Creatine. Possibly the most studied and one of the most used supplements, with evidence suggesting benefits to strength, muscle mass, cognitive function, injury prevention, recovery and more. And with no reported adverse effects in healthy individuals (those reports of creatine being damaging to the kidneys are not substantiated). So what is the deal?
Creatine is a small non-proteogenic peptide found primarily in the muscle, and in the brain. Although we can obtain it by eating meat (aka muscle!), we make most of what naturally occurs in our body. However, we don’t seem to maximise our potential for storing creatine … because if we supplement we can increase the amounts in our muscle and brain. The lower your starting levels of creatine (often lower in vegans, vegetarians and non-resistance trained individuals), the more you may respond to supplementation.
Strength, muscle mass, explosive power.
These are the primary performance outcomes that creatine supplementation may have.
Creatine (or more specifically, phosphocreatine) is the immediate explosive energy source of the body. The one that dominates in the first seconds of exercise, or when doing an explosive jump or lift. So it figures that if we have more of this we can be more powerful. And if we can be more powerful and lift heavier or for more reps, then we are providing a bigger training stimulus, and so have the potential to build greater strength and / or muscle mass.
In addition, creatine may enhance glycogen loading (i.e. carb storing) in the muscle, as well as reduce oxidative stress in the muscle. Both of these factors reduce fatigue, meaning an individual may be able to train harder for longer, i.e. provide a bigger training stimulus. Plus, potentially recover faster from training as a result of reduced oxidative damage and having more energy (carbs) available to execute repair and adaptation in the muscle.
It is also thought it may be these effects of increased energy (creatine and glycogen) and reduced oxidative stress, creatine may be supporting reduced injury risk and enhanced recovery post injury. This is valuable to any athlete who wishes to perform at the top of their game for the long term.
Finally, creatine draws water into the muscle as it accumulates, causing the muscle cells to swell. This itself can activate growth pathways to increase muscle mass!
Note … yes, creatine supports enhanced strength and muscle mass … no, creatine is not a steroid!! For a start, it is not a hormone. It is an energy source. And secondly, it requires a training stimulus to function.
Maintaining your Brain
And now, the brain! Also very relevant to an athlete. First, reaction times and cognitive function are valuable to many sports. And in combat and other sports where there is the risk head knocks and traumatic brain injury, anything that may help preserve brain health before or after such an event can be critical not just to performance, but to health!
In short it seems that creatine has the biggest benefits when there is ‘stress’ in the brain. Whether that be stress from lack of sleep, fatigue or potentially injury. This may be because it increases the availability of immediate energy and / or other mechanisms.
In the case of traumatic brain injury, e.g. from a blow to the head during a competitive fight or sparring session, there is some evidence that taking creatine pre-emptively as well as post-injury may reduce the severity or recovery time. Further case studies and other research is needed to explore this further, but it looks promising. Indeed, many combat sport nutritionists as well as official bodies recommend this in their prehab and rehab protocols.
How to take it?
The recommended intake of creatine monohydrate is 0.1g/kg bodyweight a day, for males and females. Loading phases can be applied (0.3-0.8g/kg for 5-7 days), however unless there is an explicit need to rapidly saturate creatine levels in the muscle within 5-7 days this is not necessary. We don’t have enough data to say whether this seems to also be the most effective dose for the brain: more research is needed to confirm, but it does seem that higher and / or longer periods of dosing may be needed for effects to be observed.
Take with plenty of water and / or a meal, to reduce the risk of any dehydration or stomach cramps after taking (the only reported potential side effects). It might also be worth taking it as far away from caffeine intake in the day as possible, as there is evidence to suggest caffeine may impair creatine loading. And creatine seems to work just fine whether you take it before, during, after exercise … or any time of day!
Creatine monohydrate is the cheapest form you can buy, and has been shown the most effective!! To date the ‘fancy’ stuff has not proven more effective and, in some cases, is less so!
If you are an athlete in a drug tested sport, as always, ensure any supplement you take has been Informed Sport (or equivalent) tested and take your usual precautions.
In summary, it isn’t the solution to all your problems (no one thing ever is) BUT there are a multitude of situations where creatine may provide a benefit to you for short and long term health and performance. So it is something worth looking into*.
*As with any supplement, it is not recommended to take it without appropriate professional guidance and assessment of the potential risks and benefits.
Antonio et al. (2021). Common questions and misconceptions about creatine supplementation: what does
the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18:13. https://doi.org/10.1186/s12970-021-00412-w
Dolan, et al. (2018). Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury, European Journal of Sport Science, DOI: 10.1080/17461391.2018.1500644
Kreider et al. (2017). International Society of Sports Nutrition position stand: safety and efficacy of
creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition 14:18. DOI 10.1186/s12970-017-0173-z.
Smith-Ryan et al. (2021). Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients, 13, 877. doi.org/10.3390/nu13030877