If you are an athlete or are dedicated to the gym and training, you have most likely considered a creatine supplement. While considering adding the supplement to your routine, some questions about the safety, effectiveness and side effects may have been in your Google search.
There are many myths and unsupported information about creatine on the internet or spread by people who have taken the supplement previously. Some of this misinformation includes creatine causing water retention, weight gain, upset stomach, dehydration, and cramps. Everyone’s body will react differently to taking a new supplement, so although it cannot be 100% confirmed side effects will not be present, research has found most of the myths to not be true.
Creatine supplementation is one of the most popular and researched topics in sports nutrition, so there is a multitude of data to review and discuss. This post will explain background information on the creatine supplement, recommendations, research to support the recommendations, and safety.
How does Creatine Work?
Creatine is a naturally occurring non-protein amino acid found mainly in skeletal muscle. Creatine can be found in animal products including red meat and seafood. When taking a creatine supplement, the amino acid is absorbed into the blood and uptaken by the target tissue.
The most common goals when taking creatine are increased force and power output, strength, anaerobic threshold, work capacity, and possibly enhance recovery. In a few meta-review research articles, these goals were consistently attained by the athletes being observed.
Strength and power were increased due to an increased concentration of intramuscular phosphocreatine (PCr) energy forms. The PCr energy system is used for activity lasting for 0-30 seconds which includes a vertical jump, power clean, squat, etc. Recovery is another outcome studied when observing creatine effects. A study found that creatine reduced post-exercise inflammatory responses by decreasing muscle damage markers and soreness following intense bouts of exercise. This result was not consistent in all of the studies observed, so more research needs to be done.
Overall, the literature reviews confirmed creatine monohydrate supplementation increases performance between 10-15%. The increase was observed in max power and strength outcomes, anaerobic capacity, and work during repetitive sprints and single sprints. There are many possible performance improvements that are associated with creatine supplementation while no significant side effects are present.
Two articles compared male athletes taking creatine, and the only non-strength and performance-related marker that was shown was an increased body mass found in one of the two articles. As stated before, supplements will affect every individual differently, so dosage could be something to consider in this population.
Research has determined that the most effective way for increasing total muscle creatine stores is a process called loading.
A loading dose includes taking 5 grams (or 0.3 g/kg/day) 4 times a day for 5 to 7 days. Once this phase is completed, then taking 3-5 grams per day (5-10 g/d for larger athletes) is recommended to maintain the creatine stores. Another way to increase creatine stores is through a gradual method. This method involves consuming 3 grams per day to slowly increase the muscle creatine content which will have less of an effect on training performance.
When comparing research for both dosage methods, male participants used a mixture of the set gram amounts (5 grams/d) or the amount per kilogram of body weight (0.3 g/ kg/d). Female athletes primarily used the gram per kilogram body weight amount. Although not specified in the article, using the 0.3 g/kg/d amount may be more appropriate for female athletes.
The research determined the loading method is the most effective way to increase creatine stores in the muscle. This method as well as ingesting a carbohydrate source or carbohydrates and a protein will offer the quickest way to obtain training adaptations. Performance of high-intensity/repetitive exercises was found to increase linearly to the muscle creatine content.
Is it Safe?
Creatine is a safe supplement with no clinical side effects being consistently reported.
An American collegiate football study observed the effects of the athletes ingesting 16 g/d for 5 days and then 5-10 g/d for 21 months. In conclusion, there were no clinically significant differences between the creatine and non-supplement groups. These clinical markers included renal function, muscle, and liver enzymes, electrolytes, blood lipids, red blood cell status, etc.
The only consistently reported side effect is acute weight gain in both short and long-term dosing. This is potentially due to the osmotic properties of the creatine supplement. While creatine loading, short-term fluid retention that was proportional to the weight gain was observed. The article focused more on the benefits of fluid retention, which helps with hydration status for athletes in the heat and humidity, rather than weight gain.
Organizations including the International Society of Sports Nutrition, American Dietetic Association, American College of Sports Medicine, etc. support the usage of creatine supplementation for improved performance.
Overall, a creatine supplement could be a great addition to your training routine. Creatine has been shown to improve power and force, strength, and anaerobic threshold in athletes. The loading method while ingesting carbohydrates alone or carbohydrates with protein was proven to be the most effective way to reach the desired training adaptations. It is important to note that supplementation will affect everyone differently. If your goals are similar to the potential effects of supplementation, then it is worth a try!
1. Wax, B., Kerksick, C. M., Jagim, A. R., Mayo, J. J., Lyons, B. C., & Kreider, R. B. (2021). Creatine for exercise and sports performance, with recovery considerations for healthy populations. Nutrients, 13(6), 1915. https://doi.org/10.3390/nu13061915
2. Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition Position Stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1). https://doi.org/10.1186/s12970-017- 0173-z