Creatine
Creatine is a compound that comes from three amino acids. Creatine is found mostly in your body's muscles as well as in the brain. Most people get creatine through seafood and red meat - though at levels far below those found in synthetically made creatine supplements. The body's liver, pancreas and kidneys also can make about 1 gram of creatine per day.
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Research suggests that taking a creatine supplement can be beneficial in several ways.
Creatine supplementation benefits the muscles by:
Helping you add more reps (repetitions) to your workouts
Increasing muscle size, strength, and overall performance
Increasing what's called satellite cell signaling, which helps with muscle repair and growth
Increasing water content in muscle cells, which is another factor in muscle growth
Helping reduce muscle breakdown, resulting in an even greater increase in total muscle mass
In addition, studies have noted an increase in anabolic hormones like IGF-1, which aids in muscle formation, and a decrease in myostatin, a substance that can inhibit new muscle growth.
Creatine Benefits in the Brain, Bones, and Skin
Researchers have found that supplementing the body's natural creatine stores may improve cognitive task performance, particularly in older adults. It may also slow the normal decline in bone mineral and skeletal muscle density, and creams containing creatine and folic acid may reduce skin wrinkles and improve sun damage.
Creatine Benefits in Children
You should never give a child creatine without explicit directions from their pediatrician. However, there's evidence that creatine supplementation can help reduce symptoms of specific creatine deficiency syndromes in children.
Creatine Supplementation for Low Levels
Many people can benefit from taking a creatine supplement. However, these products are most helpful to those with low creatine levels, such as vegetarians whose diets don't supply as much of it.
Creatine helps give your body's muscles energy and strength. Your muscles store creatine in the form of creatine phosphate. When the body needs a sudden burst of energy, the muscles convert the creatine phosphate into energy-carrying molecules. Because of this, creatine supplements are often used for improving athletic performance and enhancing muscle mass.
Dietary sources of creatine
Foods that are high in creatine are animal-based foods that contain protein. Dietary sources of creatine include:
Meat, especially red meat
Fish, such as herring, salmon, and tuna
Poultry, like chicken or turkey
Milk, including breast milk or cow's milk
Plant-based foods do not contain any creatine.
Supplement sources of creatine
Creatine supplements come in various forms. The most popular is powder. Creatine monohydrate in powder form has also been studied the most extensively.
Other forms, such as creatine salts and premade creatine beverages, are made because the powder form doesn't dissolve in liquid very well. But these other forms have not been well studied. And the few studies that exist seem to show that the powder form is most effective.
There are a few forms of creatine, though creatine monohydrate is the most widely studied and effective at increasing muscle creatine stores.
Research shows that other types of creatine — including creatine salts, creatine ethyl ester, creatine nitrate, creatine dipeptides, buffered creatine, creatine hydrochloride, and creatine serum — are not as effective as creatine monohydrate.
Creatine Monohydrate
Creatine monohydrate has been repeatedly shown to be most effective at increasing creatine stores and improving exercise performance.
Creatine monohydrate has more creatine per gram than any other type, and it gets absorbed quickly into your blood and muscles. It is the best form of creatine for supplements out there.
Creatine Ethyl Ester
Research shows creatine ethyl ester does not increase athletic performance or muscle strength.
Creatine Nitrate
Creatine nitrate combines creatine with nitric acid and water. Since nitric oxide can improve vasodilation and exercise performance, product makers believed that combining them would further improve athletic performance.
What Happens When You Start Taking Creatine?
Most creatine goes to your skeletal muscles, which convert creatine into a compound of creatine and phosphoric acid (phosphocreatine or creatine phosphate). Phosphocreatine then helps create adenosine triphosphate (ATP). ATP is a source of energy that your cells use when you exercise. So, creatine helps maintain a continuous energy supply to your muscles during intense lifting or exercise.
In addition to providing more energy and helping to increase muscle growth, creatine helps:
Speed up muscle recovery. When you exercise, you create micro-tears in your muscle fibers. As you recover, the micro-tears in your muscle fibers heal, and your muscles get stronger. Creatine helps activate satellite cells in your muscles, which help the micro-tears heal.
Increase anabolic hormones. Anabolic hormones contribute to growth and tissue repair. They include insulin, human growth hormone (hGH), estrogen and testosterone.
Boost water content in muscle cells. Better cell hydration may increase muscle growth and reduce dehydration and muscle cramps.
Creatine can also increase the amount of phosphocreatine in your brain, which may help with your memory.
Creatine Supplements Can Help Build Muscle Mass
Creatine is an organic compound that the body relies on for a continuous supply of energy to the muscles. It is particularly useful during brief bursts of intense, anaerobic activity, such as when lifting weights or sprinting a short distance. Creatine is synthesized by the body from a trio of amino acids, primarily by the liver. The kidneys also play a role, and the pancreas is believed to contribute, as well. The compound also is available from dietary sources, mainly red meat, seafood and chicken.
The majority of creatine is stored in the skeletal muscles in a form known as phosphocreatine, or creatine phosphate. A small amount, less than 5%, is found in the tissues of the brain and testes. Creatine aids in the production of adenosine triphosphate, or ATP. That's the body's main source of energy for crucial functions, including powering muscle contraction and release, the transmission of electrical impulses along the nerves and the synthesis of protein for tissue maintenance and repair.
Researchers have found that when someone takes creatine supplements while engaged in a program of resistance training, such as weightlifting, it can help to build lean body mass.
Additional studies into the potential health benefits of creatine supplements suggest it may improve certain blood lipid levels, aid in keeping skin elastic and healthy, aid in some symptoms of Parkinson's disease and speed recovery from muscle overuse and fatigue. There is also evidence, in newer research, that suggests creatine may have cognitive benefits for people with brain injuries, such as concussion.
A healthy person with a balanced diet that includes red meat, chicken and seafood will get an adequate supply of creatine. However, research shows that supplements can be helpful in making athletic gains. Some studies have found that using a creatine supplement can help build muscle mass and improve strength. For most people, these gains tend to be modest. Unless you're an elite athlete in search of a microsecond advantage, creatine supplements alone are unlikely to deliver significant athletic gains.
One group that can benefit from creatine supplements are people on meat-free diets. A study in which meat-eaters spent a month on a vegetarian diet that included eggs and dairy products saw a marked drop in the participants' creatine levels.
When it comes to creatine supplements, a wide body of research has found them to be safe. When taken in large quantities, some people do report experiencing gastric problems. As with any dietary supplement, it is important to talk to your health care provider before adding creatine to your daily routine. There are many types of creatine supplements, which come in a wide range of dosages. Your doctor will help you evaluate your goals and can guide you in choosing the right supplement for your needs.
Indirectly testing creatine by testing creatinine is the most common way to test. Specifically, the following two tests are recommended:
Creatinine Clearance
A creatinine test can be helpful in monitoring kidney function, though this test may be falsely elevated with ongoing creatine supplementation. Combining creatinine alongside other markers of kidney function, such as the glomerular filtration rate (GFR), can help ensure healthy kidney function long-term.
Glomerular Filtration Rate (GFR)
Testing the GFR as part of a comprehensive metabolic panel can help provide insight into a bigger picture of kidney function, particularly in individuals supplementing with creatine who may have pre-existing kidney/liver conditions or who wish to be proactive about supporting overall health.
Creatine Supplements
The most common, well-researched form of supplementary creatine is creatine monohydrate. While other forms exist and are marketed as superior forms of creatine, research is lacking outside of creatine monohydrate.
Regarding dosage, a dose of 5 grams of creatine monohydrate daily has been linked to both athletic and brain-based benefits, though it may take up to a month to experience the benefits of supplements.
With specific regard to athletic performance, it's common to start with a "loading" phase of a higher dose of creatine (up to 20g per day) for a week, split into four doses of 4-5 grams throughout the day.
Taking creatine alongside a meal containing carbohydrates or protein can help with absorption and maximize the supplement's benefits.
It should be noted that water retention can occur when supplementing with creatine, so it's important to stay hydrated when supplementing.
If you're an active person or are part of the athletic community, chances are high that you've tried - or at least heard of - creatine. Next to protein powders, creatine is one of the most widely used supplements to improve athletic performance and increase strength.
What is Creatine Used For?
When creatine is consumed or produced in your body, approximately 95% of it is stored in your muscles as phosphocreatine. From there, it can be used as a quick energy source for short bursts of high-intensity activities as well as replenish your ATP stores (the primary energy for cells).
When you're doing high-intensity activities, like sprinting, jump-roping, or burpees, the energy demand can be greater than the speed at which your ATP stores are repleted. This is where creatine shines, providing that fast fuel and contributing to ATP storage.
In other words, when supplementing with creatine, you're increasing the phosphocreatine stores within your muscles anywhere from 10-40%, allowing your body to work at a higher intensity for a longer period of time.
That's why so many athletes who are looking to increase high-intensity exercise capacity and lean body mass choose creatine. For this purpose, creatine is the safest and most effective nutritional supplement currently available.
It's important to clarify that while supplemental creatine is helpful for high-intensity workouts, it's not going to be super beneficial for endurance exercises like running long distances.
What's the Best Type of Creatine?
When choosing a creatine supplement, know that there are several types. The most widely used and researched is creatine monohydrate, but other forms include creatine ethyl ester, buffered creatine, and creatine hydrochloride (creatine hcl).
All of them work in a similar way, but each one has its own distinct characteristics, like how quickly they're absorbed. You can also generally find them in a variety of forms, whether it's a powder to mix with water, a chewable tablet, or capsules to take before a workout.
Here's a more detailed breakdown of each type of creatine you may come across:
Creatine monohydrate: This is a white, crystalline powder that is quickly absorbed and transferred from your blood to your muscles to be used for energy. It typically has no odor or flavor.
Creatine ethyl ester: This form has been chemically modified with an ethyl group in order to boost its bioavailability. While it claims to be more effective than other forms of creatine, the evidence is mixed.
Buffered creatine: Also called Kre-Alkalyn, this type of creatine has had its pH adjusted to be less acidic compared to other forms, particularly creatine monohydrate. It also claims to be more stable, better absorbed, and have fewer potential side effects. Buffered creatine typically comes in capsules and powder.
Creatine hcl: This newest form of creatine has been modified to improve its solubility. The addition of hydrochloric acid is intended to help boost its absorption in your digestive system. In terms of creatine hcl vs monohydrate, this form is often recommended at a lower dose because of its purported better absorption, but the evidence for this is limited.
Creatine monohydrate has been around the longest and therefore we have the most data on its benefits and efficacy for athletic performance. Creatine hcl is the newest version and while promising, more research is needed.
At the end of the day, creatine monohydrate is proven to be the most effective form of supplementation. It's also the most affordable.
One 2022 analysis of the safety, cost, and effectiveness of the several forms of creatine concluded that creatine monohydrate still comes out on top. The authors agree there's not enough evidence yet to support the claims made by the other forms being sold, particularly when their price point is often higher than creatine monohydrate.
Final Thoughts
Creatine is a safe and effective nutritional supplement used by countless athletes. It works best when your goal is improving your high-intensity exercise capacity and increasing your lean body mass. When choosing one, I recommend creatine monohydrate as the best type of creatine.
Opt for a product that has been independently tested for quality, safety, and purity and bears a seal from NSF Certified for Sport or Informed Sport. This assures what's listed on the package is what's actually in the product, which is critical for athletes trying to avoid banned substances.
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