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Creatine Monohydrate

Review of Creatine Monohydrate

What is Creatine Monohydrate?

Creatine monohydrate is the most research proven sports nutritional supplement currently available on the market. A large number of studies have demonstrated that creatine monohydrate is both safe and highly effective at increasing muscle strength, muscle size, and muscular endurance. More recently creatine monohydrate has been shown to have positive effects on brain function and may have neuroprotective and antioxidant properties.

Creatine is a physiologically active substance that is made naturally within the liver, kidneys and pancreas from the amino acids arginine, glycine and methionine at a rate of 1-2g per day. We also consume around 1g daily in our diet from foods such as beef, salmon and tuna. It plays an important role in muscular contractions, where it is an alactic energy source – meaning it does not require any oxygen to produce energy. Within the muscle creatine is converted to phosphocreatine, which plays an important role in the re-formation of ATP molecules (the chemical energy source within cells) from ADP molecules (pre-used ATP molecule). There is enough creatine within our muscles to producing about 6-10 seconds of energy during maximal effort, making it the major source of energy during a 100m sprint or short sets of weights.

Research has shown that daily oral supplementation of creatine monohydrate can significantly increase the reserves of creatine within human skeletal muscles.

Who Should Consider Taking Creatine Monohydrate supplements?

Anyone who is involved in strength/power sports, bodybuilding, or who competes in sports where there are repeated periods of intense activity like boxing, martial arts, football, rugby, tennis etc should benefit from creatine monohydrate. Creatine monohydrate also appears to be of benefit to older adults for increasing lean muscle mass, muscle strength and bone mineral density. Creatine monohydrate may also be beneficial for improving recognition memory, brain function and reducing mental fatigue. Creatine may also provide neuro-protection and could be of benefit in the prevention of some neurodegenerative diseases.

Summary of Creatine Monohydrate's Phyiological Effects:

  • Creatine Monohydrate increases muscular strength and power
  • Creatine Monohydrate Increased muscle size
  • Creatine Monohydrate can improved sprint performance
  • Improves muscular endurance
  • Creatine Monohydrate Can increase bone mineral density
  • Beneficial effects on muscle size and strength in older adults
  • Creatine Monohydrate may provide protection against muscle injury
  • Can Increase fatigue resistance
  • Creatine Monohydrate can improve recognition memory and brain function
  • Appears to have a neuro-protective effect and may be beneficial in the treatment of neurodegenerative disease
  • Creatine Monohydrate supplementation Can lower excess levels of glutamate
  • Appears to have antioxidant activity

Creatine Monohydrate Research

Creatine Muscle Stores following supplementation

Normal creatine stores for a 70kg adult would total around 120g, of this around 95% is found within the muscle (Hunter, 1922). Intramuscular levels of creatine vary greatly between individuals (110–160 mmol/kg dry mass) but are typically lowest in vegetarians and highest in people who regular consume red meat and fish. Following supplementation the intramuscular stores of creatine can increase until they reach a maximum saturation level of around 160 mmol/kg dry mass, although not everyone will reach this saturation point. Once full, creatine stores stay elevated for around 14-21days but can be maintained for longer by taking a smaller maintenance dose. It is important to note that around 20% of people won’t benefit from creatine supplementation, possibly because their creatine levels are already saturated

Creatine Monohydrate and improved performance during short term exercise

Since phosphocreatine stores are important for muscular contractions, supplementation with additional creatine is believed to enhance performance during high intensity exercise (Nagle and Bassett, 1989). Creatine supplementation has been demonstrated to have the most positive benefits when used with strength/power athletes or sprint athletes. A number of studies have demonstrated that creatine monohydrate supplements enhance performance during short term exercise (Greenhaff et al., 1993; Greenhaff, 1995; Maughan, 1995; Volek et al., 1999, and; Mujika et al., 2000; Anomasiri et al., 2004; Hoffman et al., 2005).

Creatine Monohydrate and Muscle Strength and Size

Creatine supplementation has been demonstrated to improve muscular strength and size (Volek et al., 1999). In this study, nineteen male strength-trained athletes underwent 12 weeks of resistance training. Half were given creatine supplementation and the other half took a placebo or “inactive” supplement. Creatine supplementation consisted of 20g of creatine monohydrate per day, for 5 days, followed by a maintenance dose of 5g a day for the remainder of the study. Following the 12 weeks of training the creatine group increased fat free mass (muscle mass) by 6.3% compared to 3.1% in the placebo group. Muscle cross-sectional area increases were greater in the creatine group as well. The creatine group also demonstrated greater gains in strength, with their squat and bench press strength increasing by 34% and 22.6% respectively, compared to 25.8% and 15% in the placebo group. The increase in total body weight, and fat free mass, appears to be due, in part, to increased water retention within the muscle (Kutz and Gunter, 2003).

Creatine Monohydrate and Muscle Power

Similar improvements in strength and power were reported by Rawson and Volek (2005). In this study subjects took either creatine monohydrate, or a placebo, whilst doing resistance training. The researchers found that the creatine group increased muscle strength by 20% whereas the placebo group only increased muscle strength by 12%. Similarly weighlifting performance increased by 26% in the creatine group and only 12% in the placebo group. In both cases the improvement in the creatine group was around twice that of the placebo group.

Creatine Monohydrate and Cycling Performance

Creatine may also be beneficial for endurance cycling performance (Preen et al., 2001). Endurance cyclists may benefit from creatine supplementation through the way it allows them to recovery more quickly between the small increases in pace that commonly occur during cycling races. Total work, peak power, and cycling sprint performance have been demonstrated to significantly improve following creatine supplementation (Gill et al., 2004). Also reduced levels of fatigue, during intense exercise, have been found following creatine supplementation (Hoffman et al., 2005).

Creatine Monohydrate and Swimming

Creatine Monohydrate has also proved to be effective for swimmers (Anomasiri et al., 2004). In this study creatine supplementation significantly improved sprinting performance over the last 50m of 400m swimming competitions.

Creatine Monohydrate and Endurance Running performance

To date research has failed to demonstrated improved endurance running performance following supplementation with creatine (Biwer et al., 2003; Terillion et al., 1997). It appears unlikely that creatine would be of significant benefit to endurance runners, due to the increased weight gain experienced following supplementation.

Creatine Monohydrate and Football

Creatine supplementation has also been demonstrated to improve sprint performance in footballers (Mujika et al., 2000) and also improves football-specific skill performance (Ostojic, 2004).Another football study (Cancella et al., 2008) showed that creatine monohydrate appears to improve the efficiency for ATP resynthesis and may also influence glucoregulation in trained subjects. The improved ATP resynthesis is important since it may allow footballers to recover more quickly during intense phases of a game.

Creatine Monohydrate and Injuries

Creatine monohydrate supplementation appears to be beneficial in preventing muscle injuries (Burford et al., 2007). Research has found that the occurrence of cramping or injury in was significantly lower or proportional for creatine users compared with nonusers (Greenwood et al., 2003) and that creatine supplementation appears to have a protective effect on muscle injury (Bassit et al., 2010).

Creatine Monohydrate and injury rehabillitation

Creatine Monohydrate may help to protect against loss of strength and muscle size following inactivity or through injury. Research has shown Creatine monohydrate supplementation appears to be an effective way to stimulate muscle hypertrophy and to enhance the rehabilitation of a muscle following disuse such as following injury (Hespel et al., 2001).

Creatine Monohydrate Supplementation for older adults

There has been great interest in the role that creatine monohydrate could play in protecting against the age associated decrease in strength and lean muscle mass. Creatine supplementation has proved to have a number of benefits for older adults including increases in muscle strength, muscle size, muscular endurance as well as improved performance in functional tasks (Dalbo et al., 2009). Research by Chrusch et al., 2001, found that a combination of resistance training and creatine monohydrate supplementation led to a number of measurable improvements in elderly men (average age 70 yr), including: 1) increased lean muscle mass, 2) improved leg strength, 3) improved endurance, and 4) Improved average power (Chrusch et al., 2001). Further research has demonstrated that the addition of Creatine monohydrate supplementation to a resistance training programme enhanced the increase in fat-free mass, and increased several indices of isometric muscle strength (Brose et al., 2003). Creatine supplementation has also been shown to significantly increase bone mineral content by 3.2% (Chilibeck et al., 2005).

Creatine Monohydrate Supplementation and brain function

Research has shown that brain creatine levels correlate positively with recognition memory (Ferrier et al., 2001). In view of this researchers have looked at whether supplementation with creatine monohydrate might have positive effects on brain/mental function. Research has been positive with creatine monohydrate supplementation shown to reduce mental fatigue during a serial calculation task (Watanabe et al., 2002) and supplementaition with 5g/day of creatine monohydrate was shown to improve both intelligence and brain function during cognitive tests (Rae et al., 2003). Creatine monohydrate supplementation (4x5g daily) has even shown to improve cognitive performance in the elderly (McMorris et al., 2007).

Creatine monohydrate and neuro-protection

Creatine monohydrate supplementation improves bioenergetic deficits and may exert neuroprotective effects in Parkinson’s and Huntington’s disease (Adhihetty and Beal 2008; Atassi et al., 2010) the neuro protective effect amongst patients with neurodegenerative disease appears to be dose dependent with a minimum daily dose of 10g/day required (Atassi et al., 2010).

There has been great interest in the use of creatine monohydrate in the treatment of Amyotrophic lateral sclerosis (ALS, often called Lou Gehrig’s disease) a progressive neurodegenerative disease that is usually fatal. Early research using doses of 5g and 10g of creatine monohydrate failed to show any measureable benefit in ALS (Groeneveld et al., 2004; Shefner et al., 2004;).

However, a recent study looked at the effects of 5g, 10g, and 15g/daily of creatine monohydrate in patients with ALS. The researchers found that the increase in plasma creatine concentrations was dose related, and a Magnetic resonance spectroscopy (MRS) analysis demonstrated that creatine crosses the blood-brain barrier when given at higher dosages, with the highest recorded increase occurring at 15g/day (Atassi et al., 2010). The researchers also found that the concentration of glutamate-glutamine within the brain decreased with increasing brain levels of creatine. The greatest decrease in glutamate (a neurotransmitter) concentration (17% decrease) occurred with 15g daily of creatine monohydrate. This is important since: 1) Excess levels of glutamate damages/degenerates and eventually leads to the death of neurons, and 2) ALS patients are known to have higher levels of glutamate in the serum and spinal fluid. Further research is needed to establish whether a dose of 15g daily of creatine is beneficial in the treatment of ALS.

Creatine and antioxidant activity

Creatine has the potential to act as a direct antioxidant against aqueous radical and reactive species ions (Lawler et al., 2002). Recent research provides further evidence of creatine monohydrates antioxidant potential (Rahimi 2011). In this study creatine monohydrate was to reduce oxidative DNA damage and lipid peroxidation induced by a single bout of resistance exercise.

Creatine Ethyl Ester

There are currently a number of different creatine products available on the market. One of these Creatine Ethyl Ester (or CEE) has become increasingly popular in recent years. Manufacturers have made a number of claims regarding the effectiveness of Creatine Ethyl Ester including “vastly superior absoption” and “longer half-life in the body than regular creatine monohydrate”. Unfortunately, most of the claims regarding creatine ethyl ester are as yet either unfounded or have been contradicted by research. A study by Katseres et al., 2009, indicated that the half life of creatine ethyl ester in the blood in on the order of one minute and may hydrolyze to quickly to reach the muscle cells in its ester form. Another study suggested that CEE may actually provide large exogenous sources of pharmacologically inactive creatinine rather than ergogenic creatine (Giese & Lecher 2009). A further study that compared the effectiveness of creatine ethyl ester with creatine monohydrate concluded that: “when compared to creatine monohydrate, creatine ethyl ester was not as effective at increasing serum and muscle creatine levels or in improving body composition, muscle mass, strength, and power.” (Spillane et al., 2009).

Is Creatine Monohydrate effective?

Creatine monohydrate has proved to be perhaps the most effective nutritional supplement for enhancing muscular strength, size and power. It is one of the most widely researched sports supplements and has shown beneficial effects in nearly every research study. In fact the International Society of Sports Nutrition states that: “Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training.” (Buford et al., 2007). As well as the benefits of enhancing muscle size and power creatine also shows promise cognitive enhancer with possible neuro-protecive and antioxidant properties.

The beneficial effects of creatine monohydrate appear to be amplified when it is combined with Beta-Alanine. Researchers have found the combination of these two products appears to further enhance the gains in strength, muscle mass, and improve neuromuscular fatigue resistance (Stout et al., 2006; Hoffman et al., 2006).

How to take Creatine Monohydrate?

Traditionally creatine has been taken using a loading dose consisting of approximately 20g of creatine monohydrate (split into four 5g doses) taken orally with simple sugars such as 200ml of fruit juice – to increase the uptake of creatine by muscle cells – for 4-6 consecutive days. This loading dose is sufficient to keep muscle creatine levels elevated for 14-21days, however by taking a small maintenance dose (3-5g per day) you can maintain the levels of muscle creatine levels for longer. You should discontinue use after 2-3 months so your body doesn’t stop its natural production of creatine.

Currently the International Society of Sports Nutrition recommends taking ~0.3g/kg/day for at least 3 days followed by a 3-5g maintenance dose. Therefore, rather than sticking to the rigid 20g/day loading phase you should adjust the loading phase based on your body weight e.g a 70kg adult would consume 21g of creatine monohydrate per day during the loading phase whilst a 100kg adult would consume 30g of creatine monohydrate per day.

Researchers have found positive effects on performance without taking a loading dose (Anomasiri et al., 2004; Hoffmann et al., 2005). Hoffman et al., (2005) found that the consumption of just 6g of creatine monohydrate, for just 6 days, significantly improved fatigue resistance. However, the International Society of Sports Nutrition state that the performance effects of this type of supplementation are less supported than using a loading phase.

Creatine Monohydrate Side Effects

Creatine monohydrate has undergone extensive study and has a good amount of research that shows it is both safe and well tolerated (Burford et al., 2007; Cancela et al., 2008; Groeneveld et al., 2005).

Creatine Monohydrate References

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Atassi N, Ratai EM, Greenblatt DJ, Pulley D, Zhao Y, Bombardier J, Wallace S, Eckenrode J, Cudkowicz M, Dibernardo A. (2010) A phase I, pharmacokinetic, dosage escalation study of creatine monohydrate in subjects with amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2010 Dec;11(6):508-13. Epub 2010 Aug 11.

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