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If you follow any fitness influencers on social media or spend a decent amount of time in the weight room, there’s a good chance you are familiar with the purported muscle-building benefits of creatine. Before you decide to add the popular supplement to your regimen, however, it’s crucial to know exactly what it is, what it does, all the potential side effects, and exactly how to use it. We asked physician Dr. Gary Soffer, MD, and board-certified sports dietitian Tara Collingwood to tell us everything there is to know about creatine. Read on for what they had to say.
Meet the Expert
What Is Creatine?
Unlike some of the other trendy supplements on the market, creatine has been around—and in you—since the start of time. “Creatine is a naturally occurring compound that your body produces to help your skeletal muscles metabolize energy,” explains Soffer. In layman’s terms, it plays a role in converting food into energy.
Primarily stored in skeletal muscle, it can also be found in the brain, heart, and other tissues. “The liver and kidneys naturally produce creatine from three amino acids—methionine, arginine, and glycine—which are protein building blocks,” Soffer explains.
Collingwood adds that we get some creatine from dietary amino acids, “mostly from meat and fish, and our bodies make the rest naturally.” Additionally, you can take creatine supplements.
Creatine also alters several cellular processes that lead to increased muscle mass, strength, and recovery explains Collingwood. “It increases phosphocreatine levels which can help improve performance by providing more energy to the muscles.” Hence the reason why it is the most popular supplement for working out, especially for bodybuilders, Soffer points out.
How Does It Work?
Soffer explains that the cells of your muscles, myocytes, use creatine to make phosphocreatine. Phosphocreatine is then used to convert adenosine diphosphate to adenosine triphosphate (ATP). “All of our cells rely on ATP to function, and it is especially important during high-intensity exercises performed for short durations,” he says.
Phosphocreatine may also serve another purpose by buffering some of the ions that can build up with lactic acid production during challenging workouts. “With these two mechanisms creatine can increase both the strength of the muscle and the duration in which the muscle can be used,” he summarizes.
There are a few potential benefits of amping up your creatine intake, some of them with more scientific backing than others.
- It can help improve athletic ability: The greatest evidence for creatine supplementation is in athletic performance, “with a modest improvement in rowers, soccer players, and volleyball players,” says Soffer. “The evidence for other sports like running and cycling is less clear but promising.”
- It may help improve muscle strength: Creatine may also help improve your muscle strength. “Studies have demonstrated that creatine supplementation may improve both chest press strength and leg press strength,” states Soffer.
- It may help improve brain function and cognition: Collingwood points to limited scientific evidence that creatine may have brain-boosting benefits. A 2018 review of studies published in Experimental Gerontology found evidence that “short term memory and intelligence/reasoning may be improved by creatine administration.” However, in terms of other cognitive domains—long-term memory, spatial memory, memory scanning, attention, executive function, response inhibition, word fluency, reaction time, and mental fatigue—results were conflicting.
- It may improve mental performance: A few small studies found that creatine can offset the type of mental performance decline similar to when you are sleep deprived. One 2011 study published in the Journal of the International Society of Sports Medicine found that creatine was just as effective as caffeine at offsetting the impact of sleep deprivation on athletic performance.
How to Use Creatine
Creatine is generally used to improve athletic performance, says Soffer. It is available in pill, powder, and solution form, with powder serving as the most common supplemental option. “It most commonly is sold in the monohydrate form which is the most well researched,” he explains. Other formulations—sold as nitrates or di-creatine—are less studied but often come with claims not supported by the scientific evidence, he says.
And while creatine can be dissolved into any liquid, experts maintain that fruit juice or sports drinks are the best mixers as they will help up your insulin levels, increasing creatine uptake in the muscle. In terms of the liquid to solution ratio, follow the directions on the bottle.
Soffer reveals that there are several approaches to dosing. The most common is referred to as ‘acute loading,’ “initiated with a loading dose of 20 grams daily for up to seven days followed by a maintenance dose of 2-3 grams,” he explains. However, it seems that skipping the loading phase altogether and simply taking 3 grams a day may also be an effective approach.
“Some athletes like to cycle with more for a week or two at a time with 10-20 grams per day and split it up throughout the day,” adds Collingwood.
Creatine taken orally is generally safe and well-tolerated, Soffer maintains. Common side effects include diarrhea, stomach aches, dehydration, muscle cramps, and water retention. “There have also been cases reported of kidney failure, rhabdomyolysis, and blood clots,” he says. Because creatine can impact the kidneys, people with preexisting kidney problems should speak with their doctor before taking it.
The Best Creatine Supplements
Klean Creatine is “is NSF-Certified for Sport,” says Collingwood. Each serving offers 5 grams of clinically-researched Creapure creatine monohydrate.
Another NSF-Certified for Sport creatine recommended by Collingwood is the Momentous Performance Creatine, a monohydrate formula that easily dissolves into liquids.
While this creatine monohydrate option does not come with NSF certification, it has the endorsement of Amazon reviewers and is the top-selling creatine on the website. It also has an average rating of 4.6-stars from nearly 24,000 reviewers and is a cost-effective option.
If you are looking for that extra kick when working out creatine may be a good option for you, suggests Soffer. However, if you are looking for sustained and long-lasting effects, the evidence is less clear. “I typically recommend creatine for athletes looking to gain muscle mass. I have them take it during phases of heavier lifting and then cycle down to a maintenance dose,” Collingwood adds.
However, for the average person, creatine is not necessary. “I only really recommend it for athletes or for active individuals really looking for an extra edge with gaining a bit of muscle, improving high-intensity workouts, or looking for better recovery.”