Creatine Pros And Cons (Know These Before Taking It)

When considering using a supplement, weighing the pros and cons is good to determine whether it is worth trying it out.

Creatine is the most extensively researched supplement on the market, and when used in appropriate dosages, the pros will most likely outweigh its cons.

Creatine Pros

1. Enhanced Recovery

Athletes can benefit from incorporating creatine supplementation into their routine to aid recovery after rigorous training.

This is because it helps boost creatine stores and glycogen stores after exercise ^[1]. In addition, having creatine after exercise can help reduce muscle damage and inflammation after exercise ^[2,3].

For context, let’s look closely at some of the studies on creatine and recovery.

One study ^[4] found that the simultaneous consumption of creatine (5 g) with substantial glucose (95 g) resulted in improved storage of both creatine and carbohydrates in muscle tissue.

Another study on twelve men between the ages of 19 and 28 ^[1] found that engaging in creatine loading before an exhaustive exercise session, coupled with glycogen loading, resulted in more substantial glycogen restoration than relying solely on carbohydrate loading.

Replenishing glycogen fosters recovery and prevents overtraining in intensified training phases ^[5].

Including creatine supplementation could benefit athletes who extensively deplete glycogen levels during training or performance, helping them maintain optimal glycogen levels.

In a study on marathon runners ^[3], researchers studied how taking creatine before a 30 km race affected inflammation and muscle soreness in experienced marathon runners.

They found that creatine reduced the changes in certain markers related to muscle damage (which included CK by 19%, prostaglandin E2 by 61%, and TNF-alpha by 34%) and prevented an increase in lactate dehydrogenase (LDH) compared to those who didn’t take creatine.

Reducing LDH can be beneficial for recovery because LDH is an enzyme associated with the breakdown of lactate, a byproduct of intense exercise.

Elevated levels of LDH may indicate increased muscle damage and inflammation. By minimizing the increase in LDH, creatine supplementation suggests a potential reduction in muscle damage, which could lead to less post-exercise soreness and faster recovery.

A similar outcome was observed in sprint athletes ^[6].

There are many more studies on the benefits of creatine for recovery, which could be a whole article in and of itself. Still, the most important thing for you to take home is that creatine is a fantastic, science-backed tool to enhance recovery and tolerate higher training loads and volumes.

2. Injury Prevention

Numerous studies have indicated that incorporating creatine supplementation during training or competition can reduce the occurrence of musculoskeletal injuries.

In a study specifically focused on assessing the safety of creatine supplementation, American collegiate football players consumed approximately 16 g/day of creatine for 5 days and 5–10 g/day for 21 months.

They showed no clinically significant differences in markers of renal function, muscle and liver enzymes, catabolism markers, electrolytes, blood lipids, red cell status, lymphocytes, urine volume, clinical urinalysis, or urine specific gravity compared to controls ^[7].

Moreover, creatine users experienced less cramping, heat illness/dehydration, muscle tightness, muscle strains/pulls, non-contact injuries, and total injuries/missed practices than those not using creatine ^[8].

Similar positive outcomes were observed when the same researchers continued to examine injuries ^[9] in a study looking at injury rates during a 4-month American collegiate football season among creatine users (0.3 g/kg/day for 5 days, 0.03 g/kg/day for 4 months) and non-users.

The researchers reported that creatine users had significantly fewer instances of muscle cramping, heat illness/dehydration, muscle tightness, muscle strains, and total injuries than athletes who did not supplement their diet with creatine.

3. Improved Recovery From Injury

Creatine helps to prevent injuries and helps athletes recover from them more efficiently. Because creatine leads to increased muscle mass and strength, researchers were interested in how creatine can prevent muscle loss when a limb is immobilized during rehabilitation after injury ^{[10, 11]}.

In one study ^[12], individuals with a cast on their right leg for two weeks took creatine supplements (20 g/day, later reduced to 5 g/day) during a 10-week rehabilitation phase involving knee extension exercises three times a week.

The creatine group showed more significant improvements in muscle size (+10%) and strength (+25%) than those without creatine. This was linked to increased levels of critical muscle-related proteins.

Another study ^[13] found that creatine supplementation prevented muscle protein decline during immobilization and increased protein content during subsequent rehab training.

In other words, taking creatine reduced muscle loss and enhanced strength gains during recovery.

On the flip side, it was found ^[14] that using creatine supplements (20 g/day for 7 days, then 5 g/day) didn’t have a significant impact on strength or functional capacity in patients recovering from anterior cruciate ligament (ACL) surgery.

Additionally, another study ^[15] discovered that creatine supplementation (20 g/day for 6 days) did not improve the 800 m wheelchair performance in trained spinal cord injury (SCI) wheelchair athletes.

While not proven in all studies, there is some evidence that creatine supplementation might reduce muscle atrophy after immobilization and aid recovery during exercise-related rehabilitation in certain groups.

Thus, creatine supplements could be helpful for athletes and individuals recovering from injuries ^[10].

4. Enhanced Ability To Tolerate Exercising In The Heat

Contrary to popular belief, creatine does not cause dehydration but can protect against dehydration in hot environments.

Like carbohydrates, creatine monohydrate has properties that allow it to retain a small amount of water. Early studies found that creatine loading could lead to a brief increase in fluid retention, usually around 0.5 – 1.0 liters, corresponding to the temporary weight gain observed ^{[16, 17]}.

This sparked interest in exploring whether creatine supplementation could help athletes stay well-hydrated and potentially enhance their ability to exercise in hot conditions ^{[18, 19, 20, 21, 22, 23, 24, 25, 26]}.

In a study on endurance athletes ^[26], researchers studied the impact of taking creatine supplements (20 g/day for 7 days) before exercising in a warm environment (30.3 °C).

They found that creatine supplementation boosted water levels in the cells and decreased responses related to temperature regulation and cardiovascular activity during prolonged exercise.

This promoted enhanced hydration and a more effective temperature regulation response during extended exercise in the heat.

When investigating the impact of creatine on responses to intermittent sprint exercise in a hot and humid environment, researchers had ten active men undergo a warm-up and sprints in the heat.

They did this first with a placebo and then with creatine supplements. Creatine increased body weight, but there were no significant differences in core temperature, water loss, or plasma volume compared to the placebo.

However, sprint performance improved with creatine loading, showing higher peak and mean power during the exercise test.

In summary, taking creatine for six days didn’t alter how the body regulates temperature during sprints, but it did enhance sprint performance in hot conditions ^[27].

Researchers have also examined the impact of combining glycerol and creatine to improve hydration and heat tolerance.

Their findings indicate that incorporating creatine supplementation, with or without glycerol, could be an effective nutritional strategy for hyper-hydration among athletes participating in strenuous exercise in hot and humid environments. This, in turn, may reduce the risk of heat-related illnesses ^{[28, 29]}.

5. Improved Body Composition

For the sake of this article, body composition refers to the ratio of lean body mass to fat mass.

Creatine has been shown to improve body composition by increasing lean body mass (muscle mass) in a variety of populations, including adult men ^[17], older females ^[30], adolescents ^[31], and older adults ^[32].

Many people fear the weight gain associated with creatine. However, the myth that creatine can cause fat gain is unfounded in literature.

Men who followed the standard creatine loading protocol (20 g/day for 7 days) and then maintained with 5 g/day for 11 weeks experienced an increase in fat-free mass (muscle mass) without any changes in fat mass ^[33].

In older men (around 70 years old) who took creatine for 12 weeks alongside resistance training, there were no observed increases in fat mass but increased muscle mass ^[34]. Similar outcomes were observed in older women who took creatine for 24 weeks ^[35].

In short-term studies (ranging from 1 to 8 weeks) involving older women aged 58-71 years ^[36], older men aged 59-72 years ^[37], young adult men engaging in resistance training aged 20-23 ^[38], adult recreational male bodybuilders aged 23-26 ^[39], young men aged 21-24 ^[40],

In exercising males and females aged 21-23 ^[41] and rugby union players aged 27-30 ^[42], creatine intake did not influence fat mass.

6. Brain And Spinal Cord Protection

If you play contact sports, there is the risk of getting concussions and spinal cord injuries. Creatine supplementation is known for its neuroprotective benefits and has been studied for its effects on traumatic brain injury, cerebral ischemia, and spinal cord injuries ^[10].

However, much of this research on creatine and spinal cord injuries/concussion treatment is still done in animal models and cannot necessarily be directly translated to humans.

Considering the proven safety of creatine, the risk-benefit ratio may be in favor of adding it to your supplementation protocol if you have a brain or spinal cord injury.

7. Medical Benefits

Several research studies have explored the immediate and prolonged therapeutic advantages of supplementing with creatine in individuals of all ages diagnosed with different neuromuscular disorders.

Such as muscular dystrophies ^{[43, 44, 45, 46]}, Huntington’s disease ^{[47, 48, 49)} Parkinson’s disease ^{[50, 51, 52]}, diseases related to mitochondria (the powerhouse of the cell) ^{[53, 54, 55]} and amyotrophic lateral sclerosis or Lou Gehrig’s Disease ^{[56, 57, 58]}.

There is also evidence that creatine can help with depression ^{[59, 60, 61]}.

Creatine Cons

1. Short-Term Weight Gain (Water Retention) When Loading

You might see a short-term increase in scale weight when you do a 5 – 7 day creatine load of 0.3g/kg per day or 4 doses of 5g spread throughout the day.

This is due to initial water retention ^[62]. However, this water retention subsides after the loading phase is completed.

If you wish to avoid this side effect, you can use the maintenance dose of 3 – 5g once a day for a minimum of 28 days, although this will take longer to yield performance and body composition results ^[10].

2. Chronic Dose Needed

It is important to take creatine every day, even on rest days, if you wish to see results. This is because building up your creatine stores in your muscles takes time.

If you only take creatine haphazardly, you might not see the results you want and risk not getting value for your money.

Should You Take Creatine?

Regarding its impact on performance, the International Society of Sports Nutrition (ISSN) has previously asserted in its stance on creatine supplementation that creatine monohydrate stands out as the most efficacious nutritional supplement currently accessible to athletes.

This supplementation has proven effective in enhancing high-intensity exercise capacity and promoting lean body mass during training ^[10].

Recent position statements from the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine regarding nutrition for athletic performance have echoed these findings, establishing a widespread consensus in the scientific community ^{[63, 64]}.

However, is creatine the right supplement for you? Well, that depends on your training goals.

If you aim to recover from an injury, enhance muscle building, and improve performance, creatine can help.

However, taking creatine should be combined with a well-structured training plan that is progressive and done consistently.

Creatine alone won’t “make up” for a lack of proper training. It’s also important to have a nutrition plan with sufficient energy, macronutrients, and micronutrients, as well as proper nutrient timing, to ensure that you reap the benefits of all the hard work you put in in the gym.

Summary

The pros of using creatine vastly outweigh the cons, and numerous studies have shown that creatine is safe to use if you use creatine consistently and in the recommended dosages.

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