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.

As 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.

In 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

Daily 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:

 

Featured Image By: neliconcept