Creatine – the gold standard

   Over the last 10 years no supplement (other than protein) has become more popular or has been researched more often than creatine monohydrate. Creatine is well liked amongst fitness enthusiasts, bodybuilders, and athletes looking for improvements in strength, muscle hypertrophy and athletic performance.

   Creatine is found naturally in the body, stored in skeletal muscle with small amounts also found in the brain and heart. It can be obtained through the diet by eating meat or fish but it is also produced by the body. Once created or consumed, it is converted into phosphocreatine and stored in  muscle to be used for energy. Here is the organic reaction:

   During high intensity exercise a large amount of power needs to be produced, creating a high demand for ATP (energy). This energy is created by the phosphagen system, which is the quickest way to synthesize ATP.  Indeed, creatine works as a type of energy shuttle. As seen above, it is stored as phosphocreatine but when it is converted to creatine (by creatine kinase) it creates ATP. This happens naturally, without any supplementation. However, creatine monohydrate supplementation has been shown to increase muscular stores (1). Essentially, this increase in phosphocreatine creates a saturated system so that you can create more ATP. More energy leads to more exercise volume without fatigue, and increased intensity. Importantly, no carbohydrate or fat is used in this process; the regeneration of ATP comes solely from stored phosphocreatine. Since this process does not need oxygen to resynthesize ATP, it is considered anaerobic.

    Some people are skeptical about the benefits of creatine, but it is one of the most supported supplements by research. The first reports by Harris et al., showed that creatine levels could increase by ~50% following 20 grams of oral creatine monohydrate per day for three days. To put that into perspective, you could get about 5 grams of creatine from a 2.5 pound steak. Hence, the reason to use a supplement instead of eating whole food.  It is important to note that not everyone responds to creatine supplementation. Some individuals already have high levels of phosphocreatine in their muscles, so they are already saturated such that the levels can’t be increased further. One study shows that up to 30% of individuals are non-responders.

   Multiple studies have investigated the benefits of creatine which include significant increases in: strength, power, sprint performance and work performed during multiple sets of maximal intensity. As early as 1979 studies reported a 20 to 25% increase in 1-repetition maximum strength in untrained women participating in a 70 day resistance-training program. Then, in 1995, another group investigated its effect for 58 days. They found a ~4 lb increase in lean body mass after the duration of the study (3). These were just the beginning of many studies to show the benefits of creatine. Over the last two decades multiple scientists have shown the same ergogenic effects.

   Despite the plethora of research suggesting the effectiveness and safety of creatine, a misconception appears to exist among the general public. This is the idea that creatine supplementation can result in muscle cramps and dehydration. This idea is driven by media claims and anecdotal reports. However, there is little evidence that creatine supplementation presents additional risk (4).

In conclusion, creatine supplementation is a legal and scientifically proven way of increasing performance during exercise. It could be used to benefit weightlifting  or a wide range of sports. Furthermore, creatine could help any athlete who trains using short intervals (5).

1. Cooper, Robert, Fernando Naclerio, Judith Allgrove, and Alfonso Jimenez. “Creatine Supplementation with Specific View to Exercise/sports Performance: An Update.” Journal of the International Society of Sports Nutrition 9 (July 20, 2012): 33. doi:10.1186/1550-2783-9-33.

2. Harris, R. C., K. Söderlund, and E. Hultman. “Elevation of Creatine in Resting and Exercised Muscle of Normal Subjects by Creatine Supplementation.” Clinical Science (London, England: 1979) 83, no. 3 (September 1992): 367–74.

3. Vandenberghe, K., M. Goris, P. Van Hecke, M. Van Leemputte, L. Vangerven, and P. Hespel. “Long-Term Creatine Intake Is Beneficial to Muscle Performance during Resistance Training.” Journal of Applied Physiology (Bethesda, Md.: 1985) 83, no. 6 (December 1997): 2055–63.
4. Dalbo, V. J., M. D. Roberts, J. R. Stout, and C. M. Kerksick. “Putting to Rest the Myth of Creatine Supplementation Leading to Muscle Cramps and Dehydration.” British Journal of Sports Medicine 42, no. 7 (July 2008): 567–73.

5. Casey, A., and P. L. Greenhaff. “Does Dietary Creatine Supplementation Play a Role in Skeletal Muscle Metabolism and Performance?” The American Journal of Clinical Nutrition 72, no. 2 Suppl (August 2000): 607S – 17S.