Many athletes take creatine as a dietary supplement to improve their performance and build more muscle. Here’s what the evidence actually shows.
Author: Dr Christian Heinrich
An old trend, revisited: Many athletes take creatine as a dietary supplement to improve their performance and promote muscle growth – often spurred on by social media and fitness influencers. At the same time, there are many misconceptions circulating about the effects, benefits and potential risks of creatine. Who might benefit from creatine, when is it of little use – and what should you bear in mind when taking it?
What is creatine and what role does it play in muscle function?
Creatine is a compound consisting of carbon and nitrogen, found mainly in the muscles. There, in the form of creatine phosphate, it helps to provide energy. The body produces creatine itself, in the kidneys and liver, amongst other places. Creatine is also obtained from food; it is found in particular in meat, fish and milk.
Through normal muscle movement, the body uses up around 2 grams more creatine each day than it produces itself – in other words, the creatine stores in the muscles are depleted slightly. The creatine stores in the muscles are replenished by the creatine the body produces anew and that it absorbs from food.
Why do some male and female athletes take creatine as a supplement?
When a muscle is particularly active – for example, during training or in sporting competition – it uses up more creatine. After a short delay, the body replenishes these stores. To replenish creatine stores more quickly or to ensure that a large amount of creatine is always available, some athletes take creatine powder as a dietary supplement.
“This trend emerged following the 1996 Olympic Games in Atlanta. It is currently particularly popular amongst young recreational athletes. The idea behind it is to use creatine powder to train more intensively, thereby optimising performance and recovery,” says Dr Lars Donath, Professor at the Institute for Training Science and Sports Informatics at the German Sport University Cologne.
How effective is creatine supplementation?
In fact, supplemental creatine has two effects, both of which have been demonstrated in numerous studies.
- On the one hand, higher creatine stores in the muscles lead to a slight increase in performance, at least during short, high-intensity exercises – such as particularly heavy weightlifting or short-distance sprints. In endurance sports, however, scientific studies suggest that creatine offers no additional benefit.
- On the other hand – possibly due to the potentially increased training intensity – taking creatine for several weeks can have a positive effect on muscle and strength development. However, this requires training several times a week and at a sufficiently high intensity.
What is the recommended daily intake of creatine?
“It is now widely accepted that creatine, as a dietary supplement, can support training and muscle growth,” confirms Donath. “When taken over a longer period, the additional intake should not exceed 3 grams per day. For someone weighing between 80 and 110 kilograms, 3 grams a day is fine, but it shouldn’t be much more than that. However, creatine is often not needed at all: a balanced diet is entirely sufficient for most ambitious, strength-focused amateur athletes,” says Donath.
What are the benefits of taking creatine?
“Increasing training intensity with the help of creatine is nothing more than the icing on the cake that you can add to your normal training regime. The vast majority of amateur athletes do not need such dietary supplements,” says Donath, adding: “The evidence base for under-18s is also rather limited; in this case, a more cautious approach to using creatine as a dietary supplement is advisable.” According to the Consumer Advice Centre, children and young people should not take such supplements at all without a doctor’s prescription.
If you want to keep your creatine stores topped up, there’s no need to resort to dietary supplements, says Donath: “For amateur sportspeople, eating salmon or meat several times a week is enough to ensure a good intake of creatine.” This is because creatine occurs naturally, primarily in meat and fish.
Vegetarians and vegans
There is no clear-cut answer as to whether it is beneficial for vegetarians to take creatine as a dietary supplement. Vegetarians generally have lower muscle creatine levels than those on a mixed diet. If they take creatine as a dietary supplement, their creatine levels rise. In fact, the increase is greater than when omnivores take creatine supplements. However, there is no clear evidence that this also leads to a corresponding improvement in performance. As the creatine in dietary supplements is synthetically produced, it can also be taken by people who follow a vegan diet.
Older people
The loss of muscle mass and muscle strength is a common sign of ageing. This is known as sarcopenia. A lack of physical activity and a diet low in protein are considered the main causes. Furthermore, a certain degree of muscle loss is normal in old age unless specific measures are taken to counteract it. This is because, as we age, muscle cells become less responsive to stimuli that trigger muscle growth. That is why ageing researchers emphasise the importance of strength training and an adequate protein intake in old age to prevent sarcopenia.
Whether taking creatine as a supplement offers any additional benefits is the subject of scientific studies. In fact, creatine – when taken alongside appropriately dosed strength training – does have an effect on muscle strength, but only a very slight one. Under no circumstances can this dietary supplement replace strength training and an adequate protein intake. Furthermore, sufficient creatine can also be obtained through diet. Dietary supplements are therefore not actually necessary, and people with medical conditions – such as kidney disease – in particular should always consult their doctor before taking creatine.
What are the risks associated with taking creatine as a dietary supplement?
People with kidney disease or conditions that may also impair kidney function, such as high blood pressure and diabetes, may experience problems as a result of taking creatine. The reason is that excess creatine is excreted via the kidneys. If kidney function is impaired, creatine is stored in the kidneys, which can cause further damage to them. Pregnant women, breastfeeding women, children and adolescents should not take creatine, or should only do so on medical advice.
Apart from risks associated primarily with existing kidney conditions, however, taking creatine is generally considered to be low-risk. “Based on current knowledge, taking it over several years is usually safe,” says Donath. However, taking creatine can lead to weight gain. This is because water is also retained when creatine is absorbed into the muscle cells. Experts are debating whether this slightly increases the risk of injury. Long-term use may lead to further weight gain – although this is primarily an increase in muscle mass. Side effects such as gastrointestinal complaints, headaches and muscle cramps are also possible when taking creatine.
According to Donath, if creatine is taken as a dietary supplement in powder form, it is important to pay attention to its quality. Many dietary supplements contain additives or even harmful substances, meaning they are not pure. “It’s a good idea to seek advice from a pharmacist,” says Donath. Furthermore, it is important to always incorporate supplementation – as the intake of dietary supplements is known – into a healthy and varied diet.
