Creatine: Benefits, Dosage, Contraindications
Scientific name(s)
2-[Carbamimidoyl(methyl)amino] acetic acid.
Family or group:
Amino acids
Indications
Rating methodology
EFSA approval.
Sport performance ✪✪✪✪✪
Creatine supplementation has become widely used by athletes and for some, it presents the only effective ergogenic aid besides carbohydrate loading. It is used by athletes engaged in sprint disciplines (e.g., 100 m running or 50 m swimming), strength disciplines (e.g., weightlifting), or high-intensity and repetitive exercises (e.g., tennis, hockey, football, soccer). Studies indicate that creatine supplementation (about 20 g/day for 5 days or about 2 g/day for 30 days) leads to an increase in skeletal muscle creatine and phosphocreatine concentrations of about 15 to 40%, improves anaerobic exercise capacity and increases training volume, potentially leading to greater gains in strength, power, and muscle mass. Myocytes use creatine to produce phosphocreatine via the enzyme creatine kinase. Phosphocreatine is used to convert adenosine diphosphate (ADP) into adenosine triphosphate (ATP). It also buffers intracellular hydrogen ions associated with lactate production and muscle fatigue during exercise. Thus, creatine can increase both muscle contraction strength (by increasing ATP levels) and the duration of anaerobic exercise. European health authorities (EFSA, European Food Safety Authority, and the European Commission) have concluded that foods and dietary supplements containing creatine can claim to increase physical performance during short, intense, and repeated exertions if and only if the recommended daily dose is three grams of creatine. Additionally, EFSA has acknowledged that a daily intake of 3 grams of creatine could strengthen the musculature of people aged over 55 who engage in resistance sports at least three times a week (short, intense, and repeated efforts), such as bodybuilding.
Posologie
Orally
3 - 20 g
Acute creatine supplementation and performance during a field test simulating match play in elite female soccer players
Analysis of the efficacy, safety, and regulatory status of novel forms of creatine
Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training
Use of creatine in the elderly and evidence for effects on cognitive function in young and old
Effect of creatine supplementation on body composition and performance: a meta-analysis
Optimizing the Benefits of Exercise on Physical Function in Older Adults
Low-dose creatine supplementation enhances fatigue resistance in the absence of weight gain
In sickness and in health: the widespread application of creatine supplementation
Neurodegenerative diseases ✪✪✪✪✪
In recent years, a considerable amount of scientific evidence has shown that creatine supplementation can alleviate certain symptoms of neurodegenerative diseases and delay their progression. Indeed, a double-blind clinical trial conducted on patients with Huntington's disease receiving 8 g/day of creatine for 16 weeks showed an increase in creatine concentrations in the brain and serum and a reduction in oxidative DNA damage. Another clinical study showed that taking creatine monohydrate, at a dose of 20 g/day for 5 days and then 5 g/day for 12 weeks, combined with resistance training, resulted in better muscle endurance. Moreover, neuroprotective effects have been observed in animal models, but not proven in clinical trials. This may be due to the fact that the pathophysiological processes of neurodegenerative disease are different in humans, as well as the difference in dosage and timing of creatine supplementation relative to disease onset. On the other hand, a combination of creatine and Coenzyme Q10 may have additional benefits in neurodegenerative diseases as they both act at the mitochondrial level and are involved in ATP production while exerting antioxidant effects.
Posologie
Oral
5 - 20 g
Synergies
Resistance training with creatine monohydrate improves upper-body strength in patients with Parkinson disease: a randomized trial
Health implications of creatine: can oral creatine supplementation protect against neurological and atherosclerotic disease?
Creatine in Huntington disease is safe, tolerable, bioavailable in brain and reduces serum 8OH2'dG
Creatine in mouse models of neurodegeneration and aging
Fibromyalgia ✪✪✪✪✪
Theoretically, creatine supplementation may reduce muscle fatigue associated with fibromyalgia and improve strength. A study showed that taking creatine monohydrate (3g/day for 3 weeks followed by 5 g/day up to 8 weeks) improves fibromyalgia symptoms (measured by the fibromyalgia impact questionnaire), sleep quality, and pain intensity. More recently, another double-blind study, conducted over a 16-week period, showed that creatine monohydrate (at a dose of 20 g in four doses for 5 days, followed by 5 g/day for the rest of the study) increases muscle phosphoryl creatine content and improves strength in lower and core muscles compared to placebo. However, no difference was observed in cognitive function, sleep quality, and quality of life.
Posologie
Oral
3 - 20 g
Depression ✪✪✪✪✪
A potential role of creatine use in psychiatric disorders is beginning to be explored. Magnetic resonance spectroscopy (magnetic resonance spectroscopy sequences allow non-invasive exploration of brain metabolism during an MRI exam) finds changes in brain creatine metabolism in a number of psychiatric disorders, including depression. A reduction in creatine metabolism has been associated with a worse disease course and prognosis. Three clinical trials of different designs have revealed a beneficial effect of combining antidepressant medications with creatine (4 to 5 g/day for 4 to 8 weeks) in individuals with major depressive disorder.
Posologie
Oral
4 - 5 g
8 - weeks
A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder
Creatine metabolism and psychiatric disorders: Does creatine supplementation have therapeutic value?
Open-label adjunctive creatine for female adolescents with SSRI-resistant major depressive disorder: a 31-phosphorus magnetic resonance spectroscopy study
Osteoarthritis ✪✪✪✪✪
A double-blind study conducted on postmenopausal women with knee osteoarthritis showed that creatine supplementation (20 g/day for 1 week, then 5 g per day for 11 weeks) along with strengthening exercises for 3 months, improves quality of life, physical function, stiffness, and lean mass in the lower limbs compared to placebo.
Posologie
Oral
5 - 20 g
3 - months
Rheumatoid Arthritis ✪✪✪✪✪
Clinical research in adults with rheumatoid arthritis shows that taking creatine increases lean muscle mass, skeletal muscle creatine content, and muscle strength, but does not alter disease activity and does not improve objective physical function compared to placebo. This suggests that creatine supplementation may lessen muscle loss and may be beneficial for patients with severe rheumatoid cachexia. Creatine was taken at a dose of 5 grams four times a day for 5 days, followed by 3 grams per day for 12 weeks, in one study and 5 grams four times a day for 5 days, followed by 0.5 grams four times a day for 16 days, in another study.
Posologie
Oral
2 - 20 g
Bone Health ✪✪✪✪✪
According to a double-blind, placebo-controlled study conducted in elderly subjects, creatine supplementation (at a dose of 0.3 g/kg for 5 days followed by 0.07 g/kg up to 12 weeks), in conjunction with resistance training, significantly increased bone density. Another study showed that creatine supplementation at a rate of 0.1 g/kg 3 days/week (for 10 weeks) in healthy older men undergoing resistance training reduced bone resorption by 27%.
Posologie
Oral
0.07 - 0.3 g/Kg
12 - weeks
Low-dose creatine combined with protein during resistance training in older men
Conjugated linoleic acid combined with creatine monohydrate and whey protein supplementation during strength training
Timing of creatine or protein supplementation and resistance training in the elderly
Creatine monohydrate and resistance training increase bone mineral content and density in older men
Cognitive Performance ✪✪✪✪✪
Some clinical studies have shown that taking creatine (20 g/day for 5 days, then 5 g for 2 days) by healthy adults improved short-term memory and reasoning compared to placebo. Moreover, taking creatine ethyl ester at a rate of 5 g/day improved memory and attention.
Posologie
Oral
5 - 20 g
5 - days
Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial.
Cognitive effects of creatine ethyl ester supplementation
Dietary supplementation of creatine monohydrate reduces the human fMRI BOLD signal
Creatine supplementation and cognitive performance in elderly individuals
The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores
Parkinson's Disease ✪✪✪✪✪
Parkinson's disease is characterized by decreased muscle mass and strength. A double-blind study showed that taking creatine monohydrate at 20g/day of creatine for 5 days, then 5 g/day for 12 weeks, combined with resistance training, improves muscle endurance and core strength. Other preliminary clinical research indicates that taking creatine at a dose of 5 grams twice a day for 12 to 18 months slows the rate of disease progression compared to placebo, in patients not yet on conventional treatment. Further preliminary clinical research in patients with more advanced Parkinson's disease who are already on conventional treatment showed that taking creatine does not slow disease progression. However, patients who received creatine needed smaller increases in dopaminergic drugs compared to placebo.
Posologie
Oral
5 - 20 g
Fatigue ✪✪✪✪✪
A double-blind study conducted on healthy subjects showed that taking creatine at a rate of 8g/day for 5 days reduces mental fatigue compared to placebo.
Posologie
Oral
8 g
5 - days
Muscular Dystrophy ✪✪✪✪✪
Most research shows that taking creatine while participating in a resistance training program can increase upper and/or lower body muscle strength in older adults. A meta-analysis of research conducted on adults aged 50 and over participating in resistance training programs shows that creatine supplementation improves chest press strength with a moderate effect size but does not improve leg press strength compared to placebo. Similarly, another meta-analysis on adults aged 45 and above participating in resistance training programs shows that creatine supplementation improves bench press strength by 1.74 kg and leg press strength by 3.25 kg compared to placebo, with no effect on knee extension or bicep measurements. Most research also suggests that creatine improves total muscle mass in older adults, although contradictory research exists. Some studies show that taking creatine while participating in a resistance training program appears to increase muscle mass in older adults. Meta-analyses of studies on middle-aged and older adults indicate that creatine supplementation combined with resistance training appears to increase total body mass by 1 kg and lean body mass by 0.9 to 1.3 kg compared to placebo. However, a meta-analysis of studies limited to older women shows no effect of creatine on muscle mass. Similarly, in healthy men aged 49 to 69, a small clinical trial shows that taking 0.05 grams/kg of creatine monohydrate twice daily, while following supervised resistance training three days a week for a year, does not alter body composition compared to placebo.
Posologie
Orally
3 g
Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis
Creatine supplementation and aging musculoskeletal health
Effects of high-velocity resistance training and creatine supplementation in untrained healthy aging males
Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults
Effect of creatine supplementation and drop-set resistance training in untrained aging adults
Type 2 Diabetes ✪✪✪✪✪
Preliminary clinical studies show a reduction in postprandial blood glucose in individuals with recent type 2 diabetes who take 3 to 6 grams of creatine orally per day for 5 days. The effects of treatment beyond 5 days in diabetic patients are not known. However, taking 10 grams of creatine per day for 3 months seems to improve glucose tolerance in sedentary healthy men.
Posologie
Orally
3 - 6 g
5 - days
Effects of creatine supplementation on glucose tolerance and insulin sensitivity in sedentary healthy males undergoing aerobic training
Comparison of antihyperglycemic effects of creatine and metformin in type II diabetic patients
Properties
Bioenergetic
In skeletal muscle tissue, endogenous creatine is used for the production of phosphocreatine, an important form of high-energy phosphate. Phosphocreatine breaks down into phosphate and creatine during high-intensity exercise lasting 15 to 30 seconds, in a reaction catalyzed by the enzyme creatine kinase. During this process, energy is released and used to regenerate ATP, the primary energy source. Creatine is involved in an energy transport system, transferring energy from the mitochondria to the cytosol.
Usages associés
Musculoskeletal effects
Oral creatine supplementation increases phosphocreatine levels in muscles. The increase in creatine and phosphocreatine reserves leads to a faster regeneration of ATP, allowing more immediately available energy for the muscles. This is particularly important during high-intensity physical activity where rapid energy production is necessary. Increased muscle creatine may also buffer lactic acid produced during exercise, thereby delaying muscle fatigue and soreness. On the other hand, some preliminary research shows that creatine may enhance the activity of muscle precursor cells, resulting in muscle hypertrophy. However, most clinical studies have shown that the primary cause of muscle gain induced by creatine is increased cell water retention.
Usages associés
Neurological
Creatine supplementation has demonstrated neuroprotective effects in several animal models of neurological diseases, such as Huntington's disease, Parkinson's disease, or amyotrophic lateral sclerosis. Several possible mechanisms have been proposed to explain the neuroprotection. One theory suggests that creatine exerts antioxidant activity and mitochondrial stabilization effects, both beneficial mechanisms in neurodegenerative diseases, characterized by mitochondrial dysfunction and oxidative damage. Other protective actions suggested by in vitro and in vivo studies include attenuating energy depletion, reducing ischemia-induced damage, apoptosis, and excitotoxicity at the brain tissue level.
Usages associés
Antidepressant
An antidepressant effect has been demonstrated in vivo using several different animal models. Creatine appears to interact with several neurotransmitter receptors, including dopamine (D1 and D2), serotonin, and N-methyl-d-aspartate. This effect has only been observed in women.
Usages associés
Antioxidant
Preliminary clinical research shows that creatine may reduce oxidative stress. Other clinical research shows that urinary excretion of malondialdehyde and 8-hydroxy-2-deoxyguanosine (markers of oxidative stress) is significantly increased with creatine, which may suggest a reduction in oxidative DNA damage and lipid peroxidation.
Anticancer
There is conflicting evidence regarding the association between creatine intake and cancer. Some research shows that creatine and its analogs, like cyclocreatine, inhibit tumor growth. Indeed, creatine could modify energy production through the creatine kinase system, which seems to play a role in controlling certain types of tumors such as breast cancers and neuroblastomas. On the other hand, cyclocreatine, an analog of creatine, has proven effective when added to standard anticancer agents and resulted in a greater delay in tumor growth in lung cancer cells than that obtained with anticancer drugs alone.
Hypoglycemic
The exact mechanisms of creatine's action on glucose regulation are not yet clear. However, it appears to modulate the expression of proteins and genes involved in insulin sensitivity and glycemic control. This includes the AMPK-alpha protein, which increases GLUT-4 translocation (glucose transporter 4, whose essential role is to transport glucose from the plasma to adipose tissue and muscle). In vitro and in vivo results also suggest the possibility that creatine increases insulin release.
Usages associés
Bone density
In vitro, creatine stimulates osteoblast differentiation. In humans, research has shown that creatine reduces markers of bone resorption. However, most clinical research suggests that creatine does not improve bone density with aging.
Usages associés
Cognitive function
Creatine supplementation increases creatine and phosphocreatine levels in the brain and improves cognitive performance.
Usages associés
Safety dosage
Adult from 18 year(s): 2 g - 20 g
There are two common dosing regimens: Loading regimen: -Fast loading: a loading dose of 5 g is taken four times a day for 5 to 7 days, followed by a maintenance dose of 2 to 10 g per day for 1 week to 6 months. A second cycle will be started again after a 4-week break. -Slower loading: a similar effect can be achieved with a daily dose of 3 g for 28 days. Simultaneous ingestion of carbohydrates (50 to 100 g) can improve creatine absorption. Once muscles are saturated, it takes about 4 weeks to return to baseline levels. Non-loading regimen: A daily dose of 3 g. In practice, creatine is often taken with simple carbohydrates, like glucose or fruit juices, to increase creatine accumulation in the muscle.
Plantes ou autres actifs
Creatine: weak interaction
Theoretically, concomitant use may increase the risk of serious adverse effects and reduce the beneficial effects of creatine.
Precautions
Pregnant woman: avoid
Avoid use due to lack of reliable and sufficient information.
Breastfeeding woman: avoid
Avoid use due to lack of reliable and sufficient information.
Contraindications
Renal failure: prohibited
The use of high-dose creatine is contraindicated in individuals with renal failure.
