Creatine Primer

Creatine is one of the best muscle-building, performance-enhancing supplements money can buy. Here's why.

Written By Jim Stoppani, PhD

Updated March 28, 2024

Go to your local sports nutrition store and you'll be hard-pressed to find a single supplemental ingredient that produces better results and offers more benefits than creatine – one of the most popular sports supplements in the world, if not #1 hands down.

Surveys performed on creatine use in athletes indicate that creatine is used by over 40% of athletes in the National Collegiate Athletic Association (NCAA) and that athletes from about 20 different NCAA sports reportedly use creatine. Creatine use in power-sport athletes may be even more prevalent, with up to about 75% of powerlifters, boxers, weightlifters, and track and field athletes reportedly using the supplement. Furthermore, a survey of gym/health club members conducted in 2000 reported that about 60% of members are creatine users.

Why is creatine so popular among athletes and gym-goers? Quite simply because it works, and it works well. Literally hundreds of studies have been done on creatine showing its effectiveness for increasing muscle strength, muscle power, muscle size, overall athletic performance and even enhancing certain areas of health.

Creatine Basics

Creatine is a nonessential dietary protein-like compound found in high abundance in meat and fish. It's synthesized in the body, primarily in the liver, from the two amino acids arginine and glycine. Muscle tissue does not produce creatine, and therefore it must take up creatine from the bloodstream. Once inside muscle cells, creatine gets a high-energy phosphate attached to it and is then known as phosphocreatine (PCr) or creatine phosphate. It is this high-energy molecule that's one of the most critical components of creatine’s beneficial effects in the body, for this reason: Because creatine donates its high-energy phosphate to create ATP (adenosine triphosphate), which is used by the muscle for the rapid energy it needs for contraction, such as during weight-lifting.

Supplementing with creatine is reported to increase the content of PCr in muscle by approximately 20%. Having more PCr in muscle cells means more ATP can be rapidly produced during exercise, which can lead to gains in strength, power, speed and muscle growth.

Creatine Boosts Muscle Strength

Numerous studies have reported significant improvements in one-rep max strength in subjects taking creatine. For example, Belgian researchers reported in a 1997 issue of the Journal of Applied Physiology that untrained subjects taking creatine while following a 10-week weight-training program increased their one-rep max on the squat by 25% more than those taking a placebo while following the same program.

A 1998 study by University of Nebraska (Omaha) researchers found that trained collegiate football players taking creatine while following an 8-week weight-training program gained a 6% increase in their one-rep bench press strength, while those taking a placebo experienced no strength gains at all.

A review on creatine printed in the Journal of Strength and Conditioning Research reported that out of 16 studies investigating the effects of creatine on one-rep max strength, the average increase in strength was about 10% more in those taking creatine as compared to those taking a placebo.

Studies also show that creatine enables subjects to complete more reps with a given weight. University of Queensland (St. Lucia, Australia) researchers reported that competitive powerlifters taking creatine while preparing for a competition increased the number of reps they were able to complete with 85% of their one-rep max by 40%, while those taking a placebo experienced no change in the number of reps completed with the same weight. In the review paper discussed above, the researchers determined that out of the 16 studies, the average increase in reps performed while taking creatine was about 15% more than those taking a placebo.

Creatine Boosts Muscle Growth

There are a plethora of studies showing that creatine significantly boosts muscle growth as well. University of Queensland researchers found that powerlifters taking creatine gained an average of over 6 pounds of lean body weight – with some subjects gaining as much as 11 pounds of lean body weight – in less than four weeks, while those taking a placebo had no change in body weight.

Since creatine supplementation likely does not increase bone mass or organ mass, the increase in lean body weight is more reasonably the result of a gain in muscle mass. A study by researchers at Southern Illinois University (Carbondale) reported in a 2000 issue of Medicine and Science in Sports and Exercise that trained weight-lifters taking creatine gained almost 5 pounds of lean body weight in six weeks, while those taking a placebo experienced no change in body weight.

Creatine Boosts Athletic Performance

Most of the studies performed on creatine indicate that supplementing with it significantly enhances athletic performance due to its ability to produce higher muscle force and power during short bouts of exercise. The subjects used in these studies had mixed athletic ability and training status, from relatively untrained novices to competitive college-level athletes. Some of the exercise performances that showed improvement included: various types of short-term, all-out cycling, sprinting, repeated jumping, swimming, soccer, kayaking, rowing, and of course weight-lifting.

The greatest improvements in athletic performance seem to be found in bouts of repetitive high-power output exercise. For example, following a short rest period (20–60 seconds) after a short sprint, speed may be increased on the second bout of sprinting. Athletic performance during these latter bouts of exercise can be increased by 5%-20% with creatine over the placebo group. This means that athletes in sports such as football and soccer, in which continuous play typically lasts for only a few seconds, can expect a significant boost in performance from creatine.

How Creatine Works

Research shows that there are numerous ways by which creatine produces increases in muscle strength, muscle growth and overall athletic performance. The majority of creatine’s benefits were originally believed to be solely due to the boost in fast energy that’s the result of increased PCr in muscles. This allows athletes to recover faster between bouts of exercise, such as fast running or weight-lifting, which allows them to run faster or complete more repetitions with a given weight. Over time, the ability to complete more repetitions can result in muscle growth. Today, we know that creatine works through a number of different mechanisms.

One of those mechanisms is through muscle cell volumization. This is a fancy term that means the muscle cells fill up with water. Since creatine is essentially a protein, it draws water from the blood and the space outside of the muscle cells (known as the interstitial fluid) into the muscle through the process of osmosis. This is the major reason for the rapid weight gain that’s associated with creatine supplementation. However, this increase in cell volume causes the cell membranes to stretch, which is thought to initiate long-term increases in muscle growth and strength through greater protein synthesis — the method that muscle cells use to grow.

Yet another way that creatine has been found to work is by increasing the number of satellite cells in muscle fibers. Satellite cells are basically muscle stem cells, and one way that muscles grow bigger and stronger is by the addition of muscle satellite cells to existing muscle fibers. A 2006 study from the University of Copenhagen found that after eight weeks of supplementing with creatine while following a weight-training program, subjects experienced almost 100% more satellite cells in their muscle fibers, as compared to those taking a placebo. As expected, the greater number of satellite cells was associated with greater muscle size. This can also lead to greater muscle strength and power.

And yet another way that creatine works is through increases in insulin-like growth factor-I (IGF-I). IGF-I is critical in initiating processes in muscle cells that lead to enhanced muscle growth and muscle strength. St. Francis Xavier University (Canada) researchers reported in a 2008 study that weight-trained subjects taking creatine while following a weight-lifting program for eight weeks had significantly higher IGF-I content in their muscle fibers than those taking a placebo.

Creatine’s Health Benefits

In addition to enhancement of muscle size, strength, power and overall athletic performance, creatine has also been found to provide numerous health benefits. Because PCr is important for energy production involved in nerve cell function, creatine has been shown to provide numerous benefits to the brain and the rest of the nervous system. For example, research has found that creatine supplementation enhances cognitive function and memory, may help in the treatment of Parkinson’s disease, Huntington’s disease and even depression, and can also protect against brain injury.

Creatine has also been found to aid cardiovascular health, such as improvement of symptoms in those with congestive heart failure, and it may even help lower cholesterol levels. One study published in a 1996 issue of the journal Clinical Science discovered that male and female subjects taking creatine for eight weeks experienced a drop of more than 5% in total cholesterol and a drop in LDL cholesterol (the bad type of cholesterol) of more than 20%.

Similar findings were made by researchers from Skidmore College (Saratoga Springs, NY). The researchers reported in a 2001 issue of the journal Metabolism that 28 days of creatine supplementation decreased total cholesterol by 10% in healthy young males. Virginia Commonwealth University researchers also showed that healthy young males taking creatine plus a multivitamin supplement significantly reduced their levels of homocysteine (an amino acid associated with heart disease), as compared to those taking just the multivitamin supplement.

These are just a few of the ways that creatine can benefit health. And new benefits are being discovered all the time. For example, German researchers found that creatine supplementation enhances skin cells’ protection from sun and oxidative damage.

Creatine Safety

Although there's ample research showing that creatine is safe for most people to use, there are still myths regarding creatine’s safety and purported side effects. One of the longest-standing myths is that creatine can cause muscle cramps. Numerous studies debunk this claim. A 2003 study by Arkansas State University researchers concluded that NCAA football athletes taking creatine over the course of three years experienced no increase in incidence of muscle cramps or muscle injuries. In fact, another 2003 study performed at Baylor University (Waco, TX) found that NCAA football players taking creatine for one full season actually had a significant reduction in muscle cramps and muscle injuries.

Another misconception about creatine is that it can lead to impaired liver and kidney function. Studies done in the ’90s were some of the first to show that short-term creatine supplementation does not impair kidney function in healthy adults. Two recent studies from Uruguay have further shown that eight weeks of creatine supplementation in soccer and football athletes had no effect on health markers that included kidney and liver function measures.

Longer-term studies have also been done to confirm creatine’s safety. Truman State University (Kirksville, MO) researchers concluded that NCAA football players taking creatine for up to about six years experienced no long-term detrimental effects on overall health or kidney or liver functions. Researchers from the University of Memphis also reported that NCAA football players taking creatine for close to two years exhibited no negative effects on general health or kidney and liver function.

Forms of Creatine

There are numerous forms of creative on the market today, including creatine monohydrate, creatine hydrochloride (HCl), creatine tartrate, creatine ethyl ester, magnesium creatine chelate, and buffered creatine to name just a few. The majority of research on creatine has been done with creatine monohydrate. For most people, creatine monohydrate makes a cheap, yet effective way to supplement with creatine.

That said, by far my preferred form of creatine is creatine HCl, specifically the Con-Cret® patented version – that's why I include it in both my Pre JYM and Post JYM formulas. The reason why is that creatine HCl is more soluble than creatine monohydrate and is absorbed better by body. In fact, one study found that creatine HCl was absorbed by the body 50% better than creatine monohydrate.

One benefit of this is that creatine HCl typically produces far less gastrointestional discomfort (upset stomach) than creatine monohydrate. This is important because many, many people experience stomach issues with monohydrate – me being one of those people. HCl's better solubility also allows for a lower dose to be used.

For a more thorough explanation as to why I feel creatine HCl is superior to monohydrate, read my Creatine HCl article.

One form of creatine that you may want to not bother spending the extra money on is creatine ethyl ester. One study from Baylor University found that this version of creatine was actually leas effective than creatine monohydrate. This may be due to creatine ethyl ester being readily converted into the creatine breakdown product, creatinine, as some research has shown.

Creatine Dosing

How much creatine you take depends on the form. For creatine monohydrate and most other forms of creatine, research shows that the adequate dose is 5 grams taken both before and after training.

However, as I just mentioned, my preferred form is creatine HCl, and the dosage is significantly smaller because of the better solubility. Both Pre JYM and Post JYM include full effective doses of creatine HCl: 2 grams Pre JYM (taken before workouts) and 2 grams in Post JYM (taken immediately after training, or during your workout if you prefer).

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