Creatine: The KING OF SUPPLEMENTS?

What is Creatine and how does it work?

Creatine is a naturally occurring compound that is involved in energy formation within the muscle cell. Creatine is critical in the regeneration of ATP (our bodies energy supplier) during short and hard exercise or mental activity.  We naturally produce 1-3 grams of creatine within the body, that is stored primarily in the muscles (95% of supply). We also gain further stores of creatine through our diet, Red meat and Fish contain the highest doses.

Lets break down the above paragraph to better understand how creatine acutally works. This is going to get a little content heavy but I will try to keep it to the minimum information needed.

During periods of hard exercise we need energy as quickly as possible. Our Adenosine triphosphate – Creatine Phosphate system (ATP-CP System) meets this need in its ability to supply energy very rapidly to working muscles, for a short periods of time (8-12 Seconds). Above this time our supplies run out and the body must work with the presence of oxygen (Aerobic Metabolism).

To create energy a substance called ATP is broken, the breaking of this bond releases energy that is used within the body for almost every task, from your heart beat, to a muscle contraction and even maintaining parts of our fluid balances. When this ATP is broken down it is converted into ADP + a phosphate (which was broken away). This phosphate will bind to creatine to create our creatine phosphate (CP). Our body needs more ATP for this high energy demanding environment, to regenerate our ATP quickly, our CP molecule will give its phosphate to the ADP molecule to form ATP which can now be recycled and used for energy again. (There are things called enzymes that help with all these connections and breakages but lets not concern ourselves with them as creatine is often the reaction limiting agent).

Lets use a silly example. Imagine you have 3 chocolate covered strawberries on a stick (This is our ATP) and someone comes along and takes one of the strawberries off and runs away; they had to use energy to pull off the strawberry and run away. Your left wth only 2 Chocolate strawberries on your stick (This is now our ADP; gets it the strawberries are our little phosphate groups; albeit delicious phosphate groups). Now your friend Creatine see’s this happen and catches your strawberry thief and begins carrying the strawberry back to you (This is our Creatine Phosphate). Once your friend gets back to you, with the use of only a small amount of energy (They are very willing to hand it over) they return your Strawberry to the stick and you have all 3 off them again (Back to ATP), ready to repeat the process all over again; you really need to stop eating your strawberries in rough neighbourhoods !.

With higher levels of creatine we have an increased ability to rapidly recycle and reform our ATP levels. Again this is only a short term solution, after this period we tend to have our power output and intensity drop as we start to reply on more efficient but slower forms of energy release.  

What does Creatine supplementation do and why should you take it?

Strength and Power Improvements

By increasing the overall pool of cellular phosphocreatine, creatine supplementation can accelerate the recycling of ADP into ATP, thereby making more energy available for high-intensity exercise. This increased availability of energy can promote improvements in strength and power output.

Outside of the acute strength improvements studies have found that chronic strength improvements occur as a result of improvements in skeletal muscle mass due to a higher anabolic environment combined with a slightly higher ability to maintain training intensity both inter and intra sessions.

Lean Muscle Mass conservation and increase

Creatine has Anabolic effects or more specifically is has Anti Catabolic Effects. This means have higher creatine levels aids in minimising muscle breakdown which enhanced maintenance of Lean muscle mass. This is particularly relevant for those who are immobilised due to injury; eg a broken ankle that injured side is fully immobilised for up to 12 weeks - depending not he break type and placement). Studies have shown conclusively that creatine supplementation enhances lean body mass maintenance when combined with unilateral strength training on the un injured side compared to test subjects who were taking a placebo (Not creatine).

It has also been shown that we can see a modest increase in lean muscle mass within the general population when they supplement creatine and combine it with a 3 x per week resistance training program. It is believed that creatine initially creates a Hydrostatic gradient differences which results in a net positive water and salt gain acutely within the cell. This 2-4 weeks water gain transitional period further enhances your ability to make strength improvements through muscle hypertrophy; due to the highly anabolic environment created by the increased water levels.

Improved Recovery

Creatine has shown to reduce the time it takes to recover between training sessions, between sets within the same session and to decrease the overall severity of Delayed Onset Muscle Soreness (DOMs). Several studies have shown that when creatine supplementation was kept near saturation point the loss of muscular strength that occurred inter and intra session was reduced. When looking at Plasma Creatine Kinase (CK); a marker of inflammation, levels were reduced in those supplementing with creatine compared to the placebo group. This suggests that there was less muscle damage sustained overall for the creatine group.

Hormones: Testosterone

Creatine has an indirect effect on testosterone. It is widely known that an acute elevation in testosterone levels occur post resistance training; with large muscle groups and higher intensity exercise having the largest of effects. Creatine provides the ability to push a little harder in each set as well as move a slightly heavier weight for longer, which will allow this acute elevation to increase comparative to non creatine takers.

This is significant as it creates a greater anabolic environment for muscle growth and recovery. The higher your lean body mass the more capacity you have for a higher testosterone level (Ofcourse stress, Sleeplessness and Poor diet can dramatically effect this). Testosterone levels being adequate or even above adequate can contribute to increased feelings of  arousal, motivation and enhances overall energy levels.

Brain: Cognition and Memory

The cognitive benefits found with creatine supplementation is the newest area of reach and thus still has the least amount of evidence to support the theories. That being said, this is a very, very exciting area of research that does have some real credibility and several high quality studies.

The cognitive benefits have bene shown to be the greatest in those who needed it most. That makes sense right? That doesn’t mean it isn’t an important finding. Studies have found that the greatest improvement in memory (Long term) and cognition was experienced by the elderly that were given creatine as a supplement. They saw quite significant improvements in their recall at the 1 Hour, 1 Day and 1 Week Mark. Cognition was tested using a serious of common tests this time not only elderly were tested but also those who were sleep deprived (24 Hours). They again found significant improvements in test subjects given creatine, compared to those in the placebo group.

It is worth noting that the studies have shown for cognitive improvements the dose of creatine has to be higher and a longer loading period is recommended (25 grams for 4 weeks) before dropping down to 15 grams for the following 4-6 weeks. It was believed that it takes longer for the creatine to firstly not be uptake by all the muscle cells (these must be close to saturated first) and secondly to cross the blood brain barrier and enter our brain cells.

This is a very interesting area of search that could potentially have positive implications for Dementia patients.

Bone: Mineral Content and Density

This one here is also very interesting, particularly for the elderly and for those women entering or on the other side of menopause. Creatine supplementation when combined with resistance exercise has shown to increase bone mineral content, which translates into at the very least a maintain of our bone density. They say it isn’t possible to improve your bone density and that the best case scenario is a maintenance of bone density and an improvement within the supporting muscular tendinous structures. Im not going to be the one to argue this as i just don’t have the qualifications nor the evidence to back it up, however the bottom line is an increase in mineral content in our bones does lead to a more resilient frame upon which we can continue to build skeletal muscle strength and size.

Are there any Side Effects?

It seems to good to be true doesn’t it? And trust me your not the only one thinking that. All of these fantastic benefits, there has got to be a catch right? Scientists have been thinking the same thing for some time now and consequently have devoted a lot of hours to trying to find the down sides. To be exact there are over 1300 quality studies on creatine; with huge amounts more that are poor quality, So far there haven’t found any adverse side effects.

They have however noted that some people may experience GI distress with higher doses (Over 20grams/ Day) when insufficient amounts of water are consumed with it. This is usually very short lasting and limiting to diarrhoea or nausea.

Who should take it?

Well this is a very broad question as after reading this you may feel that well everyone should take it shouldn’t they? Its not quite that simple (Ahh Darn is it ever that simple?). Yes majority of people both female and male will see benefits from it; when combined with Resistance Training, but lets try to remember that this is 1 small facet of a much larger issue; Our health. Creatine is a supplement so should not be your first line of defence as you cannot consume creatine to fix a bad diet, poor exercise habits nor other lifestyle related health conditions. Creatine will be most effective when combined to supplement your current healthy diet and exercise regime.

If you do eat well and try to exercise regularly (both aerobic and resistance) then yes i feel that you should at least try creatine supplementation for an 8 week period and see how you feel. Id go as far as recommended everyone get a DEXA scan before and after to monitor the differences (Particular if you are post menopausal and are at increased risk of Osteopenia or porous).

This list is not exhaustive but these are the tops ones that come to mind: Athletes, Those immobilised due to injury, Post menopausal women, General Population who eat well and train regularly, Elderly; particularly those who are more frail and those who have early stages or family history of Dementia.

How to take it and when?

Studies are showing that it takes 6 weeks to fully saturate our muscle cells with Creatine. This means that they are at the highest levels they can be, any more than this won’t give us any extra effect. Onto of this our cells can stay saturated for 28 days without us having to consume any more creatine. What this means is that if we so desire we can but dont have to cycle creatine. A cycle of creatine might look like 6-8 weeks on to fully saturate the muscle fibres followed by 2-3 weeks off in which the cells will still remain saturated. Given the lack of side effects and the relative cheapness of creatine, most people decide to just continually use it year round, which is totally fine aswell.

As for the timing of when to take creatine, all studies have shown that it makes NO difference when you take creatine. So pick a time that is going to work best for you and dont forget to take it.

There are 2 ways that people can take creatine, you can either start with a loading phase which is usally 20-25grams per day for 5-7 days and then settle into the more standard amounts of 0.1g/ Kg of Bodyweight. The loading period has been shown to help you reach the saturation point sooner, however if you plan on taking this for the long term a loading phase really doesn’t matter as what’s a couple of weeks difference compared to the rest of our lives. If this is your thought process then starting on the standard amount from the get go is perfect aswell.

An example of the standard amount I; at the time of writing this, am an 85Kg Male. 0.1 x 85 gives me 8.5 grams of creatine daily. Now i round this up as a standard scoop is 5 grams and I’m happy to consume a little more, particularly given then i do fall on the side of higher muscle mass.

Micronised Creatine Monohydrate is the best for both absorption and quality, so try to avoid any of the other crap thats out there. At Zion Fitness we stock a creatine that we believe to be of a very high quality. The coaches are I never stock anything that we personally wouldn’t use, we do not sacrifice quality of product for price.

By: Lachlan Bisshopp

M.C.ExPhys, G.CertWHS, Pn1
Accredited Exercise Physiologist ESSAM AEP