Creatine Benefits, Side Effects, & Dosage For Best Results

 by Dr. Charlie Seltzer, MD | July 8, 2013

An organic acid, creatine plays a key role in supplying energy for muscle cells during intense activity. It is produced naturally by the body and found in small quantities in animal products. Creatine stored in muscle cells helps produce ATP (the primary energy currency in the body). While creatine is not an essential nutrient (the body can synthesize it from arginine, methionine, and glycine), it is one of the most widely used supplements because there is strong evidence it can improve performance and is safe for most people. Additionally, creatine may have other health-promoting properties beyond its ability to make a person stronger or faster.

Creatine Supplementation vs Dietary Intake

An average human body contains between 3.5 and 4 grams of creatine per kilogram of muscle. However, it is capable of storing up to 5 grams per kilogram. The idea behind supplementation is that by saturating the body with creatine, you augment its benefits. The richest sources of creatine from food are beef and fish, which contain between 2 and 5 grams per pound.

Because most research on the benefits of creatine is done on dosages of 5 grams, it is largely impractical for most people to try to reap the benefits seen in studies without supplementation. Of course, the potential risks of any supplement should be weighed against the benefits before using. But, should you decide to use creatine as a muscle builder, you will need to supplement in order to receive its effects.

Creatine Benefits

Extensively studied for both its safety and benefits, some of creatines’ supposed benefits are supported by research and some are not. Creatine also shows promise outside of the athletic and performance setting, but more research is needed in these areas.

1. Increase in muscle size – Creatine supplementation causes an increase in the water content of muscles, making them “larger.” This is not due to an increase in the size of the muscle fibers. However, creatine can increase “real” fat free mass over time, as its strength and power-boosting properties allow higher quality training and thus, better gains.¹ Additionally, creatine may actually increase the number of muscle fibers as well², though one study is by no means conclusive.
2. Improved athletic performance – A large body of research shows that oral creatine supplementation can make an athlete faster and stronger when performing high intensity activity.^34 5 6
3. Increased muscle protein synthesis – I found a few studies which refuted this claim.^7 8 Still, if someone who uses creatine can lift more weight, muscle protein synthesis should increase.
   Remember, there has never been a scientifically controlled study showing that jumping out of an airplane with a parachute is any better than jumping out without one.
4. Treatment of medical disorders – Emerging evidence is showing that creatine may help people with heart failure⁹, Alzheimer’s and Parkinson’s Disease.¹⁰

Creatine Side Effects & Risks

Creatine supplementation should be safe when used by healthy individuals. Most of the health risks attributed to creatine (kidney and liver damage, increased risk of injury) have not been shown in clinical studies.¹¹ And although no long term studies have examined use of creatine, I am unaware of any reports of physical harm from supplementation in a person without kidney disease. However, there is evidence creatine supplementation can damage unhealthy kidneys.¹²

Dehydration is also a concern with supplementation, as creatine will draw water into the muscle cell. If you use creatine, be sure to drink plenty of water, which you should be doing anyway. And as with all supplements, due to a lack of regulation, toxins and impurities in a product are always a concern. Buying a reputable brand makes this less of an issue.

GI distress is a common side effect of creatine. Taking it with food, not “loading” (see below) or perhaps using a form besides monohydrate may lessen or eliminate this reaction.

Again, creatine is very safe for most people. However, since kidney and liver disease, in their early stages, may not produce any symptoms, it is a good idea to have your doctor test your kidney and liver function, especially if you plan on using supplements.

Creatine Recommendations & Dosage

There are many different kinds of creatine available. If you look on the shelves of a supplement store, you will see creatine monohydrate, creatine ethyl ester, creatine hydrochloride, creatine AKG and others. The oldest form is creatine monohydrate, and this has been the compound used in essentially all of the well-designed studies. For this reason, I recommend this form over the newer, non-research backed forms. It also happens to be the cheapest. I recommend a pharmaceutical grade product such as Myogenix to avoid the possibility of toxins or impurities in the product.

Creatine users often do a “loading phase” of taking 20 grams throughout the day for 5-7 days before moving a maintenance phase of 2-5 grams per day. Research has shown this to increase the rate at which muscles become saturated.¹³ However, loading is not necessary for creatine to exert its positive effect.¹⁴.

The presence of insulin increases the amount of creatine that is absorbed into the muscles.¹⁵ Caffeine may lessen it.¹⁶

Conclusion:

Take 3-5 grams of creatine monohydrate with either your pre or post workout shake. Should you choose to load, take 5 grams 4 times per day for 6 days followed by 3 grams per day, after your doctor tells you your kidneys are healthy.

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I used to take creatine before, but then I stopped. I'm more natural now. It is good stuff though. I used to push serious weight after loading.

What do you mean by "more natural"?

By that I mean I do not use supplements such as creatine, readymade shakes, pre and post workout drinks, etc. I basically renounced all workout related stuff in favor of my own. I get my protein primarily from animal protein and I use proper food combining in order to maximize my food intake. The shakes I consume are made from things such as hemp protein, chia seeds, almond milk, etc. Gives me enough protein and I don't have to worry about the 'protein paradox' since I know how to work with the proportions.

I don't know what the prices of creatine are in your country, but here you can buy a bottle of creatine monohydrate for only 10 USD. And with taking only 3 grams a day, the bottle can last up to 2 months. Protein powders however are very expensive (plus you use up protein much faster too).

Well … some people think the more protein you take the better. That’s not necessarily the case and it’s actually a fallacy. We need to take a certain amount of protein per body weight in order to get maximum gains. If an individual goes over that limit the excess protein goes through the urine (also called proteinuria) and thus reduces amino acid availability. It’s a paradox in the sense that you take more but actually get less for the purpose of body building. My sources for this are my nutritionist and a booklet I received from Universal when I used to use the Animal line of products (Animal Pak, Animal Nitro, Animal Stak, etc).

That and an excess amount is really bad on your kidneys.  Drink A LOT of water when taking a lot of protein.