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Creatine – The muscle and brain supplement

Creatine supplemental nutrition benefits

Back in college, my roommate was obsessed with getting ripped. He spent hours in the gym, religiously mixed his protein shakes, and talked endlessly about “gains.” One of the staples of his routine was creatine. He swore by it. He said it helped him push harder, lift more, and recover faster. I listened politely, but frankly, I tuned most of it out.

Creatine, in my mind, was for serious weightlifters, not for someone like me, who enjoyed playing tennis and going on long walks. Years later, I found myself struggling to maintain my energy levels. I started to wonder if maybe my old roommate was right about creatine.

What is Creatine and how to use it

Creatine supplementation is a safe and smart choice for people looking to improve athletic performance and build or retain muscle mass and strength. Although many people associate creatine with strength and power athletes, it also benefits endurance athletes and people who face age-related muscle mass and strength declines.

Creatine monohydrate is one of the safest and most researched substances available.

What is Creatine

Creatine is a chemical found naturally in the body. It’s also in red meat and seafood. It is often used to improve exercise performance and muscle mass.

Creatine is involved in making energy for muscles, and about 95% of it is found in skeletal muscle. The majority of sports supplements in the US contain creatine. People who have lower creatine levels when they start taking creatine seem to get more benefits than people who start with higher levels.

People commonly use creatine to improve exercise performance and increase muscle mass. It is also used for muscle cramps, fatigue, multiple sclerosis (MS), depression, and many other conditions, but there is no good scientific evidence to support most of these uses.

Sources of Creatine

Creatine is an amino acid we naturally produce in our bodies, and we can eat it in meat, fish, and poultry. Omnivorous athletes struggle to saturate muscles with creatine through dietary sources, and supplementation can increase muscle stores by about 20%. Vegan and vegetarian athletes face even greater challenges and often have lower levels of creatine in their muscles. All athletes can increase creatine stores with supplementation, and it may be even more important for vegans and vegetarians (many supplements are vegan-friendly).

Benefits of Creatine

The benefits of creatine extend far beyond just bigger muscles. Studies show it can also give a slight edge in rowing, jumping, and soccer. And for those of us getting older, creatine, paired with exercise, is a powerful weapon against age-related muscle loss. Creatine also helps your muscles store more glycogen, which is key for endurance, and it can even improve your body’s ability to handle intense workouts by reducing lactate production.

  • Athletic performance: Taking creatine by mouth somewhat improves rowing, jumping, and soccer performance. Whether it helps with sprinting, cycling, swimming, or tennis is unclear.
  • Increased muscle strength: By increasing muscle stores of creatine phosphate and free creatine, supplementation increases the capacity of your muscles’ ATP CP system for short, high-intensity efforts. This increases muscular force during workouts, leading to more muscle strength and power gains.
  • Age-related muscle loss (sarcopenia): Taking creatine orally for up to 12 weeks improves muscle strength in older adults. It seems to work best when used along with exercise to build muscles.
  • Enhanced glycogen storage: Multiple recent studies have shown increases in the rate of muscle glycogen replenishment when creatine monohydrate was eaten with carbohydrates. These findings suggest creatine supplementation can improve sport-specific performance in events where repeated surges and accelerations factor into the outcome.
  • Enhanced buffering capacity: During exercise, you use all mechanisms to provide energy, and elevated muscle stores of creatine phosphate means the ATP CP system can contribute more energy to that total. This may reduce the reliance on the glycolytic system, reducing lactate production during high-intensity efforts.

Creatine supplementation and cognition

Recent evidence suggests that creatine supplementation may positively affect cognition.

The brain uses a lot of energy, and as with muscles, the contribution from ATP CP increases during periods of high demand. Research shows creatine monohydrate supplementation increases levels of creatine in the brain. A 2019 review study from Dolan and colleagues said, “The effects of creatine supplementation on brain function appear to be larger under stressful conditions that lead to acute (e.g. mental fatigue, exhaustive exercise) or chronic (e.g. ageing, depression, posttraumatic stress disorder) depletion of brain creatine, whereas no or minimal effect is shown in a healthy individual under unstressed conditions.” (Dolan et al., 2019)

How to dosage Creatine

Creatine is found in foods such as meat and seafood. Creatine is also found in many different types of sports supplements. In supplements, adults have most often used creatine in a one-time loading dose of up to 20 grams by mouth daily for up to 7 days, followed by a maintenance dose of 2.25 to 10 grams daily for up to 16 weeks. Speak with a healthcare provider to determine what product and dose might be best for a specific condition.

Here are some of the best practices pulled from the cited research:
  • Loading dose + maintenance dose: Eat 20 grams/day for 5 days, divided into 5 gram doses throughout the day. This quickly increases muscle creatine levels. Continue with 3 to 5 grams/day to keep muscle creatine elevated.
  • Steady dose: Start and stick with 3 to 5 grams/day. It will just take a few weeks to achieve the same levels as the ‘loading + maintenance’ method.
  • Dosage for ageing athletes: Aiming for the upper end of the 3 to 5 g/day range may be beneficial. Overloading on creatine monohydrate is pointless because once muscles are saturated, more doesn’t help.
  • Eat carbohydrates with creatine: Co-ingestion increases creatine retention by about 25%. This increases the saturation rate but may not be additive in improving performance further.

Creatine can be taken long-term, but constant use may not be necessary. Research indicates that using up to 10 grams/day for 5 years is generally safe but probably unnecessary. We’d recommend supplementing appropriately (3 to 5 g/day for most, perhaps 5 to 7g/day for older athletes) for a few months during higher training load and competition periods. Consider taking a break from it during recovery or low-intensity aerobic training.

No dosage information is known for brain health: The protocols above are well established and safe, but it’s unknown if there are specific dosages that would be best for preserving brain function or recovering from a concussion.

Side effects

While side effects are generally mild and rare, staying well hydrated and starting with a lower dose can help minimize any potential stomach discomfort or cramping.

  • When taken by mouth: Creatine is likely safe for most people. Doses up to 25 grams daily for up to 14 days have been safely used. Lower doses up2 to 4 to 5 grams daily for up to 18 months have also been safely used. Creatine is possibly safe when taken long-term. Doses up to 10 grams daily for up to 5 years have been safely used. Side effects might include dehydration, upset stomach, and muscle cramps.
  • When applied to the skin: There isn’t enough reliable information to know if creatine is safe. It might cause side effects such as redness and itching.

Precautions and warnings

While creatine has an excellent safety profile and has been studied, there are specific situations where extra caution is warranted. Whether you’re an athlete, pregnant, or have underlying health conditions, here’s what you need to know about using creatine responsibly.

  • When taken by mouth: Creatine is likely safe for most people. Doses up to 25 grams daily for up to 14 days have been safely used. Lower doses up3 to 4 to 5 grams daily for up to 18 months have also been safely used. Creatine is possibly safe when taken long-term. Doses up to 10 grams daily for up to 5 years have been safely used. Side effects might include dehydration, upset stomach, and muscle cramps.
  • When applied to the skin: There isn’t enough reliable information to know if creatine is safe. It might cause side effects such as redness and itching.
  • Pregnancy and breastfeeding: There isn’t enough reliable information to know if creatine is safe to use when pregnant or breastfeeding. Stay on the safe side and avoid use.
  • Children: Creatine is possibly safe when taken by mouth, short term. Creatine 3 to 5 grams daily for 2 to 6 months has been taken safely in children 5 to 18 years of age. Creatine 2 grams daily for 6 months has been taken safely in children 2 to 5 years of age. Creatine 0.1 to 0.4 grams/kg daily for up to 6 months has been taken safely in infants and children.
  • Bipolar disorder: Creatine might make mania worse in people with bipolar disorder.

References

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