Creatine is one of the most popular supplements in the fitness and bodybuilding community. But, what is creatine and how does it work?
It increases the capacity and production of ATP, the body's primary energy source.
This article explains all there is to know about creatine.
Table of Contents:
The studies done on creatine show that this supplement can increase strength, muscle mass and can also improve exercise performance, such as endurance and power. (1)
It is also the worlds most studied supplement and has an excellent safety record. (2)
A review conducted of the most popular supplements came to the conclusion that creatine was the most beneficial dietary supplement.
Further Reading: Top 3 Best Bodybuilding Supplements
What Is Creatine?
Creatine is a compound that is actually found naturally within cells in your body.
It is found in higher concentrations in your muscle cells - around 95% of creatine is found in your muscles and the other 5% is found in the brain, liver and kidneys. (3)
It is actually very similar to amino acids, your body can also produce creatine from the amino acids; glycine and arginine.
Taking this supplement is very popular among fitness enthusiasts, bodybuilders and other athletes.
When you supplement with creatine, your bodily stores of phosphocreatine will increase.
Phosphocreatine is a form of stored energy which helps create your body's main energy source, called ATP.
When your body has more ATP, you can perform better.
Your bodies natural production of creatine is influenced by various factors, including: (3)
Dietary meat intake.
Level of exercise.
Amount of muscle mass.
Levels of hormones like testosterone & IGF-1.
There are several other processes that happen while taking creatine, which can also lead to increased muscle mass and strength.
Further Reading: Is Beta-Alanine the Best Pre Workout Supplement?
How Does Creatine Work?
Creatine has many effects in the body.
In high intensity exercise, creatine's main role in improving exercise performance is to increase phosphocreatine stores.
These additional phosphocreatine stores can be used to produce more energy in the form of ATP, which is the primary energy used in high intensity and high resistance exercises.
Creatine also helps you gain muscle by:
Below is a breakdown of each of these mechanisms.
Increases Workload
Creatine allows for increased overall effort and total volume during training sessions, which aids in the promotion of long-lasting muscular development. (4)
Increases Anabolic Hormones
It has also been shown that creatine may raise the levels of some anabolic hormones, such as IGF-1, in the body. (5)
Improves Cell Signalling
With the addition of creatine, the signalling of satellite cells is enhanced, which is important for both muscle development and repair in the body. (6)
Increases Cellular Hydration
Creatine will increase the amount of water contained inside the cells of the muscles, a process known as cellular volumization (this also an effect seen with the muscle pump, click here to learn more).
It is also thought to have a hypertrophic impact (making the muscles larger). (7)
Reduces Myostatin
The supplementation of creatine has been shown to lower myostatin levels in the body. (8)
Myostatin is a catabolic hormone, which means that it may cause muscle tissue to break down or restrict muscular development.
Reduces Protein Breakdown
Creatine may also help you build muscle by decreasing the amount of muscle protein breakdown that occurs. (9)
Muscle protein synthesis and muscle protein breakdown are in a constant state of balance, reducing protein breakdown increases the total protein synthesis rate.
Summary
There are other effects, such as an increase in phosphocreatine levels within the brain.
This can improve brain health and may even help prevent neurological disease. (10)
In summary; creatine can help provide the body and muscles with increased energy and also improve energy production.
Further Reading: How Much Water to Drink With Creatine
Top 3 Benefits of Creatine
Creatine has a fairly large list of benefits.
Below is a list of the top three benefits of creatine.
1) Increased Strength & Performance
Creatine has also been shown to significantly improve strength and exercise performance.
In fact, one study has shown that adding creatine to a resistance training program improved strength by around 8%, weightlifting performance by around 14% and increased bench press one-rep max by up to 43%. (11)
This supplement can help to maintain strength and exercise performance while also increasing muscle mass during over-training.
In another study; 28 days of supplementing creatine increased bike-sprinting performance in well-trained athletes by 15% and improved bench-press performance by 6%. (12)
These improvements in strength and performance are mainly caused by your body’s increased capacity to produce energy, called ATP.
ATP usually becomes depleted after around 8-10 seconds of high intensity exercise - because creatine helps you produce and store more energy, you can increase this capacity by a few seconds.
Further Reading: Creatine Increases Strength & Performance
2) Increased Muscle Mass
Creatine has shown to be useful in increasing long-term, as well as short-term, muscle growth. It has also been chosen as the number one most beneficial dietary supplement. (13, 14)
In one 14-week study done on older adults found that adding creatine to a resistance training program significantly increased muscle mass and leg strength. (15)
In another 12-week study examining already trained individuals, creatine was able to increase muscle fibre growth over 2x more than training without supplementation. (16)
In these studies; taking creatine led to increased fat-free mass, physical performance and enhanced muscle morphology in response to resistance training, possibly mediated by higher quality training sessions.
In conclusion; creatine is able to enhance muscle growth, strength and performance in trained and untrained individuals.
Further Reading: Creatine Increases Muscle Growth
3) Improved Brain Health
Creatine may also be of help in those with neurological disease, it may ease symptoms and slow the progression, although more research is needed to conclude anything.
Like muscle tissue, your brain also stores phosphocreatine and needs ATP for optimal functioning.
Even though there may be potential benefits of creatine for treating or preventing neurological disease, most of the research so far has been performed with animals.
Parkinson’s Disease
Alzheimer’s Disease
Huntington’s Disease
Epilepsy
Brain/Spinal Cord Injuries
Motor Neuron Disease
Ischemic Stroke
Cognitive Decline
Despite the fact most research is with animals, there still has been human research conducted.
A six-month study on children who experienced traumatic brain injury have observed a 70% reduction in fatigue and a 50% reduction in dizziness with creatine supplementation. (20)
Human research suggests that it can also aid the elderly and those at risk of neurological diseases. (21)
Another interesting fact is vegetarians actually have less phosphocreatine stores due to less, or no meat intake and therefore respond very well to creatine supplementation. (22)
Further Reading: Creatine Improves Brain Health
Other Benefits
Creatine may have many other benefits too. Although more research is needed, there is preliminary research that suggests creatine may be able to help with the following.
Help in treating non-alcoholic fatty liver disease.
Help improve general brain function.
Help lower blood sugar levels and fight diabetes.
Help in reducing tiredness and fatigue.
Help in improving quality of life and muscle function in older people.
Further Reading: Creatine's Benefits
Side Effects
Creatine has an excellent safety profile. It is one of the most well researched dietary supplements.
Although there aren't many adverse effects, some anecdotal reports include the following.
Stomach discomfort
Does Creatine Cause Dehydration & Cramps?
Some people claim that creatine can cause dehydration and cramps, however, research on this matter is very much mixed.
Some studies suggest that it can actually reduce the incidence of cramps and dehydration during high intensity endurance exercise in high temperatures. (23)
However, others suggest it can increase the risk of dehydration. You can read more about creatine and dehydration on this article.
Does Creatine Cause Baldness?
Another claim is that creatine can cause baldness, this is mostly based on anecdotal reports - however, a small study in 2009 did find around a 40% increase in DHT levels following supplementation. (24)
DHT is a hormone responsible for promoting baldness - therefore it is theoretically possible that creatine could promote the rate of hair loss.
However, this is not proven.
Further Reading: Does Creatine Cause Baldness?
Other Side Effects
However, studies lasting up to 4 years on the long-term safety of creatine have found no adverse effects. (25)
There is also no evidence that it can harm the liver or kidneys in healthy people who take normal doses. (26)
However, those with pre-existing liver or kidney issues should consult a qualified doctor before supplementing with creatine, or avoid supplementing with it altogether.
One of the most comprehensive studies conducted on creatine measured 52 different blood markers and observed no negative effects following 21 months of supplementation.
Overall, creatine seems to be extremely safe, well researched and has essentially no proven adverse effects.
Further Reading: Creatine's Side Effects
Types of Creatine
There are multiple types of creatine, the most common listed below.
1) Creatine Monohydrate
Creatine monohydrate is the most common, cheapest and most widely available form of creatine.
It is the form used with most research and studies.
This means that most of creatine’s beneficial effects, such as; improved strength, muscle gain and endurance, have been seen almost exclusively when the monohydrate form was used.
Creatine monohydrate is made up of a creatine molecule and a water molecule, it can also be processed in a few ways. Such as when the water molecule is removed, resulting in another type called creatine anhydrous.
The removal of this water molecule increases the amount of creatine in each dose - the anhydrous type is 100% creatine by weight, whereas monohydrate is around 90% creatine by weight.
It can also be micronized or mechanically processed in order to improve water solubility.
In theory, better water solubility could improve your body’s ability to absorb it - however, this isn't proven.
2) Creatine Ethyl Ester
Creatine ethyl ester is another common type of creatine.
Manufacturers often claim that the ethyl ester form is better than the other forms of creatine. Some evidence indicates it may be better absorbed than creatine monohydrate in the body. (27)
Due to differences in muscle uptake rates, some believe that the ethyl ester form could outperform creatine monohydrate.
However, one study directly comparing the two types of creatine found that it was worse at increasing phosphocreatine content in the blood and in the muscles. (28)
Because of this, using creatine ethyl ester is not recommended.
3) Creatine Hydrochloride
Creatine hydrochloride is another type of creatine that has gained popularity with some manufacturers and users.
It's thought to have superior water solubility - because of its superior solubility in water, it’s speculated that a lower dose can be used.
However, this is only theory until it's proven.
One study found that creatine hydrochloride was 38 times more soluble than the monohydrate form. (29)
However, there are no published studies on creatine hydrochloride usage in humans.
Given the large amount of studies supporting the effectiveness of creatine monohydrate, the hydrochloride form can’t be recommended until more data is published.
Further Reading: Types of Creatine
Dosage
Most people who use creatine go on a process called "loading" and "maintenance", or some just take the same amount each day.
Absorption may be also improved slightly by taking creatine alongside a carb or protein based meal due to the release of insulin. (30)
Both ways are fine and safe, however, to get the quickest increase in phosphocreatine stores, loading is the better option.
To load with creatine, take 15-20 grams creatine per day for 5-7 days. This should be split into three or four 5 gram servings per day.
After this loading period, take 3-5 grams per day to maintain these higher levels of phosphocreatine within your muscles. There is no benefit to cycling creatine, so stay on this dosage for as long as you want.
If you choose not to do the loading phase, you can simply take 3-5 grams per day.
However, it may take 3-4 weeks to maximize your phosphocreatine stores.
Since creatine has a volumizing effect and pulls water into your muscle cells, it is advised to take it with a larger glass of water and keep well hydrated throughout the day.
Summary
Creatine is one of the safest, most well researched and beneficial dietary supplements you can take.
Supplementation can support quality of life in older adults, improves brain health and increases endurance, strength and muscle growth.
The most recommended type of creatine is creatine monohydrate, it is the most researched and has proven benefits.
Older people, vegetarians and those with busy lives may find it useful to supplement with creatine.
More Information
Below is more technical information about creatine, such as other names, functions and roles, synergies, etc.
Other Names: Creatine monohydrate, creatine 2-oxopropanoate, a-methylguanidinoacetic acid
Primary Role: Exercise performance, muscle gain
Other Roles: Anti-aging and longevity, cognitive function and brain health
Synergies: Carbohydrates, Caffeine, Beta-alanine, Alpha-Lipoic Acid, Leucine (due to mTOR activation), HMB (metabolite of leucine)
Confused With: Creatinine, Cyclocreatine, Creatinol O-phosphate
Things to Note
Anecdotal reports of a mild but significant stimulatory impact on alertness have surfaced, however this may be a placebo effect.
Anecdotal complaints of restlessness have been reported when creatine is taken less than an hour before bedtime.
Water retention might reach around 5 pounds when greater loading dosages are used (more than two kilograms). Water retention may be reduced with lower dosages.
While water mass is not the same as muscle mass (both are lean mass), long-term creatine administration promotes muscle development.
Written by Billy White
Billy White is a qualified Kinesiologist and Personal Trainer. He is an aspiring bodybuilder, fitness enthusiast, and health and fitness researcher.
He has multiple years of experience within the fitness, bodybuilding and health space. He is committed to providing the highest-quality information.
References
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This evidence-based overview of creatine features 30 references, listed below.
1. Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr. (2012, Jul 20) ✔
2. Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. (2007, Aug 30) ✔
3. Persky AM, Brazeau GA. Clinical pharmacology of the dietary supplement creatine monohydrate. Pharmacol Rev. (2001, Jun) (Review) ✔
4. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc. (2000, Mar) (Clinical Trial) ✔
5. Deldicque L, Louis M, Theisen D, Nielens H, Dehoux M, Thissen JP, Rennie MJ, Francaux M. Increased IGF mRNA in human skeletal muscle after creatine supplementation. Med Sci Sports Exerc. (2005, May) (Clinical Trial) ✔
6. Dangott B, Schultz E, Mozdziak PE. Dietary creatine monohydrate supplementation increases satellite cell mitotic activity during compensatory hypertrophy. Int J Sports Med. (2000, Jan) ✔
7. Häussinger D, Roth E, Lang F, Gerok W. Cellular hydration state: an important determinant of protein catabolism in health and disease. Lancet. (1993, May 22) ✔
8. Saremi A, Gharakhanloo R, Sharghi S, Gharaati MR, Larijani B, Omidfar K. Effects of oral creatine and resistance training on serum myostatin and GASP-1. Mol Cell Endocrinol. (2010, Apr 12) (Randomised Controlled Trial) ✔
9. Parise G, Mihic S, MacLennan D, Yarasheski KE, Tarnopolsky MA. Effects of acute creatine monohydrate supplementation on leucine kinetics and mixed-muscle protein synthesis. J Appl Physiol (1985). (2001, Sep) (Clinical Trial) ✔
10. Matthews RT, Ferrante RJ, Klivenyi P, Yang L, Klein AM, Mueller G, Kaddurah-Daouk R, Beal MF. Creatine and cyclocreatine attenuate MPTP neurotoxicity. Exp Neurol. (1999, May) ✔
11. Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res. (2003, Nov) (Review) ✔
12. Earnest CP, Snell PG, Rodriguez R, Almada AL, Mitchell TL. The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol Scand. (1995, Feb) (Clinical Trial) ✔
13. Nissen SL, Sharp RL. Effect of dietary supplements on lean mass and strength gains with resistance exercise: a meta-analysis. J Appl Physiol (1985). (2003, Feb) (Meta-Analysis) ✔
14. Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. (2007, Aug 30) ✔
15. Brose A, Parise G, Tarnopolsky MA. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. J Gerontol A Biol Sci Med Sci. (2003, Jan) (Clinical Trial) ✔
16. Volek JS, Duncan ND, Mazzetti SA, Staron RS, Putukian M, Gómez AL, Pearson DR, Fink WJ, Kraemer WJ. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc. (1999, Aug) (Clinical Trial) ✔
17. Matthews RT, Ferrante RJ, Klivenyi P, Yang L, Klein AM, Mueller G, Kaddurah-Daouk R, Beal MF. Creatine and cyclocreatine attenuate MPTP neurotoxicity. Exp Neurol. (1999, May) ✔
18. Kaemmerer WF, Rodrigues CM, Steer CJ, Low WC. Creatine-supplemented diet extends Purkinje cell survival in spinocerebellar ataxia type 1 transgenic mice but does not prevent the ataxic phenotype. Neuroscience. (2001) ✔
19. Bürklen TS, Schlattner U, Homayouni R, Gough K, Rak M, Szeghalmi A, Wallimann T. The creatine kinase/creatine connection to Alzheimer's disease: CK-inactivation, APP-CK complexes and focal creatine deposits. J Biomed Biotechnol. (2006) ✔
20. Sakellaris G, Nasis G, Kotsiou M, Tamiolaki M, Charissis G, Evangeliou A. Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatr. (2008, Jan) (Randomised Controlled Trial) ✔
21. McMorris T, Mielcarz G, Harris RC, Swain JP, Howard A. Creatine supplementation and cognitive performance in elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. (2007, Sep) (Clinical Trial) ✔
22. Alti Arnarson. 7 Nutrients That You Can’t Get from Plants. Nutrition. (2021, Jun 9) ✔
23. Greenwood M, Kreider RB, Melton C, Rasmussen C, Lancaster S, Cantler E, Milnor P, Almada A. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. (2003, Feb) ✔
24. van der Merwe J, Brooks NE, Myburgh KH. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clin J Sport Med. (2009, Sep) (Randomised Controlled Trial) ✔
25. 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, Feb) ✔
26. Mayhew DL, Mayhew JL, Ware JS. Effects of long-term creatine supplementation on liver and kidney functions in American college football players. Int J Sport Nutr Exerc Metab. (2002, Dec) ✔
27. Gufford BT, Ezell EL, Robinson DH, Miller DW, Miller NJ, Gu X, Vennerstrom JL. pH-dependent stability of creatine ethyl ester: relevance to oral absorption. J Diet Suppl. (2013) ✔
28. Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DS. The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. J Int Soc Sports Nutr. (2009, Feb 19) ✔
29. Gufford BT, Sriraghavan K, Miller NJ, Miller DW, Gu X, Vennerstrom JL, Robinson DH. Physicochemical characterization of creatine N-methylguanidinium salts. J Diet Suppl. (2010, Sep) (Comparative Study) ✔
30. Green AL, Simpson EJ, Littlewood JJ, Macdonald IA, Greenhaff PL. Carbohydrate ingestion augments creatine retention during creatine feeding in humans. Acta Physiol Scand. (1996) ✔
✔ Citations with a tick indicate the information is from a trusted source.
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