What is creatine? Potential benefits and risks of this popular supplement

Question: A gym friend recommended taking creatine supplements. What is creatine? Does creatine have any positive effects? Are creatine supplements safe?

Answer: Creatine is often called an amino acid. But technically it is not one of the 20 amino acids that are the building blocks of all proteins. Our bodies can make creatine from three other true amino acids: arginine, glycine, and methionine.

Potential positive effects of creatine supplementation

Creatine may enhance athletic performance. It contributes to rapid energy production and may enhance power or speed bursts requiring short periods of anaerobic activity. The reason could be related to the association of creatine supplementation and increased glycogen storage in muscle. Glycogen can quickly release glucose, one of the best sources of instant energy.

There is also some evidence that creatine supplementation along with adequate calorie and protein intake can hasten muscle recovery after strenuous exercise. Again, this may be related to creatine's promotion of glycogen in muscle, because glucose-derived energy is needed to help the healing process.

Creatine supplementation does not build muscle. However, creatine supplementation along with regular resistance training and a well-balanced diet may offset age-related sarcopenia. Sarcopenia is the loss of muscle mass and power that happens as we grow older, but also occurs when muscles are inadequately activated, such as after an injury.

Creatine sources and dosing

Foods that tend to have richer amounts of creatine include meats, fish, and cow's milk. However, it's not clear that increasing intake of these foods offers any extra athletic benefits compared to getting a similar amount of protein from other sources.

Creatine monohydrate is the most commonly used form and the one most studied. Other forms do not offer any extra benefits.

The general recommendation for people who do take a creatine supplement is 3 to 5 grams per day. Studies show that loading up on a higher dose of creatine offers no advantages; you are just putting more stress on your kidneys.

Creatine supplement safety

Unlike over-the-counter and prescription drugs, the FDA does not regulate the accuracy of supplement contents. So, there is always the potential that a creatine supplement contains less or more than the amount on the label. Also, the supplement may contain other ingredients that could potentially be harmful for you.

Otherwise, an adult dose of 3 to 5 grams of creatine daily is safe. However, people with kidney disease should consult with their doctor prior to taking it.

Creatine is not an anabolic steroid, nor does it increase testosterone levels.

Some people will retain a couple of pounds of fluid during the first week they start creatine supplementation. But this is temporary, and studies of long-term use do not show a persistent problem with holding onto extra water.