Creatine: the comprehensive guide

Should you be taking creatine to help build muscle mass? Read our comprehensive, expert guide to find out

There are so many supplements available – all promising amazing health and muscle-building benefits – that it can be hard to decide what ones you should be taking, if any. Creatine is a popular bodybuilding supplement that’s been used for years to enhance muscle growth and ensure maximum gym gains are made. But what is creatine, what does it do, should you take it, and if so, how should you take it and how much should you have?

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What is it?

Creatine is a nitrogenous organic acid made naturally in the body, but it can also be found in meat and fish or taken in higher doses as a supplement. It’s available on its own, but you’ll also sometimes see it in meal-replacement shakes and other supplements.

‘Creatine is an energy-providing molecule that is remarkably well researched, especially in light of the relatively small number of studies conducted on other highly-touted supplements. And not only have research findings consistently backed up creatine’s efficacy, but new benefits pop up each year,’ says Kamal Patel, director of examine.com, an independent organisation that investigates the science behind supplementation and nutrition.

‘Structure-wise, creatine is bound to phosphate in muscles in the form of creatine phosphate. The creatine molecule is made by your body, and has three amino acids in it: arginine, glycine, and methionine. About a gram is produced by the body, and if you eat animal products you typically get another gram or so through diet.’

What does it do?

Put simply, creatine is like a back-up generator for your body. Normally, energy in your body is produced, stored, and used via a chemical called adenosine triphosphate (ATP). ‘But there are times when your body can’t keep up with energy demand,’ says doctor and weightlifting expert Nikhil Rao, ‘and it needs another source of phosphates. That’s where creatine comes in.’

Ideally, creatine is at its most efficient during brief periods of all-out effort with short recovery phases. ‘Creatine supplements also help promote protein manufacture and reduce protein breakdown following intense exercise,’ says nutrition expert Anita Bean.

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Who should take it?

People who train with weights or play sports involving repeated high-intensity movements – such as sprints, jumps or throws – are likely to see benefits. ‘There is less evidence to show that creatine supplementation is beneficial to endurance athletes,’ says Bean. It’s no surprise, then, that it’s popular among bodybuilders due to its ability to increase muscle hypertrophy by drawing water into muscle cells.

‘A wide range of people can benefit from taking creatine, from the hugest of the huge to your grandparents (not that your grandparents can’t be huge). The most basic benefit of supplementation is the ability to pump out a few more reps at the gym, or tire a bit later when doing everyday activities that are more on the intense side. That could mean something as basic as climbing stairs, for someone who is weaker or who has health issues,’ says Patel.

‘Any activity that lasts between around ten seconds and two minutes could benefit from creatine supplementation. This is the range of time in which your muscle cells use creatine phosphate to regenerate ATP, and ATP production can be the step that limits how long you can do certain activities. While there are other ways in which creatine can boost activity (such as preventing acid build-up in muscles), energy generation is the bread and butter of how creatine helps with muscle.

How much should I take?

‘An average person takes in 1g of creatine per day from food and produces another 1g from amino acids, ending up with creatine stores that are about 40% below their maximum,’ says Rao. ‘The best way to fill up seems to be with doses of around 3g a day. If you’re taking any more than 5g you’ll just excrete it.’

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When should I take it?

When using creatine, timing is key. ‘Avoid creatine before you work out,’ says Rao. ‘It’s hygroscopic, which basically means it acts like a sponge – it can draw water into your gastrointestinal tract and bloodstream from surrounding tissues or muscles. That’s what can give you a bloated feeling or muscle cramps. The ideal time to take creatine is immediately after your workout.’

How can I maximise the effects of creatine?

Creatine absorption can be improved by taking it with simple carbohydrates, such as maltodextrin or dextrose (glucose). Carbohydrates raise blood sugar levels, which increases the production of insulin. The improved uptake of creatine into the muscles is attributed to the stimulation of creatine transporters as a side effect of your body’s insulin production. Exercise, however, makes it easier for your body to absorb and use creatine. This is down to the increased movement of the creatine transporters to the muscle cell membrane.

Is it safe?

Yes. With over 2,000 research studies assessing its affect on the human body, creatine has been thoroughly evaluated in long-term clinical safety studies – it’s perhaps the most comprehensively researched supplement there is. The results of these safety studies on long-term use have consistently shown that those who use creatine suffer less injury, dehydration, cramping, heat-related disorders and gastrointestinal disturbance in comparison with athletes who don’t. Additionally, athletes who take creatine over a long period don’t have any of the side effects suggested to have been linked with protein, including significantly higher muscle and liver enzymes, altered electrolytes and increased renal stress.

Does it have any side effects?

The main side effect is weight gain, partly due to increased muscle tissue and partly the result of extra water in your muscle cells, so it’s not always ideal if you’re in a sport that uses weight categories like boxing. ‘There have been anecdotal reports about gastrointestinal discomfort, dehydration, muscle injury and kidney damage,’ says Bean. ‘However, there is no clinical evidence to support these statements.’

‘It’s also important to mix your creatine fully,’ adds Rao. ‘Most of us, myself included, drink our creatine with some of the powder still visibly floating around. At this point, it hasn’t fully dissolved and that means it’s going to suck water from the places where water is supposed to be. Mix it with enough water to saturate the “sponge”, and you’ll be fine.’

Does it work for everyone?

If you don’t notice any results from using creatine it may be because your body is able to produce enough of the stuff to keep its levels at an adequate level, or because your body finds it hard to absorb it as a supplement. In this instance, it’s recommended you combine creatine with simple sugars because they cause a peak in insulin and help drive creatine into the muscles. In fact, studies among non-responders have shown that the addition of sugars can increase your body’s creatine uptake by 60%.

Can I get it naturally from my diet?

You don’t have to rely on creatine supplements to hit your daily target and if you struggle to ingest it directly slight adjustments to your diet can boost levels naturally. Creatine levels are naturally high in raw meat and fish. In each kg of raw beef you’ll find 4.5g of creatine, for example. Raw pork contains 5g per kg and fish, in addition to being a rich source of heart healthy omega-3s, has an abundance of creatine in its muscle tissue. Herring is one of the richest sources, with 6.5 to 10g per kg, while salmon contains 4.5g and tuna 4g per kg. However, when meat is cooked the quality and quantity of its creatine levels can change. Cooking beef, pork and fish at high temperatures can cause its creatine to react with proteins inside it, causing it to break down, while cooking meat for longer than is necessary for safe consumption can degrade it further. One quick solution: get used to ordering your steak on the rare side and instead of getting your fish battered, have it gently grilled or baked.

Final thoughts

‘There are a limited number of scenarios in which creatine would not be recommended,’ says Patel. ‘One obvious one is if you have a medical condition for which your physician warns against creatine use. Another one is if you’re an athlete competing within a weight class — taking creatine before weigh-in could lead to unpredictable body weight, due to water retention. The third scenario is if you are especially susceptible to male-pattern baldness and early hair loss. Creatine has been shown in one small study to increase DHT levels, and DHT is involved in male pattern baldness. That being said, this small study has not been replicated, and many people have taken creatine for years without any hair loss!’

Creatine myth-busting

The myth: Creatine loading is 100% mandatory

The truth: In the past a lot of what you’d read regarding creatine advised you to ‘load’, which basically means consuming copious amounts of the supplement. More recent research has suggested that this might actually be a waste and that less creatine is needed to deliver results than loading advocators suggest. Loading is only really required if you’re an elite athlete or pro bodybuilder, it isn’t necessary for the casual gym goer. Most of us only really require 5g to get tangible results.

The myth: Consuming creatine results in excessive water retention

The truth: This is a common yet flawed myth. A recent double blind, placebo-controlled study conducted in the US found that after three months of creatine use, test subjects showed no significant increase in the amount of water in their bodies at all. In actual fact, the group that had taken the creatine showed better gains in fat-free mass and total body mass.

The myth: All products marketed as creatine are the same

The truth: Just as there’s a difference between fine wines that cost £100 a bottle and cheaper supermarket versions for a fiver, the quality of creatine generally differs depending on how much it costs. Some of the lower grade products have even been found to contain contaminants such as creatinine, sodium, dicyandiamide and dihydrotriazine that take away from the purity of the product. These are harmless in small quantities, but will reduce the intended effect.

The myth: Creatine causes cramping

The truth: The idea that taking creatine can cause excessive cramping is purely anecdotal with no actual clinical evidence to support the claim. Studies actually show that creatine use is not at all associated with cramping. Two studies conducted at Arkansas State University in Jonesboro found that creatine use by 61 athletes during training camps had no effects on the frequency or intensity of muscle cramps, injury or illness. These athletes used 15-25g per day on the loading phase, and another 5g/day as maintenance.

Find out all you could possibly want to know about the other major supplements:

Protein

Creatine

Amino acids

Antioxidants

Fat burners

Lesser known supplements

Supplement FAQs

We consulted a number of experts to get the lowdown on creatine:

Anita Bean is the author of The Complete Guide To Sports Nutrition (£15.99, A&C Black Publishers). For more visit anitabean.co.uk

Dr Lonnie Lowery is an exercise physiologist, nutrition expert and former competitive bodybuilder. He is also a licensed dietician who specialises in sports nutrition.

Nikhil Rao is a trainee doctor, avid weightlifter and regular contributor to the US bodybuilding site t-nation.com. He has been using creatine for six years.

Gregg Marsh is a strength and conditioning coach, personal trainer and nutrition consultant. He has more than eight years of experience in nutrition.

Original article from Men’s Fitness by Max Anderton can be found here.

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