The Ultimate Guide To Creatine Supplementation Part 3

You’ve been asking for this one for a while, so here it is: Part 3—and the conclusion—of DH’s Ultimate Guide To Creatine Supplementation.

At this point, assuming you’ve read the first two installments of this series—and if you haven’t, you should go back and read them now—you know more about creatine than most supplement manufacturers and fitness gurus: the same people we see, over and over, giving us erroneous instruction on how to dose this enigmatic white powder.

 

The Ultimate Guide To Creatine Supplementation Part 1 

The Ultimate Guide To Creatine Supplementation Part 2

 

In this section, I’ll cover what science knows about dosing protocols for creatine: the timing and frequency of ingestion, what to take it in combination with—and what not to—and which types produce the best results. The most surprising aspect of the research I’ve done? Despite decades of study of creatine’s use as a sport supplement, there has not been any research conducted regarding the most beneficial way to take it.

Here, however, are the facts as we know them.

 

Stuck in a Rut

With scientific inquiry, sometimes the path we’re on gets so worn down by the millions who came before us that it’s easy to simply stay the course and do the same things we’ve always done. This is precisely what’s happened regarding the usage of creatine. Researchers kept using the same protocol for creatine supplementation after the first reports of successfully augmenting intramuscular creatine levels—and they’re still using them today.

These studies found that 20 grams per day of creatine, taken for five days, successfully raised muscle creatine content by 30-45 percent. The problem with the vast majority of these studies, however, is that they only lasted five to seven days—and yet we’ve been using them to make recommendations for people who supplement for months on end.

NOTE: I was not exhaustive in my search, but I pulled a large sample of research across different modes of inquiry, e.g., looking for improvements in endurance, strength, power, and one-repetition max.

Of the 47 studies, only 4 tested or employed a protocol lasting longer than 14 days and attempted to use a maintenance dosage of creatine[1-47]. The idea in these studies is to load for five days at a high level—the standard 20 grams per day—then maintain that supraphysiological concentration with 2-3 grams daily thereafter. This protocol was first tested in 1996 with apparent positive results[48]. It’s been used ever since.

This maintenance protocol should have seemed a bit suspect to other researchers, but only if they’d taken the time to consider that a 150 pound male (approximately 70 kilograms) will burn through about two grams of creatine naturally every day[49]. Since 95 percent of creatine exists within muscle tissue, the average resistance-trained athlete would require greater amounts of creatine just to maintain normal cellular levels.

It wasn’t until 2003 that researchers tested this maintenance protocol using more advanced methods of determining intracellular creatine levels. The group found that after two weeks of using the standard maintenance protocol outlined above, intracellular creatine levels returned to baseline[47]. In other words, the maintenance procedure didn’t maintain anything.

NOTE: The 2g/day maintenance level is the current recommendation by the American College of Sports Medicine’s expert panel on creatine[50].

 

Get On the Right Track

Unfortunately, there’s no guiding research to be found regarding what it takes to actually maintain the supraphysiological values of intracellular creatine. All we know is that the current procedure sucks. I would guess, from examining the few dozen research papers available, that the amount you initially use is the daily dosage you should maintain.

Creatine dosageAs I said earlier, the majority of these papers simply used the standard 20 grams per day mark without any rhyme or reason. This was an arbitrary choice by early investigators, and for some reason it stuck. Only a handful of people used a formula that included bodyweight, but even they arrived at their conclusions by assuming that a 150 pound man should take 20 grams of creatine per day. Again, nobody tested the assumption.

This cannot possibly be the optimal dosing schedule for everyone. On average, humans carry about two grams of creatine per kilogram of lean muscle mass, which is about one gram per pound. The maximum amount we can shove into muscles is about 3g/kg (1.4g/lb)[51]. To hit this level, a 150 pound male would need about 25 grams of creatine supplementation.

Because of the gap in research, I have to make some assumptions, but I’ll make reasonable ones. When we use these numbers to look at whole-body creatine status, we see that in order to increase the amount of creatine we carry to a level above the baseline (1g/lb), we need at least two grams per day for maintenance, plus 0.4g for every lean pound of muscle. Using the example of a 200 pound male with 10 percent body fat, we can give a rough estimate of at least 60 pounds of skeletal muscle. This would yield a reasonable calculation of:

 (0.4g/lb * 60 lbs)/0.95 + 2g ≈ 27.3g

My hypothesis is that this would be the minimum amount of creatine needed on a daily basis to maintain maximum intracellular levels (the division by 0.95 takes into account the amount of creatine absorbed by the rest of the tissue in the body). I’m saying this is the minimum daily amount needed because the well-controlled research shows that using the standard 2g/day dosing returns intra-muscular levels of creatine back to normal within 6 weeks.

There may be a better way to estimate the minimum daily dose, but the data does not exist to make a better recommendation.

There’s no need for a loading period if you’re going by these formulas. If you’re fairly lean, this leads to a simple formula to calculate your daily creatine intake:

In Pounds: Bodyweight * 0.15 = grams of creatine monohydrate to ingest

In Kilograms: Body mass * 0.3 = grams of creatine monohydrate to ingest

Even though I started from the actual difference in what muscles can hold, you’ll notice that these calculations give numbers that approximate the 20 grams studies, since many of the participants were around the 150 pound threshold. Unfortunately, the researchers didn’t extend their research to include the rest of the world.

 NOTE: These formulas appear to overestimate needs, but since one gram of creatine monohydrate is only 88 percent creatine, the overage takes this into account.

 

As Simple as Possible, But Not Simpler

Creatine supplements come in several varieties. There’s creatine ethylester (CEE), Kre-Alkalyn® (KA), creatine monohydrate (CM)—and even anhydrous creatine (AC), which has nothing attached.

I won’t go over all of these in too much detail, because you can create as many versions as you want just by making a creatine “salt.” For example, creatine citrate is a salt of creatine. None of these versions—if they’ve even been tested at all—have ever been tested to the degree of creatine monohydrate.

Creatine monohydrateIn contrast to the others, creatine monohydrate (CM) is incredibly well-studied—and nearly every study referenced herein utilized CM. It’s one of the most stable forms of creatine in solution, it’s not degraded during normal digestion, and 99 percent is either absorbed by muscle tissue or excreted through sweat or urine[52-53]. It works, and it’s damned cheap, too.

A few times now, I’ve mentioned the degradation of creatine in water. Creatine, when put into solution, will curl up into itself and create an inactive molecule called creatinine, which is a metabolic waste product. The first time I asked a doctor about creatine, he told me it was a waste product of metabolism, and that ingesting large doses of it would kill me. He was confusing creatine with creatinine, and his basic knowledge of cellular metabolism was, in fact, dangerously poor.

This leads to our next version of creatine, creatine ethylester (CEE). Advertising hype behind CEE calls out to us from just about every magazine and website in existence, but that’s all it is: hype. CEE degrades rapidly into creatinine in solution—and under normal physiological conditions (ingestion), most of it is converted rapidly and exclusively to creatinine[54]. Researchers even found a case where the rate of conversion of CEE to creatinine was so rapid that it caused false positives for liver disease[55].

CEE is pure and total crap, and the only thing you should do with it is flush it down the toilet because you might actually poison yourself by taking it. At least my doctor may have been right about one form of creatine.

Through the citation of mysterious Bulgarian studies, the idea of a “buffered creatine” recently came into vogue—giving us the supplement known as Kre-Alkalyn® (KA). KA is actually a mixture of creatine salts, ash, and baking soda. You could recreate this stuff in your kitchen sink. Its manufacturer claims that KA produces a buffered solution of creatine that lasts longer before degrading, so more is ingested, making it ten times more effective than creatine monohydrate. They claim, in fact, that 1.5 grams of KA is equivalent to 10-15 grams of creatine monohydrate.

Think about this. Your body, on a normal day, burns a minimum of two grams of creatine. The makers of KA want you to believe that although you’re ingesting less than the minimum amount utilized by your body each day, it somehow magically morphs into the 20-30 grams necessary to reach supraphysiological levels of intracellular creatine. They’re counting on public ignorance for their marketing—a familiar tactic in the supplement industry, to be sure.

What about the idea of a buffered solution? By “buffered,” the manufacturers mean one that will neutralize acidity, which will slow the degradation of creatine into creatinine. They claim that this buffering effect helps more creatine to pass through your stomach for utilization. What they fail to tell you, however, are two things.

1. Creatine monohydrate, in water, creates an almost perfectly neutral solution, so no buffering is needed there before you ingest it[56].

2. High acidity—such as the type in your stomach—actually blocks the conversion of creatine into creatinine, meaning once you swallow your creatine monohydrate, very little degrades into creatinine no matter how long it takes you to digest it[52, 57].

Now that we know something about the basic acid-base chemistry of creatine—and that none of the claims about Kre-Alkalyn® could possibly be true or meaningful—we can look in one last place to see whether KA holds up: the peer-reviewed research. The Bulgarian studies are junk, since nobody reviewed the research before it was published on a sheet of toilet paper that was later discovered in a strip club on the bottom of an unscrupulous businessman’s shoe. The research that’s actually peer-reviewed backs up the facts about KA that we already derived from a quick analysis of the basic chemistry of creatine: KA does not even remotely meet label claims and doesn’t perform nearly as well as plain old creatine monohydrate[58].

 

Dosing Schedule

creatine supplement powder shaped like a bodybuilderDaily dosage of creatine, as is the case in the majority of the research papers on the subject, is broken into three or four equal doses, taken every day throughout the day. Again, this protocol has never been directly tested to see if it’s necessary to maintain supraphysiological levels of creatine.

One group of researchers did something interesting that suggests you don’t need to take creatine all day long, and that you don’t need to take it every day, as long as you’re averaging the necessary amount per day[59]. Instead of taking 30 grams per day, it may be possible to take 60 grams every other day, achieving the same results. If anything, this research leads me to believe that taking creatine in divided doses all day long is probably unnecessary. If this is the case, we can better time when we ingest our creatine for maximal results.

How should this timing go? In general, you’ll want to time it around how you eat. Ingesting creatine with large amounts of carbohydrates can actually increase retention of creatine within muscles[60-63]. Researchers haven’t explored the reasons for this, but they assume it has something to do with an interaction with insulin[63].

Although I think they’re on the right track, I think it actually has more to do with an interaction with GLUT4, which I’ll explain in a moment. For now, this tells us that, with Carb Back-Loading in particular, the absolute best time to ingest creatine is immediately post-training with carbs. You could divide your daily dose amongst these meals—and if you’re using creatine monohydrate, it’s possible that one large load will do the job.

Avoid taking your creatine in the morning if you’re a coffee drinker, or whenever you ingest caffeine. Creatine taken at the same time as caffeine, in the absence of carbs, can actually prevent a rise in intracellular creatine levels[28, 64]. The common point of interaction, as surmised above, may have something to do with the GLUT4 transporters, since caffeine can prevent GLUT4 activation.

Creatine interacts with GLUT4 proteins in some way that hasn’t been fully elucidated[65-66], but what this does tell us is that anything that increases GLUT4 content and translocation (carbs and resistance training) will improve the results of supplementation, and anything that doesn’t (caffeine and endurance training) will negate the effects. This also helps to explain why endurance athletes don’t seem to receive any benefit whatsoever from creatine supplementation.

Don’t take creatine with coffee. Do take creatine with training and/or carbs. Otherwise, take it however you’d like.

Read more about Creatine and Caffeine. 

Conclusion

Creatine is a powerful supplement, and it’s not something that can easily be explained on the label of a bottle. For years now, we’ve been relying on supposition—and the arbitrary whims of the original researchers—to figure out how much to take, and when to take it. This is poor science, and it’s unfair to you, the consumer. Now, after reading this three-part series, you’re armed with the knowledge to make intelligent choices regarding one of the few truly effective supplements on the market, free of bro-science and supplement manufacturer bullshit.

 

References:
 

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  • nolan

    Great article. Thanks for posting up this final part. I’ve read a fair bit about creatine over the past few years or so and find it to be a fascinating supplement so much so I recommended it to my parents, not that they lift however they can still reap benefits.

    questions (bare with me) – I read a study that suggested creatine and caffeine ingested together will interrupt or blunt intracellular creatine absorption however I’ve only read the one study. Is it really conclusive to exclude this? The CBL pre workout recommends both supplements. I’ve always wondered the need to include creatine in this pre workout shake if creatine levels are already stocked, as it were.

    A very well known expert in supplements who recommends nothing other than CM and, like yourself, disregards all other forms of creatine, has suggested a few requirements of supplementation. He recommends dissolving creatine in warm/hot water otherwise the creatine will simply pass thru the body unused. I can’t find a study on this but wondered if you’d heard similar or can substantiate the claim?

    Thanks Kiefer.

    • nolan

      Will Brink on Creatine – http://www.youtube.com/watch?v=SqY_JtJazyw

      • nolan
      • DHKiefer

        His opening premise is completely and absolutely false: that any creatine that doesn’t dissolve is not absorbed. Nothing he claims or says in the video is true or useful, other than hot water will dissolve more creatine than room temperature water.

        • nolan

          Thanks Kiefer. Another piece of “mythinformation” dead and buried.

          • Will

            Comments regarding me are in relation to a vid I did on fully dissolving CM before drinking. I may have over stated the importance of it in the vid, but, the fact is, creatine must be solubilized before it will get absorbed. There’s a number of papers confirming that unless there’s another route of absorption for CM I’m not aware of… It will either get solubilized in digestion or it can be done first in the glass.

            People who get stomach problems from creatine have been told to pre solubilize their creatine for decades. For people who get stomach upset, non responders (approx 30% of users) they may get better responses from fully dissolving, but that’s hypothesis on my part.

            Clearly, some of the creatine not dissolved in the glass will be made soluble and absorbed and I should have been clearer about that in the vid, but it’s well established in human digestion that compounds with poor solubility are often poorly absorbed. It’s also going to be dose dependent (large amounts of CM are more likely to not get solubalized and absorbed, causing stomach issues, etc) while smaller amounts, less so.

            At this point, I tell people If one has gotten good response from not fully dissolving, don’t sweat it, but it’s my opinion that fully dissolving *may* optimize absorption for some, reduces waste, may improve effects in non responders, and will reduce stomach discomfort in those who experience it with creatine.

            It’s also going to be individual. Back when loading was all the rage, some got killer cramps, the runs, and a bloated stomach from those mega doses, some had no issues. That was due to the hypotonic effects of large doses of CM. That’s all I plan to say on the matter. Use the info or ignore, all good with me.

  • Alan

    Kiefer,

    Does this alter your recommendations for pre- and post-workout nutrition regarding the interactions of not only caffeine and GLUT-4, but also the creatine, caffeine and GLUT-4 trinity?

    • http://bodynsoil.com/blog/ Bodynsoil

      I’m interesting in this as well as the book mentions caffeine and creatine taken preworkout and caffeine, creatine, leucine post workout.. I’m confused, I own both books, I didn’t get any updates or emails regarding this (or any other) protocol change.. Are updates pending for this, and all the other changes to the book, which I’ve read about in the forums (by a group of bro scientists.) I would prefer changes to come directly from the creator of the protocol as I trust that to be more on point..

      My question is this… Are the changes to the protocols and deviations from the book, which are discussed in the forums, accurate, and should I follow their BS (bro scientist) advice, or should I stick to the book as written?

      • John

        Well, in the book he says to not trust anybody else’s recommendation and only the things he says.

        With that, take what I say with a grain of salt haha. But in the article, the caffeine effects on creatine are with the absence of carbs (“Creatine taken at the same time as caffeine, in the absence of carbs, can actually prevent a rise in intracellular creatine levels”).

        I would follow the protocol in his book (5g pre and 5g post workout) and slam the rest of the creatine recommendations with your carby meals.

        I, at 195lbs on CBL, take about 30g of creatine a day as follows:
        1) 5g pre-workout (5:30pm)
        2) 5g post workout (~7:00pm)
        3) 10g w/ first carby meal (~8:30pm)
        4) 10g w/ last carby meal (Right before bed at around 10pm)

  • Shae

    Could you distill how much Creatine HCl would be required? It is a salt, yes, but it is highly acidic when applied to low volumes of water, preventing degradation to creatinine due to low pH. I know the designer studies showed a highly increased solubility (“59” times greater to that of monohydrate, I don’t know if that’s exactly accurate, I need to look at the studies after finishing my 2 weeks of exam hell) and half life. Here’s a link to the patent by Mark Faulkner: http://www.google.com/patents?id=Q_zvAQAAEBAJ&printsec=abstract&zoom=4#v=onepage&q&f=false

    • DHKiefer

      The question is, “why?” It is true that if you increase the pH of solution once the salt breaks down that you increase the solubility of the creatine, but only at pH’s above 7 and below 2.5 does the acidity make creatine more stable. In the middle range, it becomes less stable. There’s this “myth” that the more soluble creatine is in water, the more your body absorbs. This has never been proven. CM dissolves at 14 grams per liter, which sucks. Yet, we absorb nearly 100% during digestion. How much better can you get?

      • Shae

        Thanks for the insight! I’ll switch back after this batch, the stuff is expensive as hell anyways.

    • DHKiefer

      Also, if we’re only concerned with solubility, we could use dicreatinol sulfate with is 100 times more soluble in water…which kicks the hell out of Creatine HCL (out of most forms of creatine, actually).

      • Zenon Garnett

        A supplement i’m taking contains a mysterious ingredient called ‘dicreatine malate’

        so is this ingredient effective or total garbage?

  • Goto Dengo

    Great article, as always. Thank you very much. I have a question though – what about cycling creatine? Is it necessary/beneficial?

    • http://www.facebook.com/jerodL.brunick Jerod Brunick

      I am definately not an expert on this but it would seem to me that if the maintenance dosage utilized in research has been insufficient, then it would negate the resulting theory of a diminishing effect with prolonged usage. It would be only logical for the benefits to decrease over time with week dosage. It is an amino acid, and I have never understood why I should have to cycle it. Do you cycle off of protein? Does your car have more power if you run it out of gas from time to time? Maybe I am wrong, let me know if I am, always trying to learn.

  • bluprint

    Wow, so no coffee in the afternoon/evening since it interferes with GLUT4 translocation?

    Also, do you have a recommendation for sourcing creatine? Are they all (more or less) the same as long as it is CM?

  • Ralph

    This fixed some mistakes I’ve been making. Thank you!

  • http://www.facebook.com/ericalan333 Eric Alan

    very good article! but, quick question, nobody has ever deemed ceatine to be completely “safe”. now that we know what it actually does and how much you can supplement with, is it safe to say that there is no actual side effects, or risks taken when supplementing correctly with creatine monohydrate? if you search the internet with this you won’t find a straight answer anywhere.

  • http://www.facebook.com/profile.php?id=12924941 Josh Bobbitt

    I’ve read this a couple times, and I’m still trying to puzzle out the implications for me. I’m a morning trainer doing CNS. I always do coffee before training.

    Does a dose at night with an ULC meal make sense, or does it only make sense to load up after my actual Carb Nite?

    • Kyle Fenton

      Definitely the night before your training sessions.

  • http://www.facebook.com/people/Mohannad-Afeef/1403684150 Mohannad Afeef

    I know that this is Off Subject, but have you read any research on the possible uses of HMB? I know you have been a huge fan of Leucine. So, would adding like 3 grams or more of HMB along the usual doses of Leucine make any difference, good or bad?

  • OBARmuscle

    How long AFTER caffeine would carbs and creatine come into play? For example, on Carb Nites would you cut off caffeine 4hours before the first carb meal, or would 1 hour suffice?

  • AnguisViridis

    Great series, Kiefer – thank you very much!

  • Jason Detwiler

    Kiefer, can you provide some guidance on 5AM training WRT Creatine? I’ve been using your suggested pre/during workout coffee w/ coconut oil, 10g whey, 5g Creatine. PWO I use 2 scoops Blend H, 1 scoop (30g) Hydro Whey, 10g Leucine, 5g Creatine (optional 1-2 ripe bananas, depending on goals). From reading this article, I take it that I should increase the Creatine (200 lbs ==> 30g) and I should add it to my CBL meals at night so that it doesn’t interact with the coffee. Should I shift it all to the evening (I drink coffee w/ HWC and CCO during the morning) or keep the morning as is?

  • Ed

    i would be interested to learn the answers to Goto Dengo’s and Alan’s questions regarding cycling creatine and PWO nutrition, respectively. thanks. CBL rocks

  • Tuomo A.

    How much creatine is there in animal protein sources? Would you subtract that from your daily optimal intake and only supplement with the difference or is that taken into account when formulating the dosage suggestion?

    Also, as a side note. You state that a 200 pound guy with 10% BF probably has 60 pounds of muscle. Are you sure about that? That sounds awfully low. According to a recent body composition test my BF is 13% and I weigh 163 lb. Of that 82 lb is muscle mass according to the measurement (~58% of all lean mass).

  • http://www.facebook.com/dancerninja Kristin Laine Newman

    THANK YOU!

    I also would like to hear your take on cycling. I’ve never read anything persuasive about adverse effects, and it would seem that these “maintenance phases” force cycling and I’m wondering if that is where it came from.

  • Peter

    One simple question Kiefer – so how should we take Creatine? With water or somehow else?

  • http://twitter.com/marc_david Marc David

    At the end you say “Don’t take creatine with coffee.” But in the CBL manual 1.0, the Accelerator Shake calls for 5g of Creatine. Maybe best to ditch it there and just add it to the post workout shake and any shakes with carb meals after?

  • Guest

    So this means that if I wanna just drop a big spoonful of CM in my mouth and pound it down with my protein shake, it’ll be just as effective as putting it in a glass and making sure it has been completely and utterly dissolved..right?

  • http://www.facebook.com/bsjamin.smith Ben Smith

    Life is going to be so much easier now that I don’t have to worry about dissolving this shit lol. That’s unfortunate that there was not much research to be found. Great article nevertheless!

  • cookie

    “Creatine taken at the same time as caffeine, in the absence of carbs, can actually prevent a
    rise in intracellular creatine levels[28, 64].”

    So basically if your doing ULC PWO shake then ditch the caffine.

    “caffeine can prevent GLUT4 activation”

    ok, this has me confused. So NO caffine before strength training if you want the nutrient partitioning to occur?

  • Drewtai

    Kiefer, have you heard about Crea-Crete Creatine Hydrochloride? Im taking it 1 before and 1 after my workout. Each pill contains 750mg. Is it as effective or less?

  • http://twitter.com/DeSimoniDan Dan

    thx for the info, I understand the minimum daily dose post work out but what about non-workout days. Do you see this minimum as still beneficial for those of us that travel due to work.

  • Wade

    I’m confused, in your CBL book you give a recipe for an ignition shake that specifically calls for mct oil, 10 grams of whey protein, caffiene(coffee) and 5g of CREATINE. Why now do you say NOT to use coffee with creatine? Completely contradictory. Please make this clear.

    • Alexander

      Wade, I would suggest the study Kiefer cites had not appeared when he wrote CBL, as both the study by Frederico SC Franco, et. al. and CBL were published in the same year (2011). I believe this will be one of the issues Kiefer will be addressing in his next instalment of the book. If there are any other issues you come across, check the date of publication; studies are always being published, resulting in the nullification of recommendations.

  • Chris

    Hello Kiefer, I´m like many others confused about the Creatine/Caffeine Mix because it is not what you recommended in the book.

  • Magnum6

    Several people have commented without response on how this article clearly contradicts the “Ignition Formula” on page 131 of CBL and the Hypertrophic Potentiator on page 139 of CBL, both which combine 200-800mg of caffeine and 5g of creatine. Keifer – any comments or clarification?

  • A.M

    Would you recommend women afraid of water retention using Monohyrate? Im currently using KA, and have seen some changes in my body, but I don’t know if its the placebo effect now that I’ve read this. I take my KA in the morning rare workout at 5am on an empty stomach.

  • Steven

    Thanks for the info. You discuss achieving the optimum level. I’m curious if there is still a lesser benefit to taking less. Sorry if this was mentioned and I missed it.

  • Mark Tennis

    The poweders always mess up my stomach. I use the Dr Max Powers Creatine Supplements and its so much easier than making a shake everytime you need some creatine. You can pop them in a case and take them at work or even while you workout. The main thing is that this stuff works and you will see gains in strength and size but also some water retention.