Should Athletes Take Creatine?

Creatine is becoming increasingly popular for its performance-enhancing effects in athletes. It is a naturally occurring compound in animal muscle tissue such as red meat, seafood, and chicken. Nowadays, creatine supplements are getting all the hype, and it’s important to recognize if you, as an athlete, might benefit from taking a creatine supplement. 

The Role of Creatine in Your Body

Let’s get into the science of creatine. Creatine plays a major role in the energy availability of athletes. Adenosine triphosphate (ATP) is the universal energy molecule used in muscle, especially during short bursts of exercise. ATP releases energy when it is broken down into adenosine diphosphate (ADP) and phosphate (P_i). ATP is depleted very quickly, so the muscle turns to Phosphocreatine (PCr) to replenish these energy stores. PCr donates P_i to ADP to restore ATP, thus sustaining energy levels during short duration, high-intensity exercise. The quick ATP and PCr energy systems are especially active during anaerobic exercise lasting up to 10 seconds. The body can create ATP from carbohydrates during aerobic exercise, but this energy system is much slower and provides energy for endurance-based training. 

The Benefits of Creatine as an Athlete

As an athlete, you are required to have a high aerobic/endurance capacity to maximize performance during your 90-minute matches, but the low to moderate running fueled by carbohydrates does not have a major influence on game outcomes. Instead, anaerobic and power movements such as accelerating, sprinting, and passing have a much bigger impact on the game. These movements are powered by none other than ATP and PCr! It is critical for athletes to have adequate energy stores in the form of carbohydrates and creatine to support both aerobic and anaerobic activities throughout a match.

Can I Get Creatine Through My Diet Alone?

When eating a normal diet, muscle creatine stores are at about 60-80% capacity. Creatine stores can decrease by about 1-2% throughout the day, so it is important you replenish creatine by eating at least 3 g per day. Your liver, kidneys, and pancreas can make about 1 g per day, and animal-based proteins may provide 3-4 g of creatine per pound. 

As you can see, it is possible to get creatine through consuming animal products. However, getting the recommended performance dosage can be difficult: 

1. Female athletes may not be able to eat one pound or four 4 oz. servings of meat in a day, 
2. Your body only produces enough creatine to replenish what was lost and doesn’t completely maximize creatine stores in the muscle
3. Plant-based athletes may have a harder time meeting this requirement since most plant-based proteins do not contain considerable amounts of creatine. Therefore, plant-based athletes have a lot less creatine stored in the muscle and blood. Vitamin B12 is important for the production of creatine, but this vitamin may also be lacking in plant-based athletes and can further impair creatine stores.

Creatine is NOT a Banned Substance

One of the most common questions I get from athletes is if they are allowed to take creatine. The answer is yes! Several organizations, including the World Anti-Doping Agency (WADA), International Olympic Committee (IOC), and the National Collegiate Athletic Association (NCAA), allow you to supplement with creatine. Note that creatine is allowed at the collegiate level, but athletic departments are NOT allowed to provide it.

Should You Only take Creatine Out of Season?

Creatine supplementation can help you both in and out of season. During your season, taking creatine increases strength and power output while reducing fatigue during your field training and games. This is especially useful for sports with intermittent sprint and rest intervals (ex. soccer). During the off-season, an athlete’s priorities may shift: training includes more lifting and sprinting to improve strength and speed. Creatine can help during this time to improve muscle mass, plyometric performance, and anaerobic power, which then transfers to improved performance on the field.

It Helps You Stay Hydrated!

Taking creatine also promotes proper hydration status which has been proven useful in preventing injuries such as cramps, heat illness, muscle tightness, and muscle strains. When eaten with protein and carbohydrates, creatine can reduce inflammation and increase an athlete’s tolerance to training intensity, further enhancing their recovery.

Taking creatine during recovery may also smoothen the transition back to training if you are injured. Plant-based athletes may see an even greater benefit from creatine supplementation, possibly due to the “super-compensation” effect of having lower creatine levels than their omnivorous teammates.

Creatine Monohydrate

Out of all of the different types of creatine on the market, creatine monohydrate is the most common and most easily absorbed form out there. Creatine monohydrate is the type of creatine that is most heavily researched, so this is the one I recommend to my athletes. It comes in a colorless, tasteless powder that dissolves in water, or in pill form, so supplementing can be as simple as adding it to your water, sports drink, or post-training shake!

Creatine Supplementation

Starting a creatine supplement may differ from other supplements that you can just add to your daily regimen (with the guidance of your dietitian, of course!). It is possible to start off with 5 g daily for 28 days, but the beneficial effects may not kick in until later when muscle creatine levels are finally maximized. Therefore, I recommend a moderate loading phase of a 5 g serving, 4x per day, for 5 days. This helps to completely top off your creatine stores in a shorter period of time. Note that loading phases any faster than this are available online, but I recommend a more moderate phase to prevent any side effects.

Afterward, you can take 3-5 g per day to maintain these stores, but larger athletes with high-intensity training may need 5-10 g per day to optimize muscle creatine. Most female athletes succeed with the 3-5 g per day. You should take creatine with a post-training meal, especially one that consists of carbohydrates and protein, as this is where you’ll see maximum creatine retention.

Is it Bad to Take Creatine?

“Creatine is a performance enhancer, so there must be a catch, right?!”

Well, you can find creatine naturally in the foods we eat, so it’s definitely safe to supplement in moderate amounts! Some may worry that it causes water retention, dehydration, and muscle cramping in the short term. However, these effects may only occur during the initial loading phase and will eventually fade away with the constant consumption of creatine. This is why I recommend a lower dosage and longer duration loading phase!

Creatine was also thought to impair liver or kidney function, but this is not the case in healthy individuals who stick to the recommended dose of 3-5 g per day. Finally, female athletes may be wary of how this supplement will impact their health and performance. There is overwhelming evidence that creatine supplementation may be beneficial throughout their lifetime, from reducing symptoms of depression to improving pregnancy outcomes in addition to enhancing athletic performance!

Creatine Regulation

As with any supplement, it is important that you know what you are putting into your body. The Food and Drug Administration (FDA), or any other government body, do not tightly regulate supplements. Supplements may contain contaminants, unlisted ingredients, or an incorrect amount of listed ingredients, so it is imperative that any supplement you take is certified by a third party such as the National Sanitation Foundation (NSF). NSF International Certified for Sport® supplements receive support from the United States Anti-Doping Agency (USADA), Major League Baseball (MLB), and other major sports organizations, so you can be sure that these supplements are safe to use. NSF International Certified for Sport® creatine supplements include Thorne Research Creatine, Cytosport Creatine, and Klean Creatine, all of which provide 5 g of creatine monohydrate per serving. 

Conclusion

Overall, creatine supplementation has a variety of benefits for an athlete’s performance on the field and in training. That being said, you will not maximize the potential benefit from creatine if you do not have a strong fueling foundation.

After reading up on the different supplements out there and consulting with a sports dietitian, go ahead and give creatine a try to see how it helps your performance! In the Performance Fueling Club, we give you personalized supplement recommendations based on your needs and goals. Join and work with a certified sports dietitian to take your performance to the next level!

Written by Reilly Beatty MS, RD, CSSD and Hannah Parducho

References

1. Andres S, Ziegenhagen R, Trefflich I, et al. Creatine and creatine forms intended for sports nutrition. Mol. Nutr. Food Res. 2017;61(6). doi:10.1002/mnfr.201600772.
2. Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J. Int. Soc. Sports Nutr. 2021;18(1):13. doi:10.1186/s12970-021-00412-w.
3. Antonio J, Ciccone V. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J. Int. Soc. Sports Nutr. 2013;10:36. doi:10.1186/1550-2783-10-36.
4. Butts J, Jacobs B, Silvis M. Creatine use in sports. Sports Health 2018;10(1):31-34. doi:10.1177/1941738117737248.
5. Certified for Sport®. Available at: https://www.nsfsport.com. Accessed February 13, 2021.
6. Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. J. Int. Soc. Sports Nutr. 2012;9(1):33. doi:10.1186/1550-2783-9-33.
7. de Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis. Nutrients 2020;12(6). doi:10.3390/nu12061780.
8. Kaviani M, Shaw K, Chilibeck PD. Benefits of creatine supplementation for vegetarians compared to omnivorous athletes: A systematic review. Int. J. Environ. Res. Public Health 2020;17(9). doi:10.3390/ijerph17093041.
9. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J. Int. Soc. Sports Nutr. 2017;14:18. doi:10.1186/s12970-017-0173-z.
10. Mielgo-Ayuso J, Calleja-Gonzalez J, Marqués-Jiménez D, Caballero-García A, Córdova A, Fernández-Lázaro D. Effects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis. Nutrients 2019;11(4). doi:10.3390/nu11040757.
11. Ramírez-Campillo R, González-Jurado JA, Martínez C, et al. Effects of plyometric training and creatine supplementation on maximal-intensity exercise and endurance in female soccer players. J. Sci. Med. Sport2016;19(8):682-687. doi:10.1016/j.jsams.2015.10.005.