Introduction
In Humans, Creatine is a nitrogenous substance linked to metabolism, and can be made in the human body, as well as found in food. It supports energy metabolism for skeletal muscle, especially when there is a high demand for energy.
Originally, Scientific investigation focused on using creatine to improve sports performance; however, it has since expanded into many areas such as neurology, healthy aging, preservation of musculoskeletal tissue, and metabolism.
An academic document discussing/reviewing creatine’s physiological function is available, summarised by the author based on current research and agreed upon by both regulatory bodies and the scientific community in the dietary supplement industry.
Mechanisms of action behind creatine
– ATP Regeneration and relation with the Energy System
– During High-Intensity Physical Activity, cells will deplete ATP levels between 3-15 seconds, as phosphocreatine levels decrease, but with creatine supplementation, the phosphagen system can increase its efficiency and allow for the ability to support the continued generation of power.
By Extension, creatine supplementation will support individuals who perform resistance training, repeat anaerobic activity, and produce the short, explosive muscle contractions typically needed in high-intensity activity.
Endogenous production of creatine
- Although creatine can be made endogenously by the liver, kidneys and pancreas, the concentrations achieved by endogenous sources are often below the maximum muscle content that can be attained.
- Many individuals do not consume sufficient amounts of dietary creatine, especially those who consume plant-based only products; thus, their levels of creatine are typically less than optimal within the muscle cells.
- Supplementation allows for an increase of creatine levels within individuals to the levels needed to produce effective muscle movement and improvements in training result.
Benefits of Creatine
Creatine supports strength, power outputs and muscle performance.
The extensive research conducted on the benefits of creatine show that it is an effective ergogenic aid. Numerous controlled trials have demonstrated an increase in maximal strength, peak power and work volume through the use of creatine.
The mechanisms through which creatine may increase maximal strength, peak power and work volume include; improved turnover of ATP, enhanced calcium handling within muscle fibers, and thus a higher quality of repetitive workout sets. All these items collectively improve the subsequent measurable performance benchmarks in strength dependent sports.
Recovery support and training tolerance provided by creatine supplements.
Through the use of creatine supplements, practitioners can expect improved recovery capabilities from creatine through; a decrease in muscle protein breakdown, an increase in muscle glycogen storage and a decrease in cellular stress induced from exercise.
Practitioners have reported improved toleration of training densities particularly during programs with a high volume of physical demands.
Together, these benefits provide practitioners with the ability to support long-term progression as a result of, when applied with sound resistance training protocols.
Cognitive development and neurological applications of creatine.
Emerging research also suggests that creatine may improve cognitive function and mental performance when faced with stressful conditions, sleep deprivation or high mental demand situations. The relationship between the use of ATP in neurotransmission and maintenance of cellular health within the brain provides evidence of creatine’s potential to improve reasoning accuracy, mental endurance and brain function during extreme conditions.
However, the current body of data in both the aging population and vegetarians provides an exciting area of further longitudinal investigation.
There’s a measurable benefit to the older adult population in creatine use as it relates to muscle mass retention, overall strength (force output), and mobility (functional mobility) in conjunction with existing resistance training programs.
There appears to be a greater response to creatine supplementation for vegetarians and vegans than their non-vegetarian/vegan counterparts due to their lower levels of creatine stores at baseline. Recent research supports the application of creatine in women also.
Existing evidence confirms that creatine may play a role in the development of strength, the composition of the body (physical composition), and outcomes on bone-related health (bone health-related outcomes) during structured training programs.
Future Directions
A number of studies investigating creatine and the regulation of metabolism have documented the relationship between creatine and metabolic regulation (including glucose handling and the cellular sensitivity of an individual to insulin).
Current research has been focused on the effects of creatine on neuroprotection and mitochondrial function. Although these studies are still in their early stages, there are enough theories and hypotheses substantiated in the current literature regarding creatine and its possible use to merit further investigation of creatine in clinical as well as non-clinical settings.
Administering Guidelines – Dosage Protocols
Typical dosages of creatine monohydrate used is from 3-5 grams a day. Some use a more rapid approach to saturate muscle cells and will use 20-25 grams daily for approximately one week. Muscle cells typically become saturated after using creatine monohydrate for 3 to 4 weeks without the rapid saturation method.
The Timing and Form of Creatine Supplement
Current trends support continuous daily dosing of creatine and therefore allow for muscle cell to maintain saturation. Daily timing of creatine consumption to support your training is not nearly as important as consistently taking creatine every day. Creatine monohydrate is the most widely used and studied form of creatine and therefore its safety and effectiveness are extensively validated, stable, and regulated.
Hydration and Diet
Creatine should be consumed with adequate fluids to help facilitate intracellular creatine distribution and also to help ease any temporary gastrointestinal sensitivity. The majority of practitioners utilize creatine with structured resistance training due to the potential for greater results.Creatine will not provide the best musculoskeletal results if no mechanical loading occurs along with its usage.
The safety of creatine when taken within the validated dose limits for healthy adults has been shown to be acceptable in research on healthy subjects over multiple years, as evidenced by the real-world examples of clinical studies with athletic participants demonstrating no evidence of clinically damage to either kidney’s vital organs.
Mild side effects can occur ; it may cause fluid retention within cells that may result in a modest increase in body mass and, in some cases, mild gastrointestinal upset from taking excessively large single doses of creatine at one time; this is not uncommon for new users of nutritional supplements.
The likelihood of experiencing these side effects can be significantly decreased by taking the dose of creatine divided into multiple daily doses throughout the day instead of all at once, thus allowing for a more gradual adaptation of the body to the supplementation of creatine.
The administration of creatine is not contraindicated in healthy individuals with healthy kidneys, but in healthy individuals who suffer from pre-existing kidney disorders, liver disease, and/or receive meds known to harm the kidneys ( nephrotoxic drugs), must be thoroughly evaluated by a qualified physician for any potential contraindication to creatine supplementation.
According to clinical guidelines for companies engaged in producing creatine and the marketing of creatine formulations, companies should only select suppliers who conduct validated purity testing and screening for contaminants according to FDA cGMP regulations. Monohydrate creatine remains the preferred standard reference for establishing both theSafety Profile, Adverse Effects, and Regulatory Considerations for creatine supplementation.
Populations with the greatest potential benefits include:
High-Intensity Athletes and Strength Trainees.
All those who are focused on sprinting and high-velocity type sports, in addition to those who perform resistance training, continually demonstrate improvements in how they generate power, the quality of their repetitions, and their overall training progress.
Older Adults Who Are at Risk for Muscle Loss.
The combination of creatine supplementation and a structured exercise program can help provide mobility, improve and maintain strength, as well as help maintain functional (ADLs) capabilities for older adults, as supported by numerous clinical observations in older adults.
Those Individuals Who Consume a Limited Amount of Creatine Through Their Diets. Because vegetarian and vegan diets contain extremely low amounts of creatine, individuals who are vegetarian or vegan have increased responses to creatine supplementation and show enhancement after creatine supplementation.
Cognitive Support.
Although research is in the early stages, creatine has so far been shown to support cognitive physical performance in periods of energy deprivation (ex. stress) and when performing high levels of physical training.
Research limitations and express/ideas/issues being supported by strong evidence:
- Strength/Power improvement
- Increased training volume
- Increased lean mass associated with resistance exercise
- Increased safety to healthy adult populations
Continued research areas;Long-term cognitive outcomes; chronic metabolic disorder treatment; more applications to other types of clinical aging populations, not just exercise; dose-response models for chronic metabolic disorders, beyond what has been studied/established through athletics.
Knowledge gaps: Long-term uses for ceratine
Real-world applications/Practical Applications:
- Daily creatine intake (3 – 5 grams) – to allow for maximum muscle saturation.
- Creatine monohydrate has been shown to have the best safety/efficacy profile compared with other versions of creatine.
- Hydration can enhance creatine tolerability and creatine distribution to cells.
- Greatest benefit occurs when creatine is used in conjunction with a structured resistance-training plan.
- Those who have compromised renal/hepatic function should consult with their clinician before taking Creatine.
FAQ’s
Does creatine assist without workouts?
Without mechanical loading, creatine produces only minor mechanical benefits. Therefore, strength, hypertrophy and performance cannot be facilitated unless resistance-based stimulants are present to produce the necessary stimulus.
When do creatine results show?
The average person typically sees measurable results after two to four weeks, depending on the amino acid loading method chosen.
Can women take creatine?
Women are known to improve their strength, physical training capacity and body composition in similar amounts to men when treated with creatine.
Do creatine effects on the kidney?
Effects of creatine supplementation on the kidney will depend on how healthy a person is prior to starting supplementation with it. If someone has underlying renal disease or other illnesses that affect their kidneys, then further evaluation will be required from a medical professional before starting the supplementation of creatine.
What are the common side effects of creatine?
Some of the most common side effects associated with taking creatine supplements (especially when taken in large amounts during a single serving) are temporary water retention within the body and mild discomfort in the stomach.