Is Creatine Worth It?

Makers of creatine supplements recommend its use for improving muscle strength, power and lean body mass. Daily use of creatine combined with resistance training does indeed seem to make a difference.

Quite popular amongst athletes, fitness buffs, fitness gurus and strength and conditioning coaches, it is, arguably, one of the most popular supplements ever!

Evidence in support of effectiveness of creatine is strong – thousands of professional and amateur athletes, weekend warriors and regular exercisers have found that out from personal experience. More importantly, irrefutable proof of creatine’s efficiency abounds in scientific literature as well (Buford et al., 2007; Terjung et al., 2000; Branch, 2003; Rawson & Volek, 2003).

So what exactly is creatine and what makes it click? Let us have a closer look.

What Exactly Is Creatine?

Creatine is a nitrogen-containing organic acid. Almost exclusively stored in skeletal muscles (95%) – the remaining 5% is found in the liver, kidney, brain and testes (Persky & Brazeau, 2001) – it forms an integral part of the phosphagen system.

Creatine is present in the body in combination with phosphate radicals (called phosphocreatine or creatine phosphate).

Of the 3 system that provide energy for muscle contraction (and functioning), the creatine is related to the phosphagen system. This system is responsible for providing energy in short bursts (lasting few seconds) for quick, explosive movements: for instance 100 meter dashes or Olympic lifting. Since the phosphagen system functions at a rapid pace; it does not require the use of oxygen and the energy producing process involves very few steps.

How Does Creatine Function?

Creatine supports energy production by rapid regeneration of ATP molecules from ADP.

A high energy molecule directly responsible for providing energy for muscle contraction is ATP (adenosine triphosphate). When ATP is broken down to produce energy, it forms ADP (adenosine diphosphate). This splitting of an inorganic phosphate radical from ATP is what causes release of energy for muscle contraction. The reproduction of ATP from ADP is the step where creatine steps in.

Creatine (present in the body as creatine phosphate) has an inorganic phosphate radical attached to it. This is donated to ADP to resynthesize ATP rapidly so that the process of contraction continues.

Sources of Creatine

Creatine is produced endogenously from amino acids arginine, methionine and glycine at a rate of about 1g/day (Cooper, Naclerio, Allgrove, & Jimenez, 2012). It can also be acquired from external food sources. Owing to the fact that creatine is mostly present in muscle tissue, non-vegetarian food is a great source, e.g. meat and fish. Although cranberries do contain some amount of creatine, veggies and fruits, in general, are poor sources. It comes as no surprise, therefore, that vegans and vegetarians tend to have lower resting levels of creatine (Burke et al., 2008).

Creatine supplements (powders, liquids formulations, pills or bars) are an awesome source especially if your diet does not contain enough meat.

Benefits of Creatine Supplementation – Why Should I Use It?

Creatine ingestion on a daily basis improves the resting creatine levels in the body (Casey & Greenhaff, 2000; Hespel & Derave, 2007; Hickner, Dyck, Sklar, Hatley, & Byrd, 2010; Volek et al., 1999). When combined with resistance training, this improved availability of creatine has been shown to have a number of benefits in improving fitness parameters; some of these are:

• increased exercise performance – direct relationship with daily ingestion of creatine was conclusively shown by Casey and his fellow researchers in 2010 (Casey & Greenhaff, 2000)

• rapid generation of ATP (the energy producing molecules), say for example, between sets of resistance training improved muscle contraction during the subsequent set thus improving quality of training (Volek et al., 1999)

• improved intensity and overall quality of training (Cooper et al., 2012)

• improved lean muscle mass and body composition (Volek et al., 1999; Dempsey, Mazzone, & Meurer, 2002; Kreider, 2003; van Loon et al., 2003; Volek & Rawson, 2004)

• increased muscle strength as evidenced by improved 1RMs (one rep max.) (Rawson & Volek, 2003)

• increased muscle endurance as evidenced by the number of repetitions performed for a given exercise and weight (Cooper et al., 2012)

• increased muscle protein deposition due to increased anabolism, especially when protein intake is increased

Notwithstanding these awesome benefits reported by several studies, there are some studies which cast doubts over the effectiveness of creatine (Jakobi, Rice, Curtin, & Marsh, 2000; Bemben et al., 2010). However, it must be noted that the protocols used in these studies either involved creatine supplementation only on training days or were not combined with resistance training or both.

However, it is indeed an undeniable fact that in some individuals (non-responders) creatine just doesn’t work – even when ingested on a daily basis and combined with a resistance training program.

How Should I Take Creatine?

Creatine is available for oral ingestion in the form of creatine monohydrate – as powder, pills, liquid formulations or bars.

Here are some of the pointers if you are planning on using creatine supplements:

• daily dose of 5g per day (recent thinking is that the loading dose of 20g/day X 5 days offers no benefit and therefore isn’t required)

• creatine absorption is better when taken in combination with a sugary liquid (grapefruit juice)

• can be taken either pre-workout or post-workout

• taking protein supplements in combination with creatine may further improve the benefits

• after a 12-16 weeks’ cycle of creatine ingestion, take 4 weeks off

To conclude, creatine is one of the very few supplements that really work. When combined with an effective strength and condition program and protein supplementation, creatine is useful in improving body composition, muscle strength, power and sprinting ability – improved performance in almost all sports after use of creatine has been observed. Thus, whether you are into short, intense activities like track and field, wrestling or are a strength athlete or just a fitness buff looking to improve your fitness parameters, you cannot afford to miss out on the benefits that creatine supplementation offers.

Reference List

Bemben, M. G., Witten, M. S., Carter, J. M., Eliot, K. A., Knehans, A. W., & Bemben, D. A. (2010). The effects of supplementation with creatine and protein on muscle strength following a traditional resistance training program in middle-aged and older men. J Nutr.Health Aging, 14, 155-159.

Branch, J. D. (2003). Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr.Exerc.Metab, 13, 198-226.

Buford, T. W., Kreider, R. B., Stout, J. R., Greenwood, M., Campbell, B., Spano, M. et al. (2007). International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr., 4, 6.

Burke, D. G., Candow, D. G., Chilibeck, P. D., MacNeil, L. G., Roy, B. D., Tarnopolsky, M. A. et al. (2008). Effect of creatine supplementation and resistance-exercise training on muscle insulin-like growth factor in young adults. Int J Sport Nutr.Exerc.Metab, 18, 389-398.

Casey, A. & Greenhaff, P. L. (2000). Does dietary creatine supplementation play a role in skeletal muscle metabolism and performance? Am J Clin Nutr., 72, 607S-617S.

Cooper, R., Naclerio, F., Allgrove, J., & Jimenez, A. (2012). Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr., 9, 33.

Dempsey, R. L., Mazzone, M. F., & Meurer, L. N. (2002). Does oral creatine supplementation improve strength? A meta-analysis. J Fam.Pract., 51, 945-951.

Hespel, P. & Derave, W. (2007). Ergogenic effects of creatine in sports and rehabilitation. Subcell.Biochem., 46, 245-259.

Hickner, R. C., Dyck, D. J., Sklar, J., Hatley, H., & Byrd, P. (2010). Effect of 28 days of creatine ingestion on muscle metabolism and performance of a simulated cycling road race. J Int Soc Sports Nutr., 7, 26.

Jakobi, J. M., Rice, C. L., Curtin, S. V., & Marsh, G. D. (2000). Contractile properties, fatigue and recovery are not influenced by short-term creatine supplementation in human muscle. Exp.Physiol, 85, 451-460.

Kreider, R. B. (2003). Effects of creatine supplementation on performance and training adaptations. Mol.Cell Biochem., 244, 89-94.

Persky, A. M. & Brazeau, G. A. (2001). Clinical pharmacology of the dietary supplement creatine monohydrate. Pharmacol.Rev, 53, 161-176.

Rawson, E. S. & Volek, J. S. (2003). Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond.Res., 17, 822-831.

Terjung, R. L., Clarkson, P., Eichner, E. R., Greenhaff, P. L., Hespel, P. J., Israel, R. G. et al. (2000). American College of Sports Medicine roundtable. The physiological and health effects of oral creatine supplementation. Med Sci.Sports Exerc., 32, 706-717.

Van Loon, L. J., Oosterlaar, A. M., Hartgens, F., Hesselink, M. K., Snow, R. J., & Wagenmakers, A. J. (2003). Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci.(Lond), 104, 153-162.

Volek, J. S., Duncan, N. D., Mazzetti, S. A., Staron, R. S., Putukian, M., Gomez, A. L. et al. (1999). Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci.Sports Exerc., 31, 1147-1156.

Volek, J. S. & Rawson, E. S. (2004). Scientific basis and practical aspects of creatine supplementation for athletes. Nutrition, 20, 609-614.



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Dr. Deepak S Hiwale

Dr. Deepak S Hiwale, a.k.a "The Fitness Doc" specializes in sports medicine in addition to being an elite personal trainer. He currently runs an elite personal training company in West London. As a sports injury and fitness writer-presenter, he tries to disseminate as much knowledge as possible for the benefit of all. MBBS (University of Pune); MSC, Sports and Exercise Medicine (University of Glasgow); Diploma in Personal Training (YMCA Dip. PT, London).

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