Creatine has been available for almost 30 years here in the US. More than 500 studies show it’s safe and effective. Millions of us have used it too. It can help you build an extra 5 or more pounds of muscle in a month, help you get stronger, and train hard set after set in the gym.
Still, there are many questions about creatine that are go answered.
In this article I review a recently published research paper that set out to answer 12 of the most common questions about creatine. In this study Dr. Jose Antonio and his colleagues reviewed hundreds of research papers to give us the facts when it comes to creatine supplements.
After reading you’ll get their answers explained to you in non-technical jargon that won’t leave your head spinning. If you’re like me and enjoy reading through scientific articles, I suggest you read their paper. I link to it at the end of this post.
Your Creatine Questions Answered
1. Does creatine lead to water retention?
I’ve been taking creatine since the mid ‘90s and remember lots of people talking about this then. I personally never experienced any bloating from it so I didn’t think too much about it.
What research finds – It’s highly unlikely that taking creatine leads to water retention (makes you bloated). If it does, it’s likely to last a very short amount of time.
Here’s the detailed explanation for us nerds.
The belief creatine causes water retention is primarily based on one study published several years ago. Here researchers found that during the first week of supplementation, taking 20 grams of creatine a day led to an increase in water retention inside and outside muscle cells.
The thing is, this increase of water in and out of the cell was temporary, only lasting the first few days. So, for the people in this study they retained water but not for very long. Kind of like being bloated for a few days after you eat a lot of mashed potatoes at Thanksgiving that goes away in a day or two.
The theory behind this if it is true is that when the Creatine you take is sent to your muscle cells, water comes along with it. This isn’t all bad. That’s because having more water stored here may lead to you building more muscle over time.
The thing is, this increase in water retention has never been replicated in another study. This is very important since something isn’t really considered proven true in scientific research unless it’s been replicated in multiple research studies.
Instead, what the authors of this paper find is that several studies actually find that men and women taking creatine do not retain more water.
2. Is creatine an anabolic steroid?
Spoiler Alert Answer
No, creatine is not a steroid. It’s made from totally different compounds and works differently. All the two have in common is that both can lead to building new muscle and gaining strength. They just do it differently.
Here’s the details
Creatine is made from amino acids. Just like we get from eating a steak or drinking a protein shake. Steroids are synthesized from cholesterol. Like we get from the fats we eat.
Another difference between the two is that they work very differently. When you fill your muscles with creatine, they give them more available energy to use when you’re lifting weights and sprinting. This enables you to do more sets and reps and recover faster during workouts. Over time this’ll lead to you build more muscle and getting stronger.
Steroids on the other hand send signals within the cells of your body to turn on protein synthesis and flip the switch of your muscle building genes on. They’re literally changing how your genes function. Creatine does not.
Another thing that makes the two different is that Creatine is a legal nutritional supplement here in the United States and steroids are not.
While it wasn’t stated in this paper, I think it’s worth mentioning that taking creatine doesn’t also doesn’t have the potential side effects of steroids (hair loss, mood changes, acne, etc.).
Similar outcomes, different mechanisms
So, while the outcomes we get from Creatine and steroids may be similar (increased work capacity, muscle and strength) the way each does is different.
3. Does creatine cause kidney damage/renal dysfunction?
I believe this is the biggest myth in the sports supplement world. Let’s see what Dr. Antonio and his colleagues learned.
Spoiler alert. Here’s what they learned.
There is not one finding across hundreds of studies that finds that when taken as directed, creatine is bad for your kidneys. The theory that it is harmful is based on one case study which misinterprets how creatine is broken down in our bodies.
Here’s the detailed answer
The belief that creatine is bad for our kidneys is the result of 1 case study from 1998. It involved a young man with preexisting kidney disease who took creatine monohydrate.
After supplementing with it for a little while, his blood tests showed an increase in something called creatinine. This is a compound that when it’s elevated too high can indicate something may be wrong with your kidneys.
The man in this case study did not have any other signs of kidney damage or decreased health. Which doesn’t get mentioned by the people using this study as their source of creatine hurting your kidneys.
People using this study as their proof also seem to overlook how creatine supplements are metabolized. leading to the belief that it’s harmful to our kidneys. What I mean by this is that although creatine can increase creatinine levels it doesn’t mean your kidneys are damaged. It’s just a side effect of taking extra creatine. Strenuous exercise can do the same thing.
Also, in the 30 years scientists have been studying creatine and testing subjects for kidney damage there is no data to suggest that it’s harmful. Not one bit. This includes studies lasting anywhere from a few days to years in healthy and unhealthy men and women of all ages and levels of fitness.
4. Does creatine cause hair loss / baldness?
Here’s a rumor I’d never heard of until reading this research paper. Apparently, many people believe that taking creatine leads to hair loss and even baldness.
Once again, this belief many people seem to have is based on one study. Funny thing is, that study doesn’t even find that the men in it taking Creatine reported losing their hair.
What it did find is that the guys taking creatine had increased levels of a hormone called DHT. Elevated DHT levels can lead to hair loss.
The thing is, the guys with greater DHT levels were still within the normal range. It was just higher than their baseline levels which are actually low. Plus they didn’t report losing any hair.
This increase in DHT has never been found in any other research done using Creatine monohydrate.
When taken as recommended, there is no data showing that creatine leads to hair loss.
5. Does creatine cause you to cramp?
Let’s see if research finds whether or not this theory holds any water (haha).
Here’s the simple answer.
There is no clinical data that finds creatine supplementation increases your risk of cramping. Even when you’re training hard in a hot and humid climate. Research actually finds that creatine’s ability to correct water and electrolyte imbalances helps protect us from cramps.
For more details, read here.
The first thing is the idea that creatine causes cramps is based on a survey performed with athletes and a theory put out by sports scientists. In these surveys they were asked about their performance, injuries, etc. Some of the people questioned reported that their cramping increased when they were using creatine.
No blood tests or follow up questioning was performed to see if their cramps were due to creatine. That creatine causes cramping is based only on the respondents beliefs.
The second reason some believe taking Creatine leads to cramps is from a theory someone in a lab put out is that since creatine pulls water into your muscles, it may take away from what your body needs to stay hydrated and lead to cramping more easily. This was published as a theory, not something that was tested and proven to be true.
In fact, there is a study showing creatine supplementation may decrease cramping. In this study, researchers had college football players take either creatine or a placebo over a 12 week period. They exercised intensely in very hot and humid weather.
Results show that the guys taking Creatine reported less cramps, not more. They also suffered fewer injuries than the placebo group.
Another study that finds people undergoing kidney dialysis suffered fewer cramps after taking 5 grams of Creatine before their treatment. Without any negative side effects.
6. Is Creatine safe for kids/adolescents?
I feel like I keep writing the same thing but here we go. There’s no data showing that creatine is bad for children and adolescents kidneys
There is actually research which shows creatine is beneficial to kids. Check it out how.
- It helps kids recover from concussions, increasing their strength and neurological health.
- Children with Duchenne’s X and lupus saw their health and strength improve with Creatine. Without any detriment to their health.
At this time there is no information suggesting creatine is harmful to children and adolescents when taken as recommended. There is instead information showing benefits in specific instances.
7. Does creatine increase fat mass?
Here’s what they found in one sentence. Creatine will not make you fat.
After combing through the research, Dr Antonio and his colleagues find nothing that shows Creatine leads to gaining fat. Build muscle yes, but not fat.
This includes studies lasting anywhere from several days to 2 years. Across all ages, genders, and from the sedentary to competitive athletes.
I personally find that when I’m dieting and training to get leaner, creatine helps me lose fat faster. I think it’s because it gives me more energy to still train hard when I’m cutting back on carbs and calories.
8. Is A Creatine ‘Loading-Phase’ Required?
I think people will forever debate the best way to take creatine. One of most popular ways is to ‘load’ or fill
Up your muscles over 5 days by taking 20 grams a day in 4 divided doses.
The other is to take 5 grams a day in a single serving.
What The Researchers Analysis Finds
They say that it depends on your goals. If you want to see results quickly, then loading your muscles over 5 days is the way to go.
On the other hand, if you don’t mind waiting you can skip the loading phase and just take a single 5 gram serving every day. It’ll take about 28 days to fill up your muscles this way. Here you’ll see results in about a month.
Another reason you may want to skip the loading phase is to avoid the short-term water retention that may occur. This is especially helpful if you’re competing in a sport with weight requirements or just don’t want to gain any extra weight
9. Is Creatine Beneficial For Older Adults?
Here, Dr. Antonio and his colleagues report that current research shows it helps older adults, with one caveat.
That is you need to combine your creatine with a strength training program. They find that when you lift weights, do calisthenics or any other muscle and strength building activity you’ll see better results.
- Stronger muscles
- Added muscle mass
- Stronger bones
All of these benefits are key to living and healthy, active life. As we get older muscle abs strength loss is too common. This can l make you more susceptible to injuries and illness and even shorten one’s life.
10. Is Creatine Only Useful For Resistance/Power Activities?
I love this question. According to their review of the research, they find there are benefits to taking creatine for any activity. Including endurance exercise (jogging, cycling). After examining several studies, they find that there are many additional benefits we can get from creatine.
Here are the major non resistance/power benefits.
- When taken with carbohydrates, Creatine helps your body store more glycogen (fuel) in your muscles.
- It helps you recover faster between workouts and repairs damaged muscle faster, even in endurance athletes.
- It can help protect your brain from injury. This is important for all of us who play sports where collisions and head contact occurs (I.e. soccer, football, MMA, etc.).
- You’ll better tolerate hot conditions which are important for many of us, whether we are runners, triathletes, golfers, or football players in summer training camp.
11. Is Creatine Effective For Women?
Pay attention to this one ladies, and any if you that works with female clients and athletes.
If you don’t want to read all the details, here’s what they find in one sentence.
Given its low risk profile, creatine has many benefits for women other than building muscle and increasing strength.
Here’s the detailed explanation
In general, women have higher levels of Creatine stored in their muscles. This is probably due to them having less muscle than a guy of the same weight. Therefore, some women may not gain as much muscle from creatine as you’d expect. This is perhaps why people say creatine doesn’t benefit women.
This Isn’t true. First of all, the authors of the article I’m revising reveal that there are several studies which find ladies can gain muscle and get stronger when they take creatine and do strength training. Their review finds this is true for college athletes and older, post menopausal women.
Like I write above, their literature review finds lots of other benefits for women.
- It can help women with depression improve their mood.
- Like in guys, it can protect your brain from injury in sports where head collisions occur.
- Creatine can also help women perform better in the gym during their period.
- Animal studies find it may even be beneficial when their pregnant, providing protection to the fetus.
Are other forms of creatine similar or superior and is it creatine stable in beverages?
The answer to this question will save time and money.
After going through all available data, they find there’s not one bit of evidence that shows any other type of creatine (creatine HCL, liquid creatine, creatine ethyl ester, etc.) is better than creatine monohydrate.
With regard to stability the same is true. I learned here that Creatine monohydrate is super stable. Even after being stored at high temperatures for more than 2 years it doesn’t break down. In other words, don’t worry about it breaking down if your Creatine sits in your protein shake for a little while. It doesn’t and it’s still good.
So there you have it, answers to 12 commonly asked questions about creatine monohydrate based on the findings of over 500 studies. I hope that it answers any you have and helps you get the most from creatine when you take it.
Antonio, J., Candow, D.G., Forbes, S.C. et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr 18, 13 (2021).
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