What is creatine and why should you take it?

Published: 6 October, 2023 | 13'

Creatine is currently considered the most effective available ergogenic aid to increase capacity in high-intensity exercises during training, as well as lean body mass in athletes. Research over several decades has demonstrated its safety and efficacy, and it is even accepted by the International Olympic Committee.

Even though our body produces creatine, in situations where it is necessary to maximize muscle growth, levels must be elevated, so a diet focused on obtaining more creatine intake and supplements can be useful.

The benefits of creatine go beyond the sports field, as recent studies suggest a potential positive effect on the nervous system. For those interested in its use, creatine monohydrate is an effective and affordable option.

What is creatine monohydrate?

Creatine monohydrate, the most popular and studied form of this supplement, is a chemical compound that combines three amino acids: glycine, arginine, and methionine. This compound helps muscle cells produce adenosine triphosphate (ATP), which is the energy substrate for muscle function. The addition of a water molecule to its chemical structure makes it extremely soluble.

Although creatine is found in some foods such as meat and fish, the amounts of intake required to increase muscle mass must be higher to obtain this benefit. Therefore, it is recommended to have an intake of at least 5 grams per day.

There are several forms of creatine, however, creatine monohydrate has been the most widely studied, demonstrating superiority in terms of absorption and effectiveness, as well as in short-duration exercises, weightlifting, high-intensity exercises, and cycling, among others.

Creatine monohydrate: What is it for?

Creatine monohydrate serves multiple purposes in the sports and physical health field. As mentioned before, creatine participates in the process of producing ATP, which is the "muscular energy currency."

When the muscle is required to perform at a higher level than usual, ATP reserves decrease, as well as the capacity for its production, leading to muscle fatigue. So, what does creatine do? It has two properties: first, it provides a quick source of energy when both intensity and frequency of muscle exercises are elevated, and it also stimulates the process of ATP production.

In addition to improving muscle performance, creatine promotes increased muscle mass, strength, and lean body mass. It is beneficial for improving anaerobic sprint exercise or resistance training, as well as improving the capacity for high-intensity short-term exercise and performing repeated sessions of high-intensity effort.

Benefits of creatine

As we have seen before, the use of creatine can improve performance in sports with repeated high-intensity exercises (e.g., team sports), as well as training programs based on these characteristics (e.g., endurance or interval training), resulting in greater increase in lean mass, muscle strength, and power.

Specifically, the International Olympic Committee and the International Society of Sports Nutrition state that the benefits provided by creatine to sports practice are:

• Greater performance in single and repetitive sprints.
• Increased work performed during series of maximum effort muscle contractions.
• Improved muscle mass and strength adaptations during training.
• Enhanced glycogen synthesis.
• Improved aerobic capacity through increased energy displacement (ATP).
• Increased work capacity.
• Improved recovery.
• Greater training tolerance.

In the same sense, the European Food Safety Authority (EFSA) states that creatine has the following health properties:

• Creatine increases physical performance in successive bursts of short-term, high-intensity exercises. This effect is obtained with a daily intake of 3g of creatine.
• Creatine enhances the effect of resistance training on muscle strength in adults over 55 years old. This effect is obtained with a daily intake of 3g of creatine in combination with resistance training performed at least three times a week for several weeks, at an intensity of 65-75% of one-repetition maximum.

Things you should know about creatine

In addition to the mentioned characteristics and benefits, there are other aspects about creatine that you should know, which we will explain below:

How much creatine should be taken?

According to sports nutrition societies, the protocols for creatine ingestion depend on the amount already stored in the muscle. In omnivorous diets (intake of 1-2g/day of creatine), muscle creatine stores are saturated at 60-80%, while in vegetarian or vegan diets, the amount is considerably lower. Therefore, dietary supplementation of creatine for sports practice will increase muscle creatine content by 10-40%, depending on the diet.

The most commonly used creatine intake protocol is called the "loading" protocol. According to the International Society of Sports Nutrition, the protocol is characterized by an intake of approximately 0.3 grams/kg/day of creatine monohydrate for 5-7 days (generally, 5 grams intake four times a day) and 3-5 grams/day thereafter. This protocol has demonstrated an increase of 10-40% in muscle creatine stores.

Other supplementation protocols suggest eliminating the loading phase and applying cyclic strategies. In protocols without a loading phase, a daily intake of 3g/day for 28 days is used to increase the amount stored in the muscle, and 6g/day for 12 weeks to increase muscle size and strength, with a more gradual increase in creatine, although with a lower ergogenic effect. On the contrary, cyclic protocols do include a loading dose, with creatine intake for 3-5 days every 3 or 4 weeks, and they seem to increase and maintain muscle creatine content before it drops to basal values, which occurs at approximately 4-6 weeks.

Additionally, it has been found that creatine intake with carbohydrates and proteins can increase muscle creatine uptake by stimulating insulin.

When to take creatine?

As we have seen in the previous section, the most common protocol for creatine is a loading phase of 20g/day or 0.3g/kg/day divided into 4 daily doses of 5g each, followed by a maintenance phase of 3-5g/day or 0.03g/kg/day throughout the supplementation period. These intakes are recommended to be taken with meals.

There are other supplementation protocols that are adapted to the characteristics of recreational or elite sports practice. Here are some examples:

• A single daily dose of between 3 and 6g or between 0.03 and 0.1g/kg/day, with ergogenic effects appearing a little slower (between 21 and 28 days).
• For intensified overwork or high-volume endurance, supplementation with creatine 0.3g/kg/day for 4 weeks followed by a 2-week reduction.
• In soccer and american football practices, creatine intake of 15-25g/day for 12 weeks is used, and there are even protocols lasting 21 months where the doses are reduced to 5-10g/day.

Foods that contain creatine

Creatine is produced in our body by the liver, kidneys, and to a lesser extent, the pancreas, in an approximate amount of 1g/day. We can obtain an approximate amount of 1g/day from an omnivorous diet. Animal-based foods contain the highest amount of creatine, ranked from highest to lowest as follows:

• Red meat
• Poultry, fish (herring, salmon, tuna), and dairy products.
• Vegetables, fruits, and cereals contain small amounts of creatine.

At what age is it advisable to take creatine?

Clinical data on the use of creatine recommends its use from 18 years old onwards. Its effective and safe use in adolescents and children is still under investigation, so if creatine is to be consumed by this age group, it should be supervised by a healthcare professional.

Can creatine be taken during pregnancy?

Different studies have established that there are health conditions that may occur during pregnancy that warrant the supplementation of creatine. These situations should be implemented and monitored by a specialist due to the protein load that comes with the additional intake of creatine. If in doubt, consult your healthcare professional.

Side effects of creatine

The International Society of Sports Nutrition on creatine monohydrate states that there is no scientific evidence of side effects or adverse effects when creatine is used properly. It is important to note that various studies have evaluated the safety of creatine through use for more than 3 years in athletes, with no moderate or severe effects observed.

The side effects that have been reported are rare and self-limiting and are related to the gastrointestinal area, such as stomach discomfort, nausea, vomiting, or diarrhea. These symptoms occur due to poor dissolution of creatine in liquids, so it is recommended to increase the volume and dissolve the mixture well.

What should you not mix creatine with?

There are some substances or supplements that can interfere with the absorption or effectiveness of creatine monohydrate and should be avoided when combined with it. These include: caffeine and diuretics, which can reduce water retention in the muscles and decrease the effectiveness of creatine. Creatine can also limit the effectiveness of vitamins A, D, E, and K. Likewise, people with alterations in blood glucose levels and who are taking medications should consult their healthcare professional before taking creatine.

Creatine for athletes

Creatine is one of the most popular nutritional ergogenic aids among athletes. In fact, there is a broad consensus among the International Society of Sports Nutrition (ISSN), the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine confirming that creatine monohydrate is the most effective nutritional ergogenic supplement currently available, as it increases high-intensity exercise capacity and lean body mass during training, benefiting not only athletes involved in numerous sports, but also individuals who exercise regularly for their physical well-being.

This ergogenic capacity of creatine supports strength/power athletes by optimizing training adaptations, those who need to sprint intermittently and recover during competition (e.g., American football, soccer, basketball, tennis, etc.), it can improve exercise performance and endurance training, as well as improve post-exercise recovery and potentially prevent injuries.

Should you take creatine before or after training?

Existing data on the best strategic (timed) intake of creatine are somewhat contradictory due to the heterogeneity of usage protocols, individuals, and training. However, there is consensus that it should be ingested around the time of training and after training, along with meals. Additionally, if creatine is ingested with other compounds such as carbohydrates and proteins, it can enhance muscle mass and performance.

Can you combine creatine with other supplements?

Creatine monohydrate can be combined with other supplements or nutrients to enhance its benefits. Some of these benefits include promoting greater muscle building and stimulating insulin secretion, which increases the uptake of creatine into the muscles. Let's take a look at some of the most common combinations.

Creatine with beta-alanine

In order to maximize muscle mass gains at the upper physiological limit, it is necessary to incorporate components that can maximize power, with the ideal combination being creatine and beta-alanine. Beta-alanine is an amino acid precursor to carnosine (muscle protein), which regulates the accumulation of protons in contracted muscle during exercise (muscle pH) and increases muscle anaerobic lactic capacity.

During exercise, creatine allows for the development of power while providing energy during the first few seconds, which is crucial in maximum strength exercises. If this is prolonged, beta-alanine improves sustained exercise performance because it regulates transient muscle acidosis resulting from the utilization of glucose stored in the muscle, allowing for the maintenance of resistance in strength exercises. Additionally, this system is also relevant in other high-intensity, short-duration moments that are not strength-related, such as sprints.

The combined doses are 3 g of creatine and 1-1.6 g of beta-alanine, which should be ingested just before exercise for at least 10 weeks. It is important to note that sustained-release forms of beta-alanine are the most efficient and produce the fewest side effects, especially paresthesia, which is the sensation of itching and tingling that generally occurs in the arms, chest, and head area and is considered unpleasant and undesirable.

Creatine with proteins

It is known that protein intake increases lean mass gain when consumed during resistance training programs due to an increased supply of building blocks (amino acids), which triggers an increase in muscle protein production and suppression of protein degradation.

During sports practice, creatine increases muscle strength and power, and microtears in muscle tissue (loss of protein integrity) can occur due to effort, leading to the appearance of muscle soreness. Therefore, it is necessary to provide sufficient and adequate protein to stimulate its production and muscle regeneration. This combination has effects on improving body composition in terms of fat mass loss and maintenance of muscle mass combined with a training plan.

Proteins also have a satiating effect that reduces total energy intake and can increase the use of fat as an energy substrate, improve glycemic control, and increase thermogenesis (increase in resting body temperature). The doses used for protein combined with creatine can reach up to 50 g, depending on the type of training and associated intake protocols.

Creatine with glutamine

Glutamine is the most abundant amino acid in plasma and muscles and is involved not only in the production of muscle proteins but also in the balance of fluids, pH regulation, body temperature and heart rate regulation, immune system function, and gastrointestinal tract function. When maximum exercise is performed, the body requires certain physiological adaptations, including increased respiratory, cardiac, and metabolic capacity.

Creatine intake increases maximum muscle capacity, and its combination with glutamine reduces muscle damage and accelerates muscle recovery, repair, and growth, as well as maintaining a regulated vasodilation state and facilitating the cardiovascular changes necessary for physical activity. The doses of glutamine used vary from 1 to 4 g, depending on the protocols followed or the training to be performed.

How long should you rest before taking creatine again?

The use of creatine monohydrate can be structured in different ways to optimize its benefits. The most common form of use is to ingest creatine in a loading phase of 20 g/day or 0.3 g/kg/day divided into 4 daily doses of 5 g each, followed by a maintenance phase of 3-5 g/day or 0.03 g/kg/day throughout the supplementation period. It is important to note that its use is recommended in conjunction with sports practice, whether recreational or elite, or in certain situations involving the maintenance of muscle mass, such as during aging.

Some experts recommend following a "cycling" regimen, where creatine is taken for a specific period, followed by a rest period. For example, you could take creatine for 8 weeks and then rest for 4 weeks. Additionally, there is evidence of continued intake of creatine above 30 g for up to 5 years, with no adverse effects on health.

When do the effects of creatine start to be noticeable?

The effects of creatine monohydrate can start to be noticed after one or two weeks of regular use, although this may vary from person to person. Some people may notice an increase in strength and energy during workouts almost immediately, while others may take several weeks to see noticeable improvements. This can depend on factors such as diet, training regimen, and individual metabolism. It is recommended to continue taking creatine consistently for at least one month to maximize its benefits.

Creatine for the muscular system

Creatine monohydrate has numerous benefits for the muscular system. It not only increases strength and muscle mass but can also accelerate muscle recovery and reduce muscle damage. Additionally, creatine can help prevent muscle fatigue during high-intensity exercise, allowing for more repetitions or lifting heavier weights.

Preventing muscle mass loss in older individuals

Muscle strength remains relatively constant until the fifth decade of life and then begins to decrease at a rate of 1.2-1.5% per year, while muscle mass starts to decrease at a rate of ~0.8% per year. Clinical evidence is showing that creatine supplementation can have a positive effect on muscle aging.

In a recent review³, it was found that low-dose creatine supplementation (0.1 g/kg/day) combined with a protein supplement (0.3 g/kg/day) increased lean tissue mass and upper body strength, while reducing markers of muscle protein degradation and bone resorption in older men (59-77 years old). Another review⁴ reported that 12 months of creatine supplementation (0.1 g/kg/day) during resistance training increased strength and preserved femoral neck bone mineral density and increased its width in postmenopausal women.

Conclusions

• Creatine monohydrate is the most effective nutritional ergogenic supplement currently available for athletes, as it increases high-intensity exercise capacity and lean body mass during training.
• Currently, creatine monohydrate is the most studied and efficient form for use in "sport" type dietary supplements in terms of muscle absorption and the ability to increase high-intensity exercise capacity.
• There are different intake schemes that will depend on the chosen protocol and the type of training to be performed. However, they all indicate that there should be a loading phase to quickly elevate muscle stores.
• Adding beta-alanine, proteins, and glutamine, among others, to a creatine supplement increases muscle absorption of creatine and maximizes performance, metabolism, and muscle structure.
• Creatine supplementation for up to 5 continuous years has been shown to have no adverse effects on the health of individuals. Additionally, research on the therapeutic use of creatine has shown benefits during aging in terms of maintaining muscle mass.

Content written and reviewed by the specialists of MARNYS Scientific Information Area. This article is informative and does not substitute the consultation with a specialist.