What Is Creatine Monohydrate and What Does It Do?

Due to the vast amount of topics on Muscletalk asking for information on creatine, we have consolidated many of the most frequently asked creatine questions into one detailed concise article.

What is creatine?

Creatine is one of the most popular sports supplements on the market and is used by bodybuilders, athletes, sportsmen and women alike. Creatine is a compound made naturally in our bodies as an energy replenisher. It is manufactured in the liver, kidneys and pancreas and secreted into blood for transport to muscle (amongst other) tissues. Its chemical name is methylguanido-acetic acid, formed from the amino acids arginine, methionine and glycine.

Does creatine work?

Well no supplement ‘works’ per se; supplements merely ‘supplement’; but, yes, creatine, when consumed in correct doses, will help the individual receive the desired effects. Creatine is probably the most scientifically researched sports supplement ever, providing strong evidence that it helps improve performance. However, a few individuals do report that they have not noticed any notable improvements from using creatine.

What does creatine do?

Creatine has a number of major functions as a sports supplement. All of these functions revolve around its function as an energy replenisher through it forming the creatine phosphate (CP or phosphocreatine) molecule.

Creatine replenishes ATP

ATP is the molecule which when broken down releases energy for the muscle to contract. When used up, ATP needs to be replenished by re-acquiring phosphates. CP acts as a phosphate transporter. CP gives up its phosphate to ATP freeing creatine to form the bi-product creatinine for excretion.

Numerous studies have demonstrated that the more creatine that is present in muscle cells, up to a maximum storage level, the more efficiently ATP can be replenished, and, hence more ATP is available for energy. The richest food source of creatine is meat and fish, but it has been found that muscles can store far more CP than is possible to obtain from food (Hultman, et al 1996), so by supplementing with creatine monohydrate you can maximise stores. Thus creatine allows you to have more energy to help lift heavier weights, train harder and at higher intensity.

Creatine stimulates protein synthesis

It has been demonstrated that creatine may also promote muscle growth by stimulating protein synthesis in two ways. Firstly, is from the increased work you are able to do as a result of its energy replenishing actions. Secondly is that the more CP that is stored in muscle, the more water is drawn into muscle making it fuller and stronger. With more CP and water in muscle, the volume increases, and the muscle cell is ‘volumised’ or ‘super-hydrated’. A volumised muscle helps to trigger protein synthesis, minimise protein breakdown and increase glycogen synthesis (Haussinger 1996; 1996). If a muscle is then trained properly, this could lead to enhanced muscle growth. The muscle ‘pump’ experienced when using creatine is reported to be much more intense, and this is as a result of the cell volumising effect.

Creatine may buffer lactic acid

Creatine may also act as a lactic acid buffer and improve exercise recovery time. Lactic acid is a bi-product from anaerobic (without oxygen) exercise, such as weight training. Lactic acid is responsible for the ‘burning’ sensation when the muscle becomes fatigued. When you cannot train anymore, it is due to you either having run out of energy or a build up of lactic acid. Creatine may act as a buffer for this lactic acid, which helps to delay the onset of fatigue.

Creatine increases body weight

Most users experience notable weight increases when they commence a course of creatine, up to six or seven pounds (about three kilograms), especially the first time they use it. Most of this weight gain is from the cell volumising effect which is not permanent.

Some weight gain is from an increase in muscle tissue, and not just water, due to the positive effects of creatine. Studies have shown that creatine supplemented subjects significantly gained more lean body mass than non-creatine-supplemented individuals, but total body water was no different from before and after the study (Kreider; et al 1995; 1996). Most size and strength gains from creatine are during the first month of its use.

What is creatine loading?

Creatine loading is where the subject takes a high dose of creatine for the initial few days which is then followed by a maintenance lower dose for a few weeks. Some studies have shown that this achieves a higher concentration of muscle CP then by simply taking a maintenance dose alone (Greenhaff, et al 1993). There are a number of loading regimens, but the following one seems to be optimal and most cost effective:

This may be followed by a period of rest from using creatine, or back on the loading phase.

Is creatine loading really necessary?

This is very controversial as there are researchers like Greenhaff, et al (1993), who show that it is beneficial to load, and others who show no benefit. The ones who show no benefit recommend 5g per day only for 6-7 weeks and claim that supplement companies advocate loading merely as a way of trying to sell more creatine.

If you compare this to companies who advocate a 10g, 15g or eve 20g loading phase and maintenance of 5g per day, then the non-loading advocators are correct. However if you compare 5g per day to the example above you will use a lot more creatine over the few weeks by not loading; (Over a 52 day period using 5g per day throughout uses 260g in total; compared with just 166g in the above regimen).

To conclude, loading may/may not be necessary but, as it will save you money by loading, it makes sense to load.

Do I need to cycle creatine?

After the maintenance phase you may desire a period of rest from using creatine, or you may go straight back on the loading phase. If you want to have some time off, have at least 2 weeks. There is no evidence that cycling creatine is any better than using is constantly. Anecdotally, there are mixed reports about cycling.

When during the day should I take creatine?

Creatine can be consumed any time of the day, as it is stored. Many experts advocate taking it immediately post workout, which is not only unnecessary, but also impractical, considering other nutrients which are consumed at this time. Furthermore, after a gruelling workout, you may feel a little sick and gulping down a creatine drink would not be desirable.

What do I mix creatine with?

Creatine is even more effective when taken with simple carbohydrates. This is due to the effect carbohydrates have on insulin release, and the insulin in turn helps muscle cell uptake of creatine.

It has been suggested that a formula of roughly 35g of dextrose plus 5g of creatine monohydrate is the optimum for an effect, though this amount may be a little excessive. Studies on a range of athletes from different sports have shown creatine plus carbohydrates to produce better performance than creatine alone (Stout, et al 1997; 1997).

A creatine serving is often preferred in a hot drink (for example tea / coffee) so it dissolves more easily, with a teaspoon of sugar and consume some fruit or fruit juice at the same time. Another idea is to drink your creatine in a hot full sugar cordial drink, like blackcurrant. However do not mix creatine into boiling fluids as creatine is destroyed at very high temperatures, let your drink cool to drinkable temperature before adding the powder.

Which creatine formulas are best?

With loads of different types of creatine and formulas on the market it’s no wonder the consumer gets confused. Creatine monohydrate is the form of creatine that is most commonly sold, because it is virtually tasteless and dissolves quite well in water. Creatine phosphate, creatine pyruvate and creatine citrate are also available, but are nowhere near as effective.

Creatine is also available as creatine serum, effervescent creatine or sublingual creatine, each claiming, by clever marketing, to be more readily absorbed, but really they are a waste of money as creatine is not stable in liquid form. Creatine capsules are also available, although reported to be less effective as powder forms. Always make sure you use creatine monohydrate; the micronised creatine monohydrate formulas are great as they dissolve well.

There are also a number of creatine transport systems made from creatine monohydrate and other ingredients claiming to help maximise uptake. Some of these are creatine and simple carbohydrates which do work, but are very expensive and it would be cheaper and just as effective to use basic creatine monohydrate powder and sugar.

Some formulas contain the amino acid taurine, which acts as an insulin mimicker, to aid creatine uptake; disodium phosphate, magnesium phosphate and potassium phosphate, all of which play a role in the formation of CP; and ribose which is also claimed to help uptake. The effectiveness of formulas containing these ingredients are controversial and not worth the increased price.

You’ll also find creatine in some pre-workout products.

What about Creatine Ethyl Ester (CEE)?

The CEE debate can be read in the article Creatine Ethyl Ester: The Best Creatine or a Supplement Fallacy?

How long before I notice the effects of creatine?

This varies and there is no definite answer. Due to the cell volumisation effects, you should notice an increase in weight during or soon after the first week if you opt to load. You should also start to notice a fuller feel to your muscles, more energy in the gym and heavier lifts with 1-2 weeks. Most size and strength gains from creatine are during its first month of use (Kreider; et al 1995).

How much fluid should I drink while using creatine?

It is not possible to put a figure on this, so in practice (and irrespective of whether you are using creatine or not, as a good fluid intake is crucial for performance) drink regularly and plenty throughout the day. Thirst is not a good indicator.

Does caffeine affect creatine?

Some studies suggest reduced effectiveness of creatine when consumed with caffeine (Vandenburghe, et al 1996; Hespel, et al 2002), but these have flaws. In Vandenburghe’s study, subjects when using creatine together with caffeine (C+C) had lower levels of performance than when they were administered creatine alone (C) (when also compared to placebo). However as CP levels were similar in C+C and C, this indicates that caffeine did not impair the transportation of creatine into muscle.

The studies were not under strict guidelines, which may explain the reduced performance: There was not a significant clearance period of creatine from stores before subjects were given the next test. Also, there was only 3 weeks rest, which may show signs of creatine storage; 4 weeks is more likely to give full clearance. So, if C+C was tested first, there may have still been some creatine in the stores. For optimal study design, a 6-week gap seems appropriate.

Another large flaw was that there was only 20 hours between the last caffeine dose and the C+C test results. This is more than enough time for caffeine to be out the system, i.e. caffeine could have had no effect (we have already showed it didn’t affect muscle uptake).

Earlier studies by Greenhaff, et al (1993) where hot tea/coffee were used to promote dissolvation and absorption of creatine, showed enhanced performance, which contradicts these findings.

Hespel, et al (2002) were different in their study design but there were still a number of flaws mainly due to the timings of caffeine intake, similar to that of Vandenburghe et al in this respect.

It is crucial to bear in mind that the ultimate limiting factor for exercise performance is hydration state (I cannot emphasise enough the importance of this), and one of the positive effects of creatine is cell volumisation, i.e. more fluid into muscles. If there is insufficient fluid in the body, then valuable extracellular water will be drawn into muscles. Caffeine in higher quantities is a diuretic, and may reduce hydration state; this could explain reduced performance and is easily rectified by drinking plenty of fluid whilst on a creatine cycle.

There is nothing wrong with taking creatine in a caffeinated beverage, nor with using caffeine pills pre-workout whilst on a creatine cycle, as long as you drink plenty of fluid throughout the day.

Can you drink alcohol while using creatine?

A small amount of alcohol consumed whilst using creatine is ok, as long as it is not too regular. The main problem with alcohol is that it can be a diuretic at higher intakes, so if you do drink make sure you drink plenty of fluid to keep hydrated afterwards.

Do acidic juices affect creatine?

In short, no, despite there being some claims that they do. Creatine is an acid itself and many early studies used acidic fruit juices as the method of administration.

What about carbonated beverages?

Again, no, infact many people enjoy their creatine in Lucozade.

Does creatine compete for absorption with other nutrients/supplements?

Creatine is made up of amino acids but is absorbed in its undigested form as methylguanido-acetic acid, therefore does not compete with other amino acids for absorption. Simple carbohydrates may improve its absorption.

What are the side effects of creatine?

Creatine monohydrate has been shown in numerous studies to be, safe, even in large quantities (Robinson, et al 2000), nevertheless there are some side effects of creatine which you need to be aware of before commencing its use.

Due to its effect on fluid balance after consuming creatine it can cause mild irritation to the stomach and nausea for a short while. This is particularly apparent during the loading phase. Whilst this is a little unpleasant, it is harmless and minimised if you consume plenty of fluid. For this reason I also wouldn’t recommend you use creatine at times when you are prone to feeling a little sick, e.g. immediately after training or first thing when you wake up.

Quite intense muscle cramps have been reported in many athletes who supplement with creatine, which could lead to injuries, and impair performance. Muscle cramps tend to be more prevalent in more energetic sports like athletics and football, rather than bodybuilding.

Some users have reported headaches, but again, drinking plenty will help prevent this side effect.

Does creatine affect the kidneys?

In the clinical setting, creatinine levels are measured to assess kidney function. Creatine supplementation raises creatinine levels, although it is completely non-toxic to the kidneys (Robinson, et al 2000). If you are supplementing with creatine and your doctor is running some blood tests, it is imperative that you inform him that you are using creatine otherwise this could give misleading information.

Can creatine cause cancer?

There has been one ‘study’ based on people’s assumptions that creatine may be linked to cancer (AFSSA 1999). However, there have been no long-term studies to suggest that is has any links. In fact, it has been noted that it may actually be protective (Myers 2002).

How old do you have to be to take creatine?

There appears to be no minimum age, but as I can see no benefit in anyone younger than 15 years old using it (due to the fact that children younger than this do not optimise their performance without ergogenic aids), I wouldn’t suggest it be consumed by anyone under 15.

What is the shelf life of creatine?

Creatine monohydrate powder has a long shelf life of years, so it can be stored at home for ages. Always consume your supplements before the ‘use by’ date on the packet.

Can I use creatine in bodybuilding competition preparation?

I would not recommend the use of creatine from four weeks before a bodybuilding competition. Despite the fact that creatine is supposed to draw water from around the muscle to within it, it has been reported to give a smooth stage appearance and the user definitely holds more water. Again supplement companies claim it can be used pre-contest for its cell volumising effect. I wouldn’t risk it.

I’ve heard creatine can help some neurological disorders, is there any truth in this?

Some people are born with genetic disorders like muscular dystrophy where they have abnormally low levels of creatine phosphate in their muscles. Creatine supplementation, in such individuals, increases their strength and energy. The replenishment of ATP in sufferers of muscular dystrophy means that cells are better equipped to protect against injury and subsequent death (Myers 2002). In theory, this may actually prolong the life of the individual.

Is creatine supplementation for me?

The aim of this article was for you to make up your own mind to answer this final question. Creatine is the most researched of all sports supplements and is still raved about by many sports people of different disciplines and definitely has a role in bodybuilding.

However, despite the scientific hype, creatine is not the be-all-and-end-all of supplements in bodybuilding, as you can build an excellent physique without ever touching it. It is certainly no replacement for a good diet and more fundamental supplements like quality protein powders. When you have an optimal diet and are training hard, it definitely may be worth giving creatine monohydrate supplementation a try to see for yourself, and I do not doubt that you will see and feel positive results.

References

• AFSSA 1999. http://www.afssa.fr
• Greenhaff PL; et al. 1993. Influence of oral creatine supplementation on muscle torque during repeated bouts of maximal voluntary exercise in men. Clin Sci 84: 565-571
• Haussinger D. 1996. Nutritional state and swelling-induced inhibition of liver proteolysis in perfused rat liver. Nutr J 126: 395
• Haussinger D. 1996. The role of cellular hydration in the regulation of cell function. Biochem J 313: 697-710
• Hespel P, Op’t Eijnde B, Van Leemputte M. 2002. Opposite actions of caffeine and creatine on muscle relaxation time in humans. J Appl Physiol 92(2): 513-8.
• Hultman E; et al. 1996. Muscle creatine loading in man. J Appl Physiol 81: 232-237
• Kreider RB; et al. 1995. Effects of ingesting supplements designed to promote lean tissue accretion on whole and regional body composition alterations during resistance training. FASEB J: A1015
• Kreider RB; et al. 1996. Effects of ingesting supplements designed to promote lean tissue accretion on body composition alterations during resistance training. Int J Sport Nutr 6(3): 234-246
• Robinson TM; et al. 2000. Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function. Br J Sports Med 34: 284-288
• Stout JR; et al. 1997. The effects of a supplement designed to augment creatine uptake on anaerobic reserve capacity. NSCA National Conference Abstract
• Stout JR; et al. 1997. The effects of a supplement designed to augment creatine uptake and fat-free mass in football players. ACSM Conference Abstract
• Vandenberghe, K.; et al. 1996. Caffeine counteracts the ergogenic action of muscle creatine loading. J Appl Physiol 80(2): 452-457.