Creatine: Efficacy and Application

Creatine: Efficacy and Application

Creatine (Cr) supplementation has been a topic of research for many years. Throughout that time an overwhelming amount of positive findings have been made, despite much discredit and fear within popular media. Below, the efficacy of creatine supplementation will be discussed along with practical applications.

Whether or not Cr is supplemented, we all use it in our bodies for high intensity, short duration exercise as the primary metabolic fuel (Smith-Ryan & Antonio, 2013). Cr can be found in most meat sources readily and synthesized within the liver, kidney and pancreas. The majority of Cr is stored within our muscles and the rest within other sites and organs. Once taken into the cell via a transporter, much of Cr is phosphorylated to phosphocreatine catalyzed by creatine kinase. This phosphorylated form of creatine is the direct phosphate donor when converting ADP to ATP. Thus, phosphocreatine is the immediate source of energy in muscle contraction (Smith-Ryan & Antonio, 2013). 

Supplementing Cr can significantly increase total body volume of Cr stores. Having more Cr within muscles drastically increases the ability of our muscles to sustain high intensity exercise since it has more phosphate donors to provide the needed energy. This not only increases muscular power and endurance, but also shortens recovery time (Garazhian & Azimkhani, 2014). Another method in which Cr supplementation aids with decreasing fatigue is by stimulating mitochondrial respiration and buffering hydrogen ion accumulation through the phosphocreatine shuttle (Smith-Ryan & Antonio, 2013). Cr also increases performance by enhancing glycogen uptake within the cell (Nelson et al., 2001). This, in combination with creatine being an osmolyte, leads to increased uptake of fluid into the cell. Cellular swelling is known to be an agonist to protein synthesis. The physical response of cellular swelling in combination with a higher amount of available fuel from glycogen and phosphocreatine can tremendously increase an athletes ability to push harder, longer. Given that progressive mechanical overload is an essential principle for muscle hypertrophy, creatine has great implications for muscle gain, even in modest doses (Oliveira et al., 2018). To date, the only side effect of Cr supplementation has been shown to be weight gain (Bizzarini & De Angelis, 2004). This is likely due to the increased uptake of water into the cells, and should be viewed positively. Instances of concern would be starting creatine right before competing in a weight-specific sport such as wrestling or powerlifting. Even long term daily use has shown to be safe (Kreider et al., 2017).

There are multiple ways to initiate Cr supplementation. If you are in a time crunch and need to reap the benefits as soon as possible then it is suggested that a loading phase take place. During this phase (anywhere between 2-7 days) you would take in 20g Cr/day in 5g doses. This will help you to completely saturate your muscles with Cr as fast as possible. But, it has also been shown that saturation can happen over a few weeks by just taking the maintenance dose around 5g/day (Smith-Ryan & Antonio, 2013). Consideration has been given as to whether or not the timing of ingestion matters. For example, should you take Cr before or after your workout? Research has shown that it doesn’t matter and that the effects are similar (Candow, Forbes, & Vogt, E. 2019). References

Bizzarini, E., & De Angelis, L. (2004). Is the use of oral creatine supplementation safe? Journal of Sports Medicine and Physical Fitness, 44(4), 411–416.

Candow, D. G., Forbes, S. C., Vogt, E. (2019).  Effect of pre-exercise and post-exercise creatine supplementation on bone mineral content and density in healthy aging adults. Experimental Gerontology, 119(1), 89–92.

de Oliveira Vilar Neto, J., da Silva, C. A., Barroso Lima, A., Rosa de Souza, F. J., Vieira Pinto, D., de Sousa Araujo, J., … de Francesco Daher, E. (2018). Effects of low-dose creatine monohydrate on muscle strength and endurance. Asian Journal of Sports Medicine, 9(3), 1–8.

Garazhian, Y., & Azimkhani, A. (2014). Combined effects of prolonged creatine supplementation and resistance training on muscular strength and body composition in collegiate athletes. Pamukkale Journal of Sport Sciences, 5(2), 60–74.

Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., … 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, 1–18.

Nelson, A. G., Arnall, D. A., Kokkonen, J., Day, R., & Evans, J. (2001). Muscle glycogen supercompensation is enhanced by prior creatine supplementation. Medicine and Science in Sports and Exercise, 33(7), 1096–1100.

Smith-Ryan, A. E., & Antonio, J. (2013). Sports nutrition & performance enhancing supplements. Ronkonkoma, NY: Linus Learning.