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Ultimate Guide to Creatine: Benefits, Dosage, and Side Effects Explained

 

Y’all want to talk about creatine?? Don’t mind if I do!! Creatine may be one of my favorite supplements! Between how well researched/studied it is and how many different conditions it can help, it really makes my performance dietitian heart happy….and super excited.

 

Creatine has earned its place as one of the most researched and widely utilized supplements in the realm of fitness and sports nutrition. In sports nutrition, it’s a fan favorite  for its ability to enhance athletic performance, promote muscle growth, and support overall health for the athlete. But did you know, creatine has also garnered attention for its diverse array of benefits.

 

But what exactly is creatine, and how can it positively impact various aspects of health and well-being? Creatine, its not just for athletes!

 

Where Does Creatine Come From??

Creatine is a naturally occurring in animal meat products. Dietary creatine is a compound found primarily in meat and fish. There is no meaningful creatine found in eggs or dairy products. And for my vegans and vegetarians out there…..sorry but there is no meaningful creatine source in your diets, but creatine supplements are vegan/vegetarian friendly!

Creatine is also in the human body, mainly in the liver, kidneys, and pancreas. How much creatine our bodies produce is based on sex and the size human you are. Males tend to produce more creatine than females, and larger humans tend to produce more than smaller humans. On average, our bodies produce between 1-2 grams of creatine each day, regardless of dietary choices.

 

What Does Creatine Do?

1.     Creatine is most well known for its crucial role in energy metabolism, particularly during short-duration, high-intensity activities like weightlifting, sprinting, and jumping. Creatine is a key component on the fastest energy production pathway in our bodies! So we use it when all other pathways are just taking too long to get us energy!


During states of energy needs, your body rapidly breaks down adenosine triphosphate (ATP) for energy. Creatine phosphate, a form of creatine stored in your muscles, donates a phosphate group to adenosine diphosphate (ADP), regenerating ATP and allowing you to sustain activity for longer. This ADP to ATP with the phosphocreatine pathway only takes a few seconds to complete and can occur anywhere in the body with or without oxygen (this is SUPER special when it comes to energy production in the body).  

 

2.     Creatine also helps move things into our cells. Most notably it helps move water and sugar (glucose) into our cells for the cells to use! These two things are super important for athletes and those who live in hot environments. More water in your cells = better hydration status!! But this can also be beneficial for folks who have diabetes or high glucose levels in their blood. Moving glucose into our cells for use is a good thing! And creatine can help with this even if you have insulin resistance!

 

3.     Creatine also is an anti-oxidant. Creatine moves around our body and neutralizes certain compounds that can cause oxidative stress and damage! There’s also a relationship between higher creatine status’ and higher anti-oxidant enzyme activity, independent of creatine’s other anti-oxidant activities.

  

4.     Creatine helps support brain health and function!! It does so much for our brains!! It helps support cognitive function in a bunch of different scenarios, it helps with certain types of mental health disorders, helps with post-partum depression (and IS safe to take during pregnancy, post-partum and during breastfeeding) and most notably it helps with the treatment of and future prevention of concussion or mild to moderate traumatic brain injury.

 

5.     Creatine is so important for concussion recovery and prevention, I put all my clients who are at risk for concussion on creatine. If you are at risk for concussion, currently have a concussion or have had on in the past—we need to talk. Send me an email it set up an appointment here (and yes I do accept insurance so this may cost you $0!)

  

6.     Creatine is also super important for females. We produce less creatine, in general, then men so we respond better to supplementation. Our hormone fluctuations will change the amount of creatine our bodies use, so supplementing consistently is important for us throughout different life stages……including pregnancy and breastfeeding.

 

7.     Creatine helps support heart health! Since it plays a big role in muscle health and our heart is a muscle…..well it also helps our heart. Our blood vessels also have muscular linings, which are also supported by creatine. Plus the added benefit of anti-oxidant effects is always a good thing for heart patients.

 

8.     Just like our heart, our gut also has a lot of muscles running through it. So creatine helps keep our intestines healthy by supporting its muscles. Studies are now coming out to show benefit sof creatine supplementation for those who have IBS, IBD and Crohn’s disease.


9.     Creatine is also showing a lot of promise to help with bone health. At higher doses we are seeing improvements in bone density!

 

Basically, creatine is the capybara of the supplement world…..its buddies with everyone.

 

Safety Considerations:

Creatine is generally regarded as safe for most people when taken within recommended doses. However, some individuals may experience gastrointestinal discomfort. During the initial stages of supplementation, creatine will pull more water into the intestines which may make some people have that “bubble gut” sensation. If this happens, it will go away as your body gets used to it. You can continue with whatever your dose is and wait it out or you can drop your dose down to half and slowly increase as you build up tolerance. Many years ago, there used to be a lot of talk about creatine and weight gain. This has been debunked. “Weight gain” is actually just an increase in muscle water mass and is only seen in individuals who are doing the “loading phase” dosing protocol. If this worries you, simply don’t do the loading phase and you won’t have a problem. With the loading dose, the average weight gain is usually between 1-5 lbs, something most people won’t even notice, to be honest.


 It is a good idea to make sure you are adequately hydrated while you are on creatine. So I usually recommend adding 1-2 extra cups of water per day for those on creatine. Additionally, individuals with pre-existing kidney or liver conditions should consult a healthcare professional before using creatine. While more and more studies are showing that creatine supplementation is safe with kidney and liver disease, it is always better to talk to your healthcare provider first.


It's always good practice to talk to your healthcare provider or dietitian before adding ANY supplement, not just creatine.

 

Choosing a Quality Brand:

With numerous creatine products flooding the market, selecting a reputable brand is important. Look for products that contain creatine monohydrate, as it's the most extensively researched and cost-effective form of creatine. Creatine monohydrate is identical to the creatine our bodies naturally produce, making it over 99% absorbable and usable by our bodies.


Do not listen to the gym bros at the supplement stores who will try to convince you to get a different form of creatine for “less side effects and more absorption.” This simply isn’t true. Stick with creatine monohydrate! And stick with a product that only has creatine monohydrate in it.


 Third-party testing for purity and potency, along with transparent labeling, can help ensure you're getting a high-quality product free from contaminants. Look for creatine monohydrate that is NSF or Informed Choice for Sport Certified.



Other brands that are really good products are Momentous Creatine Monohydrate, Klean Athlete Creatine Monohydrate or Now Sports Creatine Monohydrate.

 

Dosing Recommendations:

The dose that is “right” for you depends on what your goals are with supplementation. For bone and brain health, we need to supplement slightly higher dose. For muscular health, a lower dose is usually fine. For concussion recovery, we need a temporary high dose of creatine to encourage brain healing and then we drop down to a lower dose for maintenance.

If you are anywhere near the fitness world, you probably heard of the “3-5 grams per day” dosing protocol. While this may be fine for general fitness benefits, I (as well as most other professionals in this space) prefer to use a weight based dosing protocol. I like to recommend between 0.1-0.3 grams/kg body weight. Again, I HIGHLY recommend speaking with a dietitian before supplementing since this dose range is quite large. We want to optimize supplementation for YOU.  

 

Conclusion/Too Long, Didn’t Read

Take creatine. Its super cool and can help with SO much stuff in our bodies. But before you start creatine talk to your favorite dietitian (me!) so we get you on the correct dosage for your goals. There is a TON of science out there surrounding creatine. It is safe for just about everyone. But again, always talk to your dietitian before starting a new supplement routine.

 

 

References:

Kreider, R. B., et al. (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), 18.

Gualano, B., et al. (2012). Creatine supplementation and resistance training in vulnerable older women: a randomized double-blind placebo-controlled clinical trial. Experimental Gerontology, 48(3), 334-340.

Bender, A., et al. (2008). Creatine supplementation in Parkinson disease: a placebo-controlled randomized pilot trial. Neurology, 71(10), 687-694.

 Jagim, A. R., et al. (2019). A buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate. Journal of the International Society of Sports Nutrition, 16(1), 1-10.

 Sakellaris, G., et al. (2006). Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. Journal of Trauma and Acute Care Surgery, 61(2), 322-329.

Forbes, S. C., Cordingley, D. M., Cornish, S. M., Gualano, B., Roschel, H., Ostojic, S. M., Rawson, E. S., Roy, B. D., Prokopidis, K., Giannos, P., & Candow, D. G. (2022). Effects of Creatine Supplementation on Brain Function and Health. Nutrients14(5), 921. https://doi.org/10.3390/nu14050921

Roschel, H., Gualano, B., Ostojic, S. M., & Rawson, E. S. (2021). Creatine Supplementation and Brain Health. Nutrients13(2), 586. https://doi.org/10.3390/nu13020586

Dolan, E., Gualano, B., & Rawson, E. S. (2019). Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. European journal of sport science19(1), 1–14. https://doi.org/10.1080/17461391.2018.1500644

Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients13(3), 877. https://doi.org/10.3390/nu13030877

Candow DG, Forbes SC, Kirk B, Duque G. Current Evidence and Possible Future Applications of Creatine Supplementation for Older Adults. Nutrients. 2021; 13(3):745. https://doi.org/10.3390/nu13030745

Clarke H, Hickner RC, Ormsbee MJ. The Potential Role of Creatine in Vascular Health. Nutrients. 2021; 13(3):857. https://doi.org/10.3390/nu13030857

Kious BM, Kondo DG, Renshaw PF. Creatine for the Treatment of Depression. Biomolecules. 2019; 9(9):406. https://doi.org/10.3390/biom9090406

Bian Xiling, Zhu Jiemin, Jia Xiaobo, Liang Wenjun, Yu Sihan, Rao Yi (2023) Evidence suggesting creatine as a new central neurotransmitter: presence in synaptic vesicles, release upon stimulation, effects on cortical neurons and uptake into synaptosomes and synaptic vesicles eLife 12:RP89317 https://doi.org/10.7554/eLife.89317.1

Freire Royes, L. F., & Cassol, G. (2016). The Effects of Creatine Supplementation and Physical Exercise on Traumatic Brain Injury. Mini reviews in medicinal chemistry16(1), 29–39. https://doi.org/10.2174/1389557515666150722101926

Hall, Matthew DO, CAQSM; Manetta, Elizabeth MD; Tupper, Kristofer DO. Creatine Supplementation: An Update. Current Sports Medicine Reports 20(7):p 338-344, July 2021. | DOI: 10.1249/JSR.0000000000000863

Candow, D. G., Forbes, S. C., Ostojic, S. M., Prokopidis, K., Stock, M. S., Harmon, K. K., & Faulkner, P. (2023). "Heads Up" for Creatine Supplementation and its Potential Applications for Brain Health and Function. Sports medicine (Auckland, N.Z.)53(Suppl 1), 49–65. https://doi.org/10.1007/s40279-023-01870-9

Avgerinos, K. I., Spyrou, N., Bougioukas, K. I., & Kapogiannis, D. (2018). Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Experimental gerontology108, 166–173. https://doi.org/10.1016/j.exger.2018.04.013 

Bakian, A. V., Huber, R. S., Scholl, L., Renshaw, P. F., & Kondo, D. (2020). Dietary creatine intake and depression risk among U.S. adults. Translational psychiatry10(1), 52. https://doi.org/10.1038/s41398-020-0741-x

Ainsley Dean, P. J., Arikan, G., Opitz, B., & Sterr, A. (2017). Potential for use of creatine supplementation following mild traumatic brain injury. Concussion (London, England)2(2), CNC34. https://doi.org/10.2217/cnc-2016-0016

Algattas, H., & Huang, J. H. (2013). Traumatic Brain Injury pathophysiology and treatments: early, intermediate, and late phases post-injury. International journal of molecular sciences15(1), 309–341. https://doi.org/10.3390/ijms15010309

 

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