Creatine Supplementation

By Trevor Chung c.s.c.s.

WABBA world championship finalist.

Creatine is a substance found naturally in the body derived from Glycine and Arginine. It has been shown in a number of studies to enhance maximal strength, improve sporting performance in soccer players and accelerate gains in lean muscle mass. It plays a key role in the body's energy system, and has many secondary roles. Creatine enhances the transport of Adenosine triphosphate (ATP) between cells in the body. ATP is often referred to as energy currency and is the principal carrier of energy for all forms of life.

ATP cannot be stored and recent experiments with ATP supplementation have proved ineffective. Therefore the enhanced transportation of ATP is at present the most efficient method of enhancing energy transfer between cells. The average person gets about one gram of Creatine per day from their diet, and one gram is produced in the body. Herring, salmon, tuna, and beef are all high in Creatine, but you would have to eat very large amounts of these foods to get the benefits achieved through supplementation

What application does Creatine have?

Creatine supplementation combined with strength training has been shown to cause dramatic improvements in muscle size and strength. Additionally, Creatine supplementation causes a significant increase in hypertrophy (muscular growth).

3. How does Creatine work?

After being ingested, Creatine is absorbed into the bloodstream, most likely by the amino acid transporter, and usually reaches a maximum plasma concentration in less than two hours. While blood levels are elevated, the Creatine transporter actively transports Creatine into skeletal muscle, cardiac muscle, and the brain. At this point, there are a variety of mechanisms by which Creatine may exert its effects.

• Modulation of energy metabolism - This equates to more energy during sets and faster recovery between sets.

• Increased protein synthesis - Supplementing with Creatine has been shown to increase intracellular water retention. Not only does this have the benefit of making the muscles appear larger, it may have an anabolic effect as well. Hyper hydration stimulates protein synthesis and inhibits protein breakdown, and cell volume has a correlation with catabolism in a variety of ailments. Numerous studies have confirmed that Creatine supplementation prevents protein catabolism.

• Reduced oxidative stress - In addition to direct effects on energy metabolism and protein synthesis, Creatine also has indirect effects on them because it protects against tissue damage, thus increasing the body's ability to regenerate ATP and synthesize protein and protecting against a variety of other harms caused by exercise-induced oxidation. Creatine also protects against free radicals.

There are very few side effects associated with Creatine use. Gastrointestinal discomfort is experienced by some, but generally goes away when dosage is lowered. Weight gain is also a common side effect; however this is mostly water weight (from muscle cell volumisation). There are two case reports in the literature of Creatine exacerbating renal dysfunction, but multiple studies have shown it to have no impact on healthy individuals. You should consult a doctor before using Creatine if you have a kidney disorder.

What form of Creatine is best?

Since Creatine is one of the most popular dietary supplements, many companies have released "better" forms of Creatine. These generally have no added advantage, and some of them are much less effective.

• Creatine monohydrate - This is the most common form of Creatine. It is the kind used in most clinical trials and mixes relatively easily.
• Anhydrous Creatine - This is Creatine without the H2O molecule attached, which is about the only difference. It is about the same price per gram of Creatine as Creatine monohydrate.

• Micronised Creatine - This is Creatine that has been micronized into smaller particles. It is a good alternative for those who experience gastrointestinal discomfort from using regular Creatine.

• Tricreatine malate - Tricreatine malate may be more bioavailable than other forms of Creatine due to increased water solubility. However, it is currently much more expensive than other Creatine products, and the low bioavailability of Creatine is generally compensated for by the high dosage. Tricreatine malate is about 75% Creatine.

• Liquid Creatine - Creatine is not stable in solution and quickly breaks down into its waste product Creatinine. An analysis of various Creatine products showed that a popular liquid Creatine product had less than 2% of the Creatine that the label claimed.

• Creatine Ethyl Ester – This is Creatine with an Ethyl alcohol ester added to it to help the Creatine pass through the digestive tract intact. Once it is in the bloodstream the ethyl alcohol molecule can be broken off in the liver allowing the Creatine molecule to transverse the cell membrane.

How should I take Creatine?

Creatine is always present in the body and though simple supplementation is of a benefit, the real advances in performance occur with increased Creatine uptake and super – saturation of the cells with Creatine.

There are a variety of ways to increase Creatine uptake. Exercise, insulin, thyroid hormone (T3), and IGF-1 all increase the amount of Creatine uptake into skeletal muscle. This makes pre- and post-workout ideal times to take Creatine.

We have learned that Creatine is not stable in liquids, once dissolved Creatine starts to convert to a compound called Creatinine. Creatinine is a toxic counterpart of Creatine responsible for the adverse effects associated with Creatine use such as gastrointestinal discomfort, renal dysfunction, bloating and subcutaneous water retention. It is therefore essential that the Creatine is absorbed by the body as quickly as possible; the most popular method used at present is by Insulin Spiking.

By this method a high glycemic beverage usually containing 1g of carbohydrate per kilo of bodyweight is consumed directly after training, the beverage should also contain 0.25g of Whey protein isolate per kilo of bodyweight and 1g of Creatine per 10kg of bodyweight and be consumed with 100mg – 200mg of Alpha Lipoic Acid (ALA). The resultant insulin spike will draw the carbohydrates, protein and Creatine into the cell walls at a much higher concentration than normal, the ALA increases insulin sensitivity which makes the whole process more effective, without the ALA you would probably require twice as much carbohydrates to produce the same effect. Alpha Lipoic acid is even better than many prescription drugs at improving insulin sensitivity and also has many other beneficial antioxidant effects. The recommended dosage is 100-200 mg of ALA every time Creatine is consumed.

It is essential to use a fast absorbed form of protein as a slow release protein would slow down the whole process which will in turn inhibit the insulin spiking.

A typical post workout drink for an 80kg guy would consist of:

80g Complex Carbs

20g Platinum Protein

8g Creatine

8g L- Glutamine

100mg ALA

Other methods of Creatine use include:

• Loading - Many Creatine users believe it is beneficial to begin use with a "loading" phase in which 20-30 g is taken over 4-6 doses daily for a few days. The literature on loading is conflicting, and the same level of saturation can be achieved with regular, low-dose supplementation, although it may take longer. The decision is ultimately up to the user, as both methods are effective.

• Cycling - This is the idea of taking a week off of Creatine every 8-12 weeks to allow natural production of Creatine to return to normal levels. This is done because Creatine consumption down regulates the Creatine transporter, although levels quickly return to normal upon cessation of use. Whether or not cycling is beneficial is still up in the air, but it is definitely not necessary.