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As a fitness and nutrition coach, I tend to get a lot of queries on supplements and how to maximize muscle gain or minimize fat to look and feel great and one of the supplements that creates a lot of confusion to people is Creatine. Maybe because there is a ton of information everywhere or maybe someone somewhere must have spoken negatively or positively about its implications and health or pseudo nutritionists in our social circle making us wary of "artificial" stuff. Hopefully with the below article we can understand the facts and research on Creatine and then decide whether we want to take it or not.
What is Creatine?
Creatine is a natural compound found in the muscles of the human body. It facilitates ATP (Adenosine Triphosphate) synthesis or supports short-term muscular exertion: Strength and Power. Creatine also aids in the increase of lean body mass or fat free mass based on research.
Creatine is available in non-veg foods in around 1% by quantity. For example in mutton, chicken or fish it is available at around 0.9 grams to 1.1 grams per 100 gram of the food source. However, people who consume non vegetarian foods are liable to exert more force on the weights they lift in the gym (of course this is subjective and depends on a lot of stuff like overall neurological control, mobility, core strength, lifting age etc.) but they would need to squeeze out extra from their bodies and hence supplementation with Creatine makes sense. For vegetarians, Creatine becomes essential to perform well in the gym and or sport.
Creatine Monohydrate is the most researched variant of creatine. Other variants like Ethyl ester, Hydrochloride are also available but they have no evidence of being better than Monohydrate. Don't let supplement companies fool you into marketing products fortified with multiple types of creatine or something other than monohydrate. Always back their claim with research and analysis.
Creatine dosage:
Typically, it is recommended to take Creatine in two ways - one is called a "loading and maintenance" way where you will consume 20 grams of Creatine per day for 5-7 days to "load" the muscles and thereafter you consume 3-5 grams per day for as long as you want ("maintenance").
Second option is to consistently take 3-5 grams of Creatine for as long as you want.
Most trainers and influencers preach the consumption of Creatine with carbohydrate source however, there is no evidence proving a better effectiveness of consuming Creatine with carbohydrates against consuming only creatine (PMID:28566811)
There is a lot of confusion over the consumption of the Creatine and coffee combination which is also the base of some pre-workout supplements. However, some data suggests opposing natures of coffee (being a diuretic, it removes water from the body) and creatine (it tends to retain water from the body) could be contributing to gastrointestinal issues when taking both together (PMID:26219105).
Creatine and water retention:
Evidence shows that there is increase in body water after taking creatine. Misconceptions are that this is reason that Creatine causes water retention in the body causing "bloating" or "swelling" type look.
Water retention is as a result of Intracellular (within a cell) water and not Intercellular (between multiple cells - often the cause of bloating) water.
This process increases ATP synthesis and thus an increase in strength and power performance.
Side effects associated with Creatine:
Kidney function – There is literally no evidence that indicates bad side effects on kidneys if the dosage is adhered to as recommended (20gm per day loading and thereafter 3-5 gm per day.
however, some study has highlighted a case where dosage was way too high(20 gm per day for four weeks) to cause some degree of renal problems(PMID: 10999421).
Muscle cramps and dehydration – There is no evidence that indicates that Creatine consumption leads to muscle cramps and dehydration. However, there is contradictory evidence which shows that creatine enhances performance in humid weather by maintaining RBC count - RBC to total blood volume ratio. Creatine is shown to aid in thermoregulation and reduction of heart rate(PMID: 18184753).
Bloating and body fat increase – Bloating depends whether creatine is consumed with coffee or other ingredients in your pre workout. Evidence suggests increase in body water but no increase in body fat or caloric intake (PMID: 14636103).
Hair loss - There is only one study done that indicated a high DHT to testosterone ratio due to the intake of creatine. But based on one study we cannot conclude a hair loss problem because of creatine (PMID: 19741313).
Few important considerations:
For elder people (>50 years of age), creatine with weight training has shown an increase in lean body mass and reduction in body fat and thus prevention of diseases like type II diabetes, obesity, heart diseases etc. (NCBI, PMC: 7739317)
Whey Protein and Creatine combination isn't something magical and won’t do any better than Creatine alone. But of course, the total protein intake will be higher(PMID: 11591884).
Creatine has literally no calories, so if you’re not working out it won’t help you nor deteriorate you in any way.
Personally, I have been taking creatine since more than three years (3-5 gm/day) and have seen good amount of progress with my muscle growth and energy during workouts with no side effects whatsoever. I have used ON and Labrada Crealean brands till now.
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