Creatine is one of the most researched supplements in the world. Primarily used by athletes, science is starting to discover more and more benefits to this naturally occurring compound.
Below I reveal what these key benefits are, and why you should start supplementing with creatine if you're not already.
But first, what is creatine and why is it so useful?
Creatine is a compound made up of the amino acids methionine, arginine and glycine.
In the human body, it is found predominately in muscle tissue. We ingest creatine in our diet (herring, salmon and beef are some of the densest sources), or through supplementation.
Creatine can also be stored and resynthesised by the body.
Why are researchers so interested in creatine? I have covered the benefits of creatine supplementation below, but in a nutshell, creatine is used in the production of adenosine triphosphate (ATP).
ATP is needed for cellular metabolic processes. The more ATP the body has (and can produce) the more processes it can run (more power output, more energy etc).
Hence, why creatine is so popular with athletes. Creatine boosts strength and power. It can add an extra rep to that set of squats you are doing.
But as I'm about to show you, athletes aren't the only ones who benefit from creatine!
If you're looking for a comprehensive guide on creatine, including topics such as the best type of creatine to use, whether it's safe, how much to use and much much more, be sure to sign up to my newsletter as I will be releasing an extensive guide to the creatine in the very near future.
A big benefit for athletes when it comes to creatine supplementation is the increased levels of creatine in the muscle (2). The body creates around 1 gram of creatine a day, and on a typical omnivore diet, we ingest another gram of creatine. Supplementation (from 1-20g a day) will boost muscle creatine stores.
95% of the bodies stored creatine is in muscle tissue (with 5% in the brain and testes). Two-thirds of the creatine found in the muscle is stored as phosphocreatine (PCr) and the remaining is stored as free creatine (1).
As mentioned above PCr is used in the production and re-synthesis of ATP. And PCr is used heavily in two energy systems of the body - the lactate system and the phosphocreatine system.
The latter is used in very short, intense movements lasting a few seconds.
This is why creatine supplementation is so appealing to athletes - especially those who compete or train using weights or sprints.
The evidence is clear, creatine supplementation increases power output. This is true whether you are an untrained athlete or an elite athlete. Creatine helps.
One meta-analysis study (a review of existing studies) concluded that creatine was: Able to increase a 12% improvement in strength to 20% and able to increase a 12% increase in power to 26% following a training regiment using creatine monohydrate" (3).
Not to bad huh.
And the increased power benefits apply to all works of life and sport including:
This means those who sprint, weight train, do CrossFit or any other form of intense exercise will see a benefit of creatine supplementation.
Researchers use the Wingate test to measure anaerobic capacity (9).
Given that anaerobic power reflects the ability of the ATP and phosphocreatine energy pathways to produce energy, it is no surprise that creatine supplementation has a positive effect.
There are loads of studies showing the performance benefits (11,12). This 2005 paper showed a 7.6% improvement (10) on the Wingate test for the group using creatine.
Where do I start!
Type creatine + strength into PubMed and you will be overwhelmed with studies showing how creatine supplementation increases strength.
To save you doing this, I have listed a few key takeaway from some of the studies below:
Creatine supplementation can increase muscle strength (allied with 4 weeks of strength training) ... the greater the Creatine uptake and associated body mass changes, the greater the performance gains.(13).
A 2012 double-blind study found that creatine supplementation increased strength (14).
A 2008 study found that creatine increased reps on a bench press (15).
This 2003 study titled Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance found creatine 1 rep max bench press increased by 3-45%.
The researchers concluded," Thus there is substantial evidence to indicate that creatine supplementation during resistance training is more effective at increasing muscle strength and weightlifting performance than resistance training alone, although the response is highly variable."(16)
For endurance athletes wanting to benefit from strength training, you will like the work of Russian scientists who found: "... creatine supplementation during strength training potentates an increase of force-velocity characteristics of trained muscle group without impeding aerobic capacity of the organism." (17)
A more recent 2013 study (18) found that creatine supplementation increased both muscle strength and muscle endurance.
Participants were tested using big lifts such as the squat and bench press.
And if you're a vegetarian, good news, the strength benefits are even higher when if you supplement with creatine (19). This is no doubt due to a lack of creatine in your diet.
I could go on and on. But the evidence is clear. Creatine increases strength!
As I mentioned in the introduction, creatine isn't just for athletes.
A randomised clinical trial that was published in 2007 looked at the effect of creatine supplementation on cognitive function in elderly (80+) individuals.
The researchers tested on random number generation, forward and backward number and spatial recall, and long-term memory tasks.
The findings? Results showed a significant effect of creatine supplementation on all tasks except backward number recall. It was concluded that creatine supplementation aids cognition in the elderly. (20)
Some people worry that creatine will cause bloating, or swelling. And yes this can be a short-term effect of creatine supplementation ( I will cover this issue and how you can avoid this in more detail in my next blog on creatine. Be sure to sign up to my newsletter to receive that article).
However, an increased hydration level can be beneficial for athletes, those exposed to high temperatures and individuals who are prone to dehydration.
The literature is clear that creatine increases hydration levels in the body (21-23). For those looking to really boost hydration levels in their body, the addition of glycerol to creatine supplementation is the way to go (24).
Creatine and Glycerol is an effective method of hyperhydration capable of reducing thermal and cardiovascular responses - again this may be beneficial for athletes, soldiers or emergency workers.
More importantly, creatine helps increase weight without increasing fat mass (25).
A study posted in the Journal of Strength and Conditioning Research looked at the effects of creatine supplementation on fat-free mass (FFM).
The researchers used FIVE measurement devices to test for FFM change (which is unheard of as researchers usually go with one measuring tool, or two at most).
The result of their study concludes:
Following creatine supplementation there was a significant increase in body mass. In addition, all 5 body composition techniques detected the change in FFM to a similar degree. In addition, all 5 methods provided similar measures of FFM change during acute Cr supplementation.
Another study was also published in the Journal of Strength and Conditioning Research and found that 4 weeks of creatine supplementation increased total body weight (an average increase from 90.4 kg to 92.1 kg), increased total water content and had no change in body fat levels (27).
What can we derive from these studies?
Simple, creatine won't make you fat, it will increase cell hydration levels and it will help you increase body weight.
Many will not be overly excited about creatine's ability to increase water content and weight. But learning that creatine helps increase muscle size is a game changer!
Before we continue, creatine is not an anabolic. Whether it increases muscle size directly or indirectly is still up for debate.
For instance, if you simply take creatine while bedridden in a hospital will you increase muscle size? Probably not (but, as we will learn later, it will help protect against muscle wastage).
But if you take creatine while training, will it help increase muscle size (above what the training itself would cause) then yes, it appears so.
Here's what the research shows:
If we look at a meta-analysis review (31) we find that creatine increases body weight initially due to water uptake, but ongoing creatine supplementation has a positive benefit on lean muscle mass.
Bringing this full circle, it's important to look at the work of Aguiar et al, which concludes that:
Creatine supplementation alone did not promote significant alterations in muscle fiber. Our results show that muscle Creatine loading does not promote any additional hypertrophic effect on soleus muscle fibers when Creatine supplemented trained muscles are submitted to same training regimen than Creatine nonsupplemented trained muscles.
Specifically, our findings indicate that any benefits of Creatine supplementation on hypertrophy gains during resistance training may not be attributed to a direct anabolic effect on the skeletal muscle.
In other words, creatine may not directly increase muscle mass. But creatine does increase strength and work output, meaning one can train harder and in turn indirectly increase muscle mass.
Not only does creatine increase strength and power, but it boosts testosterone.
5 days of creatine supplementation increases testosterone (32). And this finding is supported by other studies (33, 34) with a dosage ranging from 0.1 to 0.3 g per kg. Which is only 1-2grams a day for a typical guy.
Given the low cost of creatine every guy in the world should be supplementing with it!
Also, if you're looking for the best resource on boosting testosterone naturally be sure to have a read of my article on natural ways to boost testosterone.
This one is for the endurance athletes out there.
A 2005 study set out with the goal to determine 1) whether creatine supplementation affects cardiovascular structure and function and 2) to examine its effect on aerobic power (35).
What did they find?
That creatine doesn't impact cardiac structure or function in any negative way (good news) and it improves submaximal cycling efficiency (great news).
What about VO2 Max?
A HIIT protocol combined with creatine supplementation had a 9% improvement, but no change in aerobic capacity (36)
And Ventilatory Threshold (VT)? This is another predictor of endurance performance.
Research has shown that creatine does boost VT levels more than non-creatine groups (36).
The benefits from creatine's effect on endurance sports mainly comes from the increased power output in short intense training workouts. Similar to the effect creatine has on muscle size.
Creatine itself may not create the change, instead, it allows the athlete to train harder and in turn see performance benefits.
So the performance benefits of creatine are significant. But what about the health benefits?
Let's start with depression.
A small preliminary study published in 2007 found that some slight improvement in bipolar patients when they supplemented with creatine.
And a bigger, double blind trial done in 2012 on depressive woman found that creatine improved patients HAM-D score (a measure of depression) as early as 2 weeks into supplementation. This benefit continued for the full 8 weeks of the study (38).
Creatine helps with complex executive task performance in sleep deprived individuals (39).
A similar study was done on elite athletes. In fact this second study compared the effect of caffeine and creatine on skill performance in sleep deprived (3-5hours) rugby players.
The findings? Creatine did improve skill performance to the same level as the caffeine group in sleep deprived athletes (40).
Even after 24 hours without sleep creatine has been show to have a positive effect on mood state and tasks that place a heavy stress on the prefrontal cortex (41).
And finally, a rat study found that creatine supplementation decreases the need for deep sleep (42).
So skip the coffee next time you're sleep deprived, have some creatine instead?!
Yes thats right, creatine improves your cholesterol levels!
A randomised, double-blind, placebo-controlled trial utilizing creatine as a potential lipid-lowering agent was conducted in men and women ranging in age from 32 to 70 years.
What did the study find?
Creatine supplementation was also shown to be effective at lowering homocysteine markers, though not by massive amounts (and it was a small 4 week study) (44).
If you're keen to learn more about cholesterol be sure to read my article on why saturated fat isn't bad here.
Knowing that creatine can decrease so called 'bad cholesterol' researchers wanted to see what other health benefits creatine had.
What did they find?
That creatine supplementation decreases oxidative DNA damage and lipid oxidation caused by intense resistance training (45).
Another study looked at creatine supplementation on inflammation markers after sprint training in humans. The results showed that those who supplemented with creatine had lower inflammation markers (TNF-a and CRP) post workout than the non-creatine group (46).
Creatine supplementation has also been found to speed up muscle rehabilitation after immobilisation (through injury etc) (65). Creatine effectively works as an insurance policy incase you ever get injured!
Finally, a paper published in the Journal of Chemical and Pharmaceutical Research found evidence that creatine supplements protect agains malathion exposure (an insecticide that leads to brain and liver toxicity damage).
There is a substantial body of literature, which has demonstrated that creatine has neuro-protective effects both in vitro and in vivo.
Researchers attribute these benefits to the significant pool of creatine in the brain.
Though the science is still in it's infancy (unlike the research on athlete performance and creatine!) to date there is positive evidence that creatine supplementation is:
In rats, creatine supplementation was shown to be an effective antioxidant when associated with resistance training (51).
It's anti-oxidant properties are supported by two other studies (51, 53). This anti-oxidant effect may explain some of the performance enhancing properties creatine has in athletes.
We know that creatine helps increase hydration status, but creatine has been shown to also improve humans tolerance to heat stress.
The research shows that:
The hyper-hydration properties of creatine can result in a more efficient thermoregulatory response during prolonged exercise in the heat (54).
Creatine supplementation increases repeated sprint cycle performance in the heat without altering thermoregulatory responses (55).
These findings should be exciting for any endurance athlete, or workers required to do physical work in high heat environments (fire fighters for example).
Glycogen is stored glucose in muscle tissue. Any athlete should be familiar with the importance of glycogen levels and performance.
Also, athletes who compete in multi-day events or have multiple races in one day understand the importance of glycogen replenishment for recovery.
Therefore, athletes will find this benefit of creatine supplementation rather exciting!
It is believed that creatine increases cell volume, and this is known to promote glycogen synthesis (57). The more glycogen an athlete stores, the more energy the muscle has.
Human studies have found that creatine itself stimulates muscle glycogen storage without affecting GLUT-4 expression (58).
Carbs with creatine seem to boost glycogen uptake when ingested post exercise (59). But it has been suggested that a muscle's glycogen loading capacity is influenced by its initial levels of creatine and the accompanying alterations in cell volume (60).
Meaning the true benefits of creatines effect on glycogen replenishment come from ongoing use of creatine, not acute ingestion.
The final benefit to creatine supplementation is a big one. Creatine supplementation protects against muscle wastage in elderly men and woman.
Why is this such a big benefit? Muscle is metabolically active, so it's important for fat loss and muscle levels naturally decline with age.
But more importantly, significant muscle levels are protective against various health issues. For instance, if you undergo chemotherapy treatment, the more muscle you have the greater your chances of survival (61).
Creatine supplementation has been well documented to boost muscle levels in elderly (62,63), but it was the work of Moon et al, in the paper 'Creatine Supplementation in the Elderly: is Resistance Training Really Needed?' who found that creatine without resistance training slowed muscle wastage in elderly (64).
This is quite a significant finding, knowing how important muscle mass is for the elderly, how inexpensive creatine is and it's minimal side effects, not to mention the 18 other benefits that creatine brings to the table, it begs the question - should we be giving our grandparents creatine? I think so!
It boosts strength, power, immune function, decreases the need for sleep, protects the brain and liver against toxins and the body against heat stress, helps against muscle wastage, has an anti-oxidant effect, increases weight without increasing body fat.... I could go on.
Not only are the benefits immense, but creatine supplementation is inexpensive and the side effects are almost nonexistent (I will go into the side effects and dosing in part 2 on creatine, be sure to sign up to my newsletter to receive that).
If you can't wait until my part 2 article is out, and want to know my thoughts, then here goes:
I have all my clients take creatine, whether their goal is fat loss or health.
And I think everyone in the world should be taking creatine. From the 18 year old kid trying to put on muscle to your 95 year old grandma who has never stepped foot in a gym.
But thats just my view based on the research of have done! As mentioned, please sign up to my email newsletter as I am working on a comprehensive guide to creatine. This guide will answer every question you can possibly have about creatine.
Speaking of which, to be sure it is the most comprehensive guide possible, please leave all your questions you may have about creatine in the comments section below.
This blog post was written by Alex Fergus. Alex is an ISSN Sports Nutrition Specialist, Fitness Professional and certified Superhuman Coach who continues to expand his knowledge base and help people across the world with their health and wellness. Alex is recognized as the National Record Holder in Powerlifting and Indoor Rowing and has earned the title of the Australian National Natural Bodybuilding Champion. Having worked as a health coach and personal trainer for over a decade, Alex now researches all things health and wellness and shares his findings on this blog. Learn more about Alex's Credentials HERE.
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