Creatine: Much More Than an Athletic Performance Ehnancer
Written By: Matt Lococo, CPT, NCI L1
If you’ve worked out long enough, you’ve probably heard that taking a creatine supplement will help you build muscle and increase your strength.
Numerous studies have shown that creatine does in fact: boost athletic performance, increase strength, increase fat-free mass, and reduce fatigue and tiredness associated with resistance training.
However, there’s new evidence that suggests the effects of creatine go beyond just physical performance.
What is Creatine?
Creatine occurs naturally in the body. It is a nitrogenous, organic compound synthesized primarily by the liver and helps to supply energy to all cells in the body.
Creatine is mostly stored in skeletal muscle in the form of phosphocreatine (PCr), while a small amount is stored in the brain, heart, and kidneys. Additional stores are then used to help create adenosine triphosphate (ATP), the critical energy source in the body. Creatine’s role in energy metabolism is essential to the formation of ATP during exercise and helps to fuel short-duration, high-intensity activities (i.e., 100m sprints or 1RM Squat). The more PCr available means a more rapid production of ATP during exercise and may help to prevent a decrease in performance. The more creatine the body has available, the greater likelihood of sustaining that level of work at a higher intensity.
The benefits of increasing the body’s creatine stores are why taking a creatine supplement should be something just about everyone considers. Supplementing with creatine provides more readily available creatine for the body, but can also increase the phosphocreatine stores in the brain leading to improved brain health and the prevention of neurological diseases.
Creatine Supplementation
Creatine is one of the more widely used supplements among athletes and fitness enthusiasts. With that being said, it’s time it gains more popularity among the general population.
Concentrations of creatine are highest in meat products. However, these types of foods take time to go through the digestion process, reducing the rate at which the creatine is absorbed and available for the body.
The body produces roughly 1-2g of creatine per day. High energy demands and the rather quick absorption rate of creatine, can only provide so much benefit with that amount of creatine. This is why supplementing with creatine, or supplying the body with more creatine, can provide added benefits to help the body function at a more optimal level.
Creatine supplementation has been reported to increase the creatine content of muscle by about 20%. (CSCS Book)
How to start supplementing with creatine has been largely talked about topic for decades now. The million-dollar question is: Is the loading phase completely necessary or not?
The loading phase for creatine is about five to seven days. In this phase, 20g of creatine is to be consumed, usually in 5g increments, about four times a day. Once the loading phase is over, consuming 5g of creatine daily will provide sufficient stores. The purpose of this is to saturate the creatine stores of the body, allowing the areas of high energy demand, such as skeletal muscle and the brain, to reach sufficient storage levels. However, there is emerging evidence that suggests this loading phase may not be all that necessary.
Because creatine is absorbed rather quickly by the body, one could make the argument that larger doses slow down the rate of absorption. In fact, smaller doses have been shown equally effective at reaching maximum creatine stores in muscle, though it may take a little longer. Supplementing with creatine does appear to have a saturation limit as well. Once creatine concentration in skeletal muscle reaches roughly 150-160mmol/kg of dry weight, additional supplementation no longer appears to increase muscle creatine concentration. (CSCS Book)
It’s worth mentioning that there have been some associations of gastrointestinal distress when taking creatine in larger doses. Other concerns in taking creatine in high doses include weight gain and bloating, most likely the result of increased water retention in the muscle.
A beginning dose of just 5g of creatine a day may not lead to immediate maximal creatine stores in the muscle, but consistent consumption will eventually reach that point of optimal storage. There’s been virtually no evidence to suggest that consuming smaller doses of creatine results in any sort of bodily discomfort or other side effects. Taking creatine in lower doses may be the less problematic and arguably safer option. However, some individuals may benefit more from a larger dose. It’s important to realize that creatine supplementation may affect everyone differently, and it may be smart to consult a physician if there are any underlying health conditions of concern.
Creatine supplementation is extremely safe to use and should be a part of any health regimen. Not only is it safe to use, but it’s probably the most cost-effective supplement on the market today.
Types of Creatine
With creatine becoming a more and more popular supplement, different forms are starting to hit the market.
While most come in designer forms, here are the most popular forms and how they stack up:
Creatine Monohydrate: Creatine Monohydrate is the most common form on the market. It is the most extensively researched in which most data and scientific effects of creatine have been observed when consuming this form. This form consists of a creatine molecule and a water molecule. In its monohydrate form, it is about 90% pure creatine per dose. When the water molecule is removed, creatine monohydrate becomes anhydrous creatine, a form that is 100% pure creatine. Other forms include a micronized option to allow for better water solubility. The logic behind the micronized option is to allow for a faster rate of absorption in the body. However, early indications have shown this to be somewhat inconclusive.
Creatine Hydrochloride: Creatine Hydrochloride has been gaining popularity for its water-solubility properties. This form is a result of the binding of creatine to a hydrochloride molecule. Some research has found it to be significantly more soluble than creatine monohydrate. This form is also rumored to be absorbed more effectively in the body than the monohydrate form. Unfortunately, there is a lack of evidence to support these claims. There just simply hasn’t been enough studies conducted at this time to prove any significant differences between the hydrochloride and monohydrate forms. However, creatine hydrochloride may be a more suitable option than creatine monohydrate for those who have experienced some gastrointestinal stress related to supplementing with creatine monohydrate. These types of side effects tend to occur much less when taking creatine hydrochloride. Other than experiencing some gastrointestinal distress, creatine monohydrate is still the more researched form and arguably a better option for supplementation.
Buffered Creatine Monohydrate (Kre-Alkalyn): Buffered Creatine Monohydrate is another designer creatine, particularly manufactured to reduce the breakdown of creatine in the stomach. This form contains a slightly basic compound to help combat the acidic nature of the stomach and improve the absorption of creatine into the muscle. There are limited studies showing the effectiveness of this type of creatine. However, the evidence that is out there suggests it is somewhat comparable to creatine monohydrate in its effects of saturating the body’s creatine stores. With creatine monohydrate being the more researched form, it still appears to be the superior form when compared to Kre-Alkalyn.
Creatine Magnesium Chelate: Creatine Magnesium Chelate is a lesser-known designer creatine. This form is produced by binding magnesium to a creatine molecule. There are relatively no studies that can conclusively show its effectiveness when compared to that of creatine monohydrate. Due to the limited research, it’s apparent that creatine monohydrate is the superior option when comparing the two.
Other than creatine monohydrate, it would appear that the other forms of creatine were produced to minimize the amount of water retention in the body. If retaining water or gaining water weight is of concern, it might be worth looking into a creatine option other than the monohydrate form. However, with that being said, again, creatine monohydrate is the most extensively researched form. A large majority of the data out there came from the testing of this form
Dietary Sources of Creatine
The body needs about 1-3g of creatine per day to carry out its basic functions. Half of that comes from the diet, while the other half is synthesized by the body. It’s worth mentioning that larger individuals or those whose training regimen consists of more high-intensity movements may need to consume a greater amount (5-10g) to maintain optimal creatine stores.
In terms of the diet, creatine concentrations are the highest in red meats, fish, and poultry.
10 Foods with the Highest Creating Concentrations (per 100g of food):
Herring Fillet (raw and dried) - 1.1g
Beef patties (raw) - 0.9g
Salmon - 0.9g
Pork - 0.7g
Blood Sausage - 0.6g
Ham (cured, dry) - 0.6g
Lamb - 0.5g
Chicken Breast - 0.4g
Tuna - 0.4g
Rabbit meat - 0.4g
While dietary sources of creatine with the highest concentrations are predominantly found in animal products, practicing vegans and vegetarians can still achieve creatine levels from plant-based sources. Creatine is synthesized from a few amino acids: arginine, glycine, methionine. These amino acids can be found in foods familiar to vegetarians and vegans.
Vegetarian Foods with Creatine Concentrations:
Eggs
Milk
Cheese
Vegan Foods with Creatine Concentrations:
Tofu
Quinoa
Spinach
Spirulina
Pumpkin seeds
Sesame seeds
Walnuts
Almonds
Legumes
Seaweed
Vegan and vegetarian food sources have much lower creatine concentrations than animal sources, which leads to lower amounts of creatine in the muscle of vegans and vegetarians. Creatine supplementation is highly recommended for these lifestyles.
The Effects of Creatine on the Brain
While the majority of creatine is stored in skeletal muscle, creatine stores in the brain can have some pretty profound effects on daily life.
Creatine saturation in both skeletal muscle and the brain decline with age. This makes creatine a particularly interesting option for advanced age populations. Vegetarians and vegans also experience reduced creatine saturation levels due to the lack of meat consumption. Not only does creatine supplementation help to slow both of these declines, but it helps to saturate the tissues of higher creatine concentrations, such as the brain.
It’s important to note that muscle tissue and brain tissue are not similar in nature. Therefore, in theory, their response to creatine supplementation may be different. Because the brain has to function at such a high and intricate level compared to muscle, it is more selective about what chemicals or nutrients enter that space. So with that being said, the emerging theories are that larger doses of creatine are needed over an extended period of time to reach an optimal saturation level.
Studies linking creatine to improved brain function have only just begun. While the testing is relatively new compared to that of muscle, there are studies that show consuming supplemental creatine monohydrate for 2-4 weeks has increased the concentration of creatine in the brain by 5-15%. (6)
Creatine has also been shown to improve cognitive function. Studies whose participants have lower creatine concentration levels, such as the elderly and vegans or vegetarians, have shown improvements in their cognitive function when supplementing with creatine. One study reported that the older populations scored higher on long-term memory tests as well as immediate recall and intelligence tests after taking a creatine supplement for two weeks.
A separate study conducted with adults over the age of 75, showed that creatine buffered age-related cognitive decline while improving verbal and spatial short-term memory and long term memory after just one week of taking the supplement.
Vegans and vegetarians have also seen improvements in their cognitive function with a creatine supplement. A particular study highlighted an improvement in a series of cognitive tests when compared to a placebo group. These tests included word recall, repeating numbers backward, pattern recognition, and reaction time. (6)
As the evidence shows, beginning a creatine supplement can lead to some pretty significant benefits, especially for those who might suffer from declining or lower creatine levels.
What the Future Holds for Creatine Supplementation
As previously discussed, creatine has been shown to improve cognitive function. However, there are some new studies being performed that might suggest the effects creatine has on the brain go beyond just improving memory and intelligence. Studies that may link creatine as a somewhat preventative measure for some more traumatic conditions in the brain.
While research here is still in the early phases, there has been speculation that creatine may positively impact certain conditions such as Alzheimer’s disease, Parkinson’s, depression, and traumatic brain injuries, just to name a few.
Much of the research involving creatine supplementation and the potential preventive measures of various neurological diseases has been performed on laboratory mice. Research may be in its early phases, yet some studies have reported some rather interesting findings.
One study in mice suggests that creatine supplements may slow the progression of Parkinson’s disease, a neurodegenerative disorder resulting from declining dopamine levels. Tests showed that mice with Parkinson’s disease expressed only slightly lower dopamine levels compared to that of healthy mice when taking a creatine supplement. (7)
Creatine is also being considered as a possible treatment option for particular conditions without a cure or viable treatment option, such as Huntington’s disease and amyotrophic lateral sclerosis or ALS. Both of these conditions display symptoms that greatly affect cognition and motor coordination. One study in which mice were given a strain to mimic the conditions of Huntington’s disease found that with creatine supplementation, the mice showed improved motor performance, reduced atrophy of neurons, and an observed increased survival rate or life-span. In a separate study of mice with a mutated gene to mimic ALS symptoms, long-term creatine supplementation was showed to promote survival and improve motor coordination, as well as protect neurons from oxidative damage.
Slowing the progression of Alzheimer’s disease has also been a speculated benefit of creatine supplementation. Symptoms of this condition, which include severe dementia, confusion, and long-term memory loss, may be slowed with an increased creatine intake. The link between creatine supplementation and treating Alzheimer's disease is through a molecule called creatine kinase (CK). CK is an enzyme that catalyzes the synthesis of ATP to provide energy at a high rate. Creatine kinase activity is reduced by as much as 86% in those with Alzheimer’s, suggesting there are lower levels of phosphocreatine in the brain in the beginning stages of this disease. (9) Therefore, it can be speculated that increasing creatine intake, thus further saturating brain creatine concentrations, may be beneficial for this condition. This, in turn, can lead to an increased number of creatine kinase reactions, supplying the body with more energy and slowing the progression of this disease. One particular study found some truth to this speculation. In this study, the expression of creatine kinase in the hippocampus and frontal cortex (areas of the brain that play a major role in learning, memory, and decision making) provides one clue that creatine metabolism participates in higher mental functioning. (8)
While the majority of these studies have been performed with mice, there are some studies showing human response to creatine supplementation when dealing with traumatic brain conditions.
One study highlighted the effects creatine has on traumatic brain injuries in children. Findings showed fatigue, dizziness, and headaches fell drastically after taking a creatine supplement for six months. A boost in recovery following a concussion or brain injury when increasing creatine consumption was also reported. (7)
Creatine supplementation has also shown some benefit to treating those suffering PTSD, depression, and fibromyalgia. A woman suffering from all three experienced abnormally low levels of phosphocreatine and was otherwise unresponsive to psychotropic medications before taking creatine. After taking her daily supplement, she reported measurable improvements in her depression and fibromyalgia and reported a 30% improvement in her overall quality of life. In an additional study, creatine was found to improve symptoms in men and women with treatment-resistant PTSD. (8)
Again, it’s important to note that the research still remains relatively inconclusive. However, there are some promising results heading into future testing. The future is very bright in regards to creatine supplementation and its potential effectiveness in treating or possibly even preventing some of these conditions.
Creatine and You
The evidence speaks for itself. As far as dietary supplements go, creatine may have the largest impact on our overall well-being. From the well-known physical health benefits to the now emerging mental health benefits, the effects of creatine cannot be ignored.
As you can see, the argument can be made that creatine can benefit just about anyone. And it’s not a stretch to say that everyone should be taking a creatine supplement.
References
Haff, Greg, and N. Travis Triplett. Essentials of Strength Training and Conditioning. Human Kinetics, 2016.
Mawer, Rudy. “Creatine 101 -- What Is It and What Does It Do?” Healthline.com, 25 October 2018, https://www.healthline.com/nutrition/what-is-creatine#muscle-gain.
“Everything You Need to Know about Creatine and Its Forms.” GYMBEAM.COM, 10 June 2019, gymbeam.com/blog/everything-you-need-to-know-about-creatine-and-its-forms/.
Wilson, Debora Rose. “Creatine: Uses, Benefits, and Health Risks.” Medical News Today, MediLexicon International, 20 Dec. 2017, www.medicalnewstoday.com/articles/263269.
Booth, Lisa. “30 Natural Food Sources of Creatine (+ How Much To Eat).” Fitbod, Fitbod, 11 Mar. 2020, www.fitbod.me/blog/natural-food-sources-creatine.
Totoro, Joel. “Can Supplementing with Creatine Support Your Brain?” Thorne, 13 Mar. 2020, www.thorne.com/take-5-daily/article/can-supplementing-with-creatine-support-your-brain.
Mawer, Rudy. “10 Graphs That Show the Immense Power of Creatine.” Healthline.com, 18 March 2020, https://www.healthline.com/nutrition/10-graphs-power-of-creatine#section6
Allen, Patricia J. “Creatine Metabolism and Psychiatric Disorders: Does Creatine Supplementation Have Therapeutic Value?” Neuroscience and Biobehavioral Reviews, U.S. National Library of Medicine, May 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3340488/.
Smith, Rachel N, et al. “A Review of Creatine Supplementation in Age-Related Diseases: More than a Supplement for Athletes.” F1000Research, F1000Research, 15 Sept. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4304302/.
About The Author:
