When creatine became available as a dietary supplement in the early 1990s, it was regarded as a genuine panacea. It fully delivered on its promise – a power increase of 10 percent and more. Since then, creatine has become one of the most popular supplements in strength sports, especially because it is still affordable. We have listed the most important information about creatine for you in the form of a handy FAQ.
How does creatine supplementation ensure more muscle growth?
How much should you take?
Should you take it before or after training?
Should you cycle it or use it continuously?
How come you gain weight?
When should you start?
1. WHAT IS CREATINE AND CREATINE MONOHYDRATE?
Creatine is a pseudovitamin and a component of meat (kreas is the Greek word for meat). It therefore also occurs naturally in the human body, especially in skeletal muscles, but also in the heart and brain.
Muscles need creatine for their energy supply and use about 2 grams of it per day. The body can form (‘synthesize’) creatine itself from the amino acids arginine, glycine and methionine – a process that mainly takes place in the liver. But not enough to maintain your creatine stores. Creatine should therefore be obtained in part from your diet and/or supplementation.
Raw meat and raw fish (herring, salmon, tuna) contain the most creatine in percentage terms. But about a third of the creatine is lost through heating. Herring, sushi and sashimi are excellent sources of creatine as raw fish products.
Eggs, although an animal source of protein, contain very little creatine. They do contain the amino acids from which the body can synthesize creatine itself. Breast milk, including cow’s milk, contains only trace amounts of creatine.
Creatine monohydrate is the standard form of creatine. When someone talks about ‘creatine’ without further explanation, they usually mean monohydrate, which is by far the most researched and probably the best form of creatine.
2. HOW DOES CREATINE INCREASE MUSCLE GROWTH?
Supplementing with creatine has a positive effect on training performance and possibly also on recovery. To be precise:
- It increases neuromuscular activation, which means an increase in strength (you can train more intensively);
- It increases the high-energy phosphate metabolism, making you a higher training volume handle (you can do more training);
- It probably reduces the breakdown of proteins, so that you recover better (you can train more often if desired) [ lvi ] .
Better training performance means that you can create easier and/or more overload in your training, which is a precondition for stimulating muscle growth. In addition, as mentioned, creatine supplementation may have a beneficial effect on your recovery. And recovering sufficiently from your workouts is also a precondition for muscle growth.
Creatine supplementation may offer bodybuilders even more benefits, such as an increase in growth hormone and testosterone levels and an improvement in nutrient partioning. However, convincing scientific evidence for these claims is still lacking .
3. HOW CAN CREATINE MAKE YOU STRONGER?
Creatine contributes to increasing the energy stores in the muscle cells.
During short, heavy efforts, the energy is supplied by the phosphate system (anaerobic alactic system). The phosphate reserves in the body are formed by the substances adenosine tri phosphate (ATP) and creatine phosphate (CrP).
The energy is supplied by ATP (which consists of three phosphate groups) to split into adenosine di -phosphate (ADP), and a ‘loose’ phosphate (P), in fact ‘adenosine mono-phosphate (AMP), formerly known.
The stock of ATP is exhausted after a few seconds of intensive work. However, the body can rapidly form new ATP (‘resynthesize’) from ADP. The fastest way to do this is by breaking down the creatine phosphate in the muscle, in other words the splitting of CrP into Cr and P. This ensures that ADP can, so to speak, ‘recharge’ itself to ATP, so that the muscle can ‘fast energy’. The body then makes new CrP from Cr and P.
After about 20 seconds – the duration of the 200 m sprint (athletics) at top level – the stores of ATP and CrP are completely depleted and the lactic acid system (anaerobic lactic system) takes over the energy supply. That system is less efficient and performance decreases.
In short, creatine is essential for the formation of creatine phosphate and ATP, and thus ultimately influences the amount of ‘fast’ energy available to the muscles and performance during short, heavy efforts.
Creatine supplementation increases the concentration of creatine in the muscles [ i ] . Result: more explosive and maximum muscle power. This effect has now been demonstrated by dozens of scientific human studies [ ii ] [ liii ] . No wonder that creatine has long been one of the most popular supplements among strength athletes.
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4. DOES CREATINE SUPPLEMENTATION WORK (EQUALLY WELL) FOR EVERYONE?
No. There are differences between people in the maximum amount of creatine that the muscles can store [ xx ] . The ratio of muscle fiber types plays a role here, as does the amount of muscle mass.
But whether and to what extent you actually benefit from creatine supplementation mainly depends on your natural creatine levels. Your body can only process a limited amount of creatine and you automatically pee the rest. The higher your initial creatine levels, the less well creatine supplementation will work (and vice versa).
And there are also people for whom taking creatine has no effect whatsoever, the so–called non-responders [ xxi ] . It would be one in four.
Your diet also determines how much you benefit from creatine use. For example, vegetarians and vegans generally have less creatine in their muscles than people who eat a lot of meat and poultry.
By the way, if you don’t notice any effect from creatine, that doesn’t automatically mean you’re a non-responder.
5. DOES CREATINE WORK EQUALLY WELL FOR ALL MUSCLE GROUPS?
No, probably not all muscle groups respond equally well to creatine. Research suggests that during an eight-week course of creatine, upper body muscles grow more than lower body muscles [ xxii ] [ xxiii ] .
6. DOES CREATINE SUPPLEMENTATION ALSO WORK FOR ENDURANCE ATHLETES?
Creatine is pre-eminently a strength sports supplement, but endurance athletes can also benefit from it, namely with short power efforts, such as final sprints.
Creatine supplementation may also increase performance that utilizes the anaerobic lactic system, such as running or swimming short distances. However, this effect appears to be small.
Finally, creatine supplementation may reduce muscle damage that occurs as a result of endurance sports [ li ] .
7. IS CREATINE SUPPLEMENTATION ALSO SUITABLE FOR THE CUT?
Yes, creatine is ideally suited for the cut. Creatine supplementation helps you to maintain your training performance and recovery, which is important for maintaining your muscle mass. And we already saw that it may also help to prevent muscle breakdown due to endurance efforts, which is useful if you do a lot of cardio during your cut.
There are no valid reasons to stop your creatine use when you start cutting. The fact that your body retains fluid as a result of the supplementation should not be an obstacle either.
8. IS CREATINE SAFE?
Creatine is one of the most researched supplements due to its popularity [ liii ] . Several long-term studies have also been conducted to test the safety of long-term use [ liv ] . Based on the extensive research available, we can now conclude without hesitation that creatine supplementation is safe [ lv ] [ xxviii ] .
The use of creatine therefore has no harmful effect on the liver and kidneys [ xxix ] .
9. WHAT TYPES OF CREATINE ARE THERE AND WHICH ONE IS THE BEST?
In addition to creatine monohydrate, there are various types of ‘designer creatines’, whose effectiveness or advantages over ‘regular’ creatine have not always been proven.
Creatine monohydrate is the standard form of creatine. When someone talks about ‘creatine’ without further explanation, he usually means creatine monohydrate.
Creatine monohydrate is the best known and most popular form of creatine. It has been proven effective and with its low price, this strain offers you the best value for money.
In creatine monohydrate, the creatine molecule is bound to a water molecule (mono = one; hydro = water). This creatine contains 83 percent pure creatine. On packaging you read ‘contains 100% creatine monohydrate’, but that makes sense.
Creatine monohydrate is usually sold in micronized form for better solubility, which does not necessarily result in better absorption.
Creatine Ethyl Ester
Creatine Ethyl Ester is creatine linked to an ethyl ester. An ethyl ester is an organic compound that is formed when an acid reacts with (ethyl) alcohol, or ethanol. The idea behind this is higher bioavailability, or this creatine promises to be more efficient.
Creatine Kre-Alkalyn is the brand name for a creatine to which sodium carbonate, or baking powder has been added. This creatine is so-called alkaline, or basic, which means that the substance has a pH value higher than 7. Because of that higher pH value, or lower acidity, this creatine would be more effective. In reality, Kre-Alkalyn creatine is just as effective as ‘regular’ creatine, but more expensive. So there is no reason to prefer this creatine over ‘old-fashioned’ creatine monohydrate.
Creatine-a-ketoglutarate (creatine alpha-ketoglutarate) or creatine AKG for short consists of a creatine molecule bound to an AKG molecule. AKG is a precursor of glutamine. This creatine would be more easily absorbed by the intestines and also more easily end up in the muscle, but that has not been proven.
Creatine hydrochloride (HCL)
In creatine hydrochloride, the creatine molecule is bound to a hydrochloric acid group. That would increase the bioavailability of this creatine, in other words you can achieve the same effect with a lower dose as with creatine monohydrate. This claim is not supported by scientific research.
Creatine nitrate is in fact a mixture of creatine and hydrogen nitrate, or nitric acid. The nitrate is converted in the body into nitric oxide (NO), a vasodilator. This would make the creatine more effective, but it is not clear whether the benefits exceed those of the two separate supplements (creatine and an NO booster) [ xxxii ] .
Other creatines, which we will not discuss further, but would like to mention for the sake of completeness, are creatine malate, creatine citrate, magnesium creatine chelate and creatine pyruvate.
The conclusion is that when purchasing a creatine supplement it is best to choose the ‘primal form’: creatine monohydrate. After all, this is the only form of creatine whose effectiveness and safety have been conclusively proven. If you do not react (sufficiently) to creatine monohydrate, you can of course try a variant.
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POWDER OR PILL?
Creatine powders are by far the most common form of creatine. They are sold in pure form or as a flavored water-soluble powder. Pure powders give you the most value for money per gram.
Creatine pills and creatine capsules have been gaining in popularity lately. Most pills and capsules contain 100% creatine, but some are fortified with amino acids, for example. Pills and capsules usually contain about 2.5 g of creatine.
10. WHAT IS THE BEST DOSAGE OF CREATINE MONOHYDRATE?
Partly because the original creatine levels differ from person to person, there is no generally valid optimal dosage of creatine monohydrate. Many studies use doses of around 5 g per day. This dose is also often recommended by manufacturers, even though some people may already have enough with 2 to 4 g per day.
Since it is difficult to determine exactly how much creatine you need for optimal effect, 5 g per day seems like a good general guideline. All the more so since creatine is relatively cheap and you do not have to be overly frugal with it. If you have to go to the bathroom very often after starting creatine supplementation, your dose may be too high (you will then pee out the excess creatine). This can especially happen if you use a charging phase (see next question), where 20 g per day is the guideline.
ARE HIGHER DOSES USEFUL?
Higher doses of creatine, up to 10 g, could be effective in people with a large amount of muscle mass and people who are very active, according to Examine.com [ xxxiii ] . Although they will have to have low natural creatine levels.
According to scientist and creatine researcher Darren Candow, you may also need larger doses as you get older, but that has not yet been sufficiently researched.
11. DOES A LOADING PHASE MAKE SENSE?
A so-called loading phase (or ‘build-up phase’) is often recommended, certainly by a manufacturer. This means that you apply a higher dose for the first 5 to 7 days of your creatine course, and then switch to a normal dose (the ‘maintenance phase’).
The theory is that this way you reach the optimal creatine levels in your muscles faster and therefore notice the effects faster. Whether and to what extent this actually works depends on the level of your natural creatine levels. Perhaps the dose during the loading phase is much too high for you and you pee most of the creatine out again. If you are in a loading phase and you suddenly have to go to the toilet remarkably often, then your creatine dose is probably unnecessarily high.
For the loading phase, a daily dose of 0.3 g per kg body weight applies. Manufacturers often recommend a fixed dose of 20 g per day, spread over 4 intakes.
A loading phase is not necessary per se. In fact, it is only useful if you want to have the optimal effect of creatine as quickly as possible. Or to quickly determine whether creatine supplementation works for you. By taking the creatine with carbohydrates and proteins, you may be able to increase that quick effect (see question 13).
In the slightly longer term, a loading phase is of no use at all. After a week the difference in muscle strength is no longer noticeable and you achieve a comparable effect if you slowly build up your treatment with 2 to 5 grams per day [ xxxiv ] .
12. DO YOU HAVE TO TAKE CREATINE IN COURSES OR CAN YOU USE IT CONTINUOUSLY?
Creatine ‘cures’ or ‘cycling’ does not increase the effect of creatine. It even seems rather disadvantageous, because if you stop the creatine supplementation, it may lead to some loss of strength (not muscle loss). As a result, it may be temporarily more difficult to create overload in your training. We therefore prefer continuous use.
On the other hand, according to creatine expert Darren Candow, it probably doesn’t matter in the long run whether you take creatine on a course or continuously.
Some people take cures because they are afraid that the body will otherwise no longer be able to produce creatine, or because they are afraid that habituation will occur and the effect of creatine will decrease as a result. However, these fears are unfounded. And we already saw in question 7 that creatine is safe – that also applies to long-term use.
13. SHOULD YOU TAKE CREATINE BEFORE OR AFTER TRAINING?
Can you enhance the effect of creatine by taking it at a specific time, for example immediately before or after training? A good question, but one that is difficult to answer. Remarkably little research has been done into the timing of creatine supplementation.
Analysis of the handful of studies on this subject shows that taking creatine immediately after training may lead to a slightly better absorption. Remarkable, because creatine is also often found in pre-workout supplements.
Presumably, the timing of creatine does not matter if you use the substance for a long time (ongoing). If you’re new to it or if you’re taking it in cycles, timing may make a slight difference and it’s better to take the supplement right after your workout [ l ] .
14. SHOULD YOU TAKE CREATINE WITH CARBOHYDRATES?
Another variable that may influence the absorption of creatine in the muscles: do you take the supplement separately, or do you mix it with carbohydrates, for example?
Scientists are not completely unanimous on this either, but the benefit of the doubt goes to intake of creatine with fast carbohydrates, for example fruit juice. Or possibly as part of your post-workout shake. That could increase the absorption of creatine by up to 60 percent. The sugars cause an insulin spike and insulin transports creatine to the muscles, the likely explanation says.
From this perspective, you would need less creatine to achieve the same effect when you take creatine with water. Nevertheless, we advise you not to take any unnecessary ‘risks’ and just use the standard dose of 5 grams per day. Creatine is not that expensive after all.
The same applies here as for applying a loading phase: you reach your maximum creatine level faster, so that the creatine will work faster. But once you have reached that maximum, carbohydrate intake has no additional effect. Although that does not prevent you from taking your creatine, for example.
15. WHAT ABOUT CREATINE AND FLUID RETENTION?
Creatine supplementation leads to fluid retention within the muscle cells (intracellular) and possibly also outside of it (extracellular), although the latter is disputed [ xxxv ][ xxxvi ] . As a result, the muscle fiber size increases, making your muscles appear fuller. We also experience this, although that effect seems to have diminished or disappeared after about a week.
It is disputed whether and to what extent extracellular fluid retention takes place. But some users report that creatine use makes them look a bit fuller (or ‘puffy’), whether or not just on the face, which is why people sometimes speak of a ‘hydrocephalus’. However, we and many with us do not have that experience.
You may see another consequence of fluid retention on the scale: you are ‘suddenly’ a bit heavier [ xxxvii ] . Don’t panic, because from the foregoing you can conclude that this sudden weight gain has nothing to do with an increase in fat, but everything to do with the increase in fluid and consequently the weight gain of the muscles (which has also been scientifically proven). In addition, that increase stops once your creatine levels have reached their maximum and your supplementation is only for maintenance.
16. DOES CREATINE WORK (EVEN) BETTER IN COMBINATION WITH HMB?
Probably not. If we are to believe a Polish-American study from 2001, HMB and creatine enhance each other’s effect on maximum strength and lean body mass. At least, for relative beginners. The researchers discovered that HMB lowered the concentration of creatine kinase in the subjects’ blood. Creatine didn’t. The researchers also found less nitrogen in the urine of the HMB users. Both variables point to an anti-catabolic effect of HMB [ xlvi ] .
The subjects took a placebo, or HMB (3 g), or creatine (20 g for 7 days, 10 g during the rest of the study), or HMB + creatine in the same amounts for three weeks. It must be said that creatine alone is a lot more effective than HMB alone, but HMB + creatine turned out to be more effective than creatine alone.
The said study is the only one to date that has shown a mutually reinforcing effect of HMB and creatine. Moreover, the question is whether this also applies to experienced strength athletes. Two other studies measured the effects of HMB and HMB + creatine in experienced rugby players, in both strength and non-strength training. In both studies, the supplementation had no effect, so not even the creatine [ xlvii ] [ xlviii ] . Since the effect of creatine in strength athletes is now undisputed, these two studies do not seem relevant for pure strength athletes.
17. DOES CREATINE WORK (EVEN) BETTER IN COMBINATION WITH BETA-ALANINE?
Supplementation with beta-alanine has a modest positive effect on sporting endurance. That effect is only there for sports performances that last between 60 and 240 seconds. In strength training, this means that you will only benefit from beta-alanine in very long sets (metabolic finishers), dropsets, supersets and circuit training.
There are some studies that suggest that beta-alanine and creatine potentiate each other, but the amount of studies and results are not (yet) convincing enough to speak of a real synergy between the two supplements [ xlix ] .
18. DOES CAFFEINE INHIBIT CREATINE ABSORPTION?
That’s still not entirely clear. Creatine and caffeine both have a performance-enhancing effect on strength athletes in their own way. Creatine mainly in the sense of increasing strength and muscle mass, caffeine especially with regard to fitness and (to a lesser extent) fat burning. However, if you use them simultaneously (not even literally simultaneously, but on the same day), they would undermine each other’s effectiveness. For example, creatine would negate the fat-burning properties of caffeine [ xxxviii ] and worse, caffeine, in turn, is said to inhibit or cancel out creatine’s positive effects on strength and muscle building. The latter because creatine and caffeine work against each other in the field of hydration. While creatine tries to retain water (see question 14), caffeine tries to push it off. Although the latter seems to be the case only to a limited extent [ xxxix ] .
The alleged negative influence of caffeine on creatine is suggested by a Belgian study from 1996 [ xl ] , to which reference is invariably made on this issue and which often has some serious comments [ xli ] [ xlii ] . Fifteen years later, a second Japanese study on the subject showed that caffeine causes the muscle cell to neglect its creatine metabolism. Daily high doses of caffeine thus undermine the effect of creatine, but an occasional high dose of caffeine, for example as a training booster, is not a problem [ xliii ] .
Because there is only limited research available on the interaction between creatine and caffeine, most see no harm in taking both substances at the same time. Although the wish seems to be the father of the idea: both caffeine and creatine are very popular among strength athletes (they are often both in pre-workout supplements), especially for those who are also coffee enthusiasts (like us). On the other hand, many strength athletes have positive experiences with creatine supplementation, while many of them probably also use caffeine.
19. CAN CREATINE MAKE YOU GO BALD?
Creatine supplementation could cause hair loss and thus baldness in men who have a hereditary predisposition to it. However , the scientific evidence for this is shaky [ xliv ] .
There is exactly one study that suggests that creatine supplementation increases Dihydrotestosterone (DHT) [ xlv ] and DHT causes hair loss. But it is not said that this increase also effectively causes an increase in the DHT concentrations at the hair root follicles and therefore actually causes hair loss.
Supplements research site Examine.com delved a little further into this matter and came up with the following answer:
It’s plausible , but unlikely. (…) To this day, no studies have directly examined creatine’s effects on hair loss. [ li ]
Creatine specialist Darren Candow concludes that creatine balding is a myth.
20. SHOULD YOU USE CREATINE?
A male natural bodybuilder can gain a maximum of 10 to 18 kg (an average of 13 kg) of muscle mass in his life through strength training. With a thorough training program, good nutrition, sufficient rest and an unwavering dedication, that should not be a problem at all.
Supplements can be a helping hand and sometimes help you over difficult points, but nothing more.
21. WHEN SHOULD YOU START TAKING CREATINE?
We advise you to start using creatine only when you have reached a serious strength plateau. As long as you continue to grow as a beginner without creatine supplementation, you should continue to do so.
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