Creatine

Effects and Benefits

Core Identification

Common Names:
- Creatine
- Creatine Monohydrate
- Cr

Latin Name: N/A (Synthetic compound)

Category: Amino Acid Derivative

Uses

Traditional Uses

• No traditional medicinal use - Creatine was first identified in 1832 by French chemist Michel Eugène Chevreul and has been used as a supplement since the 1990s
• Athletes began using creatine supplements following the 1992 Barcelona Olympics when it was revealed that several gold medalists had used it

Modern Uses

• Athletic Performance Enhancement - Improves short, repeated bursts of high-intensity exercise | Research quality: Strong
• Key findings: Approximately 100 clinical trials demonstrate benefits for activities like weightlifting, swimming, sprinting, and interval training. Less effective for endurance activities like distance running and cycling.

• Source citations: Moyad - The Supplement Handbook; Moline - The Doctors Book of Natural Health Remedies

• Muscle Size and Strength - Increases muscle mass and maximal force production | Research quality: Strong

• Key findings: Works by drawing water into muscle cells, which may reduce protein breakdown and increase protein synthesis. Studies show improvement in muscle strength and reduction in muscle fatigue with 5 grams per day. Considered one of the best supplements for improving muscle size based on benefit-to-risk ratio.

• Source citations: Moyad - The Supplement Handbook; Ferriss - The 4-Hour Body

• Parkinson's Disease Support - May slow disease progression and improve symptoms | Research quality: Moderate

• Key findings: Studies with Parkinson's patients show creatine monohydrate with resistance exercise may improve muscle weakness, fatigue, muscle loss, and mood. A major NIH-funded Phase 3 trial (LS-1) tracked 1,700 PD patients over 5 years using 10 grams daily. Creatine appears to act as both an energy source for muscle tissue and a neuroprotectant.

• Source citations: Moyad - The Supplement Handbook

• Blood Lipid Reduction - May reduce triglyceride and cholesterol levels | Research quality: Preliminary

• Key findings: One clinical study found slight reductions in triglyceride levels with creatine supplementation. Pure creatine monohydrate has been shown to reduce blood lipids in both men and women.

• Source citations: Moline - The Doctors Book of Natural Health Remedies; Barrett - The Handbook of Clinically Tested Herbal Remedies (Earnest CP, Almada AL, Mitchell TL, 1996)

• Heart Attack Recovery - May improve exercise capacity post-cardiac event | Research quality: Preliminary

• Key findings: A few studies found that creatine can increase exercise capacity in those who've suffered a heart attack, but further research is needed.
• Source citations: Moline - The Doctors Book of Natural Health Remedies

Active Compounds

Primary Active Ingredients:
- Creatine - Stored as phosphocreatine in muscles, rapidly regenerates ATP (adenosine triphosphate) during high-intensity activity
- Creatinine - Metabolic byproduct excreted by kidneys; excess creatine is converted to creatinine and eliminated in urine

Dosage Information

Standard Dosage:
- Form: Powder (most common) or capsule
- Amount: 3-5 grams per day
- Frequency: Once daily, about an hour before or right after exercise

Therapeutic Dosage:
- Form: Powder
- Amount: Loading phase of 20-30 grams per day (in 5-gram doses) for 5-7 days, then 5-10 grams daily for maintenance
- Purpose: Rapid muscle saturation for athletic performance
- Duration: Can be used long-term; some prefer cycling 8 weeks on, 4 weeks off

Alternative Protocol:
- Skip loading phase entirely and take 3.5-5 grams daily
- Achieves same muscular saturation over a longer period
- Avoids intestinal discomfort associated with loading doses

Maximum Safe Dosage:
- Daily maximum: 5-20 grams per day demonstrated safe in studies
- Warning threshold: Loading doses of 10-30 grams per day can cause severe intestinal discomfort

Bioavailability Notes:
- Creatine monohydrate is the most studied and cost-effective form
- Powder mixed in liquid is best absorbed
- Taking with carbohydrates may enhance muscle uptake
- Vegetarians and vegans may see greater benefits as they have lower baseline creatine stores from diet

How to Take It

Timing:
- Best taken before or after exercise (within an hour)
- On non-training days, timing is less critical
- Some protocols recommend splitting dose: 3.5 grams upon waking and before bed

Hydration:
- Creatine draws water into muscle cells and is dehydrating
- Drink at least one extra glass of water with each dose
- Maintain increased fluid intake throughout the day

Synergies - What It Works Well With

Complementary Supplements:
1. Carbohydrates - Insulin response helps drive creatine into muscles | Enhanced muscle uptake
2. Beta-Alanine - Complementary mechanisms for exercise performance | Beta-alanine buffers muscle pH while creatine provides ATP
3. Protein/BCAAs - Support muscle protein synthesis | Enhanced muscle building when combined with resistance training
4. Alpha-Lipoic Acid - May enhance creatine uptake | Improved muscle saturation

Avoidance - What NOT to Combine With

Supplement Interactions:
1. Caffeine - Caffeine counteracts the ergogenic (performance-enhancing) action of muscle creatine loading | May negate exercise performance benefits | This is a well-documented interaction

Drug Interactions:
1. Nephrotoxic Medications - Drugs that stress the kidneys | May compound kidney burden | Severity level: Moderate
2. NSAIDs (long-term use) - Combined kidney stress | Use caution with chronic NSAID use | Severity level: Mild
3. Diuretics - May exacerbate dehydration effects | Monitor hydration closely | Severity level: Mild

Food Interactions:
- None significant
- Note: Meat, fish, and poultry are natural dietary sources of creatine

Safety Information

Contraindications:
- Pre-existing kidney disease or impaired kidney function (use only under medical supervision)
- Individuals with a history of kidney stones
- Those taking medications that affect kidney function

Side Effects:
- Common: Weight gain (water retention in muscles), mild bloating
- Occasional: Muscle cramping, dizziness, gastrointestinal upset
- Rare: High blood pressure (reported but uncommon)

Long-Term Use:
- Studies have demonstrated safety for extended use in healthy individuals
- The concern about kidney damage is overhyped according to research; studies have not found excessive protein in urine or kidney damage in healthy subjects
- Most long-term studies have involved young, healthy men; less data available for older populations
- Monitor kidney function if using long-term, especially in older adults

Special Precautions:
- Kidney concerns: While studies show safety in healthy individuals, those with any kidney issues should consult a physician
- Hydration: Critical to maintain adequate fluid intake
- Surgery: Consider discontinuing 1-2 weeks before surgery due to potential effects on fluid balance
- Pregnancy/Breastfeeding: Insufficient safety data; not recommended
- Children/Adolescents: Limited safety data; use with caution and medical guidance

Primary Uses At-a-Glance

Primary: Athletic performance, muscle strength and size, high-intensity exercise support, post-workout recovery

Secondary: Parkinson's disease support, blood lipid reduction, heart attack recovery support

Sources

Local Library:
- Moyad, Mark - The Supplement Handbook
- Moline, Peg - The Doctors Book of Natural Health Remedies
- Ferriss, Timothy - The 4-Hour Body
- Barrett, Marilyn - The Handbook of Clinically Tested Herbal Remedies (Earnest CP, Almada AL, Mitchell TL research citations)
- WRCHM - Herb-Drug-Nutrient Interaction (caffeine interaction reference)
- Stewart, Rufus - Herbs to Treat Diabetes (guanidine group/creatine chemistry reference)

General Knowledge:
- Creatine has been extensively studied with approximately 100 clinical trials
- First identified in 1832 by French chemist Michel Eugène Chevreul
- International Society of Sports Nutrition position stands
- NIH National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson's Disease (LS-1 study)