Creatine - A Guide To One Of The Best Known Sports Supplements

Creatine, or Creatine Monohydrate, is perhaps the most talked about sports supplement ever. The reason for this? Because it works. Well, at least that is for most people! In this article I will tell you what creatine actually is, what it does and what its uses are as a sports supplement. With this background knowledge you will then be better armed to make a decision as to whether creatine supplementation is for you.

What Is Creatine?

Creatine is a nitrogenous organic acid (C4H9N3O2) that occurs naturally in our bodies and helps to supply energy to our muscles in order for them to contract and perform their duties. Michel Eugene Chevreul discovered the substance in 1832 when he found it to be a part of skeletal muscle and named it after the Greek word for ‘flesh’ – Kreas.

Around half of all the creatine in our bodies comes from our food (mainly meats) whilst the other half is synthesised from three amino acids – arginine, glycine and methionine. Ninety-five percent of our creatine is stored in our skeletal muscles. These facts would indicate that a vegetarian could have lower creatine stores due to a lack of meat in the diet and this is indeed usually the case. Supplementing the vegetarian diet with creatine has been shown to significantly boost these levels. (1)

What Does It Do?

Adenosine Triphosphate, or ATP, is a nucleotide that provides the energy for muscle contraction by releasing one of its phosphate molecules. When this happens the ATP becomes Adenosine DiPhosphate, or ADP. It now has to wait to be reunited with another phosphate molecule, in a process known as ATP regeneration, before it can become ATP once again and continue its role in providing energy to the muscles. The speed at which energy can be provided to the muscles, and hence how hard a muscle can work, is therefore dependent on its supply of phosphate.

Creatine is stored in our muscles as Phosphocreatine and helpfully provides the spare phosphate molecule that the ADP is looking for. Therefore the more creatine you have in your muscles, the larger the supply of phosphate molecules you will have, the quicker and more efficient the ATP regeneration will be and this leads to an increase in muscle performance.
Also, because the ATP is being regenerated fast and efficiently, it reduces the muscles need to use Glycolosis as an energy supply (the breaking down of glucose in the body). Glycolosis produces lactic acid as a by-product and this impairs performance when it builds up. For short burst activity, like bodybuilding or sprinting you can see the benefits of having an optimal supply of creatine in the muscles.

Creatine As A Supplement

It was way back in 1912 that scientists first realised that you can dramatically increase muscular stores of creatine by ingesting extra levels of it (2). However, it wasn’t until the Olympic games in Barcelona in 1992 that creatine as a sports supplement began being discussed. Linford Christie, Sally Gunnell and several British rowers were reported to have used creatine to boost their performances during the games.
Commercially, creatine wasn’t available to the consumer market until 1993 when EAS produced the first creatine supplement branded as Phosphogen. Since then creatine has gone on to become perhaps the most discussed supplement ever and holds about a 10% share of the sports supplement market (3).

It has been branded and repackaged in many ways, being combined with protein shakes and fruit juices (which is meant to aid absorption), sold as powder or pills and more recently being available as creatine ethyl ester (CEE) which is touted as being the most easily absorbed form, although some studies state it as actually being inferior to creatine monohydrate (4).

Does It Work?

For short burst activity and power athletes creatine has indeed been shown to work (5). The effect on endurance athletes however is negligible (6). I think it has become one of the best-known sports supplements because of this fact. In most people, it does really produce good results. However, it doesn’t seem to work for everyone and one of the reasons for this could be due to naturally high levels of creatine in the user. It is in the user with low natural creatine levels that the biggest effects are going to be noticed.

As an aside, creatine supplementation has been shown to produce positive effects in the treatment of muscular, neuromuscular, neurological and neurodegenerative diseases such as arthritis, Parkinson’s and Huntingdon’s disease (7). It also showed positive results in double blind cognitive and memory tests in vegetarians (8).
What Does This Mean To My Training?

Creatine works because it allows the muscles to work for longer than they would normally without becoming fatigued. This may only mean an extra few seconds or so in real life but adding this to every workout and every set you lift, the strength gains due to increased time under load can be significant.

Less fatigue = more weight/sets = bigger gains.

A by-product of creatine use is that it will increase the water retention in the muscles. This leads to a ‘fuller’ look and a feeling of ‘pumped’ muscles, which makes many people think that this is its only benefit. The benefit first is that you will be able to lift more. The ‘pumped’ muscle benefit is just a bonus!

It must be remembered that creatine is not a magic supplement and will not work if you do not train properly. It will not build muscle for you. If you follow a proper training plan and lift weights consistently then it will allow you to train for longer, to train harder, to lift more and therefore to see improved muscle growth.

Is It Safe?

Creatine is perfectly safe to use and no detrimental effects have been found in healthy individuals (9). It has been suggested that kidney damage could occur due to the increased strain put upon them with creatine use (a 90% increase in urinary creatine concentrations when supplementing) but no long-term studies have been concluded on this point. Creatine supplementation using recommended dosages has not been linked with any adverse side effects beyond occasional dehydration due to increased muscular water uptake from the rest of the body (10).
It is suggested that extra water be ingested when using creatine to make up for its water retention capabilities and to avoid cramp and also to cycle creatine in perhaps an 8 week on 4 week off manner to avoid prolonged use.

Provided high purity creatine monohydrate is used in foods for particular nutritional uses, the Panel of European Food Safety Authorities (EFSA) considers that “the consumption of doses of up to 3g/day of supplemental creatine, similar to the daily turnover rate of creatine, is unlikely to pose any risk" (11). They did however state that they endorse their previous opinion “that high loading doses (20 gram / day) of creatine should be avoided (12).

How To Take It

The most common practice in the supplementation of creatine is that you follow a ‘loading phase’ for the first five days and then revert to a ‘maintenance phase’ for the following weeks.
Looking something like this:

Days 1-5 (loading) = 5 grams of creatine, 4 times a day = 20 grams in total daily
Maintenance = 3 – 5 grams daily

This however has not been proven to show any additional benefit other than saturating the muscles with creatine and providing results faster. After 30 days both loading and non-loading test subjects were shown to have the same levels of muscle creatine. If you want to see results faster, then load up on it. If you want to save your money and creatine supplies just start taking 3-5 grams daily without the loading phase.
Another common discussion point is whether you should take your creatine dosage with fruit juice, protein powder or just water. Studies have shown that taking it with a fast acting carbohydrate source such as fruit juice or with a protein source is more effective (13). The reason for this is that as the carbs break down and release glucose into the blood the body reacts by releasing insulin. Insulin is a hormone that helps the glucose get transferred into the muscle cells where it is stored as glycogen. Not only does insulin offer transport to glucose, it does the same for other substances including creatine. Therefore, the insulin spike created by the fast-acting carbs will allow for greater uptake of creatine within the muscle cells.

Conclusion

Creatine has become one of the most widely used sports supplements because it works. As I stated above it isn’t magic and will not work unless you put serious time in at the gym on a dedicated programme, but if you do, you will almost certainly see results. If you do your research on the Internet you will find people saying it is a waste of money and hasn’t worked for them but these stories are in the minority. I have known people it hasn’t made too much difference too but from my own experience it works wonders. The best thing you can do is to try it and see if it works for you. The price of creatine has dropped dramatically over the years and high quality 99.99% pure creatine monohydrate now costs around £10 ($15) for 500 grams of the powdered variety so wont break the bank. It is a safe, perfectly legal and cheap sports supplement that really is worth all the hype.

References:

1) Burke DG, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky M (2003). "Effect of creatine and weight training on muscle creatine and performance in vegetarians". Medicine and science in sports and exercise 35 (11): 1946–55.
2) Folin O, Denis W (1912). "Protein metabolism from the standpoint of blood and tissue analysis. Third paper, Further absorption experiments with especial reference to the behavior of creatine and creatinine and to the formation of urea.". Journal of Biological Chemistry 12 (1): 141–61.
3) "Creatine sales totalled $193 million in 2003 — or roughly 10% of the $1.9-billion sports supplement market, according to the San Diego-based Nutrition Business Journal
4) Child, R. & Tallon, M.J. (2007). Creatine ethyl ester rapidly degrades to creatinine in stomach acid. International Society of Sports Nutrition 4th Annual Meeting
5) Olsen, S; Aagaard P, Fawzi K, et al. (2006). "Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training". The Journal of Physiology 573 (Jun 1): 525–34.
6) Engelhardt, M; Neumann G, Berbalk A, Reuter I (1998-07-01). "Creatine supplementation in endurance sports". Medicine & Science in Sports & Exercise (Lippincott Williams & Wilkins) 30 (7): 1123–9
7) Tarnopolsky M, Martin J (1999). "Creatine monohydrate increases strength in patients with neuromuscular disease". Neurology 52 (4): 854–7
8) Rae, C., Digney, A .L., McEwan, S.R. and Bates, T.C. (September 2003) Oral creatine monohydrate supplementation improves cognitive performance; a placebo-controlled, double-blind cross-over trial. Proceedings of the Royal Society of London - Biological Sciences.
9) Bizzarini E, De Angelis L. (December 2004). "Is the use of oral creatine supplementation safe?". J Sports Med Phys Fitness
10) Creatine's Side Effects. Fact or Fiction?, An interview of Professor Jacques R. Poortmans
11) EFSA statement, 26 April 2006
12) http://www.efsa.europa.eu/cs/BlobServer/Scientific_Opinion/opinion_afc_0...
13) Steenge GR, Simpson EJ, Greenhaff PL (01 Sep 2000). "Protein- and carbohydrate-induced augmentation of whole body creatine retention in humans". J. Appl. Physiol. 89 (3): 1165–71