Recently, the International Society of Sports Nutrition published a review in which it highlighted some of the frequently asked questions and misconceptions regarding creatine. Without going into details about its possible mechanisms of action and its already established evidence in improving sports performance, creatine remains surrounded by myths and errors despite its more than 500 articles. In this entry, we are going to analyze each of these errors, and I hope that from today, you can know a little more about this supplement.
One of the most common myths surrounding creatine supplementation has to do with water retention. Although it is true that mainly intracellular and extracellular water can increase in the first days of creatine supplementation, in the long term this has not been corroborated.
Perhaps one of the most surprising myths is the one that identifies creatine as an anabolic steroid. Although creatine can increase muscle mass and enhance performance, neither its chemical structure, mechanisms of action, nor of course, its safety and legality, are the same. Therefore, it is not an anabolic steroid.
One of the common concerns about the use and safety of creatine is whether it affects kidney function or not. Based on current scientific data, creatine does not appear to cause any kidney damage in healthy individuals at the recommended creatine intakes. It is important to clarify both aspects since in some of the case studies that attributed kidney damage to creatine, the doses used were 100 times higher than recommended or there was pre-existing kidney disease, intake of other supplements, or use of steroids. Therefore, current experimental and controlled research does not indicate that, at the recommended doses and in healthy people, creatine causes kidney damage.
Another of the issues that exist regarding creatine is its relationship with hair loss, which was attributed, based on data obtained from a study, to an increase in dihydrotestosterone (DHT), a hormone that is linked to hair loss through its binding to androgen receptors in the hair follicle of some men. Fortunately, these results have not been reproduced again, and current studies do not associate creatine consumption with increases in total, free, or DHT testosterone, and therefore, with hair loss.
Muscle cramps and dehydration have been other negative effects that creatine, unfairly, has had to face. However, experimental and clinical research do not validate these effects.
A sensitive topic regarding the use of supplements, even with scientific evidence, is their use in populations of children and adolescents (ages <19 years). While it seems safe and beneficial from a clinical point of view in different pathologies, in my opinion, I believe that, especially in children, supplement consumption should be avoided. As studies from more than a decade ago indicate, the use of supplements can, in certain cases, be a gateway to the later use of illegal substances. Moving to the other side of the age spectrum, creatine increasingly enjoys a larger scientific literature indicating its benefit in older adults, improving, among other things, the anabolic environment generated by strength training in these populations and thus mitigating the loss of mass.muscular that occurs with age. It is important to highlight that the effects of creatine supplementation in these populations on the preservation of muscle mass and its function have been seen when combined with strength training. Likewise, there is an emerging body of data that positions creatine as an effective supplement, when combined with strength training, for the improvement of bone mass.
A common belief among many creatine consumers is that it can increase their fat. However, as studies in different populations have shown, creatine does not increase body fat. In a recent systematic review and meta-analysis that included studies with adults over 50 years old who supplemented with creatine and did strength training, it was observed that compared to those who received a placebo, creatine consumers reduced body fat.
Something that interests all of us when it comes to supplementing has to do with the dose we should take for the supplement to be effective and also, of course, safe. Classic creatine studies showed how carrying out the so-called loading phase (20-25g/day, in several doses of 5g, for approximately one week or 0,3g/Kg/day for a week) effectively increased muscle creatine content. This phase was followed by a maintenance phase that included 3-5 g/day. However, lower daily doses to those established by the loading phase, that is, intakes between 3-5g per day for a minimum of four weeks, they seem to be equally effective. Although this will depend on the time you have available to optimize muscle creatine stores, so that, if it is limited, you can opt for the loading phase. But be careful, the loading phase can be accompanied by weight gain, which, depending on the sport you practice, may be detrimental. In addition, allow me to add that, although traditionally creatine use has been applied in strength or power sports, many other athletes can benefit from its use due to its effects on muscle glycogen recovery, post-injury recovery, hyperhydration, and improved heat tolerance in circumstances where there is exposure to high temperature and humidity conditions. In recent years, interest in its neuroprotective effects has also increased, making its supplementation extremely interesting as part of prevention strategies in athletes who practice sports with a risk of suffering a concussion.
Regarding the form of creatine, the market is flooded with different forms (creatine salts, complexes with other substances, etc.). However, the most studied and scientifically supported form remains creatine monohydrate. Among creatine monohydrates, the German patented ®Creapure has been reported to produce creatine with a 99,9% purity without contaminants. This is important since other sources, such as those originating from China, are processed differently, generating a greater amount of contaminants that can potentially compromise health.
References
Antonio, J., Candow, D.G., Forbes, S.C. et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 18, 13 (2021). https://doi.org/10.1186/s12970-021-00412-w
Forbes S, Candow D, Krentz J, Roberts M, Young K. Body fat changes following creatine supplementation and resistance training in adults > 50 years of age: A meta-analysis. Journal of Functional Morphology and Kinesiology. 2019;4:62.
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AUTOR
Fernando Mata ( Col. AND-01053)
MSc in Physiology; MSc in Biomedicine; MSc in Nutrition; PhD student.
General Director of the Center for Advanced Studies in Nutrition.
