What is Creatine used for?

Creatine is an amino acid that is naturally found in the body - mostly in muscles - where it is stored as creatine phosphate (phosphocreatine). During high-intensity, short-duration sports, phosphocreatine is converted into ATP - the major form of energy used by the body. Our liver, kidneys, and pancreas synthesize about 50% of the creatine in our body - which is then transported to our muscles via our blood. The other 50% is obtained through our diet with meat and fish notably high in creatine.

Creatine can also be made in a laboratory and creatine is one of the most popular dietary supplements worldwide, with the global creatine market estimated to be worth $520 million by 2024. Creatine can help improve lean muscle mass and enhance performance, particularly for sports requiring explosive power such as weightlifting, sprinting, and high jumping.

What are the benefits of creatine?

Creatine is one of the most studied supplements and research has consistently shown it has benefits with regard to improving performance. The position of the International Society of Sports Nutrition (ISSN) is that:

• Creatine monohydrate is the most effective ergogenic nutritional supplement currently available for athletes wanting to increase their high-intensity exercise capacity and lean body mass
• Creatine monohydrate supplementation is safe, and also has some therapeutic benefits in other populations, such as improving cognition in the elderly and neurodegenerative conditions in children
• Short- or long-term administration of creatine monohydrate (up to 30 g/day for 5 years) is safe and does not have any detrimental effects
• Creatine supplementation should only be considered for use by younger athletes involved in serious competitive supervised training, who are already consuming a well-balanced and performance-enhancing diet, who do not exceed the recommended dosages, and who are knowledgeable about the appropriate use of creatine
• The safety of creatine far outweighs potentially dangerous anabolic androgenic drugs.

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How effective is creatine?

Research indicates that there may be a wide individual variation in response rates - athletes with naturally high body stores of creatine do not seem to get an extra energy boost from supplemental creatine. In addition, endurance events, such as middle-to-long-distance running, do not appear to benefit from extra creatine.

The response appears more likely in people in their early twenties. Although data investigating the safety of creatine is lacking in teenagers, research has shown that this group is more likely to exceed the recommended loading and maintenance doses. The National Collegiate Athletic Association (NCAA) has forbidden colleges and universities from supplying creatine and androstenedione (Andro) to their students with school funds, although athletes can continue to take the supplements by themselves. Similarly, while not banned by the International Olympic Committee, using it for athletic performance is controversial. Current testing methods are not able to distinguish supplemental creatine from natural body occurrence.

Is creatine safe?

Generally, creatine appears to be safe with few side effects when taken at recommended dosages for periods of up to 5 years. Theoretically, high dosages may cause kidney problems or stop the body from making its own creatine, but trials have not reported this effect. However, experts advise people with pre-existing kidney disease, diabetes, or high blood pressure against supplementation with more than three to five grams per day.

Anecdotal reports of muscle or abdominal cramps and water retention have not been replicated in clinical trials. Probably one of the biggest concerns is contaminated creatine or creatine supplements made by less than reputable companies. Buying a reputable brand from a well-recognized supplier is the best way to safe-guard against contaminated products.