I recently listened to a podcast by The Ready State where Kelly and Juliet Starrett spoke with Dr. Darren Candow. Dr. Candow, PhD, CSEP-CEP, is Professor and Director of the Aging Muscle and Bone Health Laboratory in the Faculty of Kinesiology and Health Studies at the University of Regina, Canada. His internationally renowned research program is focused primarily around developing effective lifestyle interventions especially surrounding nutrition (specifically creatine monohydrate) and physical activity (resistance training). You can learn more about him and his work here or follow him on Instagram here.
They discussed all things creatine in this 2023 podcast episode (check it out here). I am going to give a review of the main topics they covered which spanned from what creatine is, to myths vs facts, dosage recommendations, and more. I hope you can take away some key points to help your training and recovery.
What is creatine?
Dr. Candow defines creatine as a very simple compound that is naturally produced in the liver and kidney. Our bodies create creatine to provide energy to all of our cells in the body and 95% is stored in our muscles with the rest in our bone and brain. It is also found in foods such as red meats and seafood. The idea is that we use it to maintain our energy currency, so if we have more of this then we should be able to exercise longer/faster and get greater adaptations. He believes creatine to be the safest and most effective dietary supplement on the planet.
What are the benefits of creatine?
-improves muscle mass
-improves walking speed
-combats sarcopenia (age-related muscle loss) and helps muscle function in other diseases such as muscular dystrophy
-decreases muscle cramps
-decreases fat
-helps with sleep deprivation and therefore mental clarity
-improves bone strength in those with bone density issues like osteopenia (not believed to have any changing results unless combined with exercise)
-helps recovery (specifically shown to decrease inflammation response in athlete's post-marathons and triathlons)
-helps people after a concussion (especially in children)
-maintains muscle mass in post operative situations
What kinds of creatine are there and what should you take?
The only recommendation is to take creatine monohydrate. Stick to brands that have this as a single ingredient.
How much creatine should you take and how often?
It depends.
Standard Recommendation:
If you're the average joe taking it for the overall health benefits, then:
3-5 grams a day everyday forever will serve you well. That dose is shown to replenish what we naturally excrete in a day.
You can calculate a more precise dose for you by multiplying 0.1 grams x weight in kilograms.
Pre-competition aka Loading Phase:
If you have a competition coming up and need a “quick fix” then you can take
20 grams per day for 7 days (split up into four 5-gram doses throughout the day). Not recommended if your sport is very sensitive to weight gain though.
Post-Concussion:
You need a higher dose if you are post-concussion. Studies shown up to 0.4 grams x weight in kilograms for months after concussion.
Older Adults/Women over 50:
Older adults, especially females older than 50, may need a higher dose because we have a more blunted response to exercise and creatine as we age. The recommendation for older adult women is closer to 0.14 x weight in kilograms.
Can you miss a day of creatine?
If you have been taking it for more than 30 days then yes. Skip a day, skip a week, it won't matter. Your muscles will have some reserve up to 30 days. If you eat red meat or fish, then you are probably good for the day.
When during the day is best to take creatine?
Dr. Candow recommends taking your caffeine (if you choose) before your work out and then creatine after.
Myths vs facts:
Can creatine cause weight gain or water retention?
Yes, creatine can cause weight gain as it pulls water from your blood to your muscles. This is called intracellular water retention. The primary instance that this is noticed is during a loading phase (ex. 7 days of high dosage like 20 grams a day before a competition) which can cause 3-6lb of weight gain in that week. If you don’t want this gain as you start creatine, there are ways to avoid that. Take the 3 recommended grams a day which will likely have little to no effect on your weight at all. You can also split those 3 grams up into three 1-gram doses throughout the day which has shown no water retention whatsoever. After you have been on for 30 days, you should be able to continue at a recommended dosage of 3-5 grams with no effect on weight.
Does creatine cause hair loss?
Dr. Candow states that this is a myth and that there is no evidence to suggest hair loss with the use of creatine.
Does creatine cause GI issues?
It can during a loading phase. That is why taking high dosages is not recommended or necessary for most.
Is creatine safe for children and teens?
Dr. Candow states that there is absolutely no research to suggest that it is not safe for kids and teens to take. There is research to support the positive effects of creatine for kids and teens.
Summary:
-Take the most basic form: creatine monohydrate. Choose a product with one ingredient.
-Creatine is safe for everyone from children to older adults. But those with preexisting medical conditions such as kidney disease, treated with dialysis, or those with a heart condition should consult with their physician before starting any supplements.
-Most of us need a daily dose of creatine in the 3-5 grams per day range. If you’d like to be more specific, use 0.1 x your body weight in kilograms. You may need more if you are post concussion, or a female over 50. If you have a competition coming up, you may consider 20 grams a day for 7 days leading up the event.
-Best results are found when combining creatine with exercise.
-Take creatine after your training.
-Vegans and vegetarians can struggle to get enough creatine. You will be able to train more and recover better by supplementing the creatine that you naturally miss in your diet.
-There are a ton of amazing health benefits to be had from supplementing creatine. Creatine is safe and relatively inexpensive. It is overall recommended for most individuals, especially active adults and athletes who have body composition, performance, and recovery goals.
I hope this was informative and helpful! I have started implementing creatine into my daily routine at a 5 gram dosage with a positive subjective report on my performance in the gym and recovery.
Let's talk soon,
Dr. Sieara
Physical Therapist, Certified Strength and Conditioning Specialist, Cert. in Dry Needling
P: 828-808-3704