Creatine is a nonessential amino acid produced in the body from other amino acids. It is found mostly in muscles, including the heart, and in small amounts in the brain. Most people can get creatine through food, such as meat, poultry, and seafood. It is also available in supplement form.
Creatine is a common supplement used by athletes due to its evidence-based benefits for muscle mass and exercise performance. However, it has also been researched for its ability to support brain function and blood sugar control, with conflicting results.
1. Improves Muscle Mass
Creatine is a popular supplement among athletes to enhance muscle mass growth.
A review of 16 clinical studies published in Nutrients found that creatine (compared to a placebo) led to increased muscle strength in healthy young adults when combined with resistance training. Whether the individuals were trained or untrained, positive effects on muscle mass were seen. This included increases in muscle hypertrophy (muscle size), muscle strength, and improved sports performance.
Other research showed that using creatine along with resistance training led to a small increase in muscle hypertrophy over six weeks compared with resistance training alone.
Some evidence suggests that creatine supplementation appears to increase lean body mass in males in conjunction with resistance training to a greater extent than in females.
2. Increases High-Intensity Exercise Performance
Research has found that the performance-based benefits of creatine may include:
- Enhanced recovery
- Greater training tolerance
- Improved performance in maximal effort muscle contractions (using as many muscle fibers as possible to create force)
- Improved performance in single or repetitive sprints
- Increased muscle mass
- Increased work capacity
- Lower incidence of injuries
- Possibly, greater muscle gains during rehab
- Reduced muscle atrophy after injury
Studies suggest that creatine is particularly useful for short-term, high-intensity periods of exercise rather than endurance activities. This is because creatine helps to make adenosine triphosphate (ATP), supplying the body’s muscles with energy.
It may be more beneficial in those who have low baseline creatine levels (e.g., vegetarians). However, studies are mixed on whether creatine supplementation benefits vegetarians more than omnivores (people who eat meat).
3. Reduces Age-Related Muscle Loss
People tend to lose muscle mass as they age. This age-related loss of muscle mass is sometimes called sarcopenia. However, there are steps that you can take to mitigate this.
Creatine supplementation has been studied in older adults at risk of sarcopenia and loss of muscle mass. Some research has found that when combined with resistance training, creatine supplementation may improve muscle mass gain and functional capacity in older adults.
Creatine supplementation has also been suggested to preserve muscle loss when restricting energy intake for weight loss. However, researchers of creatine in older adults caution that more high-level research is still needed before routinely recommending creatine supplementation for older adults.
While creatine is primarily safe for older adults, discussing appropriate supplementation with your healthcare provider is recommended.
4. Boosts Brain Function and Cognition
Small amounts of creatine are present in the brain. Studies have shown that creatine supplementation can increase this amount.
Researchers have theorized that increasing creatinine levels in the brain could improve cognitive function or delay cognitive decline as we age. One systematic review concluded that creatine supplementation may enhance memory, attention time, and information processing speed.
Another recent systematic review found that while creatine supplementation improved brain creatine levels, it did not benefit cognition.
The research on creatine has not shown convincing results in improving memory or cognition. Further well-designed trials are still needed.
5. May Regulate Blood Sugar Control
Glucose (blood sugar) control in people with diabetes is crucial to prevent the effects of high and low glucose levels. Well-controlled glucose levels can also prevent long-term complications that affect circulation, eyesight, and kidney function.
Some research has shown that creatine supplementation may enhance glucose uptake (allowing cells to take up sugar from the blood) and insulin sensitivity (the ability of cells to respond to and use insulin, which helps take up blood sugar), helping with glucose control in people with diabetes when used with exercise.
However, other studies found no effect of creatine on glucose parameters.
Further research is still needed before creatine can be recommended for this use.
People with diabetes should work with their healthcare provider or certified diabetes educator to determine their individualized plan for blood sugar management.
Creatine vs. Creatinine: What’s the Difference?
Creatine is a nonessential amino acid found mostly in muscle. It is also available in animal products like beef, poultry, and fish. Creatine monohydrate is the most popular form of creatine supplement used by athletes.
Creatine breaks down to form creatinine, a waste product excreted in the urine. Blood levels of creatinine are used as a marker of kidney function, with high blood levels sometimes indicating kidney problems.
Side Effects and Safety
Creatine supplementation is generally safe for healthy people.
Although labels caution against children or teenagers from using it, research has not reported ill effects from creatine supplementation in this age group. So long as they are following proper dosages and are knowledgeable about proper creatine use, young athletes can safely implement creatine supplementation.
Research shows that creatine monohydrate is safe and well-tolerated, with minimal side effects in healthy people. One consistently reported side effect is weight gain.
Anecdotally, side effects of creatine use have been reported to include nausea, diarrhea, cramps, and gastrointestinal (GI) distress, but the research does not support this.
Does Creatine Cause Hair Loss?
There is no evidence that creatine supplementation causes hair loss. This misconception started with a small study of 16 male rugby players who took creatine of 25 grams (g) daily for seven days, then 5 g daily for 14 days. After supplementation, researchers found increased serum dihydrotestosterone (DHT) levels. Elevated DHT levels have been associated with some incidences of hair loss.
Additional studies have not been able to confirm these findings. There is no evidence to establish a cause-and-effect relationship between creatine and hair loss.
Precautions
There is no evidence that creatine harms kidney function in healthy people. Yet, for anyone with preexisting kidney conditions, it’s a good idea to discuss creatine with your healthcare provider before starting.
There is insufficient safety data on creatine supplementation during pregnancy or breastfeeding to recommend it.
Creatine may interact with certain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin (ibuprofen) and Aleve (naproxen), caffeine, and drugs that affect kidney function.
Is Creatine Right for Me?
Creatine is popular among athletes, but it is only helpful for those whose goals are muscle gain or increased performance involving short bursts of energy.
Creatine may be most beneficial for:
- Athletes looking to gain muscle, especially in conjunction with powerlifting, Olympic weight lifting, or bodybuilding.
- Athletes looking to improve performance in sports that involve short, high-intensity bursts, such as football, rugby, lacrosse, soccer, hockey, or certain track and field events (e.g., sprinting).
- People with a rare creatine synthesis deficiency or creatine transport deficiency who require additional creatine intake.
- Athletes who are also vegetarians.
Creatine does not benefit endurance events like marathons, triathlons, or long cycling races.
Is Creatine Banned in Sports?
Since creatine is also available in certain foods, it is not banned by any sports organizations. The National Collegiate Athletic Association (NCAA), which governs student athletics, reports that creatine is the most popular nutrition supplement used by male athletes.
How Much Creatine Should I Take?
Small amounts of creatine get broken down into creatinine daily, which is excreted through urine. These small losses then need to be replenished to maintain normal creatine stores.
Creatine is replenished either through the diet or through what the body makes. Consuming 1–3 grams of creatine daily may be needed to maintain normal creatine stores. Creatine is synthesized from arginine and glycine in the liver and kidneys. A normal diet will provide about 1–2 g of creatine daily.
A loading dose of 5 g of creatine monohydrate taken four times daily for five to seven days is suggested to increase muscle creatine stores. Then, a maintenance dose of 3–5 g daily should be sufficient to maintain creatine stores. Larger athletes engaged in intense activity may need 5–10 g daily.
Alternatively, some may choose to skip the loading dose and take 3–6 g of creatine daily for three to four weeks. This can also produce an ergogenic effect (enhance performance, energy, and recovery), but it may take longer to get there.
Taking creatine with carbs and protein may promote greater creatine retention. Drinking plenty of water daily while taking creatine is also recommended.
Types of Supplements
The most common form of creatine is creatine monohydrate. This form provides the largest amount of free, usable creatine. It is also the most studied form.
Creatine supplements are available in powders, gummies, tablets, and liquid formulations. Since creatine breaks down in water over time, powders should be mixed in warm water to more easily dissolve. Consume the mixture right away.
Liquid creatine supplements should be avoided because creatine is broken down to creatinine in water. These supplements may have no detectable level of creatine by the time you purchase them and will, therefore, be of no benefit.
A Word From Verywell
Creatine supplements are not regulated by the FDA, so it’s essential to research products to ensure their quality, such as checking if the creatine was tested and certified by an independent laboratory. It’s also wise to check with your provider about the safety of creatine for you, especially if you have a medical condition or are taking other medications.
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Summary
Creatine is an amino acid mostly stored in the muscle. It is broken down and replenished through diet and the body’s ability to make creatine from other amino acids.
Creatine supplements are widely available and popular among athletes. Research shows that supplementation can increase muscle strength and improve high-intensity exercise performance. Several professional organizations recognize creatine as an effective ergogenic aid (used to enhance performance, energy, and recovery).
While there is increasingly more research on creatine supplementation for different health conditions, the evidence is preliminary and sometimes with mixed results.
Understanding Creatine: Benefits, Risks, and Usage
What is Creatine?
Creatine is a naturally occurring amino acid primarily stored in muscle tissues. It is synthesized in the human body from other amino acids and is also obtained through dietary sources such as red meat and fish. In addition to its presence in muscles, creatine is found in smaller quantities in the heart and brain, contributing to various biological functions.
Key Benefits of Creatine Supplementation
1. Enhances Muscle Mass
Athletes and fitness enthusiasts often use creatine supplements to promote muscle growth. A comprehensive review of 16 clinical studies published in Nutrients demonstrated that supplementing with creatine alongside resistance training could significantly increase muscle strength and size in healthy young adults. This effect was observed in both trained and untrained individuals, indicating its broad applicability.
Further investigations revealed that individuals using creatine during resistance training exhibited a modest increase in muscle hypertrophy over six weeks compared to those who did not supplement. Moreover, males may experience more pronounced gains in lean body mass than females when supplemented with creatine during resistance training.
2. Boosts High-Intensity Exercise Performance
The performance advantages of creatine are notable, especially for high-intensity physical activities. Some documented benefits include:
- Enhanced recovery and training tolerance
- Improved power during maximal muscle contractions
- Better results in repeated sprints and short bursts of effort
- Increased muscle mass and work capacity
- Lower risk of injuries and muscle atrophy during rehabilitation
Creatine supplementation is particularly beneficial for short-term, high-intensity exercises. It aids in the production of adenosine triphosphate (ATP), the primary energy carrier in muscle tissues. While vegetarians may benefit more due to lower baseline creatine levels, studies have shown mixed results regarding differences between vegetarians and omnivores.
3. Mitigates Age-Related Muscle Loss
As individuals age, they typically experience a decline in muscle mass, a condition known as sarcopenia. Creatine supplementation, particularly when combined with resistance training, has been shown to enhance muscle mass and functional capacity in older adults at risk of this condition. Some evidence suggests that it may help preserve muscle during caloric restriction for weight loss. Nevertheless, more high-quality research is necessary before universal recommendations can be made for older adults.
4. Supports Brain Function
Although the brain contains only small amounts of creatine, supplementation can elevate these levels. Preliminary studies have suggested that increased brain creatine could potentially bolster cognitive functions or delay cognitive decline with age. A systematic review indicated that creatine might enhance memory and information processing. However, other studies questioned these findings, indicating a need for further investigation.
5. Potential Impact on Blood Sugar Regulation
Effective glucose control is crucial for individuals with diabetes to prevent the complications stemming from high and low blood sugar. Some studies have indicated that creatine supplementation may improve glucose uptake and insulin sensitivity, aiding in better glucose management when combined with exercise. However, conflicting results highlight the need for additional research before recommending creatine for this purpose.
Understanding Safety and Side Effects
Generally, creatine supplementation is regarded as safe for healthy individuals. While some caution against its use in children and adolescents, research has not indicated significant adverse effects in this demographic when proper dosages are followed. The most commonly reported side effect is weight gain, although nausea, gastrointestinal distress, and cramps have been mentioned anecdotally, with research largely not supporting these claims.
Precautions to Consider
While creatine appears safe for most healthy individuals, those with preexisting kidney conditions should consult their healthcare provider before beginning supplementation. Additionally, the safety of creatine during pregnancy or breastfeeding has not been thoroughly established.
Is Creatine Right for You?
Creatine can be particularly beneficial for athletes aiming for muscle growth or improved performance in high-intensity activities, such as:
- Powerlifting, Olympic weightlifting, or bodybuilding
- Sports characterized by short bursts of high energy like football and soccer
- Athletes with a creatine synthesis deficiency
- Vegetarians
However, creatine may not offer benefits for endurance sports.
Recommended Dosage
A common approach to creatine supplementation involves a loading phase of approximately 20 grams divided into four doses per day for about a week, followed by a maintenance dose of 3-5 grams daily. Alternatively, one might consume 3-6 grams daily for an extended duration without a loading phase. Combining creatine intake with carbohydrates and protein might enhance its retention, and staying well-hydrated during supplementation is advised.
Forms of Creatine Supplements
The most prevalent and researched form of creatine is creatine monohydrate, available in various forms, including powders, capsules, and gummies. It is essential to dissolve powder in warm water for optimal absorption. Caution should be exercised with liquid creatine supplements, as creatine may degrade to creatinine over time in water.
