What it is:
Creatine (C) is a natural chemical our body forms using three amino acids (glycine, methionine, and arginine), and three enzymes (AGAT, MAT, and GAMT). It is stored in our muscles (~95%), and we naturally produce about 1-2g/day. Creatine is also found in animal foods such as fish and red meat. For example:
Herring contains ~0.5g of C per 3 oz
Beef contains ~0.4g of C per 3oz
Salmon contains ~0.4g of C per 3oz
A can of tuna contains ~0.4g of C
Creatine does not exist in plant foods at significant levels, but plant options for the building blocks include:
Arginine
Nuts and seeds (Almonds, Sesame, Pumpkin seeds)
Legumes (Soybeans, Chickpeas, Lentils)
Spirulina, Seaweed
Glycine
Nuts and seeds (Almonds)
Grains (Oats, Quinoa, Wheat germ)
Soybeans
Methionine
Nuts and seeds (Brazil nuts, Hemp, Sesame, Pumpkin seeds)
Grains (Oats, Wheat)
Seaweed
Creatine is not considered an essential nutrient, as the body can produce it on its own, so there is no official Recommended Dietary Allowance (RDA) for creatine stated by regulatory agencies such as the FDA. However, research suggests a dose of 3-5g per day for those looking to increase athletic performance. Replacement requirements exist at around 2g/day, where half comes from food sources, and half is produced internally.
Purported claims:
Supplementing with creatine may:
Increase lean muscle mass and strength
Improve anaerobic endurance performance
Enhances recovery, and adaptive response
What the science says:
Creatine provides energy to muscles, which may help delay fatigue and improve endurance. This can allow a person to go longer in training. The mechanism behind this is adenosine triphosphate (ATP). As an energy source, creatine can hold and then donate a phosphate (CP - phosphocreatine) to form ATP. ATP is our cells' primary energy source. High-intensity anaerobic exercise such as sprinting depends upon this process. Therefore the higher the pool of CP, the higher the potential for ATP to borrow phosphate and perform higher rates of energy output.
Supplementation
Creatine monohydrate is the cheapest and most extensively researched form for increasing power and strength. Supplementing creatine has shown increased strength and power output during exercise, and increased lean muscle mass. However, the research also suggests creatine is more effective as a long-term training item than a direct performance enhancer. So a long-term routine is essential for results to develop.
Extra creatine supplementation may not be beneficial for those who consume a balanced diet as their muscle capacity is fully saturated. On average, females can store a maximum of ~100g and males ~160g of creatine in their muscles. Therefore consuming more than you’re utilizing will just pass out in the urine and may cause gastrointestinal issues.
But for those who are under-nourished, vegetarian, or generally do not generate enough creatine, supplementation may be beneficial.
Dosage
The National Sports C Academy suggests an initial loading dose of creatine at ~0.3 g/kg/bw or ~20g daily for 4-7 days, with further maintenance dosages of 3g/day. To avoid gastrointestinal issues, you can split the loading dose of 20g/day into four smaller doses of 5g throughout the day.
A loading dose may not be necessary if you have a longer length of time to reach your saturation level (~30 days) and can, therefore, begin on a regular maintenance dose ~3g/day. Creatine levels will maintain at this level as long as the dosing continues.
Bloating and water retention can occur in the initial week of loading, so some may choose to skip this phase by beginning with the regular maintenance dose. Ensure you’re consuming enough water and not too much sodium to reduce the effects of swelling.
How to:
It is optimal to take creatine at the same time each day. However, it can be either morning or night, but it's not crucial whether before or after a workout. Consistency is the key.
Carbohydrates alongside creatine intake may assist in our cells absorption. When we consume carbohydrates, it increases insulin and the more insulin, the more creatine can be driven into our cells. So consuming creatine alongside carbohydrates may be beneficial to our muscles.
Staying hydrated is also a critical focus when supplementing with creatine, not just because it requires more water but also for healthy kidney function.
Cognitive Health
As creatine is also stored and utilized in the brain, it makes sense that supplementation may also be beneficial to our cognitive health. Studies have shown that creatine supplementation can increase phosphocreatine levels in the brain, which can help to support brain energy metabolism and cognitive function. This is particularly important in tasks that require short-term memory, mental processing speed, and reasoning ability.
A study (Rawson, 2020) suggested that after an initial loading dose, a daily dose of 5 grams of creatine monohydrate may be optimal for cognitive benefits for older adults.
Menopause and Menstruation
Studies have shown creatine supplementation may assist females through symptoms of menopause and menstruation. During the menstrual cycle, it may aid in brain health and sleep.
Reduced muscle and bone strength is an issue seen in some females. Preempting the possible deterioration by increasing overall protein and creatine may assist in muscle and bone preservation.
Rehabilitation from Injury
Muscle atrophy prevention and recovery in those who have been immobile or are currently rehabbing an injury has shown mixed results on whether creatine supplementation is effective. However, no studies reported detrimental outcomes, and supplementation may therefore assist in reaching pre-injury strength rates.
Our take:
Creatine supplementation may benefit those looking to increase their athletic performance and who find it difficult to source from whole foods. However, the body's cells can utilize creatine in a limited capacity, and excess creatine is excreted through urine.
Multiple studies have compared whole food items such as beef, salmon and tuna against creatine supplementation and found both whole foods and supplementation provided the desired increased muscle creatine levels and improved strength gains with no significant differences between the groups.
By eating the whole foods items, you consume other benefits, such as with herring and salmon; you’re also getting Omega-3’s, Vitamin D, and a complete protein profile. So although creatine supplements are safe, they can distract from building a healthy diet pattern.
A strategy you might consider is to load with a creatine supplement for the first 7 days, split into doses of 5g per 4 meals. Then continue with a maintenance dose of 3-5g/day of creatine in whole foods. This can include a combination of items such as:
6oz of Herring (1g C),
6oz of Salmon (~0.8g C)
4oz of Steak (0.5g C)
3oz Beef liver (0.7g C)
But remember, our bodies naturally form creatine, so getting the main building blocks of glycine, methionine, and arginine is essential, especially for vegetarians.
Will this benefit you?
Yes. Creatine supplementation may benefit those looking to increase their long-term athletic performance. And the studies do show a positive outcome in this regard.
Some studies also suggest a high inadequacy in the general population, where internal synthesis may not fully fulfill creatine needs. Creatine supplementation may therefore be an item to consider for more than just athletes.
Speak with your Apeiron Life Client Advocate to learn more about our supplement program.
Still curious to try it? If you do, here’s what to keep an eye on:
Gastrointestinal issues may occur, such as nausea, bloating gas, or diarrhea.
Make sure to consume enough water alongside supplementation to avoid gut problems and discomfort.
Creatine may lead to weight gain due to increased total body water mass.
Be wary with weight-sensitive sports.
Caution for those with kidney disease, especially if taking nonsteroidal anti-inflammatory drugs (NSAIDs). On blood tests, creatinine levels may also increase, and therefore it should be disclosed to your doctor.
Preparation of food may matter so boiling can reduce the creatine content, while grilling or broiling may increase it.
References and additional reading:
Krause's Food & the Nutrition Care Process. Elsevier Inc, 2017.
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