Creatine: Everything You Need To Know

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Will Brink

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Well almost everything. These are the most common Qs I get, and I have done an extensive FAQ on creatine for readers to cut through the often confusing BS on this supplement:

What does creatine do?


In a nutshell, creatine works to help generate cellular energy. When ATP loses a phosphate molecule and becomes adenosine diphosphate (ADP), it must be converted back to ATP to produce energy. Creatine is stored in the human body as creatine phosphate (CP) also called phosphocreatine.


When ATP is depleted, it can be recharged by CP. That is, CP donates a phosphate molecule to the ADP, making it ATP again. An increased pool of CP means faster and greater recharging of ATP, which means more work can be performed. This is why creatine has been so successful for athletes. For short-duration explosive sports, such as sprinting, weight lifting and other anaerobic endeavors, ATP is the energy system used.

To date, research has shown that ingesting creatine can increase the total body pool of CP which leads to greater generation of energy for anaerobic forms of exercise, such as weight training and sprinting. Other effects of creatine may be increases in protein synthesis and increased cell hydration.


Creatine has had spotty results in affecting performance in endurance sports such as swimming, rowing and long distance running, with some studies showing no positive effects on performance in endurance athletes. Whether or not the failure of creatine to improve performance in endurance athletes was due to the nature of the sport or the design of the studies is still being debated.


Is creatine bad for me?


Creatine the most studied nutritional supplement that exists. Hundreds of studies to date have shown that creatine monohydrate is an amazingly non-toxic and safe supplement with numerous benefits. Further studies directly examining possible side effects, both prospective and long-term retrospective (up to five years), have failed to find any serious side effects of creatine supplementation (1-5) on various markers studied, such as renal function, hepatic function, and others.


Contraindications of creatine monohydrate:


Although creatine monohydrate is clearly safe for healthy people with a very low side-effects profile using up to 10 grams per day, are there specific groups who should not use it?

Again, the data suggest very few actual contraindications. The population who should avoid creatine supplements are those with a history of renal disease and/or those taking nephrotoxic (poisonous to the kidneys) medications. There’s been a handful of case reports that show very high doses of creatine (and the reports were not always clear as to what form of creatine was used) were associated with kidney dysfunction.(70) Typical for such a simple case report, it’s unclear what other medications were involved or pre-existing medical condition existed.


However tenuous the connection between high-dose creatine monohydrate and pre-existing kidney dysfunction, it’s prudent to advise people with a history of renal disease and/or those taking nephrotoxic medications to avoid creatine supplementation until more data exists examining that connection. As creatine monohydrate supplementation may cause a transient increase in creatinine levels in some individuals, it may act as a false indicator of renal dysfunction.


How should I take creatine, capsule/powder/with food/morning/afternoon/night?


Most cost effective way to take creatine is as a powder mixed into a warm liquid. Mixing in a warm liquid may not impact absorption and utilization, pre solubilizing creatine generally eliminates any gastrointestinal some may experience. Early studies mixed creatine hot tea and coffee. Timing does not appear to matter, although one small study suggested post workout was superior. Most take creatine post workout, but as creatine is a chronic effect (due to increased tissue levels of PC) vs. an acute effect such a caffeine does.


Should I/How should I take creatine if I only lift weights occasionally?



Because creatine works by elevating tissue levels of CP, vs an acute effect on any one workout (like taking a stimulant before a workout) creatine should be taken daily to maintain elevated tissue levels. Once higher tissue levels are reached, via a simple intake of 3-5g per day for at least 30 days, or a loading phase done, followed by maintenance dose, it’s possible creatine does not need to be taken daily. However, what dose at what schedule to maintain tissue levels is unclear at this time. I recommend simply taking 3-5 daily. For an extensive discussion on dosing schedule, see article by Monica Mollica HERE.


Does creatine help with muscle mass or overall health?



Yes and yes. Creatine does both assist in building muscle and or preserving muscle, as well as other tissues. Most know creatine as a “muscle building supplement” but are unaware of it’s potential health benefits and medical uses. If I didn’t exercise at all, I’d still use creatine personally. From my report on creatine, which is a free down load, which although in need of updating, was written for both clinicians and non looking for objective science based info:


This report will cover much of what creatine has to offer as a safe and inexpensive supplement with an exceptionally wide range of potential uses. Though I will go into depth about each, creatine may positively effect:

Sarcopenia (a loss of muscle mass due to aging)
Improve in brain function of healthy and damaged brains
Modulate inflammation.
Diseases effecting the neuro muscular system, such as muscular dystrophy (MD)
Wasting syndromes/muscle atrophy
Fatigue
Gyrate atrophy
Parkinson's disease
Huntington's disease and other mitochondrial cytopathies
Neuropathic disorders
Various dystrophies
Myopathies
Various brain pathologies.
May increasing growth hormone (GH) levels, to those seen with exercise
Reduce homocysteine levels
Possibly improving the symptoms of Chronic fatigue Syndrome
Improve cardiac function in those with congestive heart failure

Creatine is proving to be one of the most promising, well researched, and safe supplements ever discovered for an exceptionally wide range of uses.


A an updated article on the many potential benefits of creatine can be found HERE


What are the downsides to creatine?



There’s a risk/benefit to anything and everything we do, but I’m aware of no serious downsides that would outwigh the benefits in the vast majority of users at this time. Most reported downsides, such a dehydration or cramping and such, are mythology that has been studied and debunked in the studies, which actually found a slightly reduced rate of cramping and improved thermoregulation with creatine as an example.


What’s the best form of creatine?



Creatine monohydrate (CM) form is far and away the most extensively researched. To date, every “alternative” to CM claiming to be superior, once actually tested in a research setting has failed miseralbly to show any superiority to CM. Two, I recommend using Creapure, which testing continuous to show as the most consistently high quality and purity. Additional info on that can be found HERE.


Additional info From report of possible:



Section One


Creatine is formed in the human body from the amino acids methionine, glycine and arginine. The average person's body contains approximately 120 grams of creatine stored as creatine phosphate.
Certain foods such as beef, herring and salmon, are fairly high in creatine. However, a person would have to eat pounds of these foods daily to equal what can be obtained in one teaspoon of powdered creatine.
Creatine is directly related to adenosine triphosphate (ATP). ATP is formed in the powerhouses of the cell, the mitochondria. ATP is often referred to as the "universal energy molecule" used by every cell in our bodies.
An increase in oxidative stress coupled with a cell's inability to produce essential energy molecules such as ATP, is a hallmark of the aging cell and is found in many disease states.

Key factors in maintaining health are the ability to:

Prevent mitochondrial damage to DNA caused by reactive oxygen species (ROS)
Prevent the decline in ATP synthesis, which reduces whole body ATP levels.

It would appear that maintaining antioxidant status (in particular intra-cellular glutathione) and ATP levels are essential in fighting the aging process.



It is interesting to note that many of the most promising anti-aging nutrients such as CoQ10, NAD, acetyl-l-carnitine and lipoic acid are all taken to maintain the ability of the mitochondria to produce high energy compounds such as ATP and reduce oxidative stress.

The ability of a cell to do work is directly related to its ATP status and the health of the mitochondria. Heart tissue, neurons in the brain and other highly active tissues are very sensitive to this system.



Even small changes in ATP can have profound effects on the tissues' ability to function properly. Of all the nutritional supplements available to us currently, creatine appears to be the most



1: Kreider RB, et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003 Feb;244(1-2):95-104.

2: Poortmans JR, Francaux M. Adverse effects of creatine supplementation: fact or fiction? Sports Med. 2000 Sep;30(3):155-70.

3: Robinson TM, et al. Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function. Br J Sports Med. 2000 Aug;34(4):284-8.

4: Terjung RL, et al. American College of Sports Medicine roundtable. The physiological and health effects of oral creatine supplementation. Med Sci Sports Exerc. 2000 Mar;32(3):706-17.

5: Groeneveld GJ1, et al. Few adverse effects of long-term creatine supplementation in a placebo-controlled trial. Int J Sports Med. 2005 May;26(4):307-13.
 
Defy Medical TRT clinic doctor
Nice summary Will. One of the more exciting benefits extending beyond human performance is the potential protective effect in fatty liver disease. A recent review is attached for those interested...
 

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Nice summary Will. One of the more exciting benefits extending beyond human performance is the potential protective effect in fatty liver disease. A recent review is attached for those interested...

Yes! There's many additional benefits I didn't even touch on, including TBI, etc.
 
KSPhD, nice post. I do use Creatine monohydrate but only use a 1/4 tsp daily, makes my creatinine look high.
 
KSPhD, nice post. I do use Creatine monohydrate but only use a 1/4 tsp daily, makes my creatinine look high.

My nurse practicioner trips on me for that exact thing, can't correlate Creatine use, my size/muscle mass and the fact that I wasn't fasted when she pulled a CMP on me...of course it was HIGH. When I'm fasted 10hrs, off the gym and creatine 72hrs, my creatinine/kidney function drops to well within lab ranges. I really like her but its another spot of they don't want to learn.
 
Yes I done that in the past, but since I cut down to a 1/4 tsp, I'm good. I like the effect it has on my workouts, that's why I no longer stop taking it for a few weeks, before labs.

Ah, ok, Rgr rgr. In the 2-5g range, rarely impacts creatinine. At higher doses some use, it can raise creatinine, but that has not been a consistent finding in the lit or clinically.
 
Ah, ok, Rgr rgr. In the 2-5g range, rarely impacts creatinine. At higher doses some use, it can raise creatinine, but that has not been a consistent finding in the lit or clinically.

I am told when they test creatinine levels, the essay does not separate the two.
 
If I take 2 scoops daily pre workout and on days off for a loading phase. How many days do I continue with 2 scoops before I can take less? It's expensive to begin with.
 
Is 1 scoop a day good enough? Also to be clear you take it pre workout and on days off? Someone told me daily period but want to make sure since everyone does it different.

How would I know what's in a "scoop"? Follow dosing recs in the OP, 3-5g per day. Take that dose every day, and per above, timing does not appear to matter.
 
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Is 1 scoop a day good enough? Also to be clear you take it pre workout and on days off? Someone told me daily period but want to make sure since everyone does it different.

a scoop isn't a dose, come on...how is anyone supposed to talk to you about something being enough when you only can manage "1 scoop"...
 
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