Creatine: What Does The Evidence Really Say that the Influencers Don't?
Creatine is the most legal nutritional supplement in the world. It is conceivably the most utilized supplement on the market by elite athletes (approved by the NCCA, IOC and many other sports governed bodies). It is also the most extensively studied and scientifically validated supplement (International Society of Sports Nutrition) with proven benefits for strength, muscle, power, exercise capacities, and not to mention several plausible benefits that are beginning to be supported for cognitive health/aging as ongoing research and meta-analysis studies are conducted.
If you are on Instagram, Facebook or Tik-Tok influencers have saturated social media platforms with misinformation and unfounded claims of how much dosage to take for optimized benefits and what creatine actually can do for you.
Before I break down the evidence, let us first understand where the initial misinformation was attached to the use of Creatine, which dates back to the early 90's.
In the 90's when power, strength, and growth began showing up in mainstream sports, "the Major League Baseball Steroid Era", perception of Creatine was linked to being dangerous and an anabolic steroid due to the players blaming their enhanced gains on Creatine during congress interviews throughout 1994-2004.
We now know this was incorrect misinformation directly from MLB Players in an attempt to hide their Steroid use and deflect onto Creatine. As a result, many people mistakenly believed Creatine was a steroid.
Also in 1997, three wrestlers from three different colleges had separate deaths where Creatine was linked due to dehydration. The uproar was that bad due to the steroid era in baseball, that the FDA investigated and cleared Creatine from being the cause, as each wrestler that had passed was severely dehydrated due to crash weight diets, which are common in cutting weight for wrestling in many circles.
We now know this was misinformation, and Creatine was incorrectly linked to these deaths.
It took Creatine years of meta-analysis studies after these accusations to regain public confidence, and now due to influencers on social media, I am personally seeing more misinformation about benefits and usage guidelines that are quite frankly, incorrect and not supported at all by evidence.
Here are influencers claims that the current evidence doesn't support:
1- Mega Dose Creatine for optimal gains (10-20 grams) and obtain superior results.
What Does the Evidence Say for Loading & Amount Needed & Saturation:
You do not need to do the "loading phase". I remember receiving this 3-month loading guide in the late 90's from a GNC employee in Texas on how to load accordingly, boy was it unnecessary. Just take your daily dose.
If you do load, 20 grams a day for 6 days is an effective and rapid way to "load creatine" and saturate it into skeletal muscle. After those 6-7 days you will just need to maintain 2-3 grams a day. However, a conceivable alternate way is to just maintain 3 grams daily and you will obtain the same/equal results as loading, but it might take about 28 days to fully saturate.
In fact, most studies show 3-5 grams is all that is needed and anything above 5 grams is a waste of money and diminished results, especially after saturation.
Creative Saturation occurs rapidly, about 5 days after usage, and shows up in greater percentages 20%-50% on all muscle fibers based upon 30 years of biopsy research compared to brain saturation around 4% due to the brain barrier and also has its own pool of creatine (BB-CK).
2- Creatine is a metabolic optimizer. Huh?
What Does the Evidence Say:
Creatine is a raw material, and its primary goal is to improves performance and recovery through restoration and regeneration of ATP.
It helps ease the transition of the body's energy system, specifically ATP, as Creatine is converted into ATP during extreme contractions. Creatine doesn't do anything with the metabolism, and it doesn't increase resting ATP levels.
Creatine ultimately keeps the skeletal muscle "saturated" by continually supplementing it back and forth like a shuttle between the mitochondria (CK-Mit) where it is produced and recharged and myofibrils (CK-M) where it is used for contractile purposes.
Saturation accelerates muscle damage repair and rapidly decreases Creatine Kinase in the blood (representation of muscle damage).
3- Cognitive Enhancer for Everyone- Not so fast.
What Does the Evidence Say:
Although there are some studies showing benefit for older adults (short term memory/reasoning) at very large doses (20 grams plus) or those that might be at risk for insufficiency (vegans), this is still ongoing research. The benefits to this point have been modest at best, and the effects on other cognitive domains and working memory are unclear and still being studied.
To date, studies suggest that Brain saturation (CK-BB) is around 4% and absorbs, slower, modestly, and differently than muscle tissue. This slow and modest saturation across the brain is varied and outcomes vary based upon diet, dosing, sleep, age, stress, and conceivable cognitive injuries.
This influencer claim has some potential and possibility in the right situation, but there are also individuals who are "non-responders" to creatine due to having enough already thru diet.
4- Creatine for Mental Health. No supporting evidence and definitely not a stand-alone intervention.
5- Creatine for Energy, like caffeine. No, it is not a Red Bull or Double Shot Expresso.
What Does the Evidence Say:
Creatine regenerates during demand. More contractions, more capacity. Creatine is not going to give you more energy if you snort it or drink it when sitting behind your desk.
As the misconceptions roll in on these influencer social media platforms, Creatine does have some other misconceptions from the casual user in terms of general use.
Here are a few general misconceptions that have been extensively studied in meta-analysis summaries and debunked.
CASUAL USER MISCONCEPTIONS:
1- Bloating/Water Retention. Although there is initial water retention due to intracellular hydration in the first several days (1-2%) in the muscle. Evidence shows that it doesn't cause an increase in total body water relative to muscle mass.
2- Kidney Damage. Creatine when taken in the correct dosage does not result in kidney damage or renal dysfunction in healthy individuals. In fact, Creatine is a byproduct of the food we eat, specifically meat, chicken, fish (halibut has the most).
3- Anabolic Steroid. Totally unfounded and linked to baseball steroid era.
4- Dehydration. Most of this is based upon speculation and the 1997 situation with the wrestlers. It is important to note to keep Creatine within the suggested range of 3-5 grams as exceeding this range is not recommended and could potentially lead to muscle cramps, etc. as more continued studies need completed on excessive consumption.
Now that we have most of the misconceptions out of the way, what really does the CREATINE EVIDENCE and DATA SUGGEST:
1- Creatine Helps Add Lean Mass When You Train (Average Muscle Gain is 2.4 lbs.). Creatine acts as a buffer to help restore ATP faster allowing you to grind out extra reps and contractions.
2- Creatine Improves High Intensity Performance (Replenishing ATP Rapidly). Muscles store ATP and about 50% of ATP is used within 2-3 seconds of muscle contraction, by 10 seconds you have depleted 70%, and once you reach 30 seconds...well there probably isn't any and at this point your body will now use glycoses or oxidative metabolism for energy,
Supplementing creatine or having enough in your system from food sources (most individual only have about 2 grams from daily food) gives you a greater pool for regeneration of ATP during activity as glycolysis and oxidative metabolism aren't a match for the Creatine/ATP Supply and if you have enough in the pool after 2 to3 seconds the creatine is breaking down to regenerate ATP supply immediately.
Glycogen is not the fastest energy supply source for ATP, Creatine is.
3- Creatine Improves Lactate Threshold = More Strength, More Gains, Faster Recovery, Faster Progress
4- Creatine Helps Store More Water in Muscle Cells = Looks Fuller and Performs Better (not water retention)
5- Creatine Intake Timing. Studies have shown that it doesn't matter when you take Creatine (morning, afternoon, evening, pre workout, post workout).
IMHO, conceivably due to the benefits of restoring ATP, taking Creatine pre-workout might be the best protocol and it replenishes ATP faster, leading to extra reps, increased volume, and enhancing greater muscle gains.
6- Creatine Gummies. Avoid them. Quantity low, quality is questionable, and costly.
7- Mixing. Water, shake, juice, etc. Absorption is the same. However, hot drinks can break down Creatine.
BEST PRACTICE and BOTTOM LINE:
BOTTOM LINE:
There are many types of Creatine on the Market from Creatine Hydrochloride (HCI), Creatine Ethyl Ester, Creatine Magnesium Chelate, and German Crea pure.
Creatine Monohydrate is the most recommended form of creative supplementation due to its high bioavailability, ability to increase creatine levels in muscles and other tissues, proven safety record when used appropriately, and generally lower cost when compared to other forms.
Note #1: German Crea-Pure is slowly being recognized as the purest form of Creatine.
Note #2: Creatine administration in anyone under 18 years of age has insufficient research and gold standard brands have this printed on their labels.
BEST PRACTICE (In My Humbled Opinion):
It is the only supplement you should be taking; the others are a waste of money.
I tend to lean towards Transparent Labs, Thorne, or Momentous Brand (Crea-pure).
If your vegan, you might be insufficient in your intake of Creatine due to it being derived from meat sources. You might want to consider supplementing it.
If you are aging, you might want to consider supplementing Creatine as well. Not for the "energy myth", but because you are insufficient due to possible muscle loss or insufficient amino acids/protein consumption and studies suggest it could potentially be beneficial.
Personally, I keep my dose between 3-5 grams. Cheap. Safe. Effective. No Load.
Stay Hydrated. Be Consistent. Don't overthink it. Don't listen to those influencer claims either.
-Jesse
Disclaimer: Sharing a study in NOT an endorsement. You should read the orginal research yourself and be critical.
