What is creatine?
Over the past few years, perhaps due to the increased availability of information online or the advancement in research, I’ve noticed a large jump in the number of people asking me about creatine. If you want to learn more about what it is, why we should be ensuring adequate intake, how to take it, and more, then keep reading - this newsletter is for you.
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What is creatine?
Before we go much further, it is important to stress that creatine is a naturally occurring compound in the body. It has a very important role in energy production; any time you perform high-intensity exercise, creatine plays a role in this production pathway. Typically, this pathway can fuel high-intensity exercise for between 8 and 10 seconds, so the next time you watch the 100m sprints at the Olympics, you can be pretty sure they’re making the most of this system.
This system of energy production is referred to as the ‘Phosphagen System’ or ‘ATP-PCr’ system. As the name suggests, the main components include:
Adenosine Triphosphate (ATP) & adenosine diphosphate (ADP)
Inorganic phosphate
Phosphocreatine (PCr)
I have taken a deeper dive into the specific bioenergetics in my previous newsletter on busting the lactic acid myth; feel free to tap the gold text to read this in more depth. However, in short:
Energy is derived from the breaking of high-energy bonds in a molecule of ATP. This process also yields adenosine diphosphate (ADP) and inorganic phosphate (Pi).
Now, eventually, we are going to run into a problem. We don’t have an endless supply of ATP, and therefore, we don’t have an endless supply of high-energy bonds to break to create energy. By breaking down ATP, we do produce lots of ADP… and, yes, we can break this down further for a little bit more energy, but this isn’t hugely favourable as it doesn’t solve the problem of a shortage of ATP.
At some point, we need to synthesise more ATP to continue the process. THIS is where creatine comes in, specifically in the form of a compound either called creatine phosphate (CP) or phosphocreatine (PCr), which is how the body likes to store creatine. As the name suggests, this refers to creatine with a phosphate group attached to it. With the help of an enzyme called creatine kinase, creatine phosphate can donate its phosphate group to ADP to resynthesise ATP. This reaction goes both ways: ATP can donate a phosphate group to creatine to resynthesise PCr. Therefore, creatine (specifically, phosphocreatine) holds one of the keys to optimal energy production.
Hopefully, these pathways help you to understand how adequate dietary intake of creatine can improve sports performance, but this is just one of the suggested benefits of creatine in the body.
Benefits of adequate creatine intake
As a dietary supplement, creatine is one of the most widely researched and safe products around, probably only behind caffeine. There are strong exercise performance benefits, but more recent research suggests that there may be further reasons for adequate intake. Note: A lot of online voices have noted that creatine is either great as a fat loss tool or to help prevent or improve symptoms of Parkinson’s disease. With regards to fat loss, yes, provided exercise and diet is optimal (creatine alone will do nothing for fat loss), and with regards to Parkinson’s, much more evidence is needed at this stage.
Exercise performance and quality of life
Not surprisingly, given the biochemistry involved, creatine is primarily responsible for an improvement in power output during high-intensity exercise, especially resistance training. It also aids with exercise recovery. This is the case for both general populations and established athletes, and can also be particularly useful for older populations, where, in conjunction with regular resistance training, creatine can help to delay and reverse sarcopenia, or age-related reduction in lean mass. Consequently, it can contribute towards the maintenance of independence throughout the ageing process.
Cognitive performance, brain, and mental health
There is some evidence to suggest that daily creatine intake can aid with short-term memory, especially in older adults.1 Recent studies have also toyed with the theory that creatine may be beneficial for improving mood states for those with depression or bipolar disorder2 but again, more research is needed here.
Historical misinformation surrounding creatine
Let’s take a look at some of the myths and misinformation that seem to follow creatine around.
Kidney damage
This has become a stigma because of the link between creatine and creatinine.
Creatinine is a chemical waste product which is filtered out by the kidneys. As the name suggests, creatinine is a by-product of creatine, and therefore, the more creatine you take in, the more creatinine you filter out.
Unfortunately, one commonly used method for assessing kidney function (eGFR) does so by taking into account creatinine levels, so if you have high levels of creatinine due to high dietary intake of creatine, this gives the illusion of poor kidney function. Re-testing kidney function after ~8 weeks of no creatine intake will result in more typical kidney tests results.
So, in short, no, a base of over 20 years of research confirms no link between recommended creatine intake and kidney damage.
Weight gain
When individuals begin to increase their creatine intake, either through whole foods or dietary supplements, they tend to notice slight weight gain. Provided that total caloric intake remains the same, this is not fat gain, or indeed muscle gain, but actually increased water retention. Creatine is osmotically active and draws water into the cells, meaning that less water is lost through thermoregulation and urination.
After a 12 week period of regular training and creatine supplementation, an increase in muscle mass would be expected, and body composition analysis would confirm this.
‘Creatine is a steriod’
No it isn’t. In the same way that protein powders aren’t steroids, pre-workout isn’t a steroid, and coffee isn’t a steroid. By definition, anabolic steroids are derived from testosterone and are taken with the aim of gaining large amounts of lean mass. Creatine supplementation is legal, safe, and doesn’t require injection. It may increase testosterone levels slightly, according to one very niche study, but it isn’t a steroid. See below.
Hair loss
There is no evidence at all that creatine causes hair loss. One study in 2009 showed a link between creatine supplementation and an increase in dihydrogentestosterone (DHT - this still means it isn’t a steroid). In some cases, high levels of DHT has been associated with hair loss.
However, the vast, vast majority of research shows that creatine doesn’t tend to increase testosterone levels, and even if it did, that this can cause hair loss or baldness. The 2009 study has yet to be replicated - in the subsequent studies, no other research group has been able to achieve a statistically significant increase in DHT by supplementing with creatine.
So, we now understand what creatine is, and we have dispelled some of the myths surrounding it. Let’s now investigate recommended intake, dietary sources, and any side effects…
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