It is a nitrogenous organic acid that helps supply energy to cells throughout the body, particularly muscle cells.
It occurs naturally in red meat and fish and can also be obtained from supplements.
Athletes use creatine supplements to enhance their performance, also for older adults to increase muscle mass, and treat problems that arise when a body cannot fully metabolize creatine.
Some evidence suggests that it could prevent skin aging, treat muscle diseases, help people with multiple sclerosis (MS) exercise, improve cognitive ability, etc.
Additional evidence is needed to confirm these uses.
Fast facts on creatine
Here are some critical points about creatine:
- Athletes use creatine to aid in high-intensity training.
- It can cause an increase in body mass.
- Creatine is being studied for use in several diseases, including Parkinson’s and depression .
- Because creatine helps build muscle, it can be helpful for people with muscular dystrophy.
- There is some evidence that creatine can increase memory.
- Creatine appears safe in moderate doses, but long-term safety has not been demonstrated.
What is creatine?
Creatine is used for muscle building. It is a common ingredient that builds muscle supplements and sports drinks.
Creatine comprises three amino acids: L-arginine, glycine, and L-methionine. It makes up about 1 percent of the total human blood volume.
About 95 percent of creatine in the human body is stored in skeletal muscle, and 5 percent is in the brain.
Between 1.5 and 2 percent of the body’s creatine is converted for daily use by the liver, kidneys, and pancreas.
It is transported through the blood and is used by parts of the body that have high energy demands, such as skeletal muscle and the brain.
Different forms of creatine are used in supplements, including creatine monohydrate and creatine nitrate.
No creatine supplement has been approved for use by the Food and Drug Administration (FDA). There are dangers associated with the help of supplements without restrictions.
Source and needs
A person needs between 1 and 3 grams (g) of creatine per day. About half of this comes from the diet, and the body synthesizes the rest.
Food sources include red meat and fish. One pound of raw beef or salmon provides 1 to 2 grams (g) of creatine.
Creatine can supply energy to parts of the body where it is needed. Athletes use supplements to increase energy production, improve athletic performance, and allow them to train harder.
According to the International Society for Sports Nutrition (ISSN), older athletes who train intensely “may need to consume between 5 and 10 g of creatine per day” to maintain their stores.
People who cannot synthesize creatine due to a health problem may need to take 10 to 30 g per day to avoid health problems.
Creatine is one of the most popular supplements, especially among men who participate in ice hockey, football, baseball, lacrosse, and wrestling.
It is also the most common supplement in sports nutrition supplements, including sports drinks.
There are claims for several uses, some supported by research evidence.
Improving athletic performance
Athletes commonly use creatine supplements because there is some evidence that they are effective in high intensity training.
Creatine is popular with athletes, but is it worth it?
The idea is that creatine allows the body to produce more energy. With more power, athletes can work harder and achieve more.
For some participants in some types of exercise, increasing the body’s creatine pool appears to improve performance.
Studies and analyzes conclude that creatine “can improve performance involving short periods of potent activity, especially during repeated episodes.”
The researchers added that not all studies reported the same benefits.
A review concluded that creatine:
- Increases the effects of resistance training on strength and body mass.
- Increase the quality and benefits of high intensity intermittent speed training.
- Improves endurance performance in aerobic exercise activities lasting more than 150 seconds.
- It can improve strength, power, fat-free mass, daily life performance, and neurological function.
- It appears to benefit athletes who participate in anaerobic exercise but not an aerobic activity.
- It appears to be helpful in short duration, high intensity, and intermittent exercises, but not necessarily in other types of exercise.
However, another study found that creatine supplementation did not increase fitness or performance in 17 young athletes who used it for four weeks.
Increase in body mass
Increased creatine content in muscles has been associated with greater body mass.
However, some medical bodies point out that creatine does not build muscle. The increase in body mass occurs because creatine causes the forces to retain water.
Another review of previous studies states that “observed body weight gains are likely due to water retention during supplementation.”
It’s also possible that muscle mass develops due to working harder during exercise.
Damage repair after injury
Research suggests that creatine supplements can help prevent muscle damage and enhance recovery after an athlete has experienced an injury.
Creatine can also have an antioxidant effect after an intense resistance training session, and it can help reduce cramps. It may have a role in the rehabilitation the brain and other injuries.
Syndromes and deficiency
Creatine is a natural substance and essential for a variety of bodily functions.
An average young man who weighs 70 kilograms (kg) has a creatine reserve of around 120 to 140 g. The amount varies between individuals and depends in part on a person’s muscle mass and their muscle fiber type.
Creatine deficiency is linked to a wide range of conditions, including but not limited to:
- Chronic Obstructive Pulmonary Disease (COPD).
- Congestive heart failure (CHF).
- Depression .
- Multiple sclerosis (MS).
- Muscle atrophy.
- Parkinson’s disease.
- Fibromyalgia .
- Osteoarthritis .
Oral creatine supplements can alleviate these conditions, but there is still not enough evidence to show that this is an effective treatment for most of them.
Supplements are also taken to increase creatine in the brain. This can help relieve seizures, autism symptoms, and movement disorders.
Taking creatine supplements for up to 8 years has improved attention, language, and academic performance in some children. However, it does not affect everyone in the same way.
Although creatine occurs naturally in the body, creatine supplements are not a natural substance. Anyone considering using these or other supplements should only do so after researching the company.
Creatine and muscular dystrophy
Creatine can help improve strength in people with muscular dystrophy.
Fourteen studies published in 2013 found that people with muscular dystrophy who took creatine experienced an 8.5 percent increase in muscle strength compared to those who did not take the supplement.
“Short- and medium-term creatine treatment improves muscle strength in people with muscular dystrophies and is well tolerated.”
Using creatine every day for 8 to 16 weeks can improve muscle strength and reduce fatigue in people with muscular dystrophy, but not all studies have produced the same results.
In mouse models of Parkinson’s disease, creatine prevented the loss of cells usually affected by the disease.
An animal study that included a combined treatment of coenzyme Q (10) and creatine concluded that this could help treat neurodegenerative diseases such as Parkinson’s and Huntington’s.
However, research published in JAMA, with more than 1,700 human participants, noted that: “Treatment with creatine monohydrate for at least five years compared to placebo did not improve clinical outcomes.”
Similarly, a systematic review published in Cochrane found no strong evidence for the use of creatine in Parkinson’s.
A small-scale study found that creatine appeared to help treat depression in 14 women with depression and methamphetamine addiction.
The results suggest that: “Creatine treatment may be a promising therapeutic approach for women with depression and comorbid methamphetamine dependence.”
In 2003, researchers published evidence that creatine can increase mental performance.
After taking a 5g supplement each day for six weeks, 45 participants scored better on working memory and intelligence tests, specifically tasks performed under time pressure, than those who took a placebo.
At recommended doses, creatine is considered “probably safe” to consume.
Supplements can be safe for most people in small amounts, but it is always best to obtain nutrients from natural sources.
In high doses, it is “possibly safe.” Although these effects have not been demonstrated, it is expected to affect the liver, kidneys, or heart.
Other possible effects include:
- Stomach ache.
- Muscle cramps.
People with kidney disease are advised not to use creatine, and caution is recommended for people with diabetes.
The safety of creatine supplements has not been confirmed during pregnancy or breastfeeding, so women are advised to avoid them.
Using creatine can lead to weight gain. While this may be primarily due to the water, it can hurt athletes targeting particular weight categories. It can also affect performance in activities where the center of gravity is a factor.
In 2003, a review of 14 studies on creatine supplementation and exercise performance, published in Cochrane, concluded that:
“It appears to pose no serious health risks when taken at the doses described in the literature and may improve exercise performance in individuals requiring maximum individual effort and repetitive sprinting.”
In general, creatine, appropriately used, appears to be relatively safe.
However, one study published in 2012 warned that the “safe and ethical” status of creatine supplements could change.
The FDA has not yet approved it as safe and effective.
Effects at high doses
More research is needed on how high doses of creatine can affect other bodily functions.
Caution is advised, noting that creatine could potentially:
- Lowering blood glucose, which could affect people with diabetes or hypoglycemia.
- Raise blood pressure, affecting those with hypertension.
They also recommend caution for people with:
- Deep vein thrombosis (DVT).
- Electrolyte disorders or imbalances.
- Gastrointestinal disorders.
- Irregular heartbeat
- Kidney stones or liver disease.
- Low blood pressure when standing up.
- Bipolar disorder.
This is not an exhaustive list.
Creatine is a bioactive substance. People should approach it with caution.
Several energy drinks now combine creatine with caffeine and ephedrine. There is some concern that this could have serious adverse effects after an athlete has suffered a stroke.
Creatine affects water levels in the body. Taking creatine with diuretics can lead to dehydration.
Combining creatine with any medication that affects the kidneys is not recommended. Taking it with probenecid, a gout treatment, can also increase the risk of kidney damage.
Creatine is not practical for all types of sports, nor has it been found to benefit people who already have naturally high levels of creatine in their bodies or who are already high-performance athletes.
While it can help treat some medical conditions, individual athletes should investigate whether it is worth it. Creatine supplements should never be used long-term.
It is best to opt for moderate use and discuss it with a doctor first, as with any supplement. Whenever possible, nutrients should come first from natural sources.