Creatine… Should You Take It?

Last week while presenting at the International Swim Coaches Association in Tampa Florida, I realized there was a large amount of coaches (and I’m presuming athletes) who are interested in knowing more about creatine. In addition, I promised my cousin long ago to write a blog about this. So I’m sorry it’s taken me a while Mike, but here it is. I have my own personal story with creatine that shows how much confusion can surround supplements. When I was a teenager, I was a pretty good swimmer, and swimming was a huge part of my life. Two a day workouts, year round swimming, strength training, etc. I was a sprinter, the 50 free and 100 fly were my specialties. Throughout our region of NY I had a few competitors with whom I’d go back and worth with. Sometimes I’d win, sometimes they’d win. Then one high school season someone I had never really swam against was making great strides and starting to get faster. She was very muscular and to my high school eyes, she looked like one of the German swimmers from the 1970’s who had taken steroids. Looking back I feel bad that I thought that about a fellow swimmer, however I was (and still am) competitive and I thought it unfair. We were told it was in fact creatine she was taking. Not understanding what that was, I still thought it was a form of cheating and vowed I wouldn’t cheat to get ahead. If only I or someone with greater sports nutrition knowledge had told me it really wasn’t cheating, and could explain how our body uses creatine, it might have been beneficial to my swimming career. Onto creatine.

What is Creatine:

Creatine was discovered in the 1800’s when a French scientist was examining the muscles of animals. From the 1930s-1960’s, it was mainly studied for it’s clinical impact. It wasn’t until the 1960’s that the Soviet athletes started using it for an ergogenic aid. We Americans were late to the party and it wasn’t until the 80’s and 90’s that we started using it for the ergogenic effect.

So what is it? Creatine is a nitrogenous organic acid, that is found naturally in our body, primarily in our skeletal muscles. It’s role  is supplying energy to our muscles by the production of creatine phosphate. Creatine phosphate helps to create ATP, which is what our body uses for energy. Think of the main energy systems that create ATP. There are:

  1. Creatine phosphate (or Phosphocreatine)- this energy system provides ATP for the first :10 seconds of activity. Think explosive lifts, jumps, sprints
  2. Anaerobic glycolysis/glycolytic- this system provides ATP from 10sec-2minutes, however production is highest for :30
  3. Aerobic/oxidative- this is the system that we use for every day activities, long distance endurance events, etc.

So when we look at it that way, creatine is stored as phosphocreatine in our muscles, and when the initial :10 burst of ATP is complete, we start fatiguing and producing lactic acid. (Side note, remember it’s not lactic acid that is making our muscles sore, and it isn’t stored in our muscles. Lactic acid is converted back into use as a substrate) So, if we can store more creatine in our muscles, we can help to prolong the depletion of phosphocreatine, thus prolonging our fatigue=greater strength and power.

Where is it Found?

Creatine is found in the foods that we eat, primarily beef, pork and fish. 95% of creatine is stored in the skeletal muscle, while 5% is stored in the brain, eye, kidneys and testes. The liver, kidney and pancreas are the primary sites of its endogenous synthesis. The amino acids glycine, arginine and methionine are the precursors in its production. Vegetarians and vegans can have significantly reduced creatine stores, relative to those that consume animal products. (1)

Types of Creatine:

Creatine Monohydrate

Ethyl Ester

PEG (Polyethylene Glycosylated Creatine)

Creatine Monohydrate is currently the best of the creatine supplements as it has the most science based research behind it. Supplement companies are starting to push newer forms, however it has still stood the test. Some athletes have been deemed “non responders.” These athletes might want to try alternative forms. Creatine ingested as a solution or from food has been shown to be highly bio available. Creatine ingested as a lozenge or capsule must disperse in solution, and seems to be limited in doing so. So, stick with food, or as a solution (like a protein/creatine shake).

Benefits of Creatine:

Creatine is arguably the most research validated supplement with over 500 studies showing performance enhancing effects. 70% of those studies have shown statistically significant improvements with none showing detrimental side effects.

  • 5-15% increase in work performance
  • Physique benefits-increases in fat-free mass
  • Hypertrophy-due to increases in satellite cell activity within the skeletal muscle
  • Diminishing fatigue
  • New research focus: cognition-the focus on new research is within the brain (creatine is stored there) and how it can athletic performance with skill based sports, fine motor control or memory recall. In addition, populations clinically deficient like the elderly or vegetarians and the impact on cognitive enhancement potential in athletes with  traumatic brain injuries.

*references (2-3)

Supplementation Protocols:

#1. Traditional:

  • Creatine load for one week, using 5g doses spread evenly over 4x a day. After one week, a maintenance dose of 3-5g/day.
  • The benefit is this protocol produces the most rapid elevations in intramuscular creatine content and may benefit someone on a short time frame who needs fast saturation.

#2. New Protocol:

  • Take 3-5g for the first 3 days. Then, take .3g/kg/bw as the maintenance phase.
  • This is cheaper than the traditional phase, it may decrease GI side effects and weight gain. So athletes concerned with putting on extra weight can try to new protocol. Research shows that creatine stores can be saturated after 28 days of .3g/kg/bw/day.



The long-term safety of creatine remains a debated topic. The safety concerns are for the potential negative effect on the kidneys, increased risk of dehydration and muscle cramps.

  • To date, these concerns have not been validated in literature.
  • The only proven side effect (other than strength gains, etc) is weight gain. And if you use the new protocol, the likelihood is much less.


If you’re in a sport where high intensity efforts are key, if you’d like to build muscle mass or your physique, trying creatine is a good option. Right now if you are in good health, there aren’t really any safety concerns with taking it. If  you’re worried about weight gain, try the .3g/kg/bw protocol.



  1. Burke Dg, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky M. Effect of Creatine and Weight Training on Muscle Creatine and Performance in Vegetarians. Medicine in Science in Sports and Exercise. 2003; 35 (11): 1946-1955.
  2. Kreider R. Sports Applications of Creatine. In: Douglas Kalman JA, Jeffrey Stout, Mike Greenwood, Darryn Willoughby, Gregg Haff, ed. Essentials of Sports Nutrition and Supplements. Totowa, NJ:Humana Press;2008.
  3. Yarrow K, Brown P, Krakauer JW. Inside the brain of an elite athlete: the neural processes that support high achievement sports. Nat Rev Neurosci. 20009; 10 (8): 585-596.
  4. Hultman E, Soderlund K, Timmons JA, Cederblad G, Greenhaff Pl. Muscle creatine loading in men. Journal of Applied physiology. July 1 1996;81 (1): 232-237.

One thought on “Creatine… Should You Take It?

  1. Pingback: Sports Nutrition for Youth Ages 13&Up… Part 2 | Fueled and Focused

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