Creatine, it’s one of the most studied supplements and the benefits have been known by gym goers for decades. Primarily used by weightlifters and bodybuilders to help increase strength and size, the majority of early research was on its impact on muscle and performance. However, new evidence is showing that creatine is beneficial to our long-term health as well. 

What is creatine?

Creatine is a naturally occurring compound that is used by our body for cellular energy. Our body can produce up to half of our daily creatine needs and the rest comes from our diet, primarily red meat and fish. Due to this, vegetarians and vegans tend to have 20-30% lower creatine stores.

Around 95% of creatine is stored in our muscles with the remainder found in other tissues such as the heart and brain. Creatine helps increase anaerobic capacity and muscle mass while decreasing protein breakdown in the body. 

Essentially, creatine increases your body’s capacity to do physical work whether that be lifting weights, sprinting, or other physically demanding activities. But there is more to creatine than just performance improvement.

Creatine’s role in health

Creatine has been found to be beneficial in age-related and weight loss sarcopenia (muscle loss), cognitive function, diabetes, cardiovascular health, and cancer. 

Age-related sarcopenia (muscle loss)

Just as we tend to gain weight as we age, we also lose muscle as well. There are many factors that cause us to lose muscle as we age. However, diet and physical activity can minimize muscle loss and possibly increase it under the right conditions. 

It’s been shown that supplementing creatine in our diet as we age in combination with resistance training can stop age-related muscle loss and improve strength and balance as well. 

Weight loss sarcopenia

During weight loss our body is in a negative calorie balance and this often results in muscle loss. Decreased muscle results in a lower metabolism and makes it harder to maintain our new lower weight. 

Supplementing creatine during calorie restriction in addition to resistance training can not only stop muscle loss but increase it as well. This results in a higher metabolic rate leading to more weight loss overtime and improved weight maintenance. 

Cognitive function

Work and daily life can lead to mental stress and fatigue. Add lack of sleep and it gets even worse. Creatine supplementation has been found to increase oxygen utilization by our brain and decrease mental fatigue. 

It’s also been shown to improve our cognitive functions as well as our mood and balance related to lack of sleep.

Diabetes

Creatine has been found to improve insulin sensitivity and glucose uptake in people with type 2 diabetes. In addition, creatine has been found to improve glucose tolerance after consuming a meal with carbs. 

When used in conjunction with diet modifications and physical activity, creatine can help improve glucose levels and decrease HgB A1c levels. 

Cardiovascular health

Although the evidence is still low, normal use of creatine can protect the heart muscle during a heart attack by maintaining available energy during a period of low oxygen to the muscle. It may have a similar effect on brain tissue as well during a stroke. 

More research is still needed to fully prove these claims. However, since creatine is safe to use, the possible protective role it may play in people at greater risk for heart attack or stroke is worth the insurance. 

Cancer

Creatine’s role in cancer prevention is due to its ability to provide energy to immune cells and help maintain antitumor T-cells and a healthy immune system. There is also evidence that creatine can have anti-inflammatory effects in our body.

How to get started taking creatine

There are many types of creatine supplements on the market however, creatine monohydrate is one the best absorbed and luckily cheapest options available.

In addition, it has had the most research behind it and has been proven to be safe to use as a daily supplement. If you have any pre-existing medical conditions such as kidney disease, check with your doctor prior to using creatine. 

There are two ways to get started taking creatine. You can either start with an initial loading phase to saturate the muscle quickly or you can go straight to the therapeutic daily dose.

Skipping the loading phase will take longer to saturate the muscle (typically 30 days) but once saturated the effects will be the same.

Once the muscle has been saturated you will notice a 3 to 5-pound weight gain. This is due to water being pulled into the muscle along with the creatine. Don’t worry as this is only a temporary weight gain. 

Loading phase -  (Total of 20g/day) 5g of creatine 4x/day for 5-7 days. These should be spread throughout the day to allow for full absorption. 

Therapeutic phase - 5g of creatine daily. It does not matter when you take it but be consistent. It’s okay to miss a day or two but try to avoid longer breaks without supplementation.

How you choose how to start will depend on what your goals are. 

Start with a loading phase if:

• You are training for an event

• Starting a weight training program

• Starting a weight loss diet and going into a calorie deficit

• Want the protective effects of creatine sooner 

Start with the therapeutic dose if:

• You said no to any of the above

Regardless of how you start, it is the consistent use of daily creatine that will have the greatest impact on your overall long-term health. 

Although 5 grams of supplemental creatine daily has been shown to be effective in providing the majority of health benefits listed, some conditions may require a greater daily dose. A dietitian can help you determine if you need a higher dose for your intended purposes. 

Schedule your 30 min consult or contact Adam at dietitian2go@gmail.com to find out more!

Written by: Adam Skowyra MPPD, RDN, LD