Why is Creatine Suddenly Trendy and Should We Be Taking It?

 

You've probably seen them too: those jars full of mysterious creatine powder in health food stores. They usually sit in what I think of as the "boys" section, where products often feature the word "Gain" instead of "Lose." Of course I know that's sexist of me. Because it's no longer just beefy lads still sweating from their Crossfit workouts who go in search of quick, easy ways to get more jacked after weightlifting, or to get some modest performance gains in intense excercise situations. These days more and more women want to be Biggest Gainers too, not just Biggest Losers.

But I was never that tempted myself. Mild performance gains didn't seem worth the money or hassle, especially since I am not a competitive athlete. Competitive athletes are those who perform athletics among and against other people. Wheras I would prefer that other people not exist while I am exercising. Competitive athletes are known to challenge themselves to the max, and endure a great deal of pain and suffering in order to squeeze out every last watt of power from their well-crafted bodies. And, well, screw that. A hard pass on optional suffering.

So why am I now dutifully ingesting a heaping teaspoon full of creatine powder every day? Is there more to it than cosmetics and a mild performance boost?

Health Benefits of Creatine

I actually started taking creatine to help with a specific problem that, as it turns out, creatine is not very good at fixing. If I ever get around to writing a post on hypoparathyroidism I'll bore you with the sad tale of my f#cked up calf muscles. Ever try to get cardio done not using your calves? I'm still working on that.

But just as I was looking for solutions, both the New York Times and the Washington Post ganged up on me and started tempting me with the many health benefits of creatine, and so what the heck, I thought I'd give it a try. 

And, um, by the way? Even though it wasn't my goal, it does seem to beef up your muscles a bit. 

 

So the NYT and WaPo both have lots more info in their articles, and they actually went out an interviewed experts. Sounds like too much work! So I thought I'd put my new Research Assistant, Chatty McClanker, through her paces to dig up some more info. 

Since meathead powerlifters and gymrats gravitate to it, it's not surprising that creatine had been shown to increase strength, power, and lean body mass when paired with resistance training. 

According to an article Chatty dug up, the International Society of Sports Nutrition is a big fan of creatine use in sports contexts, stating that in addition to the above benefits, it may also enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection.

And how the heck does it work? By increasing phosphocreatine stores in muscle, it helps regenerate ATP, the body’s "quick energy currency," which fuels short bursts of activity like sprinting or lifting.

 

Yeah, so that's great if you're an athlete. But what about other health benefits? 

Health Benefits Beyond Being a Beast at the Gym

Blood Sugar Control and Diabetes 

According to Chatty, a growing body of research (which is probably growing because it's taking creatine!) suggests it may help with glucose metabolism and diabetes. In a randomized trial, creatine (5 g/day) combined with exercise lowered HbA1c in type 2 diabetics, improved glucose tolerance, and increased GLUT-4 transporter translocation in muscle compared to placebo. However, a 2022 review was grumpier about it, concluding that the evidence is still not strong enough to definitively say creatine improves glycemic control across populations.

Creatine and Brain Health

Chatty dug up a mighty fine scientific research review of creatines's role in health and disease, and boy howdy, it turns out creatine can help with pretty anything that involves your brain! 

Some of the examples include: benefits in cognitive aging, and improvements in mild cognitive impairment, mood disorders, and recovery from brain injury. Creatine may attenuate cognitive fatigue, support working memory, and protect neural tissue under energetic stress.

But because the article was so darn cheerful about the potential of creatine to do awesome things, I jumped down to the "conflict of interest" section. And guess what? 

It said the author has "conducted industry sponsored research on creatine, received financial support for presenting on creatine at industry sponsored scientific conferences, and has served as an expert witness on cases related to creatine. Additionally, he serves as Chair of the Scientific Advisory Board for AlzChem (which makes the stuff) who sponsored this special issue."

And then so I went back and rechecked the glucose study that Chatty had found and, same thing: Creatine People are behind it.

Hmm. Does that mean all the research done or reviewed by Creatine People is bullshit? No, of course not. But it's something to keep in mind.

Creatine for Bone Health and Oxidative Stress 

Our friends over at the WSJ mention that creatine may help enhance bone mineral density when combined with resistance training, and can potentially help with tissue injury and oxidative stress.  Yay!

Other Possible Health Benefits of Creatine

If we take the cheerful industry-backed research as being meaningful, the list is long!

Let's see, how about: provide immune support; help with symptoms of chronic fatigue; help lower cholesterol, triglycerides and/or manage blood lipid levels; reduce the accumulation of fat on the liver; decrease homocysteine (thus reducing risk of heart disease); serve as an antioxidant; reduce the progress of some forms of cancer; improve functional capacity in osteoarthritic and fibromyalgia patients; enhance cognitive function particularly in older populations and, in some instances, improve how well anti-depressant medications work.

 All good so far, but here's what really sold me: 

Enhanced Benefits for the Olds (And Vegans/Vegetarians too!)

Apparently creatine can be super helpful for seniors, when combined with strength training. Us older folks lose muscle mass, strength, and bone density with age. In trials where older participants took creatine during resistance training, they showed greater gain  (or less loss) in lean mass, strength, and functional capacity compared to just training alone without creatine.

A Northeastern University summary concurred, explained that supplementation can help oldsters like me stay stronger for longer, but not for those who slack on strength training.  

Another group creatine supplementation can help is vegetarians and vegans. For them it's hard to get enough dietary creatine (found mainly in meat/fish), so they are often more responsive to supplementation, with sometimes larger relative gains in strength or muscle fullness.

Dosage

I'm too lazy to go back and get the exact citations, but I saw numerous times that 3-5 grams a day is a good amount. And that despite what you may read about a "loading" phase with super high doses, that's just for intense, impatient people. If you're willing to wait a few weeks, you'll ultimately get the same benefit from that without risking an upset stomach. And speaking of that...

Risks and Side Effects

Chatty says creatine has over two decades of research supporting its use without major adverse effects. But some folks end up with gastrointestinal discomfort, bloating, or cramping, especially when large doses are taken all at once. And it can confuse lab tests of kidney function, even in the absence of damage. There is also limited safety data for pregnant or breastfeeding women, children, and those with kidney or liver disease. 

Also, apparently not everyone responds to supplementation, it might be just your luck to be a  non-responder. But it can take a number of weeks to build up enough in your muscles, so if you don't start noticing any immediate changes, you might not want to give up right away.

Best Forms of Creatine

The most reliable option is apparently creatine monohydrate, which has been tested the most. Other forms, like creatine ethyl ester or hydrochloride, have not shown consistent advantages and can cost more.  Mix creatine into water or juice, dump it in some yogurt or mashed banana, whatever. Good hydration is recommended since creatine draws water into muscle tissue.

Okay, so it appears that after doing all this research, Chatty may have become a fan!

 

 

 Does anyone else take creatine or any other interesting supplements?