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Although the doses used in some studies were quite high, recent studies suggest lower doses are just as effective for increasing the overall creatine phosphate pool in the body.
Two to three grams per day appears adequate for healthy people to increase their tissue levels of creatine phosphate. People with the aforementioned pathologies may benefit from higher intakes, in the 5-to-10 grams per day range.
One question that often comes up regarding Creatine is whether or not the loading phase is required. Originally the advice for getting optimal results was to load up on Creatine followed by a maintenance dose there after.
This advice was based on the fact that the human body already contains approximately 120 grams of Creatine (as Creatine and Creatine phosphate) stored in tissues and to increase total Creatine stores, one had to load for several days in order to increase those stores above those levels.
The idea also seemed to work well in practice with people noticing considerable increases in strength and weight during the loading phase. All was not perfect however as many people found the loading phase to be a problem, with gastrointestinal upset, diarrhea and other problems. At the very least, loading was inconvenient and potentially expensive.
The need for a loading phase was a long held belief, but is it really needed to derive the benefits of Creatine? The answer appears to be no as both research and real world experience have found the loading phase may not be needed after all. A 1996 study compared a loading phase vs. no loading phase 31 male subjects.
The subjects loaded for 6 days using 20 g/day and a maintenance dose 2 g/day for a further 30 days. As expected, tissue Creatine levels went up approximately 20% and the participants got stronger and gained lean mass. Nothing new there! And, not surprisingly, without a maintenance dose Creatine levels went back to normal after 30 days.
Then the group was given 3g of Creatine without a loading dose. The study found a similar - but more gradual - increase in muscle Creatine concentrations over a period of 28 days. The researchers concluded,
This elevated tissue concentration can then be maintained by ingestion of 2 g/day thereafter. The ingestion of 3 g Creatine/day is in the long term likely to be as effective at raising tissue levels as this higher dose."
A more recent study done in 1999 found that 5g of Creatine per day without a loading phase in 16 athletes significantly increased measures of strength, power, and increased body mass without a change in body fat levels (whereas the placebo group showed no significant changes).
The researcher of this 1999 study concluded,
So, if you have suffered through the loading phase in the past thinking it was the only way to maximize the effects of your Creatine supplement, it appears you can rest assured you don't have to go through all that hassle. A 3-5gram per day dose over and extended period of time will probably do the same thing.
It's only normal for people writing about a compound that is well excepted by athletes and researchers alike to assume that everyone understands what this particular product is and what it does.
However, I am quite sure there are plenty of people who have heard the word "creatine," or might even be using the stuff, and still don't have a clue what it is and how it works. If you are one of those people, the beginning of this section is for you.
As mentioned in previous sections, the body uses the high energy compound adenosine triphosphate (ATP) as its main energy producing compound. During short maximal bouts of exercise such as weight training or sprinting, stored ATP is the energy source.
However, stored ATP is depleted rather quickly which is why after only a few reps on a heavy lift things come to a fast finish and you run out of steam. To give energy, ATP loses a phosphate and becomes adenosine diphosphate (ADP).
At this point the ADP must be converted back to ATP to derive energy from this ATP energy producing system. So how does this happen? That's where creatine comes in.
Creatine is stored in the human body as creatine phosphate (CP) also called phosphocreatine. When ATP is depleted, it can be recharged by creatine phosphate. That is, the CP donates a phosphate to the ADP making it ATP again! Got all that?
An increased pool of CP means faster and greater recharging of ATP and therefore more work can be performed for a short duration, such as sprinting, weight lifting, and other explosive anaerobic endeavors.
Now of course the above explanation of how creatine works was highly simplified and there are many other biochemical functions going on (e.g. possible increases in protein synthesis, increased cell hydration, and others) relating to creatine's ability to enhance strength , muscle growth, and performance, but the above explanation is basically the way it works.
Creatine works to increase strength and performance in sports that require short duration high intensity performance, such as sprinting, football, and weight training.
It's much less effective for endurance sports such as long distance running, but may still have some beneficial effects that are outlined in this report, such as the research showing reduced inflammation after long distance running.
Research that has looked at creatine's effects endurance sports has not been impressive however. Bodybuilders tend to love creatine, football players and sprinters like creatine, and swimmers and runners tend to have mixed opinions, so this pretty much keeps in sink with the research findings to date.
As mentioned above, creatine can definitely increase lean body mass (muscle) and improve performance in sports that require high intensity intermittent exercise such as the aforementioned sprinting, weight lifting, etc.
However, creatine was found to be not effective on some people (approximately 30% of the people studied). Scientists theorized then that combining creatine with a simple sugar which would cause an insulin spike, might dramatically enhance creatine uptake into muscles and thus more creatine would be stored.
The main job of insulin is to control blood sugar by storing it in various compartments in the body (i.e. in muscle as glycogen and in fat cells as triglycerides). When blood sugar rises quickly, the body releases insulin to bring the blood sugar down.
In the process of the blood sugar being taken up by muscle cells via insulin secretion (not to be confused with non-insulin dependent uptake that takes place immediately after workouts), all sorts of things found in the blood stream such as vitamins, amino acids, and minerals sort of go along for the ride with the glucose.
That's a great over simplification of a complex system, but that's basically it in a nut shell minus the highly technical mumbo jumbo.
These "non responders" appeared not to store creatine well from an oral supplement. When these non responders were given creatine plus the simple sugar dextrose- which is just another term for glucose-these people were able to take up the creatine effectively.
So, creatine plug dextrose was found to dramatically reduced the number of people who didn't respond well to creatine alone.
Further research found that even the people who responded well to oral creatine ingestion responded even better if the creatine was mixed with this simple sugar.
In some cases there was a 60% improvement in creatine uptake. People given this combination had greater increases in lean muscle mass and even improved performance over creatine alone.
Various companies combine dextrose with creatine and sell it as a single product. Also, they often add in other ingredients that might be helpful for increasing creatine uptake, lean body mass, and performance, such as:
However, research showing these products are superior to simple creatine and glucose mixtures is lacking.
Some people just make their own by mixing the creatine in a glass of grape juice, but of course grape juice is not all glucose (it also contains fructose) and does not contain the other ingredients that some products offer the user may want.
None the less, many people feel they get good results just going the grape juice and creatine route.
There has been much made about creatine purity, mostly due to two articles I did some time back that exposed the fact that not all creatine is created equal. Those articles can be viewed on the BrinkZone and mesomorphosis web sites at:
So who tested out the best at the time of those articles were written? It's now sold to companies as Creapure, so if you see on the can of creatine the company uses Creapure creatine as their source, that's the good stuff. Most companies using Creapure as their source list it on the bottle of product.
Below are a few companies that use Creapure:
There are many more companies that use Creapure, so your choices are not at all limited to the above companies. Simply search bodybuilding.com for other creapure manufacturers.
Creatine is quickly becoming one of the most well researched and promising supplements for a wide range of diseases and many other health/fitness concerns. It may have additional uses for pathologies where a lack of high energy compounds and general muscle weakness exist, such as fibromyalgia.
People with fibromyalgia have lower levels of creatine phosphate and ATP levels compared to controls.13 Though additional research is needed, there is a substantial body of research showing creatine is an effective and safe supplement for a wide range of pathologies and is clearly the next big find in anti-aging nutrients.
- Field ML. Creatine supplementation in congestive heart failure. Cardiovasc Res 1996 Jan;31(1):174-6.
- Pearson DR, et al. Long-term effects of creatine monohydrate on strength and power. Journal of Strength and Conditioning Research, 13(3); 187-192, 1999.
- Odland LM, et al. Effect of oral creatine supplementation on muscle [PCr] and short-term maximum power output. Med-Sci-Sports-Exerc. 1997 Feb; 29(2): 216-9.
- Earnest CP et al. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin-Sci-Colch. 1996 Jul; 91(1): 113-8.
- Peeters B, et al. Effect of oral creatine monohydrate and creatine phosphate supplementation on maximal strength indices, body composition and blood pressure. Journal of Strength and Conditioning Reserach.
- Kreider RB, et al. Effects of creatine supplementation on body composition, strength and sprint performance. Medicine and Science in Sports and Exercise 1998;30(1): 73-82.