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Medically reviewed by Michael Ryan, MD

Creatine Benefits, Side Effects, & Dosage For Best Results


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An organic acid, creatine plays a key role in supplying energy for muscle cells during intense activity. It is produced naturally by the body and found in small quantities in animal products. Creatine stored in muscle cells helps produce ATP (the primary energy currency in the body). While creatine is not an essential nutrient (the body can synthesize it from arginine, methionine, and glycine), it is one of the most widely used supplements because there is strong evidence it can improve performance and is safe for most people. Additionally, creatine may have other health-promoting properties beyond its ability to make a person stronger or faster.

Creatine Supplementation vs Dietary Intake

An average human body contains between 3.5 and 4 grams of creatine per kilogram of muscle. However, it is capable of storing up to 5 grams per kilogram. The idea behind supplementation is that by saturating the body with creatine, you augment its benefits. The richest sources of creatine from food are beef and fish, which contain between 2 and 5 grams per pound.

Because most research on the benefits of creatine is done on dosages of 5 grams, it is largely impractical for most people to try to reap the benefits seen in studies without supplementation. Of course, the potential risks of any supplement should be weighed against the benefits before using. But, should you decide to use creatine as a muscle builder, you will need to supplement in order to receive its effects.

Creatine Benefits

Extensively studied for both its safety and benefits, some of creatines’ supposed benefits are supported by research and some are not. Creatine also shows promise outside of the athletic and performance setting, but more research is needed in these areas.

  1. Increase in muscle size – Creatine supplementation causes an increase in the water content of muscles, making them “larger.” This is not due to an increase in the size of the muscle fibers. However, creatine can increase “real” fat free mass over time, as its strength and power-boosting properties allow higher quality training and thus, better gains.1
  2. Improved athletic performance – A large body of research shows that oral creatine supplementation can make an athlete faster and stronger when performing high intensity activity.2 3 4 5
  3. Increased muscle protein synthesis – I found a few studies which refuted this claim.6 7 Still, if someone who uses creatine can lift more weight, muscle protein synthesis should increase; although, the creatine itself simply increases the available energy supply (ATP) for muscle contraction. Creatine itself does not stimulate protein synthesis.
    Remember, there has never been a scientifically controlled study showing that jumping out of an airplane with a parachute is any better than jumping out without one.
  4. Creatine Side Effects & Risks

    Creatine supplementation should be safe when used by healthy individuals. Most of the health risks attributed to creatine (kidney and liver damage, increased risk of injury) have not been shown in clinical studies.8 And although no long term studies have examined use of creatine, I am unaware of any reports of physical harm from supplementation in a person without kidney disease. However, there is evidence creatine supplementation can damage unhealthy kidneys.9

    Dehydration is also a concern with supplementation, as creatine will draw water into the muscle cell. If you use creatine, be sure to drink plenty of water, which you should be doing anyway. And as with all supplements, due to a lack of regulation, toxins and impurities in a product are always a concern. Buying a reputable brand makes this less of an issue.

    GI distress is a common side effect of creatine. Taking it with food, not “loading” (see below) or perhaps using a form besides monohydrate may lessen or eliminate this reaction.

    Again, creatine is very safe for most people. However, since kidney and liver disease, in their early stages, may not produce any symptoms, it is a good idea to have your doctor test your kidney and liver function, especially if you plan on using supplements.

    Creatine Recommendations & Dosage

    There are many different kinds of creatine available. If you look on the shelves of a supplement store, you will see creatine monohydrate, creatine ethyl ester, creatine hydrochloride, creatine AKG and others. The oldest form is creatine monohydrate, and this has been the compound used in essentially all of the well-designed studies. For this reason, I recommend this form over the newer, non-research backed forms. It also happens to be the cheapest. I recommend a pharmaceutical grade product such as Myogenix to avoid the possibility of toxins or impurities in the product.

    Creatine users often do a “loading phase” of taking 20 grams throughout the day for 5-7 days before moving a maintenance phase of 2-5 grams per day. Research has shown this to increase the rate at which muscles become saturated.10 However, loading is not necessary for creatine to exert its positive effect.11.

    In some models, the presence of insulin increases the amount of creatine that is absorbed into the muscles.12 Caffeine may lessen it.13

    Conclusion:

    Take 3-5 grams of creatine monohydrate with either your pre or post workout shake. Should you choose to load, take 5 grams 4 times per day for 6 days followed by 3 grams per day, after your doctor tells you your kidneys are healthy.

    References

    1. Volek, J., Duncan, N., Mazetti, S., Staron, R., Putukian, M., Gomez, A., Pearce, D., Fink, W., Kraemer, W. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training . PT Clinical. 2013.
    2. Prevost, M., Nelson, A., Morris, G. Creatine Supplementation Enhances Intermittent Work Performance . Exercise and Sport. Quarterly. V. 68, 1997.
    3. Skare, O., Skadberg, O., Wisnes, A. Creatine Supplementation improves sprint performance in male sprinters . Scandinavian Journal of Medicine and Science in Sports. V. 11, Apr 2001.
    4. Kreider, B., Ferreira, M., Micahel, W., Grindstaff, P., Plisk, S., Reinardy, J. Cantler, E., Alamada, A. Effects of creatine supplementation on body composition, strength, and sprint performance . V. 30. Sep 2007.
    5. Juhn, M., Tarnopolsky, D., Maek, M. Oral Creatine Supplementation and Athletic Performance: A Critical Review . Clinical Journal of Sports Medicine. Oct 1998.
    6. Parise, G., Mihic, S., MacLennan, S., Yarasheski, K., Tarnopolsky, M. Effects of acute creatine monohydrate supplementation on leucine kinetics and mixed muscle protein synthesis . Applied Physiology. Nov. 2009.
    7. Magali, L. Poortmans, J., Francaux, M., Berre, J., Boisseau, N., Brassine, E., Cuthbertson, D., Smith, K., Babraj, J., Waddell, T., Rennie, M. No effect of creatine supplementation on human myofibrillar and sacroplasmic protein synthesis after resistance exercise. Clinical Journal of Physiology. Jun 2003.
    8. Kreider, R. Creatine supplementation: analysis of ergogenic value, medical safety, and concerns. Exercise Physiology. Apr 1998.
    9. Edmunds, J., Jayapalan, S., DiMarco, N., Saboorian, H., Aukema, H. Creatine Supplemention Increases Renal Disease Progression in Han: SPRD-cy Rats. American Journal of Kidney Diseases. V. 37. Jan 2001.
    10. Hultman, E., Soderlund, K., Timmons, J., Cederblad, G., Greenhaff, P. Muscle creatine loading in men. Americal Physiological Journal. Jul 1996.
    11. Vandenberghe, K., Van Hecke, P., Van Lemputte, M., Hespel, P. Phosphocreatine resynthesis is not affected by creatine loading . Medicine and Science in Sports and Exercise [1999, 31(2):236-242
    12. Haugland, R., Chang, D. Insulin Effect on Creatine Transport in Skeletal Muscle. Biology and Medicine. Exp Biol Med (Maywood) January 1975 vol. 148 no. 1 1-4.
    13. Vandeberghe, K., Gillis, N., Leemputte, M., Van Hecke, P., Vanstapel, F., Hespel, P. Caffeine counteracts the ergogenic action of muscle creatine loading. Applied Physiology. Journal of Applied Physiology February 1, 1996 vol. 80 no. 2 452-457
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    Creatine Benefits, Side Effects, & Dosage For Best Results, 4.0 out of 5 based on 24 ratings

13 Responses to “Creatine Benefits, Side Effects, & Dosage For Best Results”

  1. Marty van den Bosch
    July 8, 2013 at 4:56 pm #

    Great write up with excellent detail and references.
    This is the one from reference 16 that kills me >> “This ergogenic effect, however, is completely eliminated by caffeine intake.”
    I just love my coffee, the caffeinated kind, lots of it.
    I do not take creatine as a result of reading this some time ago as studies suggest I need to give up my caffeine in order to benefit from this, and I am not quite ready to give up one of my last vices :)

  2. July 8, 2013 at 5:49 pm #

    Definitely an impressive number of references. Excellent job with this article. I used creatine in college and it without a doubt increases strength on subsequent lifting sets and anaerobic power. I do remember that our team would at times get serious cramps because we weren’t drinking enough water while we were taking it. I don’t take creatine anymore as I try to be as natural as possible, but there is no question it’s effective and it works. It’s almost a required supplement for power related athletes (football etc.).

  3. Lorenzo
    July 9, 2013 at 6:51 am #

    Creatine definitely works. I’ll offer my own anectdotal experience, however, that it can make you very horny, irritable, and tempermental. If you use it, pay attention to your moods and be honest with yourself.

    • July 9, 2013 at 1:52 pm #

      @Lorenzo – wow, never heard of those side effects, but thanks for sharing.

  4. uncadonego
    July 9, 2013 at 11:29 am #

    Marc, you’ve answered part of the question I have. If some of the BUILTlean team doesn’t mind discussing somewhat personal things, I’d be interested in hearing about their past and present supplementation use and their feelings on it.

    • July 10, 2013 at 10:54 am #

      Currently, I am using an essential amino acid mixture with dextrose pre workout, BCAAs with dextrose during my workouts and hydrolyzed whey with dextrose post worktout. I use fish oil, CLA and Greens Pak daily as well as micellar casein before bed. Since my genetics make it very hard for me to build muscle and lose fat, I need all the help I can get, and I have chosen my supplement regimen based on efficacy data and favorable benefit to risk ratios.

  5. uncadonego
    July 10, 2013 at 2:37 pm #

    Great answer, thanks. I hope we get a couple more replies as well.

  6. Taaza
    July 15, 2013 at 5:11 am #

    The article really impressed and persuaded me. I had been looking to aid my muscle growth in some way as weight lifting has taken a lengthy period. Majority of people in my family are relatively slim so I’m not sure if it has to do with my genetics. Buying my first supplement soon and will no doubt post my progress in the coming months.

  7. July 19, 2013 at 7:31 pm #

    Really cool publish, highly educational and professionally written..Good Work

  8. Andy
    July 24, 2013 at 5:35 pm #

    Thanks for the information on Creatine. I’m about to buy some for my fitness programme but do I take Creatine instead of a Protein supplement/shake or as well as a Protein supplement ? If so what sort of Protein would you suggest ?

    Many thanks

    Andy

  9. July 25, 2013 at 8:06 am #

    If you take Creatine in your fitness program is it instead of protein supplements or as well as protein supplements ?

    Thanks

    • July 25, 2013 at 1:12 pm #

      @Andy – creatine doesn’t replace a protein supplement and a protein supplement is simply another way to get protein. I refer to whey protein powder as a powdered form of chicken breast that digests quickly, that’s really it is.

      • Andy
        July 26, 2013 at 9:00 am #

        Ok thanks for that.

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