Creatine is a chemical that is normally found in the body, mostly in muscles. It is made by the body and can also be obtained from certain foods. Fish and meats are good sources of creatine. Creatine can also be made in the laboratory.
Creatine is most commonly used for improving exercise performance and increasing muscle mass in athletes and older adults. There is some science supporting the use of creatine in improving the athletic performance of young, healthy people during brief high-intensity activity such as sprinting. But older adults don’t seem to benefit. Creatine doesn’t seem to improve strength or body composition in people over 60.
Creatine use is widespread among professional and amateur athletes and has been acknowledged by well-known athletes such as Mark McGuire, Sammy Sosa, and John Elway. Following the finding that carbohydrate solution further increases muscle creatine levels more than creatine alone, creatine sports drinks have become popular.
Creatine is allowed by the International Olympic Committee, National Collegiate Athletic Association (NCAA), and professional sports. However, the NCAA no longer allows colleges and universities to supply creatine to their students with school funds. Students are permitted to buy creatine on their own and the NCAA has no plans to ban creatine unless medical evidence indicates that it is harmful. With current testing methods, detection of supplemental creatine use would not be possible.
In addition to improving athletic performance, creatine is used for congestive heart failure (CHF), depression, bipolar disorder, Parkinson’s disease, diseases of the muscles and nerves, an eye disease called gyrate atrophy, and high cholesterol. It is also used to slow the worsening of amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease), rheumatoid arthritis, McArdle’s disease, and for various muscular dystrophies.
Americans use more than 4 million kilograms of creatine each year.
How does it work?
Creatine is involved in making the energy muscles need to work.
Vegetarians and other people who have lower total creatine levels when they start taking creatine supplements seem to get more benefit than people who start with a higher level of creatine. Skeletal muscle will only hold a certain amount of creatine; adding more won’t raise levels any more. This “saturation point” is usually reached within the first few days of taking a “loading dose.”
Possibly Effective for:
- Improving the athletic performance of young, healthy people during brief, high-intensity exercise such as sprinting. Many factors seem to influence the effectiveness of creatine, including the fitness level and age of the person using it, the type of sport, and the dose. Creatine does not seem to improve performance in aerobic exercises, or benefit older people. Also, creatine does not seem to increase endurance or improve performance in highly trained athletes. There is some evidence that creatine “loading,” using 20 grams daily for 5 days, may be more effective than continuous use. But remember, there is still some uncertainty about exactly who can benefit from creatine and at what dose. Studies to date have included small numbers of people (all have involved fewer than 40 participants), and it is not possible to draw firm conclusions from such small numbers.
- Parkinson’s disease. Creatine might slow the worsening of some symptoms in people with early Parkinson’s disease.
- Increasing strength and endurance in people with heart failure.
- Increasing strength in people with muscle diseases such as muscular dystrophy.
- Slowing loss of sight in an eye disease called gyrate atrophy.
- Improving symptoms of a muscle disease called McArdle's disease. There is some evidence that taking high-dose creatine daily can increase exercise capacity and decrease exercise-induced muscle pain in some patients with McArdle's disease.
Possibly Ineffective for:
- Rheumatoid arthritis (RA). Taking creatine can increase muscle strength in people with RA, but it doesn’t seem to help them function better physically.
- Amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease). Taking creatine orally doesn’t seem to slow disease progression or improve survival in people with ALS.
- Muscle diseases such as polymyositis and dermatomyositis. Early studies suggest taking creatine might produce small improvements in muscle strength in people with these conditions.
- High cholesterol.
- Huntington's disease.
- Bipolar disorder.
- Other conditions.
Side Effects & Safety
Creatine is LIKELY SAFE for most people when used at recommended doses. Creatine can cause stomach pain, nausea, diarrhea, and muscle cramping.
When taken by mouth in high doses, creatine is POSSIBLY UNSAFE. There is some concern that it could harm the kidney, liver, or heart function. However, a connection between high doses and these negative effects has not been proven.
Creatine causes muscles to draw water from the rest of your body. Be sure to drink extra water to make up for this. Also, if you are taking creatine, don't exercise in the heat. It might cause you to become dehydrated.
Many people who use creatine gain weight. This is because creatine causes the muscles to hold water, not because it actually builds muscle.
There is some concern that combining creatine with caffeine and the herb ephedra (also called Ma Huang) might increase the chance of having serious side effects such as stroke.
There is concern that creatine might cause irregular heartbeat in some people. But more information is needed to know if creatine can cause this problem.
There is concern that creatine might cause a skin condition called pigmented purpuric dermatosis in some people. But more information is needed to know if creatine can cause this problem.
Special Precautions & Warnings:Pregnancy and breast-feeding: Not enough is known about the use of creatine during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Kidney disease or diabetes: Don’t use creatine if you have kidney disease or a disease such as diabetes that increases your chance of developing kidney disease. There is some concern that creatine might make kidney disease worse.
Moderate Interaction Be cautious with this combination
- Medications that can harm the kidneys (Nephrotoxic Drugs) interacts with CREATINE
Taking high doses of creatine might harm the kidneys. Some medications can also harm the kidneys. Taking creatine with medications that can harm the kidneys might increase the chance of kidney damage.
Some of these medications that can harm the kidneys include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.
The following doses have been studied in scientific research:
- For improving physical performance, several dosing regimens have been tried:
- Creatine is typically loaded with 20 grams per day (or 0.3 grams per kg) for 5 days followed by a maintenance dose of 2 or more grams (0.03 grams per kg) daily, Although 5 day loading is typical, 2 days of loading has also been used.
- A loading dose of 9 grams per day for 6 days has also been used. Some sources suggest that, instead of acutely loading, similar results can be obtained with 3 grams per day for 28 days.
- For heart failure: 20 grams per day for 5-10 days.
- For Parkinson's disease:
- 10 grams/day.
- A loading dose of creatine 20 grams/day for 6 days followed by 2 grams/day for 6 months, and then 4 grams daily for 18 months has also been used.
- For improving resistance training in people with Parkinson's disease: a loading dose of 20 grams/day for 5 days, followed by 5 grams/day.
- For gyrate atrophy: 1.5 grams per day.
- For muscular dystrophies: 10 grams per day has been used by adults and 5 grams per day has been used by children.
- For McArdle’s disease: 150 mg / kg daily for 5 days and then continue with 60 mg / kg / day.