Creatine, a natural substance that is made in the body as well as found in meat and fish, is arguably one of the most highly researched dietary supplements in history. Over the last several years creatine has enjoyed unprecedented popularity in the fitness community because it tends to make people stronger and more powerful. However, research is finding that creatine may have uses that go beyond its application in the gym setting.
Creatine and Exercise
As was mentioned above, creatine is a supplement that people use to help make them stronger and more powerful. This effect has been validated by many clinical studies. Most investigations find that the supplement helps when combined with high-intensity exercise, lasting less than 30 seconds such as powerlifting, martial arts, javelin throwing and sprinting to name a few.
The supplement does not seem to improve athletic ability in sports that are not high intensity such as jogging, low-intensity circuit training or hiking.
How Much Do You Take?
It is often recommended to start with a loading phase of about 20 grams a day for a week followed by a maintenance phase of between 2-5 grams.
That said, I don't feel the loading phase is needed in light of a 1996 study titled Muscle Creatine Loading in Man, showing that one month of using 3 grams per day elevates muscle levels as much as using 20 grams for a week.
Today many creatine supplements exist. It should be noted that most of the research to date has been done using creatine monohydrate. As such, I suggest people look at the labels of their creatine supplement. Look only for this ingredient and disregard any additional /popular ingredients.
Types Of Creatine
Currently, there seems to be no good evidence that creatine + other stuff (glutamine, etc.) is any better than taking the supplement by itself. Avoid liquid creatine supplements because they tend to break down faster. The jury is also out on Creatine Nitrate too.
Also, don't pay extra for “buffered” supplement. According to some research, they don't appear to be better than the monohydrate form.
The same thing goes for creatine ethyl ester supplements too – no better than less expensive monohydrate.
Rule of thumb: The more big /fancy words you see on the supplement container, the more you may suspect that it might be overpriced. The same thing goes for supplements containing pictures of muscular men (or women) or pictures of complicated biochemical pathways. It's a smokescreen to get you to pay more money.
Just check the ingredients for “creatine monohydrate” and compare prices between products.
Medical Uses For Creatine
Some research finds that the supplement may do more than make muscles stronger. Before using it for health issues talk to your doctor first. Never use supplements in place of medications to treat a health condition. That said, here is a list of medical issues that the supplement has been studied for:
- Gyrate Atrophy. Gyrate atrophy is a rare genetic degenerative eye disorder that can result in nearsightedness, night blindness, and cataracts. Some research notes it might help this condition.
- Congestive Heart Failure. Congestive heart failure results when the heart can no longer pump enough blood to sustain normal activities. People with this condition usually become tired and short of breath during activity. Some studies have found that creatine may improve the way people with congestive heart failure deal with the stress of exercise.
- Arthritis. At least one study has noted that creatine + exercise reduced arthritis joint stiffness more than exercise alone.
- Cholesterol Reduction. Preliminary evidence hints that several weeks of 5 grams per day may help lower cholesterol, LDL (bad cholesterol) and triglyceride levels in some people. It's effects are less powerful than cholesterol-lowering medications. That said, there is more evidence that losing weight can reduce cholesterol levels than taking this supplement.
- Parkinson's Disease. The supplement might help some people with Parkinson's disease according to some research.
- Muscular Dystrophy. Muscular dystrophy actually refers to a family of related syndromes characterized by progressive degeneration and weakness of the muscle. Some research notes the supplement may mildly improve strength in people afflicted with some forms of muscular dystrophy.
Overall, I feel the research for all of the above is in its infancy. Because of this, if you have any health issues, I suggest you speak to your doctor and pharmacist first.
Creatine Side Effects
Aside from occasional nausea and diarrhea, most studies to date have not found any serious negative side effects associated with these supplements. The most consistent side effect that has been observed is a gain in water weight (fluid retention) where people can expect to gain between 5-10 pounds following creatine use.
While the supplement has not been shown to be harmful to the kidneys or the liver, the research is on healthy people. People with kidney or liver problems should avoid it because we do not know what happens.
Some people link creatine use to rhabdomyolysis but I disagree with this. I think it was the intense exercise people were doing that caused rhabdo.
As for creatine and injuries, I think people have to remember that the compound makes muscles stronger -but not ligaments and tendons. I believe that people who experienced tennis elbow, shoulder problems etc. after taking supplements accidentally injured themselves by progressing themselves faster than their ligaments and tendons could adapt.
In healthy, people, creatine does not raise blood pressure. But all the research on this issue that I've seen has used people with normal blood pressure. I have never seen a study of creatine in people with high blood pressure. Because of this, be cautious of supplements if you have high blood pressure. Talk to your doctor.
Creatine is metabolized to small amounts of formaldehyde. While this has not yet been shown to be a problem, more research is needed to better ascertain what effect, if any, this may have in humans.
Julie Shein says
Hi Joe,
I have taken your personal trainer, master personal trainer and sports nutrition courses. When my son was asking about taking creatine I thought I would come to the expert. He is 17yrs old and interested in getting stronger. He is working on strengthening but has friends taking creatine.
Our pediatrician said no as it can cause kidney damage but your article and others does not support that information. Are they thinking of a different supplement? I would appreciate any help.
Thanks so much,
Julie
Joe says
Hey Julie, nice to hear from you! Most studies I’ve seen do not report kidney problems with creatine supplements.
To be fair, there are reports of it happening to individuals here are there Heres a report that mentions kidney problems in someone who took 20g creatine for a month
https://pubmed.ncbi.nlm.nih.gov/15273072/
Most studies dont show this though. Since studies tend to use healthy people (usually college-aged men) I would be cautious of creatine in those with kidney and liver problems. I also wonder if it might raise blood pressure in those with hypertension.
For those who ask about it, I would stick to 3-5 grams a day. I dont think the “loading phase” is needed.
Back in the 1990s there were some wrestlers who died of kidney failure while taking creatine supplements. The wrestlers were working out a LOT, trying to lose weight, while taking creatine. I wonder if your son’s doctor may be thinking about this incident? I have wondered if those wrestlers died from rhabdomyolysis. The reports back then don’t mention this but since rhabdo can impact the kidneys its something I wonder about.
All this aside, I don’t think your son needs creatine supplements. He already has his youth working for him. That is something NO supplement can compete with. He will get stronger without creatine. Just lift and eat. His body will take care of the rest.
On SupplementClarity.com I have several reports on creatine and many other muscle building supplements
Hope that helps Julie. Let me know if you have any other questions.