Creatine

TL;DR

Creatine Monohydrate is a well-researched supplement that enhances high-intensity exercise performance and muscle growth by helping to regenerate ATP, the body's primary energy currency. The research supporting its effectiveness is very strong, with a typical daily dose of 3-5 grams. It is important to maintain adequate water intake when supplementing.

Why I'm Taking It

• Increases athletic performance
• Decreases muscle recovery time (less soreness)
• Improves muscle definition (they look bigger)
• Some new studies show potential cognitive function support, although this is emerging research and less agreed upon than the previously mentioned benefits

Background

Creatine is a naturally occurring nitrogenous organic acid, specifically an amino acid derivative, composed of L-arginine, glycine, and L-methionine. It is found in vertebrate tissues, with high concentrations in skeletal muscle and the heart, and can be obtained through dietary sources like seafood and red meat. The human body also synthesizes creatine, primarily in the liver, producing about 1-2 grams per day. Its primary biochemical role is to serve as a crucial component of the phosphagen system, acting as an energy buffer by rapidly regenerating adenosine triphosphate (ATP), the body's main energy currency, especially during short, high-intensity activities. Creatine also contributes to cell volumization by drawing water into muscle cells, which may promote an anabolic environment (and makes your muscles look bigger).

Recommended Form of the Supplement

• Creatine Monohydrate: This is the most extensively researched, effective, and typically the most cost-effective form of creatine. It has high bioavailability (around 99% at standard doses). The vast majority of studies demonstrating creatine's benefits have used this form, making it the "gold standard."
• Micronized Creatine Monohydrate: This is creatine monohydrate that has been processed to reduce particle size, which increases its water solubility. This may improve mixability and potentially reduce gastrointestinal discomfort for some individuals, but there's no strong evidence it's more effective than standard creatine monohydrate in terms of muscle uptake or performance.

Expected Effects

• Enhanced Exercise Performance:
  • Increases strength and power output, particularly in short-duration, high-intensity activities like weightlifting and sprinting.
  • Increases muscle mass (lean body mass) when combined with resistance training.
  • Improves anaerobic capacity.
  • May enhance recovery and reduce exercise-induced muscle damage.
• Cognitive Function:
  • May improve certain aspects of cognitive function, such as short-term memory and reasoning, particularly in older adults, vegetarians, or individuals under significant stress (e.g., sleep deprivation).
  • Appears to reduce mental fatigue in demanding scenarios.
• Other Potential Benefits:
  • May help manage sarcopenia (age-related muscle loss) in older adults, especially when combined with resistance training.
  • May aid in injury prevention (e.g., reducing dehydration, muscle cramping) in athletes.
  • Preliminary evidence suggests potential for alleviating symptoms of depression, possibly as an adjunctive therapy.
  • Improves symptoms in children with certain rare creatine deficiency syndromes.

Dosage Recommendations

• Loading Phase:
  • Optional, but faster saturation
  • Typically 20-25 grams per day (or ~0.3 g/kg body weight/day), divided into 4-5 equal doses (e.g., 4-5g per dose).
  • Duration: 5-7 days. This rapidly saturates muscle creatine stores.
• Maintenance Phase:
  • Without a loading phase, muscle saturation will be achieved, but it will take longer (approximately 28 days) compared to a loading phase. This may be preferred to minimize potential GI discomfort or bloating associated with loading.
  • 3-5 grams per day.
  • This dose is taken daily to keep muscle stores saturated.
• General Health Support: Some recommendations suggest 2-3 grams per day for general health benefits throughout the lifespan.
• Tolerable Upper Intake Level (UL): No official UL has been established by major health authorities like the NIH Office of Dietary Supplements. Studies have shown safe use of up to 30 g/day for 5 years in healthy individuals. Excess creatine is typically excreted once muscle stores are saturated.
• Timing: Creatine can be taken at any time of day; consistency is more important than specific timing relative to workouts. Some research suggests co-ingestion with carbohydrates or carbohydrates and protein may enhance muscular retention of creatine, possibly due to an insulin response, but this is not essential for efficacy. Taking with meals or splitting doses can help minimize potential GI discomfort, especially with larger doses.

My Current Dosage & Timing

Dosage: 5-10g per day Form: Monohydrate Brand: Bulk Timing: ~5g w/ morning protein shake, ~5g w/ post-workout protein shake

Usage Notes, Best Practices & Important Considerations

• Specific Administration Tips:
  • Mix creatine monohydrate powder thoroughly in at least 8-12 oz (240-350ml) of water, juice, or other suitable liquid until fully dissolved to improve absorption and minimize potential gastrointestinal discomfort.
• Lifestyle Synergies/Considerations:
  • Hydration is Key: Maintaining adequate daily fluid intake is very important when supplementing with creatine. While creatine doesn't typically cause dehydration in healthy, well-hydrated individuals (and may even improve cellular hydration), it does draw water into muscle cells. Ensure consistent and sufficient water intake throughout the day to support creatine's cellular hydration effects, aid kidney function, and minimize any potential for cramping or gastrointestinal issues.
  • Exercise Regimen: The ergogenic effects of creatine, particularly for muscle growth, strength, and power, are most pronounced when combined with consistent resistance training or high-intensity interval training (HIIT).
• Key Safety or Efficacy Nuances:
  • Initial Water Retention: It's common to experience an initial weight gain of 0.5-2 kg (approximately 1-4.5 lbs) within the first week of supplementation. This is primarily due to increased intramuscular water (cell volumization) and is not subcutaneous water retention (bloating) or fat gain. This effect usually stabilizes.
  • Consistent Daily Use: For optimal benefits, creatine should be taken consistently, including on non-training days, to maintain elevated muscle creatine stores.
  • Gastrointestinal Comfort: If gastrointestinal discomfort (e.g., bloating, stomach upset) occurs, especially during a loading phase, consider splitting doses further throughout the day, taking creatine with meals, ensuring the powder is fully dissolved in sufficient liquid, or using a micronized form of creatine monohydrate, which may be better tolerated by some.
  • Non-Responders: A small percentage of individuals may be "non-responders" to creatine supplementation, experiencing minimal or no significant ergogenic benefits. This can be due to various factors, including already high baseline muscle creatine stores or individual genetic differences.
• Monitoring:
  • For most healthy individuals, specific physiological monitoring due to creatine supplementation is generally not required.
  • Individuals with pre-existing health conditions, particularly kidney-related issues, should consult their healthcare provider before using creatine and may require monitoring.

Contraindications/Interactions

• Kidney Disease: Individuals with pre-existing kidney disease should consult their healthcare professional before using creatine, as it might potentially worsen kidney function in those with already compromised renal capacity. Creatine is generally considered safe for individuals with healthy kidneys and does not cause kidney damage.
• Bipolar Disorder: Creatine might exacerbate manic episodes in individuals with bipolar disorder; use with caution or avoid.
• Pregnancy and Breastfeeding: Due to insufficient reliable safety information, creatine use is generally not recommended and should be avoided during pregnancy and breastfeeding as a precaution.
• Caffeine: Some research has suggested that high doses of caffeine (e.g., >5 mg/kg body weight) consumed concurrently with creatine, especially during a loading phase, might diminish creatine's ergogenic effects (enhanced athletic performance). However, the overall evidence for a significant negative interaction is weak and inconsistent, and lower doses of caffeine or separation of intake may mitigate any potential issue. For individuals with Parkinson's disease, the combination of creatine and caffeine may potentially worsen symptoms; use caffeine with caution if taking creatine.
• Medications: No well-documented, significant interactions with specific medications are broadly listed, but it's always prudent to discuss with a healthcare professional if taking any medications.

Reputability/Trustworthiness of Studies

The evidence for creatine monohydrate enhancing high-intensity exercise performance, muscle strength, and lean mass gain is very strong, supported by hundreds of peer-reviewed studies, meta-analyses, and position stands from major sports nutrition organizations like the International Society of Sports Nutrition (ISSN). The ISSN considers creatine monohydrate the most effective ergogenic nutritional supplement available to athletes for these purposes.

For cognitive benefits, the evidence is moderate to emerging and appears context-dependent, with more pronounced effects in populations with lower baseline creatine levels (e.g., vegetarians, older adults) or under conditions of metabolic stress. The European Food Safety Authority (EFSA) has dismissed general health claims linking creatine to improved cognitive function in healthy adults, citing inconsistent effects and weak evidence for proposed mechanisms.

The evidence for creatine improving muscle strength in adults over 55 when combined with resistance training is strong, supported by EFSA.

Sources/Links to Research:

• Examine.com - Creatine
• International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine
• Mayo Clinic - Creatine
• Uniformed Services University of the Health Sciences - Creatine Monohydrate: Dietary Supplement for Performance