Episode 14 – Creatine

Key Topics Covered

How Does It Work?

Creatine Benefits for Strength
  • Combines with phosphate to form phosphocreatine. This helps with the production of ATP, which in turn helps to improve exercise performance.
  • It comes from animal foods, but it is hard to get enough through food so most people benefit from supplementation.
  • Really useful for the first 10 seconds of activity, particularly for repeated sets.
  • Weight lifted for 1RM, 5RM, 8RM and 10RM is expected to improve by ~8% after supplementing for a decent period of time based on the meta-analysis data. At any given weight, you would expect a ~14% improvement in the number of reps you can perform.
  • Muscle growth increases a bit over these timeframes as well. This is likely due to increased stimulus on the muscle, but there are other proposed supplements.

Who Should Use Creatine

Creatine VPA
  • Obviously lifters and athletes sports involving power should use creatine.
  • For endurance athletes there likely is an indirect benefit due to improved resistance training and rehab work if relevant. Water weight clearly increases in the short term with creatine usage, but it appears to balance back out after a period of time, so it likely is not an issue.
  • It could make sense to drop creatine during a weight cut though since water could drop acutely a bit when it is stopped (it takes 30 days to go back to normal levels), just like it increases acutely when it is started.

Plant-Based Considerations

  • Since creatine is found in animal products, mainly red meat, it is even more relevant for people who are plant based. Since creatine has applications beyond athletic performance, such as improved cognitive function, this point becomes more relevant.

Concussions

  • Creatine appears to have benefits for mitigating risks associated with concussions.
  • This is an interesting topic because if you take creatine out during a weight cut as a combat sports athlete, you are increasing these risks.

How to Take It

  • Creatine monohydrate is the gold standard
  • Dosage is 3-5g per day (it takes ~3g to reach/maintain optimal levels for an 80kg athlete)
  • There is an optional loading phase of 20g per day (can split over 4 dosages). This would reach the optimal levels in your blood within 5-7 days. If you do not load, it takes around 30 days.
  • Theoretically taking it post work-out with carbs or carbs + protein is optimal for absorption. But it does not matter. Consistency and taking it daily is what matters. If you take it daily, you will reach the optimal levels over time regardless.
  • You do not need to cycle on and off. So theoretically you can just take it consistently indefinitely, which is another reason why consistency matters far more than specific timing.

Gastrointestinal Distress

  • GI distress is the only common side effect. And even then, in the research it is still rare.
  • Our experience in practice is that a fair few people seem to notice it, particularly if they choose to do the loading phase.
  • The simplest way to avoid it is to do the lowest necessary dose e.g. 3g for an 80kg athlete rather than 5+g.

Kidney Health

  • Creatine is safe for healthy kidneys. This is incredibly well researched.
  • It can increase creatinine on a blood test. And this in turn can reduce eGFR, which is based on creatinine levels. Therefore it looks like creatine is harming kidney function, but this is misleading. Even though those levels change, it actually is not doing any harm.

Hair Loss

  • Only one study has been done on this and it was from 2009 and did not even measure hair loss. All they did was measure DHT levels. Increased DHT levels are linked with hair loss, so because they increased in this study, people jumped to conclusions. But nobody has properly studied the linkage further since then because it seems so unlikley to be an issue.

Relevant Links/Resources

Studies Mentioned

  • Creatine Meta-Analysis – Creatine supplementation with specific view to exercise/sports performance: an update
  • DHT Levels Study – Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players

Relevant Blog Post