Can We Really Trust Creatine Supplement? A round up on the What? How? and If?


David had been exercising for 3 months. Today, he was not able to push through the bench press final set. His poundage and repetitions dropped. Here comes the Gym Bro, and straightaway declares that David needs a creatine supplement and without it, no further improvement is possible. RUBBISH!

David has not even reached that level of intensity where he needs a creatine supplement. He is actually not taking his pre-workout meals properly. His overall protein & carb intake is low and out of proportion. His form and technique is not good for pushing heavy weights. His workout plan (sequence of exercises) is also wrong. He is over-training too and his CNS (Central Nervous System) is fatigued, forbidding him to fire his muscles the way he wants. He has not even started supplementing vitamins and minerals. Creatine supplementation at this time is an absolutely foolish and money wasting idea.

This article is my honest attempt to answer basic questions (related to creatine and its supplementation) that keeps pouring into my inbox every now and then. To keep it simple, I will refrain from using too much scientific terminology or complex equations.

What is Creatine?

Creatine is a natural substance that our body makes (in liver, pancreas and kidneys) from amino acids and stores it (95% in skeletal muscles and small amounts in heart, brain and testes).

In muscles, most of the Creatine pool (two-third) is combined with Phosphate and exists as Creatine-Phosphate (CP) and remaining (one third) as free Creatine. This ratio (2:1) is maintained in all individuals. It is this CP (Creatine-Phosphate) that supports energy production in high intensity short-duration activities like a weight training set.

How does it help energy production?

Creatine Supplements

The energy in us is produced by molecule called ATP (Adenosine Tri Phosphate), which is called the energy currency of cells. When required, it breaks down into ADP (Adenosine Di Phosphate) and P (phosphate) releasing energy. This energy helps our muscle contractions.

When we begin a weight training set, say a bench press, the free ATP in muscles break down into ADP and P to release energy. This energy helps us do initial 1 or 3 repetitions. After this, the free ATP stores of the muscles are exhausted. Muscles only understand ATP as form of energy and need more ATP to continue the set.

At this time, Creatine Phosphate (CP) stored in the muscles comes into action. CP breaks to donate its own phosphate (P) to ADP turning ADP into ATP once again, which then releases energy to push few more repetitions. This simple transfer of phosphate from CP to ADP allows us to continue repetitions for 8-20 seconds. This is how creatine in the form of CP assists energy production.

Then, how do creatine supplements work?

A weight training set might continue for 30-40 seconds. If the set continues beyond 20 seconds, CP store is also exhausted and the next energy system is activated: Anaerobic Glycolysis.

The Anaerobic Glycolysis is the breakdown of muscle glycogen and then glucose (in absence of oxygen) to produce more ATP. It helps us continue our set for 1-3 minutes. Lactic acid (end product of glycolysis) slowly builds up in muscle cells.

The acidic environment stops proper functioning of enzymes that helps breakdown of glycogen/glucose in cells, so ATP production stops and no more repetitions can be done as no more energy supplied. We need to wait till lactic acid is cleared up by blood and the system is restored again. This explains why we have to stop during weight training and need to complete whole routine in sets.

The anaerobic glycolysis is a slow process as compared to CP breakdown. It also creates an acidic environment in cells, which is not good. The CP energy system is fastest and most efficient way to supply ATP to the working muscles.

Now, if we can saturate our muscles with creatine (by creatine supplementation) and hence creatine-phosphate (CP), it will replenish ATP much faster and in higher number. This will help us create more energy and in much faster way. It will also delay anaerobic glycolysis and hence muscle fatigue, which is caused due to lactic acid accumulation. This is how creatine supplementation works and helps boost energy production while keeping cell in a more anabolic acid-free environment.

More energy means more workload (more repetitions and/or poundage). More workload means more muscle micro trauma. If right amount of 1st class protein and appropriate rest is provided to these muscles, they show hypertrophy (increase in size and hence in strength).What is Creatine?

The right time to go on Creatine Supplementation

A person can go on creatine supplementation, when:

  1. S/he has moved on to advanced level of training, having properly learnt the lifts and well acquainted with the forms/techniques.
  2. Pushing heavy weights for 6 repetitions or less. A beginner or an intermediate does not need creatine supplementation as it might result in creatine lying unused in his muscles or cause a micro trauma that body cannot repair at this time. (Moving to Advance level can take anywhere from 6 months to a year or two).
  3. S/he is regular with the workouts and all workouts are intense.
  4. The nutrition is at par with the intensity of exercise. Protein, Carbohydrate and Fats are of ace quality and right proportion.
  5. There is a rich supply of antioxidants, vitamins and minerals.
  6. When a plateau has been hit and no further improvement is seen even when all above points are satisfied.
  7. Kidneys are healthy and functioning optimally.

Please note: Creatinine is a waste product produced when creatine is used in muscles, and it is filtered from blood and thrown out by the kidneys in urine. Before going on creatine, it is important to get renal function test done to see the health of the kidneys. If kidneys are not functioning well, the creatine should not be supplemented. The person also needs to lower protein intake in discussion with a Nephrologist or doctor. It is important to go off high protein diet and exercise very little 3 days prior to test.

Liver Function Test (LFT) and KFT (Kidney Function Test) should be done half yearly or at least yearly along with Lipid Profile. It just takes a blood/urine sample to know the health of the internal organs. If some problem is identified at a nascent stage, it can be controlled or even reversed. We must not wait for something to happen in full blown way and bring life to a standstill. Precaution is less energy and money consuming, and more fruitful than the cure.

All conditions met. Now, how to go about supplementation?

You must take creatine supplementation under guidance of certified coach/nutritionist/doctor, who would normally guide you in following manner:

First is choosing the supplement. It comes in various forms: Creatine Monohydrate, Creatine Ethyl Ester, TriCreatine Malate, Creatine Pyruvate, Creatine Citrate, Creatine HCL, Creatine Krealkyln, etc. Out of all the forms, Creatine Monohydrate is the most widely used one. It is thoroughly tested and believed to be the most effective in saturating muscles with creatine. It is also less expensive compared to others.

The only drawback is that it needs insulin spike and needs to be taken with glucose. It might cause a little fat gain initially. If that is a concern, one can try ethyl ester form of it which does not need insulin spike but is expensive. By far, Creatine Monohydrate is the most popular choice and promises results. Choose the micronized form of it.

The finer the powder is, the better is its solubility and absorption.

How to Take Creatine Supplement

There is a loading phase and maintenance phase. The loading phase is spread over one or two weeks. I prefer giving the two weeks loading:

  • In the first week, 10g creatine monohydrate with 30g glucose mixed in 300ml water, once on empty stomach (hopefully in morning) and second dose is immediately post workout. The two doses are kept at least 6 hours apart.
  • The second week, we bring it down to 5g creatine monohydrate with 30g glucose mixed in 200ml water, same way twice a day.
  • Third week onwards, you can go on maintenance phase, only one dose is required of 5g creatine monohydrate with 30g glucose mixed in 200ml water and that happens post workout.
  • Earlier it was taken pre workout thinking that it will help in current workout. This is not how it works. If you have worked out chest muscles today, the creatine you saturate it with today post workout, will be used in next chest workout, not even the next day leg workout. 30g Glucose is enough to cause insulin spike and take creatine inside muscle cells. More glucose is not required.

The maintenance phase can continue till the time the person is keeping up with the intense workout. Earlier it was believed that a month of abstinence from supplementation is necessary after 2 months to ensure that the natural creatine production is not stopped by body. However, it has been found that, body does not shut down its own production permanently. And any time supplementation is stopped, it begins producing creatine as it normally does.

Important points about Creatine SupplementImportant points on Creatine Supplementation:

  • Creatine is very unstable in nature. Consume it mixed in room temperature water (not cold or hot) and drink it as soon as you have properly mixed it in water and glucose. Don’t mix it or keep it for too long.
  • Do not use fruit juices, as acidic content of preserved juices can destroy the unstable creatine and also the exact glucose content of these juices is not known. They might not cause the required insulin spike.
  • Keep the creatine container away from sunlight or moisture. Heat as well as humidity can destroy it.
  • Make sure that you are taking it every day. Missed days have an effect on the creatine saturation level and the workout intensities will suffer.
  • Creatine is used for fueling short span, highly intense power movements. If your objective is to run a marathon, which is a long duration less intense exercise, creatine supplementation won’t help. Beta Alanine would be better supplement and must be started months in advance.
  • With creatine supplementation, make sure you drink more water. Creatine supplementation needs high water intake throughout the day. If the body is not hydrated enough, it would lead to muscle cramps, dehydration and heat intolerance. The water intake is decided for each individual depending upon many factors like level of intensity, protein intake, metabolism, etc.
  • This is a part of designing an effective nutrition plan. Discuss your creatine supplementation with your nutritionist and how diet is to be changed in regard to creatine supplementation. Also inform about all medications that you are taking.

Side Effects of Creatine Supplementation

  • If your kidneys are fine and your supplementation is proper (no overdosing), there should not be any side effects.
  • There might be slightly upset gut with diarrhoea if the creatine used is of inferior quality, or if it has not mixed well with water or you mixed it in less water.
  • Creatine is a cell volumizer and pulls in water giving hydrating effect, which creates anabolic environment in muscle cells. If water intake has not been proper or if high caffeine or alcohol intake is there, it would cause muscle cramp, heat intolerance and dehydration. Keep up the water supply and refrain from caffeine/alcohol consumption.
  • Creatine is one of the most trusted and widely used supplement. Very rarely are its serious side effects reported. If at all you experience some allergic reactions, cease the loading immediately and visit a doctor.

Remember, creatine supplementation is magic. But this magic works only when you are at an advance level of training, with scientific nutrition at par with the workouts and when you have the passion to train like a champion. I wish, you bring out that champion in you and live your life at an extraordinary level. Amen!


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