Creatine: What You Need to Know

When people think about the best supplements to take for overall health, things like Vitamin D, fish oil, or a multivitamin may come to mind. However, creatine is an unsung hero when it comes to overall wellness support for the general population. While creatine has often been associated with bodybuilders and those looking to build strength, it may also support brain health and overall vitality for both men and women. It is one of the most widely tested supplements in terms of safety and has been well-tolerated across different age ranges in both short- and long-term studies. 

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What is Creatine?

Creatine is an amino acid found primarily in muscle tissue and in the brain. It helps muscles produce and use energy during high-intensity exercises, such as weight lifting. The body makes some creatine in the liver, kidneys, and pancreas, and those who consume red meat and seafood are getting creatine into their diet. Supplements, however, bring a larger dose of creatine into the picture.

Creatine is mainly stored in the body in the form of phosphocreatine, and supplementation increases the body's stores of this form. Essentially, phosphocreatine is a form of stored energy in your cells that can help them make ATP, which is your body's energy currency that is needed for metabolism and meeting the body's energy demands.  

Creatine's Role in The Body

Creatine can be obtained through a diet containing red meat and seafood or made in the body from three amino acids: methionine, glycine, and arginine. Typically, the amount made naturally by the body or obtained through the diet is not equivalent to a creatine supplement, so most of the benefits of creatine may not be experienced without supplementation.  

About 95% of creatine is stored in muscle and is used during physical activity to increase the energy supply to muscle tissue. Small amounts are also found in the brain, heart, and other organs. 

The Benefits of Creatine

There are several potential benefits to creatine supplementation:

Ergogenic Aid in Strength, Muscle Development, and Performance

Creatine supplementation has been shown to help support muscle mass and strength gains in athletes and those new to exercise and resistance training.  

Additionally, it can help support power, strength, and athletic performance in high-intensity exercise due to the body's increased ability to make ATP to provide energy to musculoskeletal tissue.

Cognition and Brain Health

Your brain can also store small amounts of phosphocreatine and is an organ with a high demand for energy in the form of ATP used for optimal cognitive function. Creatine may support short-term memory and executive function, especially in those dealing with acute stressors like intense exercise or sleep deprivation. Additionally, it may help support well-being in individuals experiencing concussion, mild traumatic brain injury, and mood challenges.

Creatine also increases BDNF (brain-derived neurotrophic factor), which is a key component of learning and memory.

Counteracting Age-Related Declines in Bone and Muscle Tissue

Creatine supplementation with an exercise program has been shown to increase the effectiveness of a strength training regimen in older individuals, helping support muscle health as they age.

Help Improve Blood Sugar Regulation

Research suggests that creatine supplementation - alone or especially in combination with exercise - can help support healthy blood sugar regulation in both healthy individuals and those dealing with insulin resistance. 

Creatine Side Effects

Creatine is one of the most widely-studied supplements in terms of safety and efficacy. Both short- and long-term studies demonstrate creatine can be used safely across various age groups, from adolescents to the elderly.

While some may associate creatine with dehydration and cramping, no current research supports these claims. 

While there is no evidence that creatine can negatively impact liver or kidney function in healthy individuals, it is recommended that those with pre-existing kidney or liver conditions consult their doctor before starting a creatine supplement regimen. 

Creatine vs. Creatinine

Closely related to creatine is a compound called creatinine, which is a biomarker that is included in the evaluation of kidney function. Creatinine is a waste product created in the process of creating energy within muscles, and urinary output can be measured to help evaluate how well the kidneys are functioning and removing waste.  

As creatine is used to produce energy for physical activity, creatinine is created as a byproduct and released as waste. The two exist in a steady-state relationship, so increased creatine consumption may elevate creatinine levels. However, this elevation does not necessarily translate to kidney dysfunction and is merely a reflection of the relationship between the two compounds.  

How to Test for Creatine Levels 

Indirectly testing creatine by testing creatinine is the most common way to test. Specifically, the following two tests are recommended:

Creatinine Clearance

A creatinine test can be helpful in monitoring kidney function, though this test may be falsely elevated with ongoing creatine supplementation. Combining creatinine alongside other markers of kidney function, such as the glomerular filtration rate (GFR), can help ensure healthy kidney function long-term. 

Glomerular Filtration Rate (GFR)

Testing the GFR as part of a comprehensive metabolic panel can help provide insight into a bigger picture of kidney function, particularly in individuals supplementing with creatine who may have pre-existing kidney/liver conditions or who wish to be proactive about supporting overall health.  

Creatine Supplements

The most common, well-researched form of supplementary creatine is creatine monohydrate. While other forms exist and are marketed as superior forms of creatine, research is lacking outside of creatine monohydrate.  

Regarding dosage, a dose of 5 grams of creatine monohydrate daily has been linked to both athletic and brain-based benefits, though it may take up to a month to experience the benefits of supplements.

With specific regard to athletic performance, it's common to start with a "loading" phase of a higher dose of creatine (up to 20g per day) for a week, split into four doses of 4-5 grams throughout the day.

Taking creatine alongside a meal containing carbohydrates or protein can help with absorption and maximize the supplement's benefits.

It should be noted that water retention can occur when supplementing with creatine, so it's important to stay hydrated when supplementing.

Summary

While creatine is often associated with bodybuilding and other athletic endeavors, creatine may have benefits beyond muscle gains, including supporting brain function and healthy blood sugar regulation. It can be particularly useful for those dealing with acute stressors like exercise, sleep deprivation, or concussion/TBI. Since creatine is a well-researched supplement with an excellent safety record, it may be a good fit for anyone looking to support long-term body composition or brain health.