Creatine supplementation: evidence-based insights

This compound is one of the few food supplements that has scientific evidence about its benefits and, therefore, can and should be consumed, as long as it is in adequate quantities. It is therefore no surprise that it is one of the most studied supplements in the context of increased physical performance, increased strength, hypertrophy, muscle recovery and even at the brain level. (1,3) 

So what are the benefits of supplementation? 

There are several benefits to creatine supplementation, especially in strength and power sports or team sports. In addition to the advantages in terms of sports, there are also several advantages of its use in specific health conditions or even in the elderly. (1,4) 

Scientific studies show that creatine increases strength, power and lean mass, especially when combined with resistance training (2,3,5) 

In cases of injuries, which imply the interruption of training cycles, it also seems to be interesting to supplement with creatine, so that muscle mass losses are minimized. (1) 

An important point to highlight is that creatine is found in large amounts in food and therefore its use is not prohibited by any sports organization. (2) 

In terms of health, creatine can be beneficial in some diseases of the muscular system, the central nervous system, and even at the metabolic or bone level. It should be noted that in case of having any pathology, the use of creatine should be done with the monitoring of a health professional in the area. 

In the elderly, creatine combined with training has been shown to improve bone mineral density and reduce muscle mass loss associated with aging and maintaining brain function, which may help prevent sarcopenia and cognitive decline. (1,6) 

In addition, current scientific evidence suggests that creatine supplementation may confer beneficial effects on cognitive function in adults, particularly in the domains of memory, attention span and information processing speed. Other studies suggest additional benefits in situations of brain energy deficit, such as hypoxia or sleep deprivation. (7,8,9) 

Are there any negative effects of taking cretin? 

There is an idea that cretin causes damage to the kidneys, but does this have any scientific basis? The truth is that it is not. However, it is normal for blood tests to show blood creatinine levels higher than the reference values in people who supplement, or the greater the person's muscle mass, or if the analysis is done right after a workout. However, this is normal and does not mean that the kidneys will collapse. (4) 

Another very common fear is hair loss. However, despite some studies associating a very high consumption of creatine with shrinkage of hair follicles, no study has directly investigated the impact of creatine on hair loss, so there is no scientific basis to claim that the same happens. (4) 

Another issue that is often addressed is that supplementation causes fluid retention, and this is the only significant side effect. When you are in the "load" phase (a subject that will be covered below), creatine can cause an increase in body water. Since this "loading" phase is not necessary to do, this feat can be avoided. However, this increase in water within muscle cells may even facilitate muscle building. (1) 

As for creatine causing weight gain, there are many studies that show that there is no effect of creatine on an increase in fat mass. The only situation that seems to be able to occur will be an increase in weight due to the increase in water in the body, in a "load" phase. (4) 

What is the recommended dose? 

Chronic creatine intake of up to 5 g/day is considered safe, with evidence of no serious adverse effects, including kidney or liver effects, even when used for months or years (2,3,10,11) 

The creatine intake protocol can be done with a daily supplementation of 3g (which can reach 5g in athletes with a greater amount of lean mass), or use a "loading phase" in the first phase. 

The loading phase consists of ingesting 20–25 g/day or 0.3g/kg/day for 5 to 7 days, to quickly saturate the muscles. The maintenance phase consists of 3–5 g/day, which is sufficient to maintain high creatine levels, with proven effectiveness on strength, lean mass and muscle recovery (2,3,12) 

Scientific evidence shows that lower daily doses (3–5 g) are equally effective in maintaining muscle saturation in the long term, and that supplementation of 3 g/day for 28 days achieves results similar to 20 g/day in 6 days (2,3). 2,3 

Thus, in cases where there is no rush to maximize creatine stores, it is not necessary to go through the "loading" phase. (1,2) 

Is there a benefit in consuming more than 5 g/day? 

The studies that exist on the subject show that creatine doses above 5g/day do not seem to have consistent additional benefits in healthy adults, although they remain effective in increasing lean mass. (2,3,13) 

There are specific health cases that may benefit from a higher intake of creatine, but these cases should be analyzed by a health professional.  

Conclusion  

Creatine is one of the supplements with the greatest scientific evidence of the benefits of its use. 3 to 5 g/day is the most studied dose of creatine, but doses higher than 5 g/day seem safe, although they offer no additional benefits for most healthy people. 

The time of day when supplementation is done seems to have no relevance in practice, but if it is possible for cretin to be taken in one of the main meals, there may be a slight advantage in its absorption. The key is to do the supplementation consistently, using a time when it is known that there will be no forgetfulness. 

To conclude, you can and should take daily creatine supplementation in the recommended doses. In more specific cases of health conditions, you should, if possible, seek the monitoring of a health professional in the area, to ensure that its proper use is used. The important thing is to maintain a healthy lifestyle, with a good diet and daily physical exercise. 

Bibliography:

1.Mendes AP. Muito mais do que proteína. Porto: Ideias de Ler; 2024. 264 p. ISBN: 978-989-740-202-9. 

2.Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. doi:10.1186/s12970-017-0173-z 

3.Kreider RB, Stout JR, Schoenfeld BJ, Arent SM, Coffey VG, Willoughby DS, et al. International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2021;18(1):1-54. doi:10.1186/s12970-021-00412-w 

4.Pedro Carvalho. Os novos mitos que comemos: um guia para se proteger dos influencers e das dietas da moda. Porto: Ideias de Ler; 2021. ISBN: 978-989-740-120-6 

5.Branch JD. Effect of creatine supplementation on body composition and performance: A meta-analysis. Int J Sport Nutr Exerc Metab. 2003;13(2):198-226. doi:10.1123/ijsnem.13.2.198 

6.Gualano B, Rawson ES, Candow DG, Chilibeck PD. Creatine supplementation in the aging population: Effects on skeletal muscle, bone and brain. Amino Acids. 2016;48(8):1793-805. doi:10.1007/s00726-016-2239-7 

7.Prokopidis K, Giannos P, Kechagias KS, Brook MS. Effects of creatine supplementation on memory in healthy individuals: A systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2022;80(8):2019-31. doi:10.1093/nutrit/nuac064 

8.Xu C, Zhang Y, He W, Li Y, Wang J, Yang M, et al. Effects of creatine supplementation on cognitive function in adults: A systematic review and meta-analysis. Front Nutr. 2023;10:10180745. doi:10.3389/fnut.2023.10180745 

9.Gualano B, Rawson ES, Candow DG, Chilibeck PD. Creatine supplementation in the aging population: Effects on skeletal muscle, bone and brain. Amino Acids. 2016;48(8):1793-805. doi:10.1007/s00726-016-2239-7;

10.de Souza e Silva A, Pertille A, Reis Barbosa CG, de Oliveira Silva JA, Vilela de Jesus D, Silva Vilela Ribeiro AG, et al. Effects of creatine supplementation on renal function: A systematic review and meta-analysis. J Ren Nutr. 2019;29(6):480-9. doi:10.1053/j.jrn.2019.05.004 

11.Shao A, Hathcock JN. Risk assessment for creatine monohydrate. Regul Toxicol Pharmacol. 2008;49(1):63-70. doi:10.1016/j.yrtph.2007.08.011 

12.Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res. 2003;17(4):822-31. doi:10.1519/00124278-200311000-00024 

13.Søgaard Ø, Bagger M, Schmedes A. Effects of creatine supplementation on lean body mass: A systematic review and meta-analysis. Eur J Nutr. 2021;60(6):3019-38. doi:10.1007/s00394-021-02481-5 

 Author:

Sofia Silva 5784N