Creatine Monohydrate Guide

Q What is creatine?

A Creatine is an amino acid (amino acids are the building blocks of protein) which is made in the body by the liver and kidneys, and is derived from the diet through meat and animal products. Creatine is categorized as a food supplement by the Food and Drug Administration (like a vitamin) and is available over the counter at drug stores and nutrition centers.

Q What does creatine normally do in the body?

A In the body, creatine is changed into a molecule called "phosphocreatine" which serves as a storage reservoir for quick energy. Phosphocreatine is especially important in tissues such as the voluntary muscles and the nervous system which periodically require large amounts of energy.

Q Why do athletes take creatine?

A Studies have shown that creatine can increase the performance of athletes in activities that require quick bursts of energy, such as sprinting, and can help athletes to recover faster after expending bursts of energy.

Q Why have I been hearing so much about creatine and neuromuscular disorders?

A Two scientific studies have indicated that creatine may be beneficial for neuromuscular disorders. First, a study by MDA-funded researcher M. Flint Beal of Cornell University Medical Center demonstrated that creatine was twice as effective as the prescription drug riluzole in extending the lives of mice with the degenerative neural disease amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). Second, a study by Canadian researchers Mark Tarnopolsky and Joan Martin of McMaster University Medical Center in Ontario found that creatine can cause modest increases in strength in people with a variety of neuromuscular disorders. Beal's work was published in the March 1999 issue of Nature Neuroscience and the second paper was published in the March 1999 issue of Neurology.

Q Why might creatine be beneficial to those with ALS?

A Beal suspects that the neuroprotective effects of creatine in the mouse model of ALS are due either to an increased availability of energy to injured nerve cells or to a blocking of the chemical pathway that leads to cell death.

Q If creatine proves to be just as effective in human ALS as it is in mice, what sorts of gains might we expect in people?

A This question can only be answered by studying the effects of creatine in humans with ALS. MDA is currently planning a multi-center human trial to test the effectiveness of creatine.

Q I have ALS and I've been taking riluzole. Given that creatine has been reported to be more effective than riluzole in mice with ALS, should I switch my medication from riluzole to creatine?

A Please keep in mind that, although the results of the studies are promising, the effectiveness of creatine in humans with ALS hasn't yet been tested (but see "clinical trials" below for information on upcoming trials). Also, riluzole and creatine may exert their neuroprotective effects by different mechanisms. Riluzole works by inhibiting the release of the neurotransmitter glutamate, which is thought to injure nerve cells in ALS through a mechanism known as "glutamate toxicity." Creatine, on the other hand, may help cells that have already been damaged to keep going longer by providing the nerve cells with extra energy, or by preventing the damage from getting worse. Because the two compounds may work by slightly different mechanisms, researchers hope that they'll have an additive effect together. Until we know more about how these compounds work, please don't change your medication regimen without first discussing the matter with your physician.

Q Why might creatine be beneficial to those with other neuromuscular disorders?

A The amount of phosphocreatine in the muscles of people with some neuromuscular disorders, such as mitochondrial myopathies or inflammatory myopathies, is lower than normal. Researchers suspect that creatine supplementation in these people may improve muscle strength by bolstering the muscles' energy stores.

Q For which human neuromuscular disorders was creatine shown to improve muscle strength?

A The study reported in the March issue of Neurology examined the effects of creatine on 81 people with neuromuscular disorders, including muscular dystrophies (myotonic, Becker, limb-girdle), a metabolic myopathy (McArdle's), mitochondrial myopathies (MELAS, MNGIE and others), spinal muscle atrophy, inflammatory myopathies (polymyositis, dermatomyositis, inclusion body myositis) and congenital myopathies (multicore and central core disease).

It's important to note that the authors found an average increase in strength over the entire group of people with neuromuscular disorders in response to creatine. There didn't appear to be particular neuromuscular disorders that responded better or worse to creatine supplementation, but the sample sizes were too small to rule out greater or lesser gains for particular disorders. This was a brief (less than two weeks) study and longer studies in groups of people with the same neuromuscular disorders are necessary to address this question.

Q I want to start taking creatine -- is it safe for my disorder and how much do I take?

A There's simply not a lot of information available about the safety of creatine for those with neuromuscular disorders. For the most part, athletes haven't experienced adverse side-effects from taking creatine, although recently there have been a few reports of kidney damage linked to creatine usage. Dehydration has also been reported to be a problem while taking creatine.

Athletes generally take a "loading dose" of 20 grams of creatine a day for five or six days, then continue with a "maintenance dose" of 2 to 5 grams of creatine a day thereafter. It's not known if these dosages are safe or effective for people with neuromuscular disorders. The pilot trial reported in the March issue of Neurology showed benefits from a 10-gram "loading dose" for five days, followed by a 5-gram "maintenance dose" for five to six days. However, this study lasted less than two weeks, so the long-term effects of creatine supplementation in people with neuromuscular disorders aren't known yet.

You should also be aware that creatine, because it's categorized as a food supplement by the FDA, isn't subject to the same stringent manufacturing requirements as medications. This means that the amount and quality of creatine that you purchase may vary from one company to another or even between batches from the same company.

Because there is so little information about the safety of creatine for people with neuromuscular disorders, you're urged not to begin taking this supplement without consulting your physician.

Q Are clinical trials being planned to determine safety and effective doses of creatine in humans with neuromuscular disorders?

A Yes. MDA is currently planning a multi-center trial to test the effectiveness of creatine in humans with ALS. MDA is also considering several applications from groups that want to follow up on strength gains from creatine for specific neuromuscular disorders.

Creatine Monohydrate: Most athletes, at one time or another, have toyed with the idea of supplementing with creatine. Creatine use is currently wide spread among athletes at the professional and amateur levels, but is quickly gaining acceptance among younger athletes at the high school level. Yet, despite creatine's increasing popularity, a lack of accurate information about this important nutritional supplement exists for the layperson. Moreover, misinformation and rumors about creatine and its alleged side effects flood the internet and popular press. There is an obvious need for unbiased and responsible information about creatine for the general public.

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How much creatine to take and when to supplement?

First of all, do not oversupplement!

Secondly, no single creatine dose is right for everyone. The creatine dose you choose depends on a variety of parameters.

Finally, as of yet, creatine doses have not been independently optimized for women, adolescents or the elderly, should this be necessary.

Doses of pure creatine monohydrate typically cited in the scientific literature range from between 2-25 grams per day for an average framed male (70 kilograms/154 pounds). The operative word here is PURE. If your particular creatine product contains additives , however, then amount of product you take will obviously be greater. Nevertheless, do not exceed the actual amounts of creatine prescribed below. Read the label of your creatine product CAREFULLY to determine the amount of creatine in each "recommended" serving size. Some creatine manufacturers are a little on the generous side when recommending creatine doses.

As far as creatine is concerned, more isn't necessarily better. The actual amount of creatine monohydrate taken in a single day should not exceed more than ten-times your normal daily turnover of creatine. Creatine turnover is a function of total muscle mass and for an average sized male is roughly 20 grams per day. How to accurately calculate your creatine dose according to these guide lines is described below.

8. How does creatine cause muscle growth?

Creatine promotes muscle growth in two principal ways.

Muscle Volumizing: The first and most rapid form of muscle growth involves the movement of fluids from the blood stream into skeletal muscle, causing them to swell. This process has been termed muscle volumizing , since muscles increase in volume (size) as a result of muscle fluid retention. This early phase of muscle growth can account for as much as 1-2 kilograms (2-5 pounds) of additional body mass during the first few weeks of supplementation.

Protein Synthesis: The second form of muscle growth is slower to be realized and involves the production of new muscle proteins, a process scientifically termed protein synthesis. On one level, available evidence seems to indicate that the process of muscle volumizing itself directly stimulates muscle protein synthesis. On another level, the fact that creatine supplementation increases our exercise capacity should also result in greater increments in protein synthesis in response to a training stimulus. Remember, exercise is an essential stimulus for muscle development. However, unlike the effects of muscle volumizing that disappear about one month of terminating supplementation, the ergogenic (performance enhancing) effects of protein synthesis will persist long after discontinuing supplementation.

Other Anabolic Effects: Preliminary evidence now seems to indicate that creatine supplementation might also influence growth hormone release independently of an exercise stimulus. Growth hormone is one of our most important anabolic hormones. Two other extremely important anabolic hormones are insulin and testosterone. The consequence of this novel effect of creatine would be a greater anabolic drive for the supplementing athlete. New evidence also suggests that creatine might possess antioxidant properties, which would translate into more effective muscle recovery following intense training sessions, possibly offsetting the onset of overtraining syndrome. These other possible attributes of creatine certainly merit further examination in controlled scientific settings and have important practical implications for the serious strength athlete.

TAKE HOME: The key to making the most of creatine supplementation lies in taking full advantage of this later (protein synthetic) phase of muscle growth. 

 Is it necessary to continue taking creatine to stay strong?

Unfortunately, some of the gains in strength (and size) you made while supplementing will disappear after you stop. This is inevitable and will take about one month, which is the time it takes for your muscle creatine levels to return to normal. These attributes are temporary since they only have to do with the presence of creatine within skeletal muscle cells, i.e., muscle fluid retention (muscle volumizing) and enhanced muscle energetics (increased ATP resynthesis).

However, any gains you made in physical performance as a result of the accretion of new muscle proteins will persists long after discontinuing creatine use. Fortunately, creatine supplementation is also a potent stimulator of muscle protein synthesis; a downstream effect of enhanced exercise performance as well as other anabolic properties of creatine The fact that certain biochemical indicators of protein synthesis increase in response to creatine supplementation is biochemical proof of this conclusion.

Correctly calculating your creatine dose:

Creatine supplementation is typically divided into three separate stages, loading, maintenance and wash-out.

LOADING: The loading phase is designed to quickly fill your muscle creatine stores in a matter of just a few days. During the loading phase take no more than 0.3 grams of creatine per each kilogram (2.2 pounds) of body weight. Divide this amount into four equal parts. Take one part every four hours.

DO NOT take your entire loading dose all at once. This will only result in most of the ingested creatine being excreted in the urine and may place an unwarranted stress on the kidneys and liver. Your body can only absorb about 5-10 grams of creatine at one time depending on your total muscle mass (or body weight by closest approximation).

DO NOT load for more than five days consecutively as this is the time it usually takes for your muscular stores to reach their maximal capacity. After your stores are full any extra creatine you ingest WILL NOT be absorbed by your muscles and will simply end up in the toilet.

In other words, taking your entire loading dose all at once or loading for more than five days is a waste of creatine and cash!

MAINTENANCE: Following the loading phase your creatine stores can be "maintained" full by ingesting just a few grams of creatine each day. During the maintenance phase of supplementation your creatine dose can be reduced to just a few grams (0.03grams/kilogram body weight) a day for no longer than one month. The maintenance amount just needs to replace the amount of creatine degraded on a daily basis. In case you haven't guessed the maintenance amount of creatine is roughly equal to your daily turnover rate of creatine.

Note: Creatine turnover simply refers to its spontaneous conversion into another molecule known as creatinine. Unlike creatine, creatinine has no energetic value and hence is of no value to an exercising athlete. Following formation creatinine leaves across the muscle membrane to be excreted in the urine.

WASH OUT: Following the loading and maintenance phases, a washout period is advised. The wash out period merely a precautionary measure (just in case there are side effects to creatine use) and allows your body to recover from the abnormally high creatine levels often associated with supplementation ("creatine_background.html" \l "Creatine Information 4"). At least one month is advised for complete wash out to occur.

Periodize: The cycling between periods of supplementation (loading and maintenance) and nonsupplementation (wash out) is known as periodizing. One period consists of single phases of loading, maintenance and wash out. Periods are cycled.

WHEN TO SUPPLEMENT: I recommend that you take your creatine as soon as possible after exercising. Immediately following exercise your muscles are most receptive to the anabolic (muscle-building) effects of insulin. Exercise also has other hormonal consequences that you should know how to fully utilize in order to maximize muscle growth.

Is Loading Necessary? A loading phase is not absolutely necessary to benefit from creatine supplementation. As little as 3 grams of creatine a day for three to four weeks has been shown to increase muscle creatine levels sufficiently to detect a clear difference in physical performance. Commencing supplementation with a loading phase has the advantage that the effects of muscle volumizing are noticed sooner.

Serum, Micronized, or Effervescent Creatines? The previously discussed guidelines were originally formulated for pure creatine monohydrate powder. For information concerning other forms of creatine you'll need to refer to the manufacturer's recommendations. "http://www.creatinemonohydrate.net/creatine" for information about various other creatine products. Here you can search for creatine serum, micronized creatine, effervescent creatine etc and get the manufacturer's recommendations and product details.

Creatine is, and always has been, a natural component of skeletal muscle. Creatine was first identified as natural constituent of skeletal muscle nearly two years ago by a French scientist named Chevreul. In fact, creatine originally derived its name from the Greek word of flesh, or Kreas. It should thus be no surprise that meat and fish are the richest natural sources of creatine.

We (omnivores) have two avenues from which to fill our daily creatine requirement. The body can either produce it from amino acids made available during the digestion of foods, or it can be obtained directly from sources of skeletal muscle (meat and fish) . Therefore, in one way or another, creatine is acquired from our diets.

To become physiologically active creatine must first be enzymatically transformed within the cell into another molecule known as phosphocreatine. Phosphocreatine is nothing more than a molecule of creatine with a covalently attached phosphate group. On average the body goes through about 2 grams of creatine (creatine and phosphocreatine) each day through a process of spontaneous degradation. This entails the spontaneous conversion of creatine into an energetically inert molecule known as creatinine.

The production of new creatine (synthesis) principally takes place in the liver and kidneys, although the pancreas also contributes to a lesser extent to the body's new synthesis of creatine. Creatine itself is an amino acid that is produced in a chemical reaction involving three other amino acids, arginine, glycine and methionine. Of these three amino acids, the requirement for dietary methionine is most critical, since the body does not readily produce it from starting materials.

Nearly all (95%) of our body's reserve of creatine is contained within skeletal muscle. The remainder (~5%) is found within the heart, brain and testes. These are all tissues with extremely high energy expenditures. Following ingestion (or synthesis) creatine is transported to our muscles where it serves to increase muscle energy levels. Creatine achieves this by increasing the availability of ATP, the cell's energy molecule . The chemical reaction that produces creatine in the liver, kidneys and pancreas can be viewed "http://www.creatinemonohydrate.net/Illustrations/reactions.html".

Recently it has become popular to supplement one's diet with synthetically produced creatine in hopes of enhancing athletic performance. Synthetic creatine is sold as citrate, phosphate or monohydrate salts. Creatine monohydrate is the most commonly used form in athletics and is nothing more than a molecule of creatine accompanied by a molecule of water. A gram of creatine monohydrate also contains more creatine than a gram of either creatine citrate or a gram of creatine phosphate. You therefore consume less creatine monohydrate powder to get the same amount of active creatine.

We typically notice an improvement in exercise performance when our muscle creatine levels increase by at least 20% as a result of creatine supplementation.

2. How does creatine work?

Simply speaking, creatine (phosphocreatine) increases muscle energy availability. The cells of our body store their energy in the form of a molecule known as Adenosine TriPhohsphate, or ATP. The amount of work our muscles can perform is a direct consequence of the amount of ATP they have stored at any instant as well as the ease with which ATP is regenerated with the help of phosphocreatine during strenuous exercise.

Think of ATP as the cell's energy currency and phosphocreatine as a credit card with a adjustable balance.

First and foremost creatine enhances physical performance by increasing the number of times that ATP can be recycled during physical exertion without increasing the absolute amount of ATP stored within our muscles. In the short-term this means that creatine supplementation should improve our ability to sustain near maximal force generation during repetitive bouts of intense exercise without actually increasing the amount of peak force we can produce. However, later on, given the "creatine_guide.html", this improvement in exercise output should then translate into an increase in maximal force generation through the production of new muscle tissue.

3. What are natural sources of creatine?

In one form or another, creatine is normally obtained from the foods we eat.

DIETARY CREATINE: Creatine is directly obtained from sources of skeletal muscle, ie meat and fish. During the digestive process the creatine contained within these foods is directly released into the blood stream where it is transported to skeletal muscle for absorption.

For example, 2-3 pounds of raw meat or fish contain the equivalent of 5 grams of pure creatine monohydrate powder ("creatine_doses.html" \l "Creatine Information 7"). Since heat degrades creatine, however, cooking will reduce their creatine content and increase the amount you'll need to eat to obtain a given amount of creatine.

CREATINE SYNTHESIS: When dietary creatine intake doesn't meet the body's needs, new creatine can also be synthesized from three amino acids; arginine, glycine and methionine. These amino acids are made available during the digestion of foods. Importantly, methionine availability sets an upper limit on creatine synthesis, since the body can not produce it on its own. Methionine must, therefore, be provided in our diets.

Interestingly, the ability to synthesize creatine appears to have evolved later on in the animal kingdom. Primitive organisms, such as invertebrates, do not possess the enzymes needed to synthesis creatine from amino acids, despite containing creatine in their tissues. These organisms must therefore take up creatine from their surroundings.

· Natural Creatine Champion: Since fish is one of the richest natural sources of methionine, eating fish provides both a direct source of creatine as well as an adequate supply of dietary methionine for new creatine synthesis.

In particular, sushi and sashimi (raw seafood) are excellent natural sources of creatine since they will retain much more of their original creatine content. Remember, heat (cooking) degrades creatine. I personally recommend maguro (tuna), sake (salmon) and saba (mackerel), since they are also exceptional sources of omega 3 fatty acids. Omega 3s are essential fats that are turning out to be invaluable for overall good health.

· Vegetarians: Vegetarians, whose animal protein intake is low, typically express lower than "normal" creatine levels. The same is true for lacto-vegetarians, which limit their animal protein consumption to milk and eggs. Creatine might therefore be advisable for athletes who purposefully restrict their animal protein intake.

4.How does creatine get into muscle?

From the blood creatine is transported into skeletal muscle by special transporter molecules on the muscle surface. The activity of these creatine transporters is influenced by the availability of creatine. For example, elevated plasma creatine interrupts creatine uptake into skeletal muscle via these transporters. The new production of creatine from amino acids is also stopped by elevated plasma creatine. These are examples of normal feedback regulatory processes that are common in biology. However, how exogenous creatine supplementation influences these processes in humans is still an open issue. This is why it is often recommended to periodically stop taking creatine to let the body recuperate ("creatine_doses.html" \l "Creatine Information 7").

Transporter function is also regulated by other physiological processes. For example, creatine transporter activity is enhanced by co-ingestion of highly glycemic foods, an effect mediated by insulin release. Therefore, taking measures to improve one's insulin sensitivity should enhance creatine uptake into skeletal muscle.

5. Do all muscles respond the same to creatine?

Not all muscle types respond equally to creatine supplementation. Muscles can be loosely described as either fast or slow. As the name implies, fast muscle fibers mediate abrupt movements. Fast muscle fibers are also those that predominantly use creatine energy production. Hence, explosive movements respond best to creatine supplementation.

Slow muscle fibers, on the other hand, do not rely that heavily on creatine energy production. Slow muscle fibers are also those that play an important role during endurance exercise. It follows that endurance tasks are influenced less by creatine supplementation. In addition, many endurance sports may be adversely effected by the increase in weight associated with creatine supplementation.

6. Does everyone respond to creatine?

Not everyone responds equally to creatine supplementation. It is estimated that between 20-30% of the population are nonresponsive to creatine use. This isn't to say that many "nonresponders" wouldn't convert to "responders" given the right circumstances (and information). For example, taking creatine with highly glycemic sugars is sufficient in many instances to convert nonresponders into full-fledged responders. ( \l "Creatine Information 4").

I would warn against, however, pounding your systems with highly glycemic carbohydrates in hopes of maximizing creatine absorption. When and how these sugars are taken is a very important consideration. The chronic consumption of highly glycemic sugars can eventually lead to a condition of insulin-resistance, which would be an anabolic dead end. In fact, insulin-resistance is currently one of America's greatest health problems. Insulin is one of your most important anabolic hormones (next to growth hormone and testosterone) and you wouldn't want to attenuate its effects.

An other important consideration is your existing muscle creatine levels. Persons with naturally high creatine levels typically benefit less from creatine supplementation. This is why vegetarians are such robust responders. Furthermore, the benefits your perceive from creatine use depend on the exercise task being used to measure its effectiveness ( \l "Creatine Information 5"). There is also some indication that creatine may be less effective in children and the elderly. ("creatine_side_effects.html" \l "Creatine Information 10") Finally, simple, every day, dietary habits, such as alcohol and caffeine consumption, can profoundly influence creatine's effectiveness.

How to optimize creatine transport into skeletal muscle in order to more effectively increase muscle mass and enhance athletic performance (while at the same time mitigating harmful side effects) is discussed in detail in my "creatine_guide.html" to creatine use.

Creatine monohydrate is a popular new supplement that serves as an

energy reserve in muscle cells. Muscular contraction is powered by

the breakdown of ATP (adenosine triphosphate) to ADP (adenosine

diphosphate). When all the ATP is broken down, creatine phosphate in

the muscle donates a phosphate group to ADP, and further energy

reactions can occur. Creatine monohydrate is a precursor to creatine

phosphate. By supplementing with CM, CP levels in muscle apparently

are maximized, and more muscular work can occur, since there are

greater energy reserves to use.

Creatine also helps with resistance training by bloating the muscle

with creatine rich fluid. This allows for greater leverage and

requires the muscle to move less and lift more weight. While this may

seem kind of trivial, some researchers today think that one of the

stimulating factors of steroid use is water retention. Anabolic

steroids may actually work in part because of cellular fluid retention

in the muscles. The swelling action and the related stretching of the

cells may in and of itself cause a reaction which stimulates the

muscle cells to grow. So in some respects creatine might be as good

as steroids.

The good: Many people report increasing their lean muscle mass

between 6 and 10 lbs while using CM, though gains seem to stop after

that point. CM is nontoxic, even in large amounts.

The bad: Some people report symptoms including headaches, clenched

teeth, and the sound of blood rushing in their ears while using CM.

Creatines effects on blood pressure are an open question. Since it

has the effect of fluid retention in muscle, it might increase blood

pressure in the same way high sodium levels do, but this has not been

established or refuted. Also, it is expensive.

In addition to this, one other symptom reported is stomach cramps. Reducing the intake of creatine lead to a reduction in severity of the cramps.

Creatine seems to be well studied in scientific research. (See Section 6 - Further Reading). Scientific evidence supporting creatine is there, but while some very good results have been reported, like a 20 lbs body weight gain in 6 weeks and strength increases, others have reported no significant gains whatsoever while taking the supplement. Like all supplements, supplementing creatine is useless if your body already has enough of it. Further supplementation is then not needed and just a waste of money. If however, you do not have the optimal levels of creatine in your muscle cells, then supplementation is a good idea which can really enhance your training. Some people get minimal or no effect from creatine. This is probably due to their already high creatine levels due to dietary intake or perhaps the efficiency/inefficiency that they produce ATP. If you take creatine monohydrate and don't notice any results in about 2 weeks it's a good bet that you're one of these people. Once you plateau, your muscle cells will probably be saturated with creatine and since the body loses about 1-2% creatine a day you should be able to get away with cycling on and off creatine to lengthen your results. Once you stop creatine supplementation and your body clears it 100% (about 2 month process) you'll probably be back at your old strength and muscle mass levels. Of course the gains in mental ability (I've done this beore I can do it now) and tendon/skeletal strength increase resulting from these heavier workouts will remain.

Pharmacology

Creatine occurs in highest concentrations in skeletal muscle, followed by cardiac and smooth muscle, brain, kidney and spermatozoa. Strenuous exercise rapidly uses up cellular reserves of creatine phosphate to replace ATP, the only chemical that powers muscle contraction and relaxation. Creatine Monohydrate is a very bioavailable source of creatine, which can readily combine with normally abundant phosphorus stores to replace creatine phosphate. Six subjects performing 5 sets of 30 maximal contraction with one-minute recovery periods had greater peak muscle torque production in the final 10 contractions of set 1, throughout sets 2 to 4, and during the middle ten contractions of set 5 after creatine monohydrate supplementation for 5 days, compared to baseline performance and to six subjects taking placebos. They also had lower plasma ammonia accumulation, supporting the hypothesis of improved ATP replacement. No difference was seen in blood loctate levels. The body shows an adaptive response, building creatine stores in the muscles more rapidly when subjected to at least an hour a day of intense exercise along with frequent creatine-loading. "One hour of hard exercise per day using one leg augmented the increase in total creatine content of the exercised leg, but had no effect on the collateral.

5. Proper usage

Of course, first read the label and any additional leaflets that come with your brand of creatine monohydrate.

Usually, the use of creatine is split into a loading and maintenance phase. During the loading phase, large quantities of creatine monohydrate are taken. Because the creatine only slowly disappears from the body, a maintenance phase in which less creatine is taken will still provide the body with adequate levels of creatine. For suggested duration of the phases and quantities see below.

It is recommended to drink lots of water while on the creatine.

[From the Training-Nutrition faq: Powder form is preferred over capsules.

Most users recommend a loading phase when first starting with CM. For 5 to 7 days, take a teaspoon (approx. 5 grams) 5 times per day. After that go on maintenance at 5 grams twice per day.]

Note: it is discouraged to use caffeine while on creatine; while creatine makes your muscles hold water, caffeine will do the opposite, thereby reducing the effects of the creatine intake.

Don't mix creatine with citrus juice. Orange, grapefruit, cranberry, in fact, most fruit juices have been most recently found to neutralize the activity of creatine monohydrate. The reason is the waste product creatinine develops. A lot of you put creatine on your tongue and drink it down with grapefruit juice. If you have taken creatine this way in the past, stop it now! You are not getting creatine, you're getting waste product.

Do mix creatine monohydrate with warm water--in a glass. This is the only way to ensure you're getting the full benefits of creatine in its dry form. Creatine does not have to dissolve to be effective.

Do be sure to drink a full eight ounce glass of good water 8 times a day. Creatine pulls water from other parts of the body to perform its work in cell volumization of the muscle. This is what makes the muscle larger and firmer. Replenish your H2O!

Creatine (creatine monohydrate) dosage derived from works by Pierre Dahl (nutritionist at NSTC in Stockholm, Sweden) and professor Hultman (at Huddinge Hospital in Stockholm, Sweden)

Creatine Monohydrate, aka creatine, has been shrouded in controversy for the last decade. Those that support its use, often do so blindly without acknowledging possible ill side effects. Conversely, those who are against creatine use are often not well informed and formulate rash judgments. Either scenario is disconcerting. Also be aware that many creatine informational sites are no more than back doors to nutritional supplements dealers and in this respect their objectivity may be in question. There is a clear need for objective information on this issue.

Although creatine's influence on physical performance has been well documented since the turn of the century, it only recently came into public view following the 1992 Olympics. With the help of creatine many British athletes excelled in the Barcelona Olympics. This is, in fact, understandable since much of the early creatine research was conducted in the UK and Sweden. Allegations of wide scale use by the Soviet block countries prior to the 1990's are still a matter debate.

Creatine is a multibillion-dollar industry and its popularity is only increasing. Creatine is commonly employed by professional and amateur athletes and is increasingly gaining popularity among high school athletes. Let's face it, creatine is here to stay! Chances are someone close to you (maybe yourself) is considering creatine at this vary moment. Otherwise you wouldn't be here - right?

The creatine field is changing so rapidly that current information is outdated in a matter of weeks. It is therefore of utmost importance to get the most recent information. The information in this site is updated frequently as to reflect the latest findings. So, visit us regularly.

Creatine is currently not considered doping by the IOC (International Olympic Committee). Additionally, the FDA (Food and Drug Administration) does not consider creatine a drug, but rather a nutritional supplement, and, therefore, is not subject to the same level of scrutiny as other agents used in athletics.

There is a lot of misinformation circulating about creatine. Rumors abound as to possible side effects arising from creatine use. We have heard allegations of increased aggressiveness, hair loss, stunted growth, stimulated growth, and breast formation in men resulting from creatine use. Some side effects have been substantiated in the scientific literature while other have not. Furthermore, not all of the side effects reputedly connected with creatine use are deleterious. Others, on the other hand, need to be taken seriously. Potential adverse side effects would be most critical in children and women who are pregnant or nursing.

Who Invented Creatine?

No one really invented creatine. More precisely, creatine was discovered. In 1835 a French scientist named Chevreul discovered a component of skeletal muscle that he later named creatine after the Greek word for flesh, or Kreas (1). Therefore, although creatine may seem like something new, the scientific community has recognized it as a natural constituent of muscle for nearly two centuries. Our first indication that muscle creatine content is necessary for muscular activity came with the observation that wild animals contain disproportionately more (about 10-times more) creatine than animals kept in captivity (2). Near the turn of the century the first studies examining the effects of creatine feeding were conducted. It was noticed that not all the creatine fed to subjects could be recovered in the urine, indicating that the body, i.e. skeletal muscle, was retaining some of the ingested creatine. In fact, skeletal muscle, as well as being the largest sink for dietary creatine, is also the richest natural source of the nutrient. Thus, whenever we take a bite of steak (skeletal muscle) creatine is made available to our muscles for absorption. It is now estimated that most of us (non-vegetarians) receive approximately one gram of creatine each day in our diets.

What is creatine monohydrate?

Given the previous historical perspective, the notion of enhancing physical performance by ingesting synthetically produced creatine was an idea whose time had come with the development of synthetic chemical production. Prior to this advance creatine was either isolated directly from skeletal muscle or collected from the urine of animals. These approaches were expensive, laborious and yielded very little creatine in the end. With the advent of synthetic production, however, creatine was then readily available for widespread use in the athletic arena and for scientific investigation.

The most commonly used form of synthetic creatine is the monohydrate salt, creatine monohydrate. Creatine monohydrate is simply a molecule of creatine accompanied by a molecule of water for stability.

The first study that clearly demonstrated an effect of creatine monohydrate in humans was conducted in the lab of Dr. Eric Hultman of the Karolinska Institute in Sweden (3). This study found that ingesting 20 grams of creatine monohydrate daily for 4-5 days increased muscle creatine content by approximately 20%. An increase in muscle creatine content of this magnitude is more than sufficient to notice an enhancement in exercise performance during explosive bouts of exercise. Therefore, exercise tasks that benefit most from creatine supplementation are sprinting events of less than 10 seconds duration and repetitive maximal effort movements. Oh, by the way, the year this pivotal study appeared was 1992, the same year creatine made its controversial public debut in the Barcelona Summer Olympics. During these games the success of the British track team was allegedly due to the use of creatine; partly scandal and partly truth.

Modern Dosing Regimens

LOADING PHASE: In accordance with this dosing protocol most athletes commence creatine supplementation with a loading phase. The purpose of the loading phase is to quickly fill one's creatine stores in a matter of just a few days. A typical loading phase might be 20 grams of creatine monohydrate daily for five days. The loading phase should not exceed the time it takes our muscle creatine stores to saturate, approximately five days.

MAINTENANCE PHASE: Following the loading phase a maintenance phase should then be implemented with the sole purpose of "maintaining" our creatine stores full. The maintenance dose should just cover the amount of creatine degraded on a daily basis; equivalent to about 2 grams for a normal sized male. It is recommended that the maintenance phase not extend beyond 6-8 weeks. The reasons for this will become clearer below.

Calculating Creatine Doses

Obviously, an individual's capacity to store creatine should ultimately depend on the amount of muscle mass they possess. For this reason exactly you should adjust your creatine dose to match your bodyweight. According to Hultman et al. (4) during the loading phase take 0.3 grams of creatine monohydrate for each kilogram you weigh. The maintenance dose is 10-times less, or 0.03 grams of creatine monohydrate per kilogram of body weight. To calculate you creatine dose in pounds simply divide your bodyweight in pounds by 2.2; 1 kilogram = 2.2 pounds. In other words, an "average" sized male of 154 pounds, weighs 70 kilograms, or 154 divided 2.2. The next step is to multiply your weight in kilos by the appropriate dose. For example, our average person would load with 21 grams of creatine monohydrate per day (0.3 x 70 = 21) and maintain with 2.1 grams of creatine monohydrate daily (0.03 x 70 = 2.1).

Incorportate a Wash-out Phase.

Today it is frequently advised that a washout-out phase be incorporated following the maintenance phase. The wash out phase is an addendum to the original supplementing method of Hultman, Greenhaff and colleagues and is merely a precautionary measure in case there are any adverse consequences to creatine use. I personally recommend that you wash out for one month following every two months of supplementation. This amount of time should be sufficient to allow your system to return to normal after ceasing supplementation. After wash out supplementing can commence anew with a loading phase. Well, so much for the basics of creatine supplementation. We'll next discuss why creatine works.

Why does creatine make us stronger?

Any activity a cell undertakes is paid for with molecules of adenosine triphosphate, or ATP. This is true whether the creatine was produced in a test tube or in the liver. Simply, ATP is a molecule of adenosine attached to three phosphates molecules. Through the ages the cell has learned to store energy in the bonds between phosphate groups. ATP pays one phosphate group for just one tiny part of a single muscle fiber to move. Large, multi-joint movements can cost millions of phosphate groups! After being spent ATP becomes ADP, adenosine diphosphate, which has much less spending power.

This is where creatine comes in. Creatine quickly replaces ATP's spent phosphate group. Think of this as a loan. Creatine accomplishes this by obtaining a phosphate group of its own to become phosphocreatine, or PCr. It is this phosphate group that PCr later donates to ADP to recreate ATP. The end result is that ATP is recharged to power muscular activity with the help of PCr.

Therefore, to conclude this part of the article: 1. Creatine is something our body naturally contains and acquires as necessary. 2. Ingesting synthetic creatine monohydrate appears to do the same as naturally derived creatine. That is, increase exercise capacity by increasing the amount of creatine inside our muscles.

 Is it possible to take too much creatine monohydrate?

Obviously, ingesting more creatine monohydrate than our muscles can actually absorb is too much. In the previously mentioned study by Harris et al. (3) it was shown that one gram of creatine was not enough to significantly raise serum creatine levels above those typically observed. By stark contrast, ingesting 5 grams of creatine increased blood creatine levels 10-20-fold over normal! In other words, somewhere between one and five grams of creatine monohydrate our muscles stop absorbing creatine and most of the ingested creatine remains in the blood steam. Therefore, taking more than five grams of creatine at one time is clearly a waste of creatine. For this reason most athletes divide their daily LOADING amount into five gram increments taken every three to four hours depending on the total loading dose amount.

The MAINTENANCE dose, by contrast, is taken in one shot. I suggest that you take your maintenance dose following exercise.

5 x 5 Rule

Unabsorbed creatine is cleared from the blood by the kidneys and subsequently excreted in the urine. The clearance rate of creatine varies depending on the dose size and frequency. For example, blood creatine levels return to normal within a few hours after ingesting a single dose of five grams of creatine monohydrate. On the other hand, taking 5 grams of creatine every 3-4 hour sustains blood creatine levels well above normal levels for as long as dosing continues at this rate. Furthermore, the amount of creatine discarded in the urine steadily increases under these dosing conditions. For example, the Harris study (3) found that on the first day of loading only 40% of the ingested creatine could be recovered in the urine. Just two days later, by contrast, nearly 70% of the creatine ingested in present in the urine. This is the expensive urine some of you might have heard about. This means that our muscles gain less and our kidneys work more as loading progresses.

There is thus no benefit to LOADING for more than 5 days straight with more than 5 grams of creatine monohydrate at a shot, even if you repeat your 5 gram shots every 3 to 4 hours; My 5 by 5 rule.

Is creatine monohydrate harmful?

In my opinion creatine use has four possible avenues that might ultimately lead to adverse consequences. Firstly, abnormally high levels of creatine in the body have been shown to halt the absorption of creatine by skeletal muscle. This is a classic example of biological feedback. The production of creatine in the liver is also subject to this same negative feedback mechanism; creatine production is interrupted when creatine availability is high. These physiological responses make sense since the body should not have to waste energy storing or producing creatine if it is already present at high levels. It is thus possible that exposing the body to elevated creatine levels for prolonged periods might shut off creatine absorption and synthesis for longer than actually necessary. In short, the reversibility of this effect needs to be better understood in humans. The second avenue is that creatine use causes our muscles to retain water making them swell. This is a process known as muscle volumizing. Certain types of athlete, such as bodybuilders, might find this effect desirable because of the pump that ensues. Other athletes, on the other hand, may find that the increase in body mass is a detriment to their performance. It is easy to imagine how a few extra kilos might compromise one's performance in the marathon. Closer consideration, however, reveals that muscle volumizing might equally lead to dehydration and muscle cramping if not compensated for by adequate fluid intake. The third potential problem (alluded to earlier in this article) is the extraordinary stress creatine use might place on the kidneys, especially during the loading phase. During the loading phase the kidneys have to work extra hard to remove any unabsorbed creatine from the blood stream. Therefore, I highly recommend that you not extend the loading phase for more than five days and that persons predisposed to renal complications, such as diabetics, abstain from using creatine. Fortunately, scientific studies have preliminarily indicated that short- and moderate-term creatine use is well tolerated by persons with normal creatine function (5). A final potential problem is that creatine is not regulated by the FDA taking a lot of the responsibility away from creatine manufacturers. This in combination with the fact that creatine is a multi-billion dollar industry is a formula for abuse. Fierce market competition has caused creatine manufacturers to relax quality control measures in order to keep production cost low and to remain competitive. On the up side, this has caused a huge drop in the price of commercial creatine monohydrate. On the downside, certain contaminants that might possess adverse properties could be escaping detection. This is particularly true for cheaper brands of creatine and is especially worrisome during the loading phase when grams of contaminants could potentially be consumed weekly. Buy your creatine from a reputable manufacturer!