifters use creatine supplements, and around 60% of gym and health club members take the substance, according to a 2000 report.
Creatine is popular for two reasons – firstly, its benefits have been widely studied and documented – more so than any other supplement apart from protein powder. Studies have consistently shown that the supplement is safe and has a number of advantages. And secondly, it is extremely accessible from online platforms, nutrition stores and supermarkets and does not require a prescription.
One downside to creatine however is that many people do not take it properly, and do not properly do their research on dosage and when it should be ingested. This means that they do not get the most out of the supplement and are wasting the product (which isn’t cheap).
Before you decide to invest in creatine, take a look at our breakdown of what creatine is, its benefits and its potential side effects. We have collated information from the experts in order to give you the best information rather than searching through scientific studies and health journals for it.
What is Creatine
Creatine is naturally found in foods such as eggs, meat and fish and is a dietary protein-like compound that is non-essential but has many positive effects on the body. It is usually processed in the level by three amino acids – glycine, arginine and methionine. Muscles need creatine to help grow, but the muscles themselves do not produce creatine and instead need to source it from the blood.
When creatine is absorbed by the muscle cells, it is combined with a high-energy phosphate and is transformed into phosphocreatine (PCr). When creatine is ingested, PCr levels have been shown to increase by around 20%. This molecule then helps create a substance called adenosine triphosphate (ATP), which helps produce fast energy, allowing your body to perform at a higher rate during exercise. The more ATP that can be produced during an exercise session, the more power, strength and speed can be produced by the body. This, in turn, can lead to impressive muscle growth.
When looking at natural creatine in the body, there are a number of factors that can impact the amount naturally produced – from the amount of meat that you eat, the amount that you exercise, your muscle mass and the levels of important hormones in your body such as IGF-1 and testosterone.
Creatine within the body is mainly stored in the muscles and is known as phosphocreatine, this makes up around 95% of the creatine that you have. The final 5% of creatine is split between the liver, kidneys and brain.
Creatine can be added to the body in the form of a supplement, and this is popular in those trying to increase muscle mass, improve their strength and increase their performance in exercise. Athletes and body builders often take creatine for these results. Manufacturers have made it easier to increase protein and have created liquid, powder and tablet forms of the substance, which can be taken instead of dramatically increasing meat intake. This should not be a total replacement for protein however and should be considered as an addition to it as protein leads to better muscle repair, while creatine can increase strength levels during a workout.
Benefits of using creatine
Using creatine has a number of benefits that can positively impact the body and performance. Firstly, creatine increases the body’s production of energy by increasing the amount of adenosine triphosphate (ATP) that the body creates. ATP is the basic energy used within the cells of the body and helps aid muscle function and increases metabolism. The body however can only store enough ATP to help for between 8 and 10 seconds of intense exercise. Exercise longer than this requires the body to produce more ATP as it goes.
High-intensity exercise needs more ATP after 10 seconds than the body can make, explaining why you can only work at your peak (e.g. run at your highest speed) for a few seconds before the energy depletes. Creatine can also increase the amount of phosphocreatine stored in the body, which helps produce more ATP when completing high-intensity exercise. Completing a 6-day high creatine load, and then maintaining this by consuming 2 grams per day, can increase muscle stores allowing you to exert additional energy, working at your peak for longer before your body becomes fatigued.
Creatine can also improve your muscle’s cells in a few different ways. It can increase the water content, swelling the muscle cells, and can boost the body’s production of the IGF-1 hormone that is key for muscle growth. Both these changes can lead to processes triggering in the body that can help build up new proteins, which, in turn, leads to an increase in muscle mass.
Creatine can also stop muscle breakdown, meaning that they are likely to increase long term and are less likely to become as fatigued as easily after exercise. This also allows those working out to increase the number of exercises that they are completing or lift weights that are heavier during their training sessions, therefore increasing muscle mass even more.
Effects on muscle strength
There are many studies that have shown that creatine can increase one max muscle strength. In 1998, a study by Nebraska University found that college football players saw a 6% increase in their one-rep bench press strength after taking creatine. Those who were the control subjects and simply taking the placebo drugs showed no improvement in the slightest. Additionally, a 1997 study in the Journal of Applied Physiology found that those who were previously untrained who followed a 10-week training program found that they increased their maximum one-rep squat by around 25% more than the control subjects in this experiment.
When looking at multiple reps, studies have also proven that creatine can be a benefit, with scientists at Queensland University discovering that powerlifters increased the number of reps they were able to do after taking creatine. Their one-rep max was also increased by around 40%. Those who were the control subjects, in this case, saw no improvement for both measures throughout the study.
Effects on muscle growth
Creatine has been proven time and time again to increase muscle growth. Studies from the University of Queensland, for example, found that powerlifters who consumed creatine gained around 11lb of lean muscle weight over a four-week period. This was compared with a control group who followed the same workout routine but had no creatine, who saw no change in their body weight.
Creatine has been proven to not increase fat, bone or organ mass and therefore, this weight gain can only be attributed to an increase in muscle. This is backed up by a 2000 study which was published in the Medicine and Science in Sports and Exercise Journal and conducted by the Southern Illinois University at Carbondale. Their research found that weightlifters, who ingested creatine over a period of six weeks, gained around 5lbs of lean body weight. Again, when compared to those who were ingesting a placebo, it was found that the placebo gained no weight, even though they were completing the same training program.
Effects on athletic performance
As well as increasing muscle mass, creatine has also been found to improve athletic performance significantly. This is because the substance can increase muscle force and power during short periods of exercise. Studies on this have looked at the effect of creatine on both competitive college athletes and untrained subjects who do not undertake regular exercise.
These studies concluded that ingesting creatine can improve performance in a number of different exercises, including sprinting, swimming, jumping, cycling, kayaking, rowing, weightlifting and soccer. However, the largest improvements were found in those exercises that include a number of high-power, repetitive bouts of exercise, followed by short rest periods lasting up to 60 seconds. In instances like this, athletic performance is likely to increase by between 5 and 20% in those who are taking creatine, compare to those on a placebo.
Other health benefits of creatine
In addition to increasing athletic performance and muscle mass, creatine also has a number of additional health benefits that can improve how the body functions. The substance has been shown to benefit the brain and the central nervous system by increasing PCr in the body, which can also positively impact nerve cell function. The brain stores this phosphocreatine and uses ATP in order to help it function, and therefore increased levels of both these substances can positively impact and potentially improve conditions such as:
- Epilepsy
- Alzheimer’s disease
- Parkinson’s disease
- Brain or spinal cord injuries
- Motor neuron disease
- Huntington’s disease
- Ischemic stroke
- Memory and brain function in older adults
It is, however, important to note that studies into these neurological diseases and how they react to increased creatine have been on animals rather than adults. There has been some human research that has concluded that children with traumatic brain injuries had reduced dizziness (by 50%) and reduced fatigue (by 70%) when ingesting creatine.
Studies on humans have shown that creatine can benefit a number of different people including vegetarians and older adults. As vegetarians do not eat meat, they can lack creatine in their bodies as most natural creatine comes from animals. One studied showed that vegetarians on creatine improved around 20% on their intelligence test scores, and by approximately 50% in memory tests.
Additionally, creatine has positive benefits on cardiovascular health. It can lead to improvements in cholesterol levels and can alleviate the symptoms of congestive heart failure. A 1996 study published in the journal of Clinical Science found that both male and female study participants who consumed creatine over a period for 8 weeks saw a decrease in their cholesterol levels of 5% and LDL cholesterol of over 20%. This is significant is LDL is the cholesterol that can negatively impact the body. This was backed up by a 2001 study in which researchers in Skidmore College revealed that 28 days of creatine intake decreased the cholesterol levels in healthy males by 10%. Furthermore, Virginia Commonwealth University found that young males also saw a reduction in the homocysteine levels in their body when taking creatine and a multivitamin. Homocysteine is an amino acid that is linked to an increased risk of heart disease.
How creatine works
There has been much research published on the benefits of creatine, but how does it actually work? Creatine is known to increase muscle mass and boost energy by increasing the levels of PCr within the muscles. The increased levels of PCr in the muscles increase the recovery time in athletes, particularly between sets in weight lifting or periods of sprinting. This, in turn, increases performance allowing athletes to complete more reps in weight lifting or increase their speed. By doing so, this can increase fitness and lead to bigger muscle growth.
When creatine is first ingested, or when it is first naturally produced by the body, it binds with molecules of phosphate, creating a substance known as creatine phosphate. So, let’s look at the science of this, how it works, and the impact that it has on the body.
The body mainly gets its energy from a substance known as ATP, or adenosine tri-phosphate. This is commonly produced when the body breaks down carbohydrates, fat or protein. Adenosine tri-phosphate gives the body the energy it requires to complete the number of body processes, including creating more ATP, and this energy is created by the ATP in the body hydrolyzing a group of phosphates.
When a group of phosphates are hydrolyzed, heat is produced, which is a type of energy, and this heat then boosts the processes in the body. Once one type of phosphate has now been taken away from the ATP, it is now known as ADP, or adenosine di-phosphate. This ADP is now free and is simply a product of the ATP hydrolysis, and is left over. ADP does not have many advantages for the body and is most useful when it is converted back into ATP, by adding another phosphate. This is where additional creatine is a great benefit. Creatine added to the body can add the extra phosphate group to the ADP produced after hydrolysis, allowing it to again become ATP. This, in turn helps increase the ATP stores in the body, allowing the muscles to work harder for longer. Adding additional creatine leads to a cycle of ATP being produced, used and then reworked from the ADP, back to ADT. This is the main process within the body that creatine is used for however, there are others.
Creatine also helps the mechanism of cell volumization, in which the muscles increase their volume by being flooded with water. Creatine is so similar to a protein that it has many of the same features, including the ability to draw water from the blood and the interstitial fluid outside the cells into the muscle through osmosis – the movement of molecules through a selectively permeable membrane from an area of high concentration to an area of low concentration. This process is believed to them lead to muscle growth and increases in muscle strength as it causes the membranes of the muscle cells to stretch and therefore increases their volume. It leads to further protein synthesis, which promotes the growth of muscle cells.
Additionally, creatine has been shown to increase the concentration of satellite cells within the fibers of muscles. These special cells are effectively muscle stem cells that can help the muscles increase in mass. A study by the University of Copenhagen in 2006 found that adding creatine into a person’s diet for around 8 weeks and making them follow a weight training program led to an increase of almost double the number of satellite cells within the muscle fibers compared to the control group. The higher the number of satellite cells found within the muscles, the greater the likely size of them, leading to an expectation of increased power in the muscles, resulting in increased strength.
One final way that creatine is effective is by increasing a growth factor within the body that is similar to insulin. This growth factor is known as IGF-I and is essential in starting the processes inside the body that lead to a growth in muscle and an improvement in muscle strength. A study in 2008 from the St. Francis Xavier University in Canada found that those who weight trained and took creatine for an eight week period had a higher level of IGF-I in the fibers of their muscles, compared to those who lifted weights but were simply taking a placebo.
Is creatine safe to use?
Creatine gained popularity within the 1990s, and since then, there have been over 1000 different scientific studies across the globe on the substance. In every single study, the participants that took high doses of creatine over a long period of time (some as long as long as over 5 years) did not report any serious side effects. The most common side effect reported was weight gain due to water retention within the muscles, which occurred in infants, healthy adults and the elderly. Another side effect was slight stomach aches when large doses were taken, especially if taken with no food in their stomachs. All studies concluded that creatine was safe for human consumption.
One of the most detailed studies on creatine measured 52 markers in participants blood and found that there were no negative effects on these markers in participants who took creatine for 21 months. Furthermore, no evidence has been found in any study that creatine damages organs such as the kidneys or liver in healthy people who take a regular dose of the hormone. Those with existing liver or kidney conditions are advised, as with any products, to consult their doctor before taking the supplement.
One common myth is that a side effect of creatine is dehydration and stomach cramps however, there has been no research that affirms this. Studies have, in fact, shown the opposite, that creatine can reduce cramps and dehydration during endurance exercise, especially in high temperatures.
Which creatine should I take?
Creatine comes in different forms – powder form can be mixed with liquids to create a drink, while capsules can be easily ingested. Capsules tend to be a better option for those on the go, while powders can mean that the creatine is taken with other foods that are good for your overall health.
The most recommended and most studied form of creatine is creatine monohydrate, which is as effective whether taken as a powder or as a capsule. This type of creatine works well for most people; however, a small group do report poor side effects such as an upset stomach and bloating. If this is the case, there are some other types of creatine that can be used. Let’s take a look.
Creatine Hydrochloride
This is one of the types of creatine that fitness experts are most impressed with besides the creatine monohydrate. This is because studies have shown that it is around 60% more likely to be absorbed by the body, meaning that a lower dose is needed for the same results. It is less likely to cause stomach issues and reduces the amount of water retention beneath the skin.
Magnesium Creatine Chelate
This is when traditional creatine is combined with magnesium. The magnesium can help water enter the muscles and can help prevent muscle fatigue.
Kre-Alkalyn
This is a buffered type of creatine that is manufactured at a higher pH level than other types of the substance, which means intake is enhanced. Like creatine hydrochloride, a lower dose is required and it is unlikely to cause the same stomach problems as creatine monohydrate.
Creatine Malate
This is commonly known as dicreatine malate, or tricreatine malate and is made up of creatine mixed with malic acid. Malic acid increases energy production and, when bonded with creatine, can lead to reduced levels of fatigue and better endurance.
Creatine Alpha-Ketoglutarate
This type of creatine is bonded with alpha-ketoglutarate and is thought to be more easily absorbed into the body compared to creatine monohydrate.
Creatine Gluconate
When glucose is attached to creatine gluconate, it is easier to uptake within the body than other types of creatine on the list.
Creatine Ethyl Ester
This is creatine combined with an ester group, which can improve creatine’s ability to pass through the walls and membrane of a cell, allowing it to be more easily absorbed. Recent studies on this type of creatine have shown that it is not better at increasing creatine levels in the muscle, however, when compared with traditional creatine monohydrate.
Creatine Orotate
Also known as tricreatine orotate, this substance is made up of both creatine and orotic acid. Orotic acid becomes nucleic acid (which helps make DNA), and it helps creatine by helping the creation of creatine phosphate within the cells of the muscles. Creatine phosphate is great for quick boosts of energy that can fuel workouts such as weightlifting.
How to take creatine and what dose to use
The dosage of creatine taken daily depends on which form you are ingesting and what protocol you are using – the loading protocol or low dose supplementation protocol. If you are taking creatine monohydrate, which is recommended by most, research suggests that for a loading phase, 5g of creatine should be ingested between four and six times a day, with food taken in between. This should happen for between five and seven days, leading to results that can increase creatine levels in the body by around 40% in this time period. For a lower dose method, one 5g dose every day can produce the same results, but this takes time – around one month.
The loading phase is recommended for those who wish to see the benefits of creatine over a short amount of time. After the loading phases, a lower dose can then be taken before or directly after a workout to maintain the creatine levels within the body. Taking creatine close to a workout is the most effective, as research has proven that this is when the accumulation of creatine within the muscle can be maximized.
When choosing which food to take with creatine, it is recommended to ingest the substance with high-glycemic carbohydrates or quick digesting protein. Foods such as isotonic sports drinks or whey protein shakes are the best option. These will allow blood insulin levels to increase, allowing for fast and easy transport of the creatine to the cells within the muscles.
Loading protocol
One of the most common ways that people take creatine is to begin their consumption with a loading phase. A loading phase is where high levels of creatine are taken over a short time, with the idea that it will fully saturate creatine levels within the body’s muscle stores. After this short period of time finishes, most then take a much lower dosage, moving on to a maintenance phase, in which the levels within the body are simply kept the same.
One advantage of the loading protocol is that it is extremely effective. One supplement research and natural bodybuilder, Adam Gonzalez, Ph.D., believes that this approach is the best way to see maximum results. He states that “Research has shown the most effective way to rapidly increase intramuscular creatine concentrations is a loading method,” and goes on to describe that “A typical loading protocol consists of consuming high doses, like 20-25 grams per day, split between 4-5 daily doses, for 5-7 days. Following the loading protocol, athletes can generally maintain stores with a daily maintenance dose of 3-5 grams per day.”
Another expert that believes this method is best is the co-founder of the International Society of Sports Nutrition, Jose Antonio, Ph.D. He believes that creatine loading is something that all creatine users should definitely do to help prepare your body.
Some negatives to creatine loading are the potential side effects of taking such high doses over a short period of time. Taking smaller doses of creatine can be as effective, it just takes longer, however it may be better as loading protocol can lead to some discomfort. While these side effects are not serious, they can be avoided if they are uncomfortable. Gonzalez agrees, saying that the loading protocol isn’t essential, even though he believes it is best. He does admit, however, that some athletes may experience stomach and gastrointestinal issues such a bloating or stomach pains.
Low dose daily supplementation protocol
If you are looking to create a lower dose of creatine, there is a low dose method that involves taking between three and fives grams of the supplement every day, without doing any kind of loading protocol. One advantage of this is that it is simpler, easier to manage and is just as effective. Taking the supplement daily builds up creatine levels in the body just as effectively. Expert Willoughby describes a ‘low dose’ method as the most simple and effective way to take the supplement and assures that it can produce the same results when it comes to both size and strength gains.
One disadvantage of this process is that it takes more time to build up the amount of creatine in the body, and can lead to slightly lower levels in total, although this does not have a significant impact on the benefits over time.
Other Creatine FAQ's
Should I Load?
Loading creatine is not essential but it can increase the speed at which you will see results. In order to see results, your body must be saturated. Taking 5 grams of creatine per day will mean that you will feel results after around 30 days. Increasing your dosage, however, to around 15-25 grams per day for 5 days can see results much quicker. Once you experience results, the dose can be reduced to 3-5 grams to maintain these levels.
What If I Miss A Day?
Once you have consumed creatine for a good amount of time, through a consistently low dose or a loading protocol, your body will be saturated and, therefore, will not be greatly impacted if you miss a day. The levels within your body will, in fact, stay high for around 4-6 weeks but for best results, keep your intake as regular as possible.
Should You Cycle Creatine?
Cycling your creatine intake can help as your body can naturally begin to be comfortable with the amount of creatine you are consuming due to its internal equilibrium. Taking a large amount of creatine over a period of around 4-8 weeks can increase your creatine stores ,however, after this amount of time, it will decrease naturally. This naturally occurs in order to decrease your body’s production of natural creatine or decrease the number of receptors that absorb creatine. Stopping creatine for a short amount of time can ensure that your body can still intake as much as possible, benefiting your performance.
What should you take creatine with?
Many fitness sources will tell you that it does not matter what you ingest with your creatine, ,however, some studies have contradicted this. The graph below is taken from a study by Kreider and colleagues. They found that creatine levels increased when the substance was consumed with carbohydrates, or protein and carbohydrates together, compared to when taken by itself or with a vegetarian diet.
Another study by Steenge et al. backed up these results and recommended that the best combination is combining creatine with around 50g of protein and 47g of carbohydrates as this will increase the amount of creatine that the body retains.
Taking creatine after a workout has been found to be slightly more effective in increasing muscle gains and strength ,however, there is not a significant increase compared to taking it pre-workout. Therefore, it is worth taking it post-workout where possible as part of a carb and protein-filled meal or post-workout shake.
Should liquid creatine products be avoided?
Most creatine is available in a powder that can be dissolved in water, however, there are some liquid versions that are ready to drink. There has been some limited research to measure the effectiveness of these liquid forms, finding that they are less effective than the powders.
Creatine monohydrate powder was found to improve performance by around 10%, while the liquid version of the substance did not show this increase. It is believed that creatine breaks down and becomes less effective when it is added to liquid over a number of days. Therefore, it is best to add the powder to a liquid and consume it right away in order for it to be as effective as possible.
Can creatine cause baldness?
It is unlikely that this is the case. Creatine has been shown to increase a hormone in the body called dihydrotestosterone (DHT), with one study increasing it by around 50%. This hormone has androgenic effects allowing you to maintain muscle mass and increase fertility and sexual health. DHT is ,however, the hormone that has been found to link with inherited male pattern baldness.
There is ,however, limited research to suggest that creatine does increase hairless – studies tend to show that DHT levels even when increased were still within normal levels.
Does caffeine interfere with the effects of creatine monohydrate?
Caffeine is commonly known to increase performance, so taking it alongside creatine should ,in theory, boost the effects. However, this may not be the case as sometimes the different features of the substances can interfere with each other.
A study of 9 subjects found that those who consumed caffeine before lifting weights did not absorb as much creatine, and therefore impacted its effectiveness. This study is not wholly reliable however as it only included a small sample size and has not been backed up by additional research. Two other studies ,however, found that taking caffeine before high intensity interval training and consuming creatine actually improved performance.
Therefore, due to the conflicting studies, there is no definitive answer to this question, however, research is learning more positively in favour of combining the two ingredients. The best way to combine the two ingredients is by taking caffeine pre-workout, and creatine post-workout for the most effective results.
Can I use Creatine while cutting?
Creatine can be used while cutting, or while you are trying to lose weight as it will not cause you to gain any fat or increase your hunger levels. Creatine does ,however, lead to weight gain as it increases intracellular water content and lean muscle mass, but it will not increase fat gain as a few grams will not intake your calorie intake dramatically. If you find that you are putting on fat while consuming creatine, it is more likely to do with the food that you are consuming as your calorie intake is likely too high.
Some people report side effects while on creatine of muscle cramps, tears and strains, leading to muscle pain ,however, studies have shown that there is little evidence to substantiate these claims. It is believed that this may be more likely due to fatigue from exercise.
Wrapping Up
While there are many different types of creatine, scientific research suggests that the best form to use is creatine monohydrate as it is effective at both improving your performance during exercise and increasing the stores in your body. Other types of creatine do not have as much scientific evidence backing up their effectiveness, and more research needs to be done in this area. Another benefit of monohydrate creatine is that it can be commonly sourced and is affordable, making it easier to access.
