Creatine Monophosphate is a very common supplement used by body builders and athletes. There are many rumors out there about creatine’s safety and efficacy. In this blog post, I’ll discuss what creatine is, whether it’s safe, and what are some of the potential benefits for it’s use based on the scientific literature.

What is it?

Creatine (methylguanidine-acetic acid) is an amino acid. It is not a steroid. In the diet creatine comes primarily from meat or supplementation. The body stores creatine as phosphocreatine in the muscle where it is used to make adenosine triphosphate (ATP), the energy molecule of the cell. Supplementation has been shown to increase muscle performance and growth over a training period.

Is it safe?

Greater than 20 years of research shows that in healthy individuals, there is no evidence of adverse effects at the recommended daily doses 2-5 grams per day. Case studies that have shown possible negative effects of creatine on the kidneys are confounded by pre-existing kidney disease, medications, and higher than normal doses of creatine. According to the International Society of Sports Nutrition (ISSN), “There is no scientific evidence that the short- or longterm use of creatine monohydrate has any detrimental effects on otherwise healthy individuals.”

Can it prevent muscle loss and improve bone mineral density?

Sarcopenia is the loss of muscle mass, strength, and functionality. It is associated with increased morbidity and mortality. Sarcopenia is increased on those on androgen blockade or those who are post-menopausal.

Resistance weight training is considered the cornerstone treatment for sarcopenia Growing evidence shows that adding creatine to weight training can have a substantial added benefit. Creatine without weight training do not appear to increase lean mass.

Studies show that creatine supplementation when combined with weight training can increase bone mineral density and attenuate the rate of bone mineral loss. A two-year study of post-menopausal women who took creatine without resistance training resulted in no improvements in bone mass.

What are some other potential benefits of creatine use?

There is evidence that creatine supplementation may reduce muscle damage, injury, and enhance recovery time following intense exercise. Supplementing with creatine may reduce inflammation and muscle soreness after exercise. Creatine supplementation may improve hydration and thereby increase heat tolerance during training. Additionally, There is also evidence creatine may be neuroprotective and can reduce spinal cord injury, cerebral ischemia, and concussion/traumatic brain injury.

Conclusions:

At a recommended range of 2-5 grams per day, creatine supplementation when combined with weight training is safe and can provide myriad benefits!

References:

Antonio, J., Candow, D.G., Forbes, S.C., Gualano, B., Jagim, A.R., Kreider, R.B., Rawson, E.S., Smith-Ryan, A.E., VanDusseldorp, T.A., Willoughby, D.S. and Ziegenfuss, T.N., 2021. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. Journal of the International Society of Sports Nutrition, 18(1), p.13. Article Link

Buford, T.W., Kreider, R.B., Stout, J.R., Greenwood, M., Campbell, B., Spano, M., Ziegenfuss, T., Lopez, H., Landis, J. and Antonio, J., 2007. International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4(1), pp.1-8. Article Link

About me: I am a medical doctor living in Northern California. I received a Master’s Degree in Nutrition from Columbia University in 2010. I’ve been a practicing vegetarian since 2007.