Creatine is a nitrogenous organic acid produced in the liver which helps in supplying energy to the cells throughout the body particularly the muscle cells.

The compound is formed of three amino acids: L-arginine, glycine, and L-methionine and makes up about 1 percent of the total volume of human blood.

Creatine is transported through the blood by an active transport system; it is then used by parts of the body that have high energy demands, such as skeletal muscle and the brain.

Around 95 percent of creatine in the human body is stored in skeletal muscle.

In this article, we will look at the potential medical uses of creatine and any accompanying evidence, how creatine works, and any side effects it might cause.



Creatine is one of the most popular sports supplements in the world for mass gain. 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. And 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.
Researchers published findings in the Journal of Sports Science and Medicine suggesting that creatine use can increase maximum power and performance in high-intensity anaerobic repetitive work by up to 15 percent.Increased muscle creatine content is associated with greater body mass and total body water volume.A study published in the Journal of Athletic Training reported that creatine supplementation increased body mass and also resulted in water retention, but fluid distribution did not change.





Creatine supplements are commonly used by athletes because of their effectiveness in high-intensity training.People take creatine because it allows the body to produce more energy, and with more energy “you can lift one or two more reps or 5 more pounds” and “your muscles will get bigger and stronger,” said Chad Kerksick, Ph.D., assistant professor of exercise physiology at the University of Oklahoma.Researchers published findings in the Journal of Sports Science and Medicine suggesting that creatine use can increase maximum power and performance in high-intensity anaerobic repetitive work by up to 15 percent.Increased muscle creatine content is associated with greater body mass and total body water volume.A study published in the Journal of Athletic Training reported that creatine supplementation increased body mass; it also resulted in water retention, but fluid distribution did not change.



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Creatine may also help improve the strength of people who have muscular dystrophy. For instance, one German study found that people with muscular dystrophy who took creatine experienced an increase in muscle strength of 8.5 percent compared with those who did not take the supplement.

Dr. Rudolf Kley, of Ruhr University Bochum, Germany, lead reviewer of the study, said that the finding shows that short and medium term creatine treatment improves muscle strength in people with muscular dystrophies and is well-tolerated.





In mice models of Parkinson’s disease, creatine was able to prevent the loss of cells that are typically affected by the condition.

Research, published in the Journal of Neurochemistry, concluded that “combination therapy using Coenzyme Q(10) and creatine may be useful in the treatment of neurodegenerative diseases such as Parkinson’s disease and [Huntington’s disease]” in animal models.

However, research published in JAMA using more than 1,700 human participants concluded that “treatment with creatine monohydrate for at least 5 years, compared with placebo did not improve clinical outcomes.”

Similarly, a systematic review published in Cochrane concluded that there was no strong evidence for the use of creatine in Parkinson’s.



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It is possible that creatine could be useful in treating depression.

It may come as a surprise that a supplement for athletes has properties that can help alleviate the symptoms of depression, but evidence shows that it might be the case.

Researchers at three different South Korean universities found that women with depression who augmented their daily antidepressant with 5 grams of creatine responded twice as fast and experienced remission of the illness at twice the rate, compared with women who took the antidepressant alone.

Another study looked at the use of creatine in treating depression in methamphetamine-addicted females. Although the study was small-scale, they concluded:

The current study suggests that creatine treatment may be a promising therapeutic approach for females with depression and comorbid methamphetamine dependence.”



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Researchers from the University of Sydney and Macquarie University, both in Australia, found evidence that creatine can boost memory and intelligence.

Dr. Caroline Rae, who led the study, said that the results were clear with both our experimental groups and in both test scenarios. Creatine supplementation gave a significant measurable boost to brain power.

A group of researchers published the results of another study in a similar vein in 2007. They looked at the effects of creatine supplements on the cognitive abilities of older adults. They used a number of cognitive tests to examine the influence of creatine.

Although the study group was small, the results were positive. They found a significant effect of creatine supplementation on all tasks except backward number recall. It was concluded that creatine supplementation aids cognition in the elderly.



At recommended doses, creatine is considered safe to consume. According to the University of Maryland Medical Center, creatine can cause mild side effects.

Potential side effects of creatine may include:

Stomach pain


Muscle cramping


In addition, patients with kidney disease should completely avoid using creatine, and caution is advised for people with diabetes and anyone taking blood sugar supplements.

Overall, creatine seems to be relatively safe.Taking creatine pose no serious health risks when taken at doses described in the literature and enhance exercise performance in individuals that require maximal single effort or repetitive sprint bouts.”

but they also make it clear that certain individuals may not be best advised to take creatine without consulting a doctor.



Research shows that there are numerous ways by which creatine produces increases in muscle strength, muscle growth and overall athletic performance. The majority of creatines benefits were originally believed to be solely due to the boost in fast energy thats the result of increased Phosphocreatine 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. And over time, the ability to complete more repetitions can result in muscle growth. While this is a major way that creatine works, today we know that creatine also 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 still yet another way that creatine works is through increases in the growth factor 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.

And even still there’s another way that creatine works to increase muscle growth. Arak University (Iran) researchers reported in a 2010 issue of the journal Molecular and Cellular Endocrinology that subjects taking creatine while following a weightlifting program for eight weeks had significantly lower myostatin levels than those taking a placebo. Myostatin is a protein that limits muscle growth. The Iranian researchers concluded that since myostatin levels were lower in the subjects taking creatine, one way that creatine may work to increase muscle size and strength is by reducing myostatin levels, which reduces the limitation that this protein places on muscle growth.



Although there is 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.




How much creatine you need to take depends on the form. For creatine monohydrate, research shows that using a loading phase of 5 grams taken 4-6 times per day for 5-7 days can boost muscle creatine levels by as much as 40% in under a week. However, research has also shown that taking just 5 grams per day can also lead to similar increases in muscle creatine levels, but it takes approximately 30 days, or about a month. This is the main reason why a loading phase is recommended for those starting to supplement with most forms of creatine. The loading phase allows you to start experiencing the benefits of creatine in the shortest amount of time. After you complete the loading phase you can stick with a 5 gram dose of creatine within 30 minutes before and within 30 minutes after workouts. That’s because research shows that when creatine is taken around workouts, the accumulation of muscle creatine is maximized as compared to taking creatine at other times of day.

The best way to maximize creatine uptake by muscle cells is to take creatine with high-glycemic (fast-digesting) carbohydrates, such as a sports drink or gummy bears, and fast-digesting protein, such as whey protein. The major reason for this is that these nutrients boost blood insulin levels. This anabolic hormone is critical for stimulating the transport of creatine into muscle cells.

Many of the other form of creatine, such as creatine hydrochloride and Kre-Alkalyn, allow you to take a much lower dose and not bother with the loading phase. For the other forms of creatine use the dosing amount recommended on the label. However, I strongly suggest that whatever that dose is that you take one dose within 30 minutes before workouts along with your preworkout protein shake, and one dose within 30 minutes after your workout along with your protein shake and fast carbs. On days that you do not train, take one dose of creatine with your morning protein shake and carbs.










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