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Supplements: Creatine

Posted by Pascal Landshoeft

Jul 25, 2016 10:00:00 AM


 Supplements: Creatine

This article summarises points about the supplement creatine based on my personal experience and information that can be found publically. I am not a doctor or nutritionist, so please consult your doctor first and get your current health levels checked before you decide to supplement with anything. All in all, creatine seems to work for small performance increases for anaerobic exercises for most individuals with little studies available for long term implications and consequences especially for the kidney and liver, where most of the bodily processes to create and process creatine before it goes into the blood stream take place. 

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What is creatine ?

Creatine occurs naturally in the body and is formed from glycine and arginine. It was discovered in 1832 by Michael Eugene Chevreul, synthesized first in the 1970s and had a surge in popularity in during the 1990s. The synthesis of creatine takes place in the liver and kidney. 95% of creatine in a human body can be found located in the skeletal muscle and a bit half of it originates from food, especially meat. The levels of creatine in meat can also be used as an indicator for its quality. Oral supplementation for healthy individuals seem to be safe between 1 to 20g a day and there is evidence that supplementation with creatine seems to work to enhance athletic performance. Based on which studies you look at most benefits can be seen high-intensity work and explosive exercise. There seems to be very little positive impact for endurance athletes.

The 1992 Olympics in Barcelona had Linford Christie, Sally Gunnell and Colin Jackson take home medals and report on the use of creatine in the preparation for their competition. One of the first products to be available for purchase in the UK was phosphagen, a creatine monohydrate complex. There studies which show an performance increase for anaerobic repetitive work when using creatine in the range of 5 - 15% and for single effort work like Olympic weightlifting in the range of 1 - 5%. This is achieved by increasing the likelihood of nuclei donation from the satellite cells to the muscle cells, lowering myostatin levels, a protein which limits the growth of muscle and increasing testosterone as well as dihydrotestosterone levels. In industrial environments creatine is produced from sarcosine and cyanamide. An indicator of quality for creatine is the granularity. The more granular the produce the easier it is soluble in liquids for consumption and the costlier was the production of the end product as it has been milled for longer. The recommended form which is said to have the highest impact is powder of creatine monohydrate. Any other products like creatine in liquid or capsule form are deemed to be inferior to creatine monohydrate proper in its effectiveness. 

There are no conclusive studies on the timing of supplementing creatine. There seems to be a consensus that it has to be taken shortly before, during or shortly after exercise as it is related to the speedy ATP process of the body and the energy chain related to it. One trick I found on the internet is to mix it with fruit juice rather than other liquids to enhance its effects leveraging the extra sugar supply. 

Side effects of creatine

Creatine is very popular nowadays as it is widely distributed and can be obtained without a prescription. There are no good long-term studies available as of now regarding the effects of the body as it only has been around for 20 years (you would consider that a long time, but when it comes to long-term broad studies it actually isn't. (Read Ben Goldacre's book "Bad Pharma" if you want to understand the nature of medical tests in more depth) Apparently, 8% of adolescents take creatine and this number goes up to 40% amongst college and professional athletes. Reported side effects are:

  • weight gain caused by higher water retention
  • muscle cramps
  • upset stomach
  • diarrhea
  • dizziness
  • high blood pressure

There is a debate whether these side effects are of a more anecdotal nature than real, as there have been problems to reproduce them in short-term clinical studies. So if these side effects persist and harm especially the livers and kidneys, effects are most likely to show after years of use. Diabetes medication, acetaminophen & diuretics can have dangerous side effects with creatine. So if you are a diabetic or have liver / kidney problems it is recommended to not supplement with creatine. If you want to dive deeper into the matter there is an interesting article on creatine linking it to the death of rugby player Jonah Lomu. Here are some direct quotes:

In 2013 the Irish Sports Council recorded 56 separate requests online to check if Creatine was on its prohibited substances list. The IRFU states on its website that it "strongly advises against the use of nutritional ergogenic aids, in particular, Creatine, in young players under 18 years of age".

"Taking Creatine may cause stomach cramps, diarrhea, and renal issues," says Tom Coleman, a health scientist and consultant specialising in performance and recovery and founder of My Nutrition.

The article itself is most critical in the use of creatine for minors in sports environments, especially those which emphasize strength, like rugby, football, and martial arts. 

Personal experience with creatine

I used creatine the first time at 16 to bulk up one weight class in Judo from -73 to -81 as I could not make the cut anymore for the lower weight class. I used it for a month for the desired result as I seemed to have responded very well to it packing on about 6 -7 kg in mass. I did not change my training routine and my diet stayed the same. I personally did not experience any of the described side effects when I was younger.

After leaving school for college I quit Judo and fell into bad habits during my first years in my professional life. I found my way back to exercising regularly against a certain goal set in 2013 preparing for my first marathon. In 2015 I switched gears to weightlifting only and work my way up to a 200kg squat. I am supplementing creatine at the moment but the effects are not as obvious as when I was a teenager. I experience some of the side effects at times, but I personally can not say whether they are just related to me being older and having a generally more fragile digestive system or the creatine itself. If I cut out my whey protein and the creatine for a time I definitely feel less bloated. I do not experience any creepy / severe side effects which would make me worry.


Overall creatine seems to work for small performance increases for non-endurance athletes. It seems to be relatively safe as there are generally seem to be no big side effects and it is widely traded over the counter as an oral supplement.(Cynics would at this point say that same goes for alcohol) There is a lot of debate and advice around that minors should stay away from it so I personally would be a bad example. There were multiple mentions in my research that creatine supplementation is a high risk for patients with existing kidney and liver malfunctions. In fairness to creatine, though, if you have problems with your liver and kidney you are on a super tight diet plan anyway unless you want to needlessly experience pain and suffering followed by eventual death...

So overall it i up to you whether you want to take the risk of unknown long-term effects on your body as they are not studied to increase your performance in the gym or for the sport you do. Creatine works for that purpose if your body responds to it.

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Topics: Supplements