Benefits and side effects of the supplementation of creatine. Details about Creatine

If you spend enough time in the gym you might have heard about creatine supplement, you might have even heard about it from your favorite fitness influencer on YouTube.

But what is creatine? How does it work and what are the possible side effects?

So it’s time to drop those weights and pick up a pen to look at the science behind this fascinating supplement.

Our bodies are built to move, our bones provide a solid internal structure to hold ourselves up and our muscles attached to these bones to give us ability to move. But to move, our muscles need energy and the fuel that powers our muscles is called ATP (Adenosine Triphosphate).

Think of our muscles like the engine of a petrol thirsty car. Our muscles have a small store of ATP, that can fuel the engine for about three seconds. Our muscles need a way to continuously refuel and make new ATP. Our muscles have three energy systems that it can use to regenerate ATP.
• The Phosphocreatine System,
• The Glycogen Lactic Acid System, and
• The Aerobic System

Of these three systems, the Phosphocreatine System is the fastest and most responsive, makes it useful for short duration high intensity exercise. It can rapidly regenerate ATP, but we only have enough stored creatine to power about 10 seconds of intense activity. Our bodies can make its own creatine from three amino acids:
1. Methionine,
2. Glycine, and
3. Arginine

The first step of creatine production starts in our kidneys with the final step occurring in our liver. Our bodies make about one gram per day but we can also absorb creatine from our digestive system and our bodies can soak up this additional creatine in our muscles up to a certain limit.

This is where creatine supplement come into play, they increase the amount of creatine stored in our muscles, as a result our muscles can sustain powerful activity for longer. What this means in practical terms is the ability to push out more reps in the gym and improve performance in high intensity exercise. Over time it increased exercise capacity can lead to improvements in muscle mass and strength.

So how much benefit are we actually talking about?

Well, this depends upon multiple factors including genetics, diet, the type of training, and the type of outcome being measured. But an approximate overall performance increase of about 5-15% is what the research tells us. Studies show a spectrum of benefit, some people will get more benefit from creatine supplementation and some will experience less. For example, one review article showed that although the average increase in muscle strength from creatine supplementation was 8%.

The improvement in bench press one rep max ranged from 3% to 45%. This wide range reflects the variable response to creatine supplement. Some researchers have suggested that people who chose a vegetarian diet may have more to gain from creatine supplementation since the main source of dietary creatine are meat products. A recent study found that while vegetarians do benefit from creatine, they don’t appear to have a consistent additional benefit in performance compared to non-vegetarians who also take creatine.

So far we’ve looked at the exercise benefits of creatine but what about benefits to other aspects of our health?

In particular, there has been interest in improvements in brain health, although 95% of stored creatine is in muscles. The brain also uses the Phosphocreatine System for energy while muscles rely on creatine produced from our kidneys and liver. Our brains are different in that, they can produce their own creatine also our brain seems to be less sensitive to dietary creatine than our muscles. Studies have found that vegetarians and non-vegetarians have similar levels of brain phosphocreatine and in that response creatine supplement.

Brain creatine levels rise less than the increase in muscle creatine. Research into creatine and brain health has led to mixed results in otherwise healthy people. Some studies show an improvement in short-term memory and reasoning but others do not. The benefit seems to be greater for people who have experienced some kind of brain stress such as sleep deprivation, mental fatigue or a mild traumatic brain injury.

The authors of one systematic review state that it is possible that creatine administration improves cognition of diseased, aged or stressed individuals. Whereas for younger unstressed individuals there is no such a benefit. The primary benefit of creatine is on athletic performance. There may be some secondary benefit on brain health but the research is mixed. So don’t swap your textbooks for a creatine supplement just yet.

Side Effects

All right, now we need to talk about the side effects of creatine. Creatine has been around as a supplement since the early 1990s so we have almost 30 years of anecdotal use to go by. We should keep in mind that creatine is a dietary supplement not a medication or hormone when used within the recommended dose of 3-5 grams per day. Research shows no serious harm with up to 4 years of creatine use in adults. There is no consistent evidence that creatine causes hair loss, kidney damage or liver damage. Some people may experience gut related side effects like bloating or nausea after taking creatine. Others may experience a 1 to 2 kilos increase in body weight as creatine can increase the fluid content of muscle cells.

But we should remember that creatine has not been adequately tested for safety in children or teenagers, also potential long-term consequences for example with 10 to 20 years of use are unknown at this stage and one other consideration is that many researchers and studies looking into creatine have received either direct or indirect support from creatine manufacturers. This doesn’t mean that we should completely disregard these articles but it does mean we should approach these articles with a certain amount of healthy skepticism.

The International Olympic Committee considers creatine to be a supplement with good to strong evidence of benefit when used in specific scenarios, and Australian Institute of Sport places creatine in a ‘Group A’ of sport supplements which means that they considers it to have strong scientific evidence for use. Creatine is not prohibited by World Anti-Doping Agency. According to surveys, about 15-40% of athletes and military personnel use creatine. The people who stand to benefit the most from creatine supplement are those who already have solid training foundations and are looking for an additional edge. This means that they already have a well thought out nutrition program with the appropriate number of calories and protein content, a consistent training schedule with good technique and are willing to experiment with creatine to see if it benefits them.

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