Creatine…Does It Live Up to the Hype?

Dr. Matthew NagraArticles, Creatine, Protein Supplements, Supplements

Image of creatine powder in a scoop spoon.

There has been a lot of chatter about creatine lately. While its benefits for athletic performance have been touted for quite some time in the fitness world, it seems more and more people are looking into this supplement. Whether they heard about it from their personal trainer, their doctor, or the thousands of TikTok videos regaling the power of this powder, there has been an influx of people looking into the potential benefits (and risks) of taking creatine. But is the hype warranted? What does the research say about creatine for both strength and muscle gains? Is it safe to take long-term? Here’s what the research says… 

What is creatine?

Creatine, in the form of creatine monohydrate, is amongst the most popular and well-studied supplements in the world. If you aren’t aware, creatine is a non-protein amino acid that is primarily stored in the muscle, with some being stored in the brain and testes as well. Phosphocreatine, the main form in our muscles, is a source of energy and one of the primary fuel sources for anaerobic activities that require maximal effort, such as sprinting or powerlifting.

While our bodies do produce some creatine, it is not enough to completely saturate our muscles. It’s also possible to get some through meat or seafood. However, it’s difficult to consume enough creatine to maximize our body’s stores through food alone since sources like beef and salmon typically only contain 1 to 2 grams of creatine per pound, which is a lot of meat, and the doses used to saturate our muscle stores are typically around 3-5g per day.

What does the research say about creatine for strength and muscle gains?

Well, the largest meta-analysis of randomized controlled trials (RCTs) evaluating creatine’s effect on lean body mass found that combining creatine supplementation with resistance training could lead to a 1.1kg gain compared to taking a placebo while resistance training. However, the effect was only statistically significant in the trials on men, not women. While that doesn’t entirely rule out an effect in women, there is reason to believe that women may be less responsive to supplementation. For example, one study suggested women may have higher pre-supplementation creatine stores compared to males. However, this meta-analysis was looking at lean body mass, which includes muscle mass, bone tissue, and water, not muscle mass alone.

Another recent meta-analysis only included RCTs evaluating muscle mass specifically and found a small effect of about 0.10 to 0.16cm gains in upper and lower body muscle thickness with combined creatine supplementation and resistance training; an effect that may be greater in younger adults compared to older adults. Together, these reviews suggest that creatine can help increase lean body mass. However, a fair amount of that gain is likely water that is stored in the muscles, which can make them “pop” more, but with only a small effect on actual muscle mass. That being said, these more modest gains can add up over time.

With that said, creatine really shines when it comes to strength gain! Creatine supplementation has been shown to significantly improve both upper-body and lower-body strength largely independent of age, sex, training protocols, and study duration. However, people without a history of training may benefit the most from supplementing creatine.

Is there a benefit to supplementing creatine beyond strength and muscle gains?

In this 2017 position paper by the International Society of Sports Nutrition, it was reported that creatine supplementation can increase sprint performance, improve muscle mass and strength, enhance recovery, and more. Because of these benefits, creatine has been used in a variety of sports, from soccer to bodybuilding. Beyond athletics, some data suggests creatine may also improve cardiovascular markers and blood sugar control, minimize bone loss, and improve cognitive function in those with impaired synthesis. However, more high-quality research is needed to form more definitive conclusions.

Are vegans lacking creatine in their diet?

It’s true that vegans and vegetarians have lower levels of muscle creatine. However, there is no good evidence to suggest this results in poorer athletic performance. Without supplements, vegetarians and vegans have a similar level of physical and cognitive ability as meat eaters. Not only that, they may benefit more from supplements than meat eaters. Therefore, supplementing creatine while consuming a plant-based diet may be even more beneficial than supplementing on an omnivorous diet. 

Is creatine safe and how much should I take?

Creatine is typically dosed at 5g/day for athletic benefits, although some proponents recommend taking 20g or more per day (5g 4x/day) for the first week to maximize creatine stores much quicker, and it boasts an impressive safety profile for healthy individuals. In fact, research on individuals taking up to 30g/day (in divided doses) for 5 years has not suggested any significant concerns over adverse events. Similarly, the available data suggests a great safety profile in adolescents. Some professionals have even suggested everyone consume at least 3g/day to promote general health throughout their lives! However, caution may be warranted for those with a history of kidney disease, so as always, it’s important to speak with your healthcare provider before starting any new supplements.

Consult a Plant-Based Doctor

Are you thinking about adding creatine to your daily routine? Or perhaps you want to enhance the healthfulness of your overall diet by adding plant-based alternatives. Either way, I’m here to help. As a plant-based doctor, I can provide an added level of guidance and support as you transition to a nutrient-dense – potentially disease-curing – diet. Get in touch today!