The truth about creatine.
Since there’s so much misinformation out there about creatine, I figured I’d take the time to write up this description of creatine, what it does, how it works and the possible side effects. I am writing this for the average person to be able to understand. I really tried to make it both in depth, but not too deep for the average person to understand.......
Creatine that we supplement with comes in different synthetic forms, such as citrates, phosphates and monohydrate salts. Micronized Creatine Monohydrate is the best and most popular creatine supplement out, so that’s what I’m going to base everything on.
The chemical compound for creatine is methyl guanidine-acetic acid. Creatine is naturally occurring in the human body and other animal bodies. We can get creatine by either eating creatine rich foods such as beef and fish, by supplementing it with creatine monohydrate or by creating it by combining arganine, glycine and methionine in the liver, pancreas and kidneys. Once in the body, the majority of creatine is stored in the skeletal muscles, and the remainder is stored in the brain, heart and testes.
The synthetic creatine that we supplement is turned into usable creatine by the body and that is shuttled to the skeletal muscles via the blood. Once at the muscles, there is a special type of transport molecule that is responsible for converting the creatine so that it can enter the skeletal muscle. The creatine is converted into phosphocreatine, also called creatine phosphate. The activity of the creatine transport molecule is determined by the amount of plasma creatine and serum creatine. Elevated plasma creatine stops the creatine uptake by the transport molecules and in tern, the production of the bodies own creatine stops. This is why some people suggest that creatine be cycled, but it’s not really necessary at the suggested dose of 5mg per day. The plasma creatine level is basically what happens after the serum creatine level stays too high for too long. If you have too much creatine in your system, your body can only put but so much in your muscles and the rest can’t be filtered out of your body and it remains in your blood, this causes the plasma creatine to shut down all production of creatine and all transport of creatine into the muscles. Back to creatine phosphate. Your body uses a lot of different things for energy and the muscles use ATP (adenosine triphosphate) to power the muscles movement. The separation of the phosphate chain causes a release of energy and then you are left with ADP (adenosine diphosphate). The diphosphate chain is then broken and causes another release of energy leaving you with phosphates that have to be removed by the body as waste. When you have creatine phosphate in the muscles, the ADP is able to take the phosphate from the creatine phosphate and create another ATP chain. So you get a small increase in the available ATP for energy production within the muscles. Strength is in part dependent on how quickly ATP can be made available during muscular stress. At this point, I should also point out that some muscles have more of a concentration of creatine phosphate than others. The fast twitch muscles tend to have more creatine phosphate than slow twitch muscles. In short, creatine does increase strength and it has been used in patients recovering from orthopedic surgery and patients with severe forms of neuromuscular disorder. Exercise performance tends to improve when muscle creatine levels increase by at least 20%.
Creatine also has a propensity to draw water into the muscle cells, so you have to make sure you remain well hydrated while you are taking creatine, or it will pull fluid out of the blood into the muscles and dehydrate you. This is actually one of the good things about creatine. By pulling water into the muscle it is volumizing the muscle by making it look larger and fuller and it is also hydrating the muscle cells more than normal, so the muscle cells benefit more from the positive effects of water. Do to the increase in muscle volume, it is thought that it may actually promote the synthesis of new muscle proteins. The down side is that any gain in size due to volumizing will be lost soon after you stop supplementing creatine. There is also a limit to the amount of creatine that the skeletal muscles can hold. Once your muscles are holding as much creatine as they can hold, you will stop seeing any benefits with supplementing creatine. The maximum amount of creatine that can be stored depends on your muscle mass, but normally hovers around 150grams for the average adult male.
Creatine may improve serum cholesterol profiles, but that’s not really confirmed one way or the other (Raises the HDL and lowers the LDL).
I’ve seen a few people say that creatine has no side effects, even at higher doses, so I’ll just go through some of the confirmed side effects. These are adverse effects that we know were caused by creatine.......
Dehydration. Because as I said, creatine pulls fluid out of the blood into the muscles, your body needs more liquid to remain hydrated. If you don’t hydrate yourself to compensate you can end up dehydrated. 2oz per pound of body weight should be enough.
Gastrointestinal distress. Stomach cramps, nausea and diarrhea may be caused if you take too much creatine at one time, if it is not a micronized form of creatine, if you don’t mix the creatine with enough liquid, or a combination of any of the above. What basically happens is that the creatine clumps up in the intestine and starts to draw fluid into the intestinal tract. The creatine will be absorbed before it reaches the end of the intestinal tract, but it can cause a bit of fluid to be pulled into the intestinal tract before it is absorbed. You can also avoid using too much sugar with the creatine, so the body doesn’t have to absorb a bunch of sugar and a bunch of creatine at the same time (yes, it is better to mix creatine with a high glycemic food like sugar or glucose, just not too much of it).
Electrolyte imbalance. This is really another side effect of being dehydrated. Electrolyte imbalance can be the cause of muscle pulls, cramps and strains.
If you have kidney problems, then you shouldn’t take creatine because it can cause too much stress on a compromised kidney. If you have healthy kidneys, then it will increase some of the load, but not much. If you over do the creatine, you still aren’t really going to harm the kidneys too much, because the kidneys don’t filter out creatine, they only filter out creatinine, but there is a chance you can cause a type of clog in the kidney with too high of a serum creatine level.
Serum creatine level. You increase your serum creatine level when you take creatine, but sustained serum creatine level is a problem. I will explain that in the next part and I already touched on it a bit with the plasma creatine level.
Creatine is taken to the body and converted into creatine phosphate. ATP is used for energy by breaking the phosphate chain. Kind of like the way the atom bomb splits the uranium atom to release energy. When the phosphate is all broken down, you are left with the residual phosphate and adenosine that has to be removed. The creatine phosphate is broken so the ADP can take the phosphate and create another ATP. So there is a leftover, unbound creatine that has already been converted by the transporter and can’t be converted again, so it has to be pulled out of the muscle and discarded. The discarded creatine is called creatinine. Creatinine is put into the blood and is pulled out of the blood by the kidneys. The kidney is one of the places that creates creatine, so it’s not going to remove creatine, but it will remove creatinine. Some people think that the body will just get rid of excess creatine, but your body really can’t get rid of it. It just stops making it’s own creatine in the hopes that everything will level out. Now some people also think that creatinine is an indicator of renal dysfunction (kidney problems), but everyone urinates creatinine, if you didn’t then you’d have a problem. If you have a blood test done and creatinine is found in your blood, then that’s an indication that there’s a problem with your kidneys. There is a test you can do with urine to determine renal dysfunction, that’s called a creatinine clearance test. It’s several urine tests taken over a period of time. If the levels don’t change over time, then that indicates a problem with the kidneys. So, if your serum creatine level is too high, your body will fill your muscles to capacity, then the excess creatine will just float around in your blood and your going to stop producing your own creatine. Your body is going to eventually stop putting creatine into your muscles (we really don’t know why the body has that reaction) and the creatine can be dumped into muscles it normally wouldn’t be dumped into, like the heart. Hyperthyroidism has also been associated with high serum creatine levels, the kidneys can end up being overworked or clogged if the creatine isn’t cleared. The blood will also fail to do some of what it’s supposed to do because of the creatine. But staying at 5mg per day has been proven for long term to be safe.
Some 20-30% of people are not responsive to creatine supplementation. If you have high levels of creatine in your body already, then you will not benefit from creatine monohydrate. However, if you have low levels of creatine in your body, you will benefit the most from creatine supplementation, such as with a vegetarian that doesn’t eat red meat or fish. Fish not only has creatine in it, but it also has methionine in it. Methionine is one of the amino acids that the body needs in order to create it’s own creatine, but the body can’t make it’s own methionine, it has to be ingested in the daily diet. So the body is only able to make as much creatine as methionine is available (Low methionine, low creatine output. High methionine, high creatine output). Alcohol and caffeine can also effect creatine’s effectiveness. Creatine transporter activity is enhanced by co-ingestion of high glycemic foods, which is mediated by insulin release. Which is why people tend to take creatine with sugar, dextrose, glucose, etc.
Creatine is best when taken once a day on non-workout days and half an hour before workout and immediately following your workout. You should also only take 5mg’s of creatine at a time. If you don’t tend to eat red meat or fish, then you can load creatine for a week at higher doses such as 40g’s per day. If you do eat red meat and fish, you really don’t need to load creatine, but if you want to, you shouldn’t take any more than 20g’s for any longer than 5 days. The daily dosage shouldn’t exceed more than 5 grams for long term use.
I should also add that most of the studies using creatine have been short term (there have been a couple longer studies with low doses between 2.5-5g’s per day). Creatine has been studied mainly in males between the ages of 18-35. It has been determined that children should not supplement creatine and creatine supplementation by teens has not been determined. Women do respond to creatine also, but not as much as in males.
Now, I’ll go through some of the most common misconceptions about creatine that I haven’t already explained.
Creatine doesn’t lower the amount of lactic acid, but it does cause the body to produce less lactic acid. Because the creatine is providing another phosphate molecule for use by ADP, there will be less lactic acid buildup. There is also believed to be a binding of creatine to hydrogen ions.
Creatine does increase your body weight, but the weight is from the excess fluid that is being held in the muscles (as long as you are hydrating properly). If you take creatine and don’t take in any fluids, you will dehydrate and you will not gain any weight. The creatine will pull fluid from the blood, but there will be no fluid to replace the fluid loss in the blood.
Because creatine improves the work of ATP and ADP and that allows your muscles to work a little bit longer before exhaustion, you are able to break down a little more muscle if you are working until failure on every set and that allows you to be able to build the actual muscle fibers. But your weight training has to be optimum and your diet has to be on point, with enough protein to maximize the muscle growth. So creatine can cause growth of actual muscle cells, but will not do it if you don’t exercise. It will however cause increase in water weight and strength, even if you don’t exercise.
There is no benefit to taking creatine at bedtime. Creatine isn’t absorbed any better at night than it is during the day. There is also no added danger in taking creatine at bedtime, with the exception of increased risk of gastrointestinal distress. If you take creatine just as you lay down and you fall asleep, your digestive system slows down and may cause the creatine to pull fluid into the intestines.
I tried to make this post as detailed as possible without going into too much detail. For example, there are different types of creatinine in the body, but it’s not really necessary to go into it here. I also tried to use very simple language, so any med student or chem. student may notice some holes in my description, but that’s only because I don’t think it’s necessary to go into that much detail. I know that a lot of the commonly accepted ideas about creatine are being disputed in this post, and that’s whole reason for me doing it. It seems that most of the common thought about creatine is false information and needs to be corrected.
I hope this clears up some of the questions that people tend to have about creatine. But I know there are going to be people that want to stick with what they were told about creatine and just love to try to find fault in anything I have to say.
