All you need to know about Creatine supplementation

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In today’s health and fitness world, new, supposedly revolutionary, supplements are being released daily. These products are being advertised as the next big thing that is going to change the way people train and progress.

But the rate at which these products are released is so high, that there is no way for the science world to keep up with conclusive studies to tell us what really works and what is bogus…

In my opinion, hard work, dedication, discipline and science are the real keys to progress and success, however there are a few products, backed up by years of experimentation and several serious studies, that have proven their efficiency and potency. One of those being creatine.

Even though creatine supplementation is nothing new, it is worth noting that despite the fact that it is one of the most studied and scientifically supported supplement, it still generates controversy and a lot of people are still confused about its use and effects.

Creatine and ATP

First of all creatine is not some kind of unsafe chemical substance, it is a naturally occurring amino acid (protein building block) that is found in meat and fish, and also made by the human body in the liver, kidneys, and pancreas. Creatine is converted in and stored as creatine phosphate or phosphocreatine. 95% of the creatine in our body is stored in our muscles, but to better understand its use we have to understand what ATP is and how it is produced.

ATP (adenosine triphosphate) is a molecule that is responsible for producing and transporting the necessary energy to allow for all and any reaction and action to happen in our body or to be performed by it, from the most simple to the most complex ones. One of those reactions being muscle contraction.

ATP goes through a process called hydrolysis and loses a phosphate group, becoming ADP (Adenosine diphosphate), that reaction is going to release a precise amount of energy. But for energy production to keep happening, ADP has to be replenished with a new phosphate group to become ATP again and go through hydrolysis again. The body has three primary energy systems to produce (replenish) its ATP store. One of them relying exclusively on creatine, it is called the phosphagen system.

The particularity of the posphagen system, is that it is the first being recruited whenever the body performs a task, that is why it is the main one used during short and intense bouts of effort.

But its effect only lasts about ten to fifteen seconds, and since we have limited stocks of creatine it depletes totally pretty fast. So maximizing our creatine stores by supplementing allows for a more efficient phosphagen system and better performances in short and intense efforts (such as short sprints, near maximum weight lifts (weightlifting), explosive motions such as jumping etc…).

Adenosine units are in blue, Phosphate groups are in green. Creatine

Adenosine units are in blue, Phosphate groups are in green. Creatine is in red.

On the left you can see the process of hydrolysis, releasing energy (2), and then the creatine phosphate  (in red & green) replenishing (4) the ADP, by giving it its phosphate group, resulting in a new ATP molecule (5).

This also explains why taking creatine supplements improves recovery after training and allows one to train more often and/or longer.

The other benefits of creatine

Now that we have a clearer picture of the main effect of creatine on performance, let us look at its other profitable effects:

In many different researches studying the effects of creatine supplementation on human subjects, a noticeable increase in lean body mass was witnessed. This phenomenon can be explained by the fact that creatine phosphate promotes myofibrillar protein synthesis (protein synthesis inside muscle cells) resulting in an accretion of muscle mass or lean body mass.

Another positive effect of creatine supplementation is the reduction of blood triglycerides. Indeed, several studies thatbiceps pump took blood samples of the subjects before and after creatine supplementation, found an increase in HDL (high density lipoprotein, or « good » cholesterol) levels and a decrease in VLDL (very low density lipoprotein or « bad » cholesterol) and total cholesterol levels.

This effect of creatine supplementation is probably the most recently discovered : it has been found (mostly in studies conducted on animals) that creatine, because of its ATP replenishment capacity, supports mitochondrial health (the mitochondrion is an organ found in most cells which role is to generate energy for cellular function.) Through that process, creatine has a neuroprotective effect and is now being considered as a therapeutic mean against neurodegenerative diseases such as Parkinson’s disease or Huntington’s disease.

Creatine also has an effect that, even if it is not exactly unsafe, can have undesirable consequences.

This effect is that creatine pulls water into the muscle cells. This has two main consequences : first, the person supplementing will gain weight and look bigger (partly because of the increase in lean body mass mentioned earlier but also because of the increase in water weight), which can be a detrimental effect if one is trying to maintain or reduce weight and/or body size (cutting for a Bodybuilding competition, staying in a particular weight class for an athlete). The second effect is dehydration, someone supplementing with creatine should seriously increase his or her daily water consumption in order to stay properly hydrated.

Creatine and the Kidneys

Creatine has a bad reputation when it comes to kidneys because it supposedly impairs kidney functions.

Several studies conducted on healthy human subjects that showed no kidney impairment whatsoever, and several testimonies of long term, frequent creatine users, definitely confirm that creatine has no adverse effect on the kidneys or any other bodily function (give or take a few gastrointestinal upsets of small magnitude) on HEALTHY individuals.

Now, in the case of someone who already has deficient or impaired kidney function, because of the potential increase in serum creatinine production (the end product of creatine metabolism) that might overload the kidneys, creatine supplementation is strongly contraindicated.

The limits of creatine

It is now clear, after so many studies and years of clinical and real life trials that creatine is efficient and mostly harmless, however, creatine supplementations is limited in its efficiency by many different factors.

The total amount of creatine an individual is able to store and use is predefined genetically.

So, if through one’s dietary intake and genetics,  one has already reached the point of creatine saturation, supplementing with creatine will have no effect on one’s performances. This is why different people react differently and have different results when supplementing with creatine.

The same principle applies with dosage, if creatine indeed enhances one’s performances and increases one’s recovery, over-supplementing (consuming more than the recommended amount) isn’t going to have any positive effect, since the body’s creatine absorption ceiling has already been reached.

Another limiting factor is age, indeed, several studies analyzing the effects of creatine supplementation on older adults (sixty and over), showed no increase in performance and/or muscle growth (increase in lean body mass), however creatine supplementation in older population might diminish muscle fatigue.

Creatine supplementation is contraindicated for individuals under eighteen, for one main reason : no study so far has looked at the potential effects of creatine supplementation on a younger population, and so there is no way to be sure of the safety of such a practice.

Moreover younger athletes have such an important margin of progression through neuromuscular adaptation and skill acquisition alone that trying to increase their performances through supplementation would not make any sense.

Creatine supplementation guidelines

creatine pic 2The common usual guidelines for creatine consumption (NASM, NSCA), are as follow : a loading phase of five to seven days with a daily consumption of twenty grams of creatine (i.e : four ingestions of five grams), followed by a maintenance phase of two to five grams per day.

After a period of creatine saturation (period during which, one’s creatine stores are always at their highest), the body might « get lazy » and stop producing its own creatine, which is not a good thing. In order to avoid that phenomenon, it is a good idea to cycle on and off creatine. And since creatine stores take about four weeks to get back to baseline level after a period of supplementation, a month is a good period to cycle off.

For someone who wants to supplement year round, an option would be three months on, one month off. But usually creatine supplementation is recommended  and most useful only during periods of intense training, when the goal is a serious increase in strength, speed, or lean body mass accretion.

Whichever way one decides to supplement, one should always stop supplementing regularly for at least a month, to allow the body to go back to baseline creatine levels.

Multiple studies have shown that in order to maximize creatine supplementation, one should consume creatine with a source of simple carbohydrates (sports drink, fruit juice, fruits etc…) right after a training session (not before, and not too long after). Also, it has been found that caffeine completely cancels out the ergogenic (enhancing) effects of creatine, so one might want to avoid caffeine when supplementing with creatine.

Something to be careful about, is interaction with medication. If someone is taking any kind of medication (specially non-corticosteroid anti-inflammatory), he or she should imperatively consult his or her physician before taking creatine supplement.

And just in case a doubt subsisted : creatine is perfectly legal and tolerated by all athletic federations and organizations.

Now you know what to expect and what to look out for when supplementing with creatine, but never forget : no supplement will ever replace consistency and hard, smart work in the gym !




References :



3. Effects of creatine supplementation on body composition, strength, and sprint performance. Kreider, Richard B. ; Ferreira, Maria ; Wilson, Michael ; Grindstaff, Pamela ; Plisk, Steven ; Reinardy, Jeff ; Cantler, Edward ; Almada, A. L. Medicine & Science in Sports & Exercise: January 1998 – Volume 30 – Issue 1 – pp 73-82. Basic Sciences: Original Investigations

4. Earnest, C. P., A. Almada, and T. L. Mitchell. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin. Sci. 91:113-118, 1996.

5. Caffeine counteracts the ergogenic action of muscle creatine loading. K. Vandenberghe, . N. Gillis, . M.Van Leemputte,  P. Van Hecke, . F. Vanstapel, and . P. Hespel. Faculty of Physical Education and Physiotherapy, Department Of Kinesiology, Katholieke Universiteit Leuven, Belgium.

6.The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. Jose Antonio and Victoria Ciccone. Antonio and Ciccone Journal of the International Society of Sports Nutrition 2013, 10:36.

7. Bessman, S. P. and F. Savabi. The role of the phosphocreatine energy shuttle in exercise and muscle hypertrophy. In:International Series on Sport Sciences: Biochemistry of Exercise VII, Vol. 19. A. W. Taylor, P. D. Gollnick and H. J. Green (Eds.). Champaign, IL: Human Kinetics, 1988, pp. 167-178.

8. Ingwall, J. S. Creatine and the control of muscle-specific protein synthesis in cardiac and skeletal muscle. Circ. Res. 38(Suppl. 1):I115-I123, 1976.

9. Earnest, C. P., P. G. Snell, R. Rodriguez, A. L. Almada, and T. L. Mitchell. The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol. Scand. 153:207-209, 1995.

10. Effects of 30 days of creatine ingestion in older men. Eric  S. Rawson,  Melissa L. Wehnert, Priscilla M.Clarkson. European Journal Of Applied Physiology and Occupational Physiology June 1999, Volume 2


12. NASM Essentials of Personal Fitness Training 4th edition

13. NSCA  Essentials Of Strength Training And Conditioning 3rd Edition

14. Neuroprotective effects of creatine in a transgenic animal model of amyotrophic lateral sclerosis by Peter Kliveny ; Robert J. Ferrante ; Russel T. Matthews ; Mikhail B. Bogdanov ; Autumn M. Klein ; Ole A. Andreassen ; Gerald Mueller ; Marieke Wermer ; Rima Kaddurah-Daouk & M. Flint Beal. 1999 Nature America Inc.

15. Combination therapy with Coenzyme Q10 and creatine produces additive neuroprotective effects in models of parkinson’s and huntington’s diseases. Lichuan et Al. Journal of neurochemistry 2009


3 thoughts on “All you need to know about Creatine supplementation

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