What Are the Pros and Cons of Creatine?

Explanation of Creatine and How It Works

Creatine is a naturally occurring substance in the human body that is made of three types of amino acids. Amino acids are the building blocks of proteins. The human body makes creatine in the liver, kidneys, and pancreas. It is also found in protein-rich foods like seafood (fish and shellfish), red meat (beef, pork, veal), and animal milk (sheep, goat, and cow milk). 

Creatine is a natural source of energy for skeletal muscles. Skeletal muscles are voluntary muscles that you can control and that allow you to move. Creatine provides energy to skeletal muscles so that they can contract during exercise. About 95% of the creatine made in the body is sent to skeletal muscle fibers for use during physical activity. You can also take creatine in the form of supplements (pills, powders, liquids, and energy bars) if you work out a lot or if your diet doesn’t supply adequate creatine. 

What Happens When You Take Creatine Supplementation?

When you take creatine daily, it is transported to your skeletal muscle fibers which convert it to a compound called phosphocreatine or creatine phosphate (a combination of creatine and phosphoric acid). Phosphocreatine is then used to make adenosine triphosphate (ATP), which is a source of energy for cells in the body. In this way, creatine helps during exercise and weight training by giving your muscle cells a readily available supply of energy.

Is It Legal to Take Creatine Supplements to Improve Athletic Performance?

Yes, it is legal to take creatine supplements to improve athletic performance. However, professional athletes should be careful when using creatine supplements because all supplements carry some risk due to the possibility of contamination with banned substances.

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Benefits of Creatine

Enhances Muscle Mass

Studies suggest that taking creatine supplements along with weightlifting and exercise can lead to increased muscle mass in young adults between the ages of 18 and 30. However, there isn’t enough evidence to suggest that taking creatine can increase muscle mass in older adults (above age 65) with aging muscle status or in people with muscle diseases.

Improves Athletic Performance

Many athletes take creatine supplements to improve performance. Evidence suggests taking creatine provides a quick burst of energy, increased strength, enhanced muscle performance, reduced dehydration, decreased muscle cramping, and faster muscle recovery. Studies have found that taking creatine with carbohydrates increases glycogen availability in muscle cells. Glycogen is a source of energy, and by increasing glycogen stores in muscles, creatine helps to enhance endurance and athletic performance. 

Creatine has significant benefits especially for athletes involved in power sports and high-intensity exercise like wrestling, bodybuilding, hockey, football, running, and swimming.

Supports Brain Health

Research suggests that taking creatine supplements may have a neuroprotective effect in older adults above the age of 60. Creatine supplementation could potentially improve short-term memory and reasoning. Research is underway on the possible health benefits of creatine on brain function in people with brain disorders such as dementia.

Other Potential Benefits of Creatine

Creatine supplementation may also have potential health benefits such as:

• Counteracting sarcopenia (age-related loss of muscle mass) and aiding fall prevention in older adults.

• Improving physical therapy outcomes after muscle injuries.

• Lowering cholesterol and triglyceride levels.

• Protecting against neurodegenerative diseases such as Parkinson’s disease or Huntington’s disease.

• Reducing fat accumulation in the liver and lowering the risk of liver disease.

• Decreasing homocysteine levels.

• Reducing the risk of heart disease and heart attack.

• Acting as an antioxidant and slows skin aging.

• Improving glycemic control and blood sugar levels in people with diabetes.

• Slowing the progress of some types of cancers.

• Minimizing bone loss and muscle loss.

• Improving functional capacity and bone health in people with osteoarthritis and fibromyalgia.

• Enhancing cognitive function, especially in older adults.

• Improving the effectiveness of certain antidepressant drugs.

• Treating conditions that affect creatine metabolism or creatine transport in the body.

Drawbacks of Creatine: What Are The Negatives of Creatine Supplementation?

Potential Side Effects of Creatine

Most people tolerate creatine well without any major side effects. Some people may experience fluid retention and weight gain, dizziness, excessive sweating, and gastrointestinal distress (nausea, vomiting, and diarrhea) as side effects of creatine. If you develop these side effects after starting creatine supplementation to build muscle and improve performance, try taking the supplement in divided doses instead of taking it all at once.

Long-Term Safety Concerns

Studies have not found any long-term health risks associated with up to 4 years of creatine supplementation for improved muscular strength.

Impact on Kidneys And Liver

Taking creatine can raise your blood creatinine levels. Creatinine is a waste product made by muscles in the human body. In healthy individuals, the kidneys filter creatinine in blood and eliminate it from the body through urine. Healthcare providers measure creatinine levels in blood to assess kidney function. A high blood creatinine level can be an indicator of kidney damage and certain health conditions. 

While taking creatine may increase creatinine levels in the blood, it does not harm the kidneys or affect kidney function. In most healthy individuals, the kidneys can handle the extra creatinine and eliminate it from the body. However, it is important to talk to your doctor before taking creatine supplementation if you have pre-existing liver or kidney disease.

Misconceptions and Myths

Myth: Creatine is an anabolic steroid.

Fact: Creatine is not a steroid. It is made of amino acids (the building blocks of proteins). 

Myth: You don’t need to take creatine supplementation because it’s present in dietary sources.

Fact: Creatine is present in certain foods, but you have to eat a large amount of these foods to get the same amount of creatine as a creatine supplement. In addition, creatine is mainly found in foods of animal origin, and studies have shown that vegetarians have 20-30% less muscle creatine compared to people who eat animal-origin foods.

Myth: Creatine causes weight gain.

Fact: Some people report bloating and temporary weight gain of 2-5 pounds due to short-term water retention after taking creatine supplementation. In the long-term, weight gain on creatine supplementation may be due to gains in muscle mass.

How To Supplement With Creatine

Types of Creatine Supplements

The most common type of creatine supplement is creatine monohydrate. This is the form of creatine supplementation that has been studied extensively and is well researched through clinical trials, systematic reviews, and meta-analysis. It is therefore considered the best choice. Creatine monohydrate is water soluble and is available as a powder and pill form.

Other forms of creatine supplementation available include:

• Creatine hydrochloride: This form is more water soluble than creatine monohydrate but has not been studied as extensively. Initial research suggests it has comparable effects in improving exercise performance.

• Creatine ethyl ester: Studies suggest mixed results on whether creatine ethyl ester is more effective or less effective in improving muscle mass, strength, and power compared to other types of creatine.

• Buffered creatine (kre-alkalyn): This type of creatine supplementation is less acidic and more stable in the stomach. It may, therefore, cause fewer side effects like bloating. However, buffered creatine has not been well-studied, and these claims have not been proven by research.

• Creatine magnesium chelate: More research is needed, but small studies show creatine magnesium chelate is comparable to creatine monohydrate in improving strength during high-intensity activities. 

• Liquid creatine: This is a convenient form of creatine supplementation, but is not stable and may be less effective than other forms of creatine.

Recommended Dosages: How Much Creatine Should I Take Every Day? 

Many athletes use creatine supplementation during training for a specific event. The usual protocol consists of a loading phase in which the daily dose is 0.3 grams of creatine per kilogram of body weight for 5-7 days. This is followed by a maintenance phase with a daily dose of 2-3 grams per day of creatine, up to a maximum of 5 grams per day. However, research suggests taking creatine supplementation at 2-3 grams per day for four weeks gives the same results as the loading protocols.

Dietary supplementation of up to 20 to 30 grams per day with creatine monohydrate for up to 5 years has been studied in people with specific medical conditions. However, such high doses of creatine should not be taken without medical supervision.

Should I Take a Creatine Supplement Every Day?

From a general health, fitness, and lifespan perspective, the recommended daily dose of creatine supplements is about 2 to 4 grams per day. 

Experts used to recommend taking creatine for 2-3 months and then coming off it (cycling creatine supplementation). This was advised because of safety concerns. However, based on extensive research, this is no longer considered necessary.

Creatine for Specific Populations 

Women

It is a common myth that creatine is only for male athletes and bodybuilders. However, the truth is that creatine supplementation is suitable for both male and female athletes as well as general women’s health and maximizing exercise performance. 

Adolescents 

The American Academy of Pediatrics does not recommend creatine supplementation for people younger than 18 years of age. While a creatine supplement regimen is generally safe for use in adults, there isn’t enough research to support the safety of creatine use in adolescents or children. 

Tips For Effective and Safe Usage

Scientific evidence suggests that taking creatine supplements with proteins and carbohydrates may make them more effective. Remember, creatine supplements will only work alongside regular exercise. To ensure safety, check with your healthcare professional before starting creatine supplementation. 

What Happens When You Stop Creatine?

Your muscle size may decrease after you stop creatine use. However, as long as you continue regular exercise, resistance training, and adequate nutrition, you can maintain the muscle strength and muscle mass gained on creatine supplementation. 

Is Creatine Worth The Risks?

Creatine is generally considered safe for short-term use by healthy individuals and athletes. However, it is worth remembering that creatine is a dietary supplement and is not regulated by the U.S. Food and Drug Administration (FDA). For this reason, you cannot be sure that the creatine supplements you purchase in drugstores, health food stores, gyms, or online contain pure creatine and are not contaminated with unknown, potentially harmful substances. 

Talk to your doctor before taking creatine supplements for muscle growth, especially if you have other health conditions or take medications (prescriptions and over-the-counter products). Always purchase creatine supplements made by reputable manufacturers. Do not take more than the recommended dose mentioned in the package. If you are unsure how much creatine you should take, talk to your doctor, who can ensure the dose is safe and effective to help you meet your health goals.   

Expert Opinions and Research Findings

The American College of Sports Medicine and the International Society of Sports Nutrition's position stand is that a creatine dietary supplement is “the most effective ergogenic nutritional supplement currently available to athletes for increasing high-intensity exercise capacity and lean body mass during training.” Professional sports organizations, including the International Olympic Committee (IOC) and the National Collegiate Athletic Association (NCAA), allow athletes to use creatine supplements for muscle growth.