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Creatine

Also known as: creatine monohydrate, creatine 2-oxopropanoate, a-methylguanidinoacetic acid, creatinine, cyclocreatine, creatinol O-phosphate

Overview

Creatine is among the most well-studied and effective supplements for improving exercise performance. It does this mainly by increasing energy availability during high-intensity activity. Creatine may also provide cognitive and mental health benefits in some contexts.

Benefits

Creatine works mainly through its effects on energy metabolism. Adenosine triphosphate (ATP) is a molecule that carries energy within cells and is the main fuel source for high-intensity exercise. When cells use ATP for energy, this molecule is converted into adenosine diphosphate (ADP) and adenosine monophosphate (AMP). Creatine exists in cells in the form of creatine phosphate (or phosphocreatine), which donates a high-energy phosphate group to ADP, thus turning this molecule back into ATP. By increasing the overall pool of cellular phosphocreatine, supplementation with creatine can accelerate the recycling of ADP into ATP, thereby quickly replenishing cellular energy stores. This increased availability of energy can promote improvements in strength and power output. The pro-energetic properties of creatine don’t just affect skeletal muscle, but nearly all body systems, including the central nervous system (which comprises the brain and spinal cord).

How it works

The primary benefit of creatine is an improvement in strength and power output during resistance exercise. Creatine is well-researched for this purpose, and its effects are quite notable for a supplement, both in the general population, and specifically in older adults. When used in conjunction with resistance exercise, creatine may modestly increase lean mass. In trained athletes, creatine has been reported to reduce body fat and improve some measures of anaerobic exercise performance, strength, and power output. Creatine has also been tested for effects on anaerobic running capacity in many studies, the results of which are rather mixed but generally suggest a small improvement in performance. Although creatine has been researched far less for cognitive performance and mental health than for physical performance, it may have benefits in some contexts. Creatine appears to reduce mental fatigue in some scenarios, particularly highly stressful ones involving sleep deprivation or exercise to exhaustion. Creatine may also improve some aspects of memory, particularly for people with below-average creatine levels, such as vegetarians and older adults. There is also some preliminary evidence to suggest that creatine may reduce symptoms of depression in individuals with major depressive disorder or bipolar disorder. That said, more research is needed in these areas and on other cognitive measures before creatine can be said to be effective for cognitive performance or mental health.

Side effects

There are many different forms of creatine available on the market, but creatine monohydrate is the most extensively researched and tends to be the cheapest form. Another option is micronized creatine monohydrate, which dissolves more easily in water. In most studies, supplementation involved an initial loading protocol of around 0.3 grams per kilogram of bodyweight per day (typically divided into four equal doses throughout the day) for 5–7 days followed by a daily maintenance dose of at least 0.03 g/kg of bodyweight. For a 180 lb (82 kg) person, this translates to a loading dose of 25 g/day and a maintenance dose of at least 2.5 g/day. The “alternative” to creatine loading involves simply taking a smaller dose (usually 3–5 g) of creatine every day.

Dosage

Supplementation with creatine typically results in weight gain, partly due to an increase in total body water. The range of weight gain after a creatine loading phase tends to fall between 0.9 and 1.8 kg (1.98–3.96 lbs). This may be of particular concern to individuals competing in weight-sensitive sports. Diarrhea can occur when too much creatine is taken at one time, in which case the doses should be spread out throughout the day and taken with meals. Supplementation with creatine has been reported to negatively affect aerobic capacity to a small degree. It has been speculated that this potential detrimental effect may be related to increases in total body water and body weight following supplementation with creatine.

FAQs

What is creatine?

Creatine (which comes from the Greek word “kreas”, meaning “meat”) is a molecule that is produced in the body from the amino acids arginine, glycine, and methionine. It's primarily made in the liver and (to a lesser extent) in the kidneys and pancreas. Creatine stores high-energy phosphate groups in the form of phosphocreatine. These phosphate groups are donated to ADP to regenerate it to ATP, the primary energy carrier in the body. Creatine’s role in energy production is particularly relevant under conditions of high energy demand, such as intense physical or mental activity.

Do I need to load creatine?

Creatine loading involves taking a larger amount of creatine for the first few days of supplementation (usually around 0.3 grams per kilogram of bodyweight per day for 5–7 days) before reducing the daily dose to “maintenance” levels (at least 0.03 g/kg of bodyweight). The “alternative” to creatine loading involves simply taking a smaller dose (usually 3–5 g) of creatine every day.

What is the best form of creatine?

Several forms of creatine (other than creatine monohydrate) have been investigated, including creatine hydrochloride (creatine HCl), creatine citrate, creatine malate, “buffered” creatine (Kre-Alkalyn), and creatine ethyl ester. However, creatine monohydrate has the most scientific evidence behind it to support its efficacy and safety, and appears to be the cheapest form of creatine to purchase. For these reasons, creatine monohydrate is currently the best form of creatine.

Does caffeine counteract creatine’s ergogenic effects?

Supplementation with either creatine or caffeine has consistently been shown to enhance exercise performance in most people, with these improvements thought to occur through separate physiological mechanisms. However, some evidence suggests that caffeine may blunt the performance-enhancing effect of creatine.

How much creatine do I need?

Approximately 14.6 mmol of creatinine (creatine’s urinary metabolite) is lost on a daily basis in the average 70 kg healthy young man who has a creatine storage capacity of around 120 g. This represents a daily creatine loss rate of 1.6%–1.7% (around 2 g), and is the amount of creatine that has to be obtained from the diet or in supplemental form on a daily basis in order to maintain sufficient creatine levels.

Do vegetarians get less creatine from their diet?

In short, yes. This is because vegetarian diets lack the main dietary source of creatine — meat. With this in mind, and considering that around half of the daily need for creatine is obtained from the diet in omnivores, it’s no surprise that the muscle creatine content of individuals eating a vegetarian diet tends to be lower compared to individuals eating an omnivorous diet. Supplementation with creatine appears to close this gap.

What are the main creatine formulations and variants?

Creatine monohydrate is the most common form of creatine, and, unless otherwise stated, the default form of creatine used in most studies. It has high intestinal absorption, with bioavailability of approximately 99% at standard doses of 5–10 g.

What happens when you stop taking creatine?

When you stop taking creatine, your serum levels of creatine will start to drop, returning to baseline levels after around four weeks. This length of time may vary slightly between individuals.

Does creatine timing relative to exercise matter?

The timing of supplementation with creatine for improving training adaptations has only been investigated in a small number of trials. One 10-week trial looked at the effect of supplementation with creatine together with protein and carbohydrates both before and after resistance training compared to the same supplement taken in the morning and evening. The researchers found that taking the supplement in close proximity to the workout increased lean mass, strength, and intramuscular creatine and glycogen stores more than taking the supplement further away from the workout.