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A Bird's Eye View of Creatine

As we age, we naturally lose muscle mass and bone density increasing our risk of injury and even death. Peak muscle mass can occur as early as the late teens for women and early to mid twenties for men. Bone density begins to decline after age 30. These natural losses can be partially mitigated by exercise, but are difficult to regain once they are lost. One of the reasons it gets harder to build muscle as we age is that our bodies become less efficient at breaking down and synthesizing protein, a process called anabolic resistance. Hormonal changes (e.g. drop in testosterone levels) and chronic low-level inflammation are also thought to play a role. 

One possible strategy to help you increase muscle mass is creatine supplementation. Research suggests that creatine supplements can increase aging muscle mass and strength when combined with resistance training through various possible mechanisms including upregulation of high-energy phosphate metabolism, muscle protein kinetics and growth factors. Creatine is also thought to influence the activation of cells involved in the processes of bone formation and resorption as well as to increase bone minerals. 

Creatine is an amino acid most commonly used as either a dietary supplement or ergogenic aid (substance used to improve athletic performance). The majority of the creatine in our bodies (~95%) is found in the muscles while the other 5% is distributed among the brain, liver, and kidneys. Creatine is stored as phosphocreatine in the muscles where it is used for energy. Lifestyle factors like diet and exercise as well as muscle mass and hormone levels influence our bodies creatine stores

The main dietary sources of creatine are red meat and seafood, although our bodies can also make creatine out of the amino acids glycine (which the body produces on its own) and arginine (found in nuts, seeds, and white meat). It’s possible to increase creatine stores naturally through food, but you would have to increase consumption of creatine-rich foods very significantly. As such, supplementation can make it easier to consume enough creatine to gain muscle mass rather than relying on food sources alone. Additionally, creatine supplements have no calories and are a good alternative for individuals who have food-allergies and dietary restrictions. Creatine supplementation has been widely researched and according to the US Library of Medicine and long-term scientific studies, oral creatine is safe to use in children and adults. 

Dosing in adults is done in one of two ways: either by using body weight calculations or through generic measurements. The recommendation if you are going to estimate your supplement dosage using body weight is to 0.03g of creatine per kg body weight. So for example, if you weigh 150lbs, the your recommended dose is 2.04g/day (68kg*0.03g). Alternatively, you can also use generic measurements; the recommended dose is 5g/day. 

It is best to take your supplement shortly before or after a training session in order to reap the maximum benefit. Creatine pulls water into your muscles, so staying hydrated is extremely important to prevent dehydration. While taking the supplement, aim to consume at least 2 liters of water per day. Finally, while oral supplementation hasn’t been shown to negatively affect liver or kidney function in healthy adults, individuals with liver or kidney disease should consult with their doctor before they begin supplementation. 

Oral creatine is available at various price points and sizes. The most common forms are:

  1. Creatine Monohydrate—This is the most common and effective form. It comes as regular monohydrate crystals or smaller anhydrous (micronized) crystals that are easier to dissolve in water. There is no difference in effectiveness and only a slight difference in absorbability between regular and micronized crystals.
  2. Creatine Ethyl Ester—There is some evidence that this form may be better absorbed than others, but the science is mixed and as such, it is not recommended for use. 
  3. Creatine Hydrochloride—Lab data suggests that this form has greater solubility (ability to dissolve) than other forms, but there are currently no human trials to prove that it’s more effective than creatine monohydrate.
  4. Buffered Creatine—This form includes an alkaline powder to stabilize the creatine molecule, but scientists found no difference in effectiveness between this for and creatine monohydrate.
  5. Liquid Creatine—This form is found in ready-to-drink products, but can break down before it’s fully utilized by the muscles.
  6. Creatine Magnesium Chelate—This creatine-magnesium combination improves how cells take up creatine molecules in muscle tissues. Some research suggests this form be as effective as the monohydrate form, but there need to be additional studies to confirm these findings.

When purchasing a creatine supplement it’s important to check the label for:

  • Type of creatine (monohydrate is best unless you’ve been advised to choose otherwise)
  • Texture, regular or micronized crystals
  • Flavor, choose something you like and will drink
  • Additional Ingredients, creatine should be the main and preferably only ingredient

As with any medication or supplement, please consult with your physician before beginning creatine supplementation.

Go Deeper: 

Learn more about how creatine improves athletic performance and strength in this video.

Ready to get started? Pure Encapsulations Creatine Powder was voted best overall product by VeryWellFit (no affiliation).

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