Tip: To increase muscle strength and facilitate recovery, supplement with creatine monohydrate (20g/day in 4 divided doses x 5 days or 3g/day x 28 days) shortly after exercise.
What is creatine monohydrate?
- Creatine monohydrate is an organic compound made from 3 amino acids: arginine, glycine, and methionine. It is mainly located in the muscles and the brain.
- It is synthesized by the body and can be found in animal-based foods such as milk, red meat, and seafood.
- Vegetarians often have reduced stores and may benefit from creatine supplementation.
How does it work?
- Creatine monohydrate helps to maintain high ATP/ADP concentrations. To power through quick muscle contractions or during high-intensity exercise, the body uses ATP. To generate ATP, a phosphate molecule is transferred from creatine phosphate to ADP.
- Once the muscle has used up its store of phosphocreatine, the body turns to other sources to produce ATP, like glucose, which can lead to increased lactate levels, muscle fatigue and soreness. Thus, maintaining high phosphocreatine stores can increase athletic performance and reduce fatigue.
Who is it for?
- Creatine monohydrate supplementation can benefit not only athletes but also anyone starting a new workout to reduce fatigue, and older individuals desiring to increase their muscle mass, thereby reducing the risk of falls and injuries.
What are its benefits?
- Increased performance, especially during anaerobic exercise.
- Creatine is an antioxidant that helps to eliminate reactive oxygen species, thereby reducing muscle damage and inflammation following exercise. This means less pain after training and less time before you can train again.
- Some studies had also shown benefits for endurance exercise by preventing inflammation, for example when used in runners before a long-distance race.
- Increase in lean body mass.
- May improve brain health (cognitive processing, brain function, and recovery from trauma).
What is the dosage?
- High-dose protocol: 20g/day in four divided doses for 5 days
- Longer term, low-dose protocol: 3-5g/day for 28 days
- This method results in a more gradual increase in creatine levels compared to the high-dose protocol, and may therefore may not be as beneficial until creatine stores are fully saturated.
- Once creatine stores in the muscle are elevated, it generally takes 4–6 weeks for creatine stores to return to baseline.
What is the best time to take creatine?
- There is some weak evidence to support post-exercise Cr supplementation compared to pre-exercise supplementation, the former leading to a greater improvement in body composition.
- It is most beneficial for anaerobic: short-duration, high-intensity exercise tasks (e.g., 100-m sprint, one down in gridiron football, one set of squats) that rely heavily on muscle phosphocreatine.
What are the side effects?
- Weight gain (from increased water retention which is most often seen in short-term use)
- Gastrointestinal side effects at dosages greater than 10g: diarrhea and stomach upset
What is the safety profile of creatine?
- Creatine has been used to treat children and adults, and appears to be safe and well-tolerated when taking up to 30 g/day for 5 years. However, Both the American College of Pediatrics and the American College of Sports discourage the use of performance-enhancing supplements, including creatine.
References
- Jiaming Y, Rahimi MH. Creatine supplementation effect on recovery following exercise-induced muscle damage: A systematic review and meta-analysis of randomized controlled trials. J Food Biochem. 2021;45(10):e13916. doi:10.1111/jfbc.13916
- Rawson ES, Clarkson PM, Tarnopolsky MA. Perspectives on Exertional Rhabdomyolysis. Sports Med. 2017;47(Suppl 1):33-49. doi:10.1007/s40279-017-0689-z
- Ribeiro F, Longobardi I, Perim P, et al. Timing of Creatine Supplementation around Exercise: A Real Concern?. Nutrients. 2021;13(8):2844. Published 2021 Aug 19. doi:10.3390/nu13082844
- Forbes SC, Cordingley DM, Cornish SM, Gualano B, Roschel H, Ostojic SM, Rawson ES, Roy BD, Prokopidis K, Giannos P, Candow DG. Effects of Creatine Supplementation on Brain Function and Health. Nutrients. 2022; 14(5):921. https://doi.org/10.3390/nu14050921
- Volek JS, Ratamess NA, Rubin MR, et al. The effects of creatine supplementation on muscular performance and body composition responses to short-term resistance training overreaching. Eur J Appl Physiol. 2004;91(5-6):628-637. doi:10.1007/s00421-003-1031-z
- Santos RV, Bassit RA, Caperuto EC, Costa Rosa LF. The effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30km race. Life Sci. 2004;75(16):1917-1924. doi:10.1016/j.lfs.2003.11.036
- Kreider, R.B., Kalman, D.S., Antonio, J. et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14, 18 (2017). https://doi.org/10.1186/s12970-017-0173-z
