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Everything You Ever Wanted to Know About Creatine


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Creatine Background Information

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Creatine is one of the, if not the most, popular sports supplements in the world for mass gain. Surveys performed on creatine use in athletes indicate that creatine is used by more than 40% of athletes in the National Collegiate Athletic Association, and that athletes from about 20 different NCAA sports reportedly use creatine.

Creatine use in power-sport athletes may be even more prevalent, with up to about 75% of powerlifters, boxers, weightlifters, and track and field athletes reportedly using the supplement. And a survey of gym/health club members conducted in 2000 reported that about 60% of members are creatine users.

Why is creatine so popular among athletes and gym-goers? Quite simply because it works, and it works well. Literally hundreds of studies have been done on creatine showing its effectiveness for increasing muscle strength, muscle power, muscle size, overall athletic performance, and even enhancing certain areas of health.


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Creatine Basics

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Creatine is a nonessential dietary protein-like compound found in high abundance in meat and fish. It is synthesized in the body, primarily in the liver, from the three amino acids, arginine, glycine, and methionine. Muscle tissue does not produce creatine, and therefore it must take up creatine from the bloodstream. Once inside muscle cells, creatine gets a high-energy phosphate attached to it, and is then known as phosphocreatine (PCr) or creatine phosphate.

It is this high-energy molecule that is one of the most critical components of creatine’s beneficial effects in the body. That’s because creatine donates its high-energy phosphate to create ATP (adenosine triphosphate), which is used by the muscle for the rapid energy it needs for muscle contraction, such as during weightlifting. Supplementing with creatine is reported to increase the content of PCr in muscle by approximately 20% (see Figure 1).

Having more PCr in muscle cells means more ATP can be rapidly produced during exercise, which can lead to gains in strength, power, speed, and muscle growth.

Figure 1:

Phosphocreatine (PCr) levels in muscle before and after creatine supplementation

This graph shows the average change in PCr levels in muscle after taking creatine.


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Creatine Boosts Muscle Strength

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Numerous studies have reported significant improvements in one-rep max strength of subjects taking creatine. For example, Belgian researchers reported in a 1997 issue of the Journal of Applied Physiology that untrained subjects taking creatine while following a 10-week weight-training program increased their one-rep max on the squat by 25% more than those taking a placebo while following the same program.

A 1998 study by University of Nebraska (Omaha) researchers found that trained collegiate football players taking creatine while following an eight-week weight-training program gained a 6% increase in their one-rep bench press strength, while those taking a placebo experienced no strength gains at all.

A review on creatine printed in the Journal of Strength and Conditioning Research reported that out of 16 studies investigating the effects of creatine on one-rep max strength, the average increase in strength was about 10% more in those taking creatine as compared to those taking a placebo (see Figure 2).

Studies also show that creatine enables subjects to complete more reps with a given weight. University of Queensland (St. Lucia, Australia) researchers reported that competitive powerlifters taking creatine while preparing for a competition increased the number of reps they were able to complete with 85% of their one-rep max by 40%, while those taking a placebo experienced no change in the number of reps they were able to complete with the same weight. In the 2003 review paper discussed above, the researchers determined that out of the 16 studies, the average increase in reps performed while taking creatine was about 15% more than those taking a placebo (see Figure 2).

Figure 2:

Percent increase in muscle strength

This graph shows the average percent increase in muscle strength and repetitions completed when subjects supplemented with creatine as compared to a placebo.


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Creatine Boosts Muscle Growth

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There are a plethora of studies showing that creatine significantly boosts muscle growth. The University of Queensland researchers found that the powerlifters taking creatine gained an average of more than 6lbs of lean bodyweight, with some subjects gaining as much as 11lbs of lean bodyweight in less than four weeks, while those taking a placebo had no change in bodyweight at all (see Figure 3).

Since creatine supplementation likely does not increase bone mass or organ mass, the increase in lean bodyweight is more reasonably the result of a gain in muscle mass. A study by researchers at Southern Illinois University at Carbondale reported in a 2000 issue of Medicine and Science in Sports and Exercise found that trained weight lifters taking creatine gained almost 5lbs of lean bodyweight in six weeks, while those taking a placebo experienced no change in bodyweight (see Figure 3).

Figure 3:

Increase in lean bodyweight

This graph shows the average increase in lean bodyweight (muscle mass) that subjects gained while taking creatine and following a weight-lifting program. Both studies found no change in lean bodyweight in subjects taking a placebo.


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Creatine Boosts Athletic Performance

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Most of the studies performed on creatine indicate that supplementing with it significantly enhances athletic ability due to its ability to produce higher muscle force and power during short bouts of exercise. The subjects used in these studies have mixed athletic ability and training status, from relatively untrained novices to competitive college-level athletes.

Some of the exercise performances that are improved include: various types of short-term, all-out cycling, sprinting, repeated jumping, swimming, soccer, kayaking, rowing, and of course weight lifting, which was discussed above. The greatest improvements in athletic performance seem to be found during a series of repetitive high-power output exercise bouts.

For example, following a short rest period (20–60 seconds) after a short sprint, speed may be increased on the second bout of sprinting. Athletic performance during these latter bouts of exercise can be increased by 5-20% with creatine over the placebo group. This means that athletes in sports such as football and soccer, in which continuous play typically lasts for only a few seconds, can expect a significant boost in performance from creatine.


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How Creatine Works

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Research shows that there are numerous ways by which creatine produces increases in muscle strength, muscle growth, and overall athletic performance. The majority of creatine’s benefits were originally believed to be solely due to the boost in fast energy that’s the result of increased PCr in muscles. This allows athletes to recover faster between bouts of exercise, such as fast running or weight lifting, which allows them to run faster or complete more repetitions with a given weight. And over time, the ability to complete more repetitions can result in muscle growth. While this is a major way that creatine works, today we know that creatine also works through a number of different mechanisms.

One of those mechanisms is through muscle cell volumization. This is a fancy term that means the muscle cells fill up with water. Since creatine is essentially a protein, it draws water from the blood and the space outside of the muscle cells (known as the interstitial fluid) into the muscle through the process of osmosis. This is the major reason for the rapid weight gain that’s associated with creatine supplementation. However, this increase in cell volume causes the cell membranes to stretch, which is thought to initiate long-term increases in muscle growth and strength through greater protein synthesis—the method that muscle cells use to grow.

Yet another way that creatine has been found to work is by increasing the number of satellite cells in muscle fibers. Satellite cells are basically muscle stem cells, and one way that muscles grow bigger and stronger is by the addition of muscle satellite cells to existing muscle fibers. A 2006 study from the University of Copenhagen found that after eight weeks of supplementing with creatine while following a weight-training program, subjects experienced almost 100% more satellite cells in their muscle fibers, as compared to those taking a placebo. As expected, the greater number of satellite cells was associated with greater muscle size. This can also lead to greater muscle strength and power.

And still yet another way that creatine works is through increases in the growth factor insulin-like growth factor-I. IGF-I is critical in initiating processes in muscle cells that lead to enhanced muscle growth and muscle strength. St. Francis Xavier University (Canada) researchers reported in a 2008 study that weight-trained subjects taking creatine while following a weight-lifting program for eight weeks had significantly higher IGF-I content in their muscle fibers than those taking a placebo.

And even still there’s another way that creatine works to increase muscle growth. Arak University (Iran) researchers reported in a 2010 issue of the journal Molecular and Cellular Endocrinology that subjects taking creatine while following a weight-lifting program for eight weeks had significantly lower myostatin levels than those taking a placebo. Myostatin is a protein that limits muscle growth. The Iranian researchers concluded that since myostatin levels were lower in the subjects taking creatine, one way that creatine may work to increase muscle size and strength is by reducing myostatin levels, which reduces the limitation that this protein places on muscle growth.


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Creatine’s Health Benefits

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In addition to enhancement of muscle size, strength, power, and overall athletic performance, creatine has also been found to provide numerous health benefits. Because PCr is important for energy production involved in nerve cell function, creatine has been shown to provide numerous benefits to the brain and the rest of the nervous system. For example, research has found that creatine supplementation enhances cognitive function and memory, may help in the treatment of Parkinson’s disease, Huntington’s disease, and even depression, and can also protect against brain injury.

Creatine has also been found to aid cardiovascular health, such as improvement of symptoms in those with congestive heart failure and may even lower cholesterol levels. One study published in a 1996 issue of the journal Clinical Science discovered that male and female subjects taking creatine for eight weeks experienced a drop of more than 5% in total cholesterol, and a drop in LDL cholesterol (the bad type of cholesterol) of more than 20%. Similar findings were found by researchers from Skidmore College (Saratoga Springs, NY). The researchers reported in a 2001 issue of the journal Metabolism that 28 days of creatine supplementation decreased total cholesterol by 10% in healthy young males. Virginia Commonwealth University researchers also showed that healthy young males taking creatine plus a multivitamin supplement significantly reduced their levels of homocysteine (an amino acid associated with heart disease), as compared to those taking just the multivitamin supplement.

These are just a few of the ways that creatine can benefit health. And new benefits are being discovered all the time. For example, German researchers found that creatine supplementation enhances skin cells’ protection from sun and oxidative damage. And research has even shown improved cognitive function in those supplementing with creatine. And in yet another study, German researchers found that the mice receiving supplemental creatine in their diet increased their lifespan by 10% more than mice not receiving creatine.


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Creatine Safety

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Although there is ample research showing that creatine is safe for most people to use, there are still myths regarding creatine’s safety and purported side effects. One of the longest-standing myths is that creatine can cause muscle cramps. Numerous studies debunk this claim. A 2003 study by Arkansas State University researchers concluded that NCAA football athletes taking creatine over the course of three years experienced no increase in muscle cramps or injuries. In fact, another 2003 study performed at Baylor University (Waco, TX) found that NCAA football players taking creatine for one full season actually had a significant reduction in muscle cramps and muscle injuries.

Another misconception about creatine is that it can lead to impaired liver and kidney function. Studies done in the ’90s were some of the first to show that short-term creatine supplementation does not impair kidney function in healthy adults. Two recent studies from Uruguay have further shown that eight weeks of creatine supplementation in soccer and football athletes had no effect on health markers that included kidney and liver function measures.

Longer-term studies have also been done to confirm creatine’s safety. Truman State University (Kirksville, MO) researchers concluded that NCAA football players taking creatine for up to about six years experienced no long-term detrimental effects on overall health or kidney or liver functions. Researchers from the University of Memphis also reported that NCAA football players taking creatine for close to two years exhibited no negative effects on general health or kidney and liver function.


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Forms of Creatine

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There are numerous firms of creative on the market today. In fact, there are so many that it’s almost impossible to include them all here. But here are some of the most commonly found forms sold today.

Creatine Monohydrate – The majority of research on creatine has been done with creatine monohydrate. For most people, creatine monohydrate makes a cheap, yet effective way to supplement with creatine. If you go this route, be sure to buy micronized creatine, which is ground down to a smalller size than other creatine monohydrates, which allow it to dissolve better in fluid, cause less stomach upset, and get absorbed better by the body.

Yet some people do report poor results with creatine monohydrate, as well as bloating and upset stomach. If you fall in this category, then a different form of creatine will likely work better for you.

Creatine Hydrochloride – One form of creatine that I am most impressed with is creatine hydrochloride, which is creatine attached to hydrochloric acid. One study found that creatine hydrochloride in the form of Con-Cret was absorbed by the body more than 60% better than creatine monohydrate. This allows for a lower dose of creatine to be needed, as well as enhanced results. It also prevents stomach discomfort and any water retention under the skin that some report with creatine monohydrate.

Magnesium Creatine Chelate – This is a combination of creatine with magnesium. Research shows that magnesium can enhance creatine’s ability to draw water into muscle, as well as its ability to increase muscle energy levels and prevent muscle fatigue. This is likely due to the greater uptake of the magnesium creatine combination into muscle cells.

Kre-Alkalyn – Kre-Alkalyn is a buffered creatine. That means that it is processed at a higher pH level than regular creatine, which prevents its conversion to creatine and therefore enhances its uptake and effectiveness. It also allows for lower dose to be used, and doesn’t cause any stomach discomfort or bloating.

A good product that uses krealkalyn is: EFX Kre-Alkalyn

Creatine Malate – Often listed as tricreatine malate or dicreatine malate, this form of creatine is composed of creatine bound to malic acid. Malic acid not only helps the absorption of the creatine, but it also increases energy production in the muscles for better endurance and less fatigue.

Creatine Alpha-Ketoglutarate – Creatine alpha-ketoglutarate is creatine attached to alpha-ketoglutarate. Like with arginine alpha-ketoglutarate, the popular nitric oxide booster, this form of creatine is supposed to be better absorbed by the body than monohydrate.

Creatine Gluconate – This form of creatine involves creatine attached to a form of glucose that enhances its uptake in the body.

Creatine Ethyl Ester – Creatine ethyl ester is creatine with an ester group attached, which is supposed to enhance creatine’s ability to pass across cell membranes to make it easier to be absorbed by the intestines. Two recent studies did report that creatine ethyl ester was not better than creatine monohydrate for increasing muscle creatine levels.

Creatine Orotate – Often listed as tricreatine orotate, this is creatine bound to orotic acid. Orotic acid is a precursor to nucleic acids (what DNA are made out of). Orotic acid also enhances the formation of creatine phosphate in muscle cells, which is the form of creatine our bodies use to produce the quick energy, known as adenosine triphosphate, that fuels weightlifting workouts.

Creatine Pyruvate – Creatine pyruvate has pyruvate, which boosts endurance and buffers lactic acid in the muscle, allowing you to train harder for longer.


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Creative Dosing

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How much creatine you need to take depends upon the form. For creatine monohydrate, research shows that using a loading phase of 5g taken 4-6 times per day for 5-7 days can boost muscle creatine levels by as much as 40% in under a week. However, research has also shown that taking just 5g per day can also lead to similar increases in muscle creatine levels, but it takes approximately 30 days, or about a month.

This is the main reason why a loading phase is recommended for those starting to supplement with most forms of creatine. The loading phase allows you to start experiencing the benefits of creatine in the shortest amount of time. After you complete the loading phase you can stick with a 5g dose of creatine within 30 minutes before and within 30 minutes after workouts. That’s because research shows that when creatine is taken around workouts, the accumulation of muscle creatine is maximized as compared to taking creatine at other times of day.

The best way to maximize creatine uptake by muscle cells is to take creatine with high-glycemic (fast-digesting) carbohydrates, such as a sports drink or gummy bears, and fast-digesting protein, such as whey protein. The major reason for this is that these nutrients boost blood insulin levels. This anabolic hormone is critical for stimulating the transport of creatine into muscle cells.

Many of the other forms of creatine, such as creatine hydrochloride and Kre-Alkalyn, allow you to take a much lower dose and not bother with the loading phase. For the other forms of creatine, use the dosing amount recommended on the label. However, I strongly suggest that whatever that dose is that you take one dose within 30 minutes before workouts along with your pre-workout protein shake, and one dose within 30 minutes after your workout along with your protein shake and fast carbs. On days that you do not train, take one dose of creatine with your morning protein shake and carbs.

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