Everything You Need to Know About Creatine

By Carly Smith, BS, MPH(c)

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A recent analysis done by members of the Stanford Lifestyle Medicine team on how different supplements impact sports performance, highlighted creatine since it has been vastly researched and shown to improve muscle strength.

“What many do not realize is that supplements, like creatine, can be beneficial for more than just professional athletes and bodybuilders,” says Matthew Kaufman, MD, member of the Stanford Lifestyle Medicine Exercise and Movement research team and lead author of “The Impact of Supplements on Sports Performance for the Trained Athlete: A Critical Analysis.”

What is Creatine?

So, what is creatine? Creatine is a natural amino acid that people can gain in their diet with foods high in protein or through supplementation. Mechanistically, creatine supports powerful muscle contractions, which is why it is popular among bodybuilders. After digestion, creatine-phosphate is stored in skeletal muscle until the onset of quick, intense physical activity. Once activity is initiated, it is used to rapidly phosphorylate ADP into ATP, which drives fast-twitch muscle contractions, the primary drivers of quick, forceful exercise movements like weight lifting and sprinting.

According to the analysis, athletes that also depend on fast, powerful movements and mobility, like soccer and basketball players, may also benefit from increasing their creatine intake. Its ability to heighten muscle performance is continuing to be tested and is being used by many to increase the size and strength of their muscles.

“What’s nice about creatine, especially compared to other supplements, is how much it has been studied. It has robust, promising data that shows it can really improve athletic performance and muscle composition,” says Dr. Kaufman. “Plus, it can help muscle growth and performance for all different types of people.”

Creatine Is Not Just for Bodybuilders!

Creatine may also be a good supplement for plant-based athletes. The analysis found evidence that vegetarian athletes improved more than omnivorous athletes with creatine supplementation in terms of muscle power output and lean muscle mass, therefore plant-based athletes could consider supplementation to support their athletic performance.

Creatine is also recommended for older individuals to support muscle sarcopenia. With age, many people experience a loss of muscle vitality, which heightens risk of falling and injury. Research published in the Journal of Clinical Medicine indicates that creatine supplementation may help older adults maintain muscle vitality. It suggests that there could be significant benefits from supplementing their diets with creatine for an “anti-aging” effect for the body.

How Much Creatine Do I Need?

Whether taking creatine supplements for athletic performance or daily functioning, it is important to know what the International Society of Sports Nutrition’s (ISSN) recommended dosing strategy is. Their recommendation begins with all individuals taking 5 grams of creatine, four times per day (20 g total per day) for about a week. This first week is called the loading stage, which helps many people adjust to the supplement before experiencing any physical changes. Next, ISSN recommends maintaining a dose between 3-5 grams daily. Males and larger athletes may need 5-10 grams daily to maintain their body’s creatine stores.

People considering taking creatine should be aware of some potential side effects. Studies report the possible side effects of increased water retention and airway sensitivity in elite athletes, the latter suggesting the need for further research on how creatine affects those with asthma. We recommend consulting with your physician ahead of time so they can tailor the ISSN’s dosing recommendations for your specific needs.

Overall, creatine supplementation may be promising for many individuals, bodybuilders or not, looking to improve the power of their muscles.