Creatine Supplementation: Is It Safe?

Creatine Supplementation: Is It Safe?

Although it is one of the most extensively researched supplements on the market, it still gets a lot of hate. There are numerous myths and fallacies surrounding creatine and most of which are untrue.

These include:

• Creatine is a steroid.
• Creatine damages your kidneys.
• Creatine in general isn't safe.
• You have to load creatine or it won't work.
• You get incredibly bloated when taking creatine.
• You get fat when taking creatine.
• When you stop taking creatine you lose all your strength and go back to being fat.
• Taking creatine with juice is more effective.
• Other forms of creatine are more effective.

You can start to get the idea. This article should explain things in a bit more detail so you get a better picture of what it's about and then make your own decisions based on the truth.

This article will take you through:

1. What is creatine.
2. How does it work.
3. How should you take it.
4. When should you take it.
5. Summary of the evidence.

What is Creatine?

Creatine is an organic compound. Humans can both produce creatine and ingest it from animal products such as meat and dairy. Human synthesize creatine in the kidneys and liver at a rate of about 1g per day and then transport it to the muscle cells and other organs of the body such as the brain. On average, humans have a total intake of about 2g per day. Naturally, vegans and non-meat and dairy eaters have a significantly lower intake than their omnivorous friends, but this can be potentially offset by ingesting foods high in the amino acids glycine and arginine.

How Does Creatine Work?

The main function of creatine in skeletal muscle is to recycle ATP to fuel muscle contractions (see here for a better explanation). In the muscle cell there is Creatine Phosphate (CrP) present. This is creatine with a phosphate group linked. When muscle contraction begins, and the levels of ADP begin to rise within the cell, a reaction occurs in which the phosphate group from CrP is donated back to ADP, to form new ATP molecules. This transfer allows for a continues supply of ATP to skeletal muscle to maintain muscle contraction. This happens extremely quickly and this system is the first source of energy when muscle contractions begin. The CrP stores have enough to sustain muscle contractions for roughly 15 seconds and these are mainly recruited during explosive actions (e.g. 100m sprint).

Why Supplement With Creatine?

So, given that our body produces it, and we can get it directly from our diet, why should we supplement with it? Well, we only get on average about 2g of creatine per day from both stores. Research studies have shown us that we only begin to see a performance benefit from creatine when we are in the region of 3-5g per day over a sustained period of time. The cooking process actually degrades the creatine content of meat so as a result you'd have to eat an impractical amount of meat to get the required amount. Hence, why supplementation of creatine is a good idea if you are involved in strength training or a sport that requires explosive actions and a high level of strength and power.

Supplementing with creatine increases your intramuscular creatine concentration. Meaning, you have more CrP in the muscle. Hence, a better ability to fuel muscle contractions during explosive activities. Simple really. Having more CrP available to you will allow you to do several things:

1. Maintain the strength of muscle contractions (fatigue resistance).
2. Recover quicker between sets due to having more fuel available to you.
3. Be more explosive for longer.
4. Train at a higher intensity for longer.

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How Should You Take It?

While there is this misconception that you HAVE to go through a loading phase with creatine, it can be useful. A loading phase is not necessary but it can help increase the speed in which your creatine stores within the muscle become saturated. A loading phase simply implies that you go through a phase usually 4-8 days of supramaximal (0.3g/kg of bodyweight) dosing. In theory this will result in your creatine stores being saturated sooner rather than later. When supplementing with the normal dose (0.03g/kg of bodyweight) this effect takes place after roughly 28 days. In essence, loading isn't necessary but can be a useful protocol to use. If new to taking creatine then I would suggest stick to the normal dosage and continuously take it.

Other things of note are:

• There is no need to cycle creatine. You do not need to stop taking it every couple of weeks to give yourself a break. There is no advantage to doing this. And during this break your intramuscular CrP stores may decline back to basal pre-supplementing levels.
• You can take it whenever you like during the day. If you are new to taking it, or you are in the first month of taking it then I would recommend taking it 30-60 minutes before training. Creatine has a half life of roughly 3 hours, meaning that there is the potential for it to have passed through the system in three hours. When you are supplementing with it for longer periods then this isn't an issue. This is a another reason why having a loading phase can be ideal.
• One of the side effects of creatine supplementation is water retention. Inherently, this isn't a bad thing, although people will complain about looking/feeling fat or puffy due to it. The levels of retention are going to differ from person to person so given an exact number of how much weight you might gain would be nonsensical. As a result you will need to increase the amount of water you drink on a daily basis. You should be hitting the 30-40ml/kg of bodyweight number at the very least and then adding in an extra 500-1000ml based on how you feel on a day to day basis. 
• You do not have to take it with juice. You can take it with any liquid you like (water, milk etc). It is hypothesised that mixing creatine with fruit juice produces an insulin response (to the juice) and this will help with transporting the creatine into the muscle cell. The body of evidence for this proposed mechanism is weak at best. It all comes down to personal preference. IF you want to take it with juice then by all means do but it is not a necessity.
• There are many forms of creatine. Creatine monohydrate, creatine ethyl ester, creatine magnesium chelate, micronised creatine and many more. At the present moment most of the research has been conducted on creatine monohydrate and it appears to be the safest and most effective. There has been research on the other forms but none of which seems to be superior. Creatine monohydrate is also drastically cheaper than the other forms and so it would make sense to stick with creatine monohydrate.
• The notion that you will lose ALL of your strength when you stop taking creatine is false. There is the possibility that you may feel a slight loss in strength when you stop taking it, but you will not lose all fo your strength. Strength gains from taking creatine are not directly related to the consumption of the supplement itself, they are a result of the increased volume of work that you can do, increased recovery rates and the potential placebo effect of taking a supplement. So, you will not automatically lose all your gains but you may see a slight decline in some of these areas.
• As for losing all of your muscle, this one is completely not true. When supplementing with creatine you retain more water (as spoken about above) and you appear puffy. When you stop taking creatine this water retention slowly resides and what will happen is, the muscle mass you have developed over the previous few months training will eventually begin to manifest itself a little bit better. It will also allow you to make a better judgement call on how much fat mass you have gained as well.

Summary of Creatine Myths

As spoken about above, there are many myths surrounding creatine supplementation. Most of them are unfounded in the research and have come about from scaremongering in the media regarding certain certain supplements. For example, in the last 6 months there has been a call in the US for a ban to be placed on selling creatine to 'minors', even though the evidence suggests that creatine can be an effective dietary supplement for people on both edge of the age spectrum (18 months old up to 80 years old). Creatine has been proven to be safe in pretty much all kinds of populations with little to no risk. Those with pre-existing kidney/liver problems or a family history of it should seek medical advice before taking any exogenous supplement. If you are interested in reading more about creatine and it's effects on different parameters then click here for more info.

Take Home Message

Creatine is perfectly safe in the region of 0.03g/kg of bodyweight per day for athletes who are engaging in high intensity activity and sports on a regular basis. For simpler guidelines:

• Dosage = 5g/day
• When to take it = Anytime of day - can prioritise it 60 minutes before training/matches
• How to take it = mix it with a liquid of your choice and drink as normal, making sure that you get all of it and there isn't any residue left on the bottom of the glass.
• There is no need to cycle it, just keep taking it regularly.
• Increase your fluid intake slightly while supplementing with creatine.
• Creatine monohydrate is the most effective and cheapest blend.
• People with a family history of/previously diagnosed with kidney/liver disease who seek a professional opinion before supplementing with anything.

Make sure to check out our article of BCAA supplementation also!

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