by Scott Tindal
As an endurance athlete, pushing your limits and enhancing your performance is a constant pursuit. In this quest, various supplements have gained considerable attention, one of them being creatine monohydrate.
But isn’t creatine for bodybuilders and strength athletes to put on muscle mass? Not necessarily. Your body actually naturally produces creatine on its own, and further saturating your creatine stores with supplementation might allow you to go a little harder on your next ride, run, or swim, improving your overall health and performance.
So should you take it? Well, that depends. Consider these pros, cons, and other factors before deciding if creatine supplementation is right for you.
What is Creatine Monohydrate?
Creatine monohydrate is an amino acid that is vital for producing adenosine triphosphate (ATP), the primary energy source for muscle contractions. It’s a naturally occurring compound found in small amounts within meat and fish. The main reason for supplementing with creatine monohydrate is to saturate your intramuscular phosphocreatine stores and free-creatine levels. This saturation is not possible through diet alone. By supplementing with creatine monohydrate, endurance athletes can enhance ATP production and improve exercise performance.
The enhancement of ATP production has obvious benefits, which are outlined in the “pros” section below. Creatine also offers benefits outside of exercise performance. Emerging and recent evidence highlights potential brain health benefits from creatine supplementation.
How to Supplement
It’s best to take five grams of creatine monohydrate a day in powder form. Cycling creatine in a loading, maintenance, and rest phase is not recommended, nor required. Time of day has little effect on its effectiveness, and you can take it pre- or post-session. Many people like to take it with a protein shake after the most challenging session of the day. It usually takes at least 28 days of continual consumption of 5g/day to increase your creatine stores and start reaping the benefits. It remains saturated for about 2-6 weeks, depending on the individual.
Will Creatine Show Up on a Drug Test?
While creatine monohydrate is not a banned substance, it could be manufactured in a facility that handles banned products. Like any supplement, purchase through a reputable brand and consume products with NSF Sport, Informed-Sport, or HASTA certification. Creapure is a form of creatine monohydrate known for its purity.
The Pros of Taking Creatine
1. Increased Muscle Power and Strength
Creatine monohydrate has been shown to improve muscle power and strength, even in endurance athletes. A 2019 study demonstrated that creatine supplementation significantly increased cycling power output in well-trained triathletes, leading to improved performance during cycling segments of a triathlon. This increased power output can translate into more efficient cycling.
2. Enhanced High-Intensity Exercise Capacity
Creatine monohydrate supplementation increases the capacity for high-intensity, short-duration exercise. The International Society of Sports Nutrition Position Stand outlines how creatine supplementation can improve performance in repeated sprints and intermittent exercise. By increasing the availability of ATP, creatine monohydrate may delay the onset of fatigue and allow endurance athletes to sustain higher intensities for repeated efforts in training.
Through repetition of higher-intensity training, you can expect adaptations that translate into improved race performance. Put another way, if you can do more in training (whether it be more load or repetitions in strength training, swimming more laps, riding hill repeats stronger, or hitting faster sprint repeats on the track), those incremental changes in volume and intensity will translate to improved performance over time.
3. Accelerated Recovery
Research suggests that creatine monohydrate can aid in recovery from intense exercise. One such study reported that creatine supplementation reduced exercise-induced muscle damage and promoted faster recovery in resistance-trained individuals. This accelerated recovery can benefit cyclists, runners, and triathletes, helping them handle their training load and reduce the risk of overtraining or injury. While this is extrapolated from resistance-based athletes, muscle breakdown physiology is the same. The benefits of creatine in terms of recovery have been demonstrated multiple times.
4. Positive Effects on Brain Function
Creatine monohydrate may have cognitive benefits, which can be advantageous during endurance events. One study found that creatine supplementation reduced mental fatigue during sustained mental effort. Maintaining concentration and decision-making abilities during long races, such as triathlons, is crucial for optimal performance.
Further, recent research has shown that creatine supplementation can improve cognition and memory, especially in older adults or during metabolic stress (i.e., sleep deprivation). Interestingly, higher doses of creatine may be required. This should be considered and discussed with your health professional if brain function is a priority.
5. Improved Hydration & Thermoregulation
Concerns have been raised about creatine causing dehydration and cramping. As a 2021 article in the International Society of Sport’s Nutrition summarized, “Experimental and clinical research does not validate the notion that creatine supplementation causes dehydration and muscle cramping.” One of the few studies to investigate the role of hydration and injuries found that those athletes (footballers) who took creatine on a regular basis were found to have less cramping, less dehydration, and less heat illness than those athletes not supplementing.
Total injuries, muscle tightness, and muscle strains were also found to be less in the athletes supplementing with creatine monohydrate. A systematic review in the Journal of Athletic Training concluded that there is “no evidence to support the concept that creatine supplementation hinders heat dissipation or an athlete’s ability to control fluid balance.”
Other studies investigating the role of creatine in thermoregulation consistently found no difference or slightly lower rectal temperature, reduced heart rate, and improved blood plasma volume between placebo and creatine groups. This has been in conjunction with findings supporting improved total body, extracellular, and intracellular water volumes in those athletes supplementing with creatine monohydrate. The key takeaway is that creatine monohydrate does not enhance the likelihood of cramping or dehydration, and it appears to reduce the risk of heat injury.
The Cons of Taking Creatine
1. Possible Reduced VO2max
An interesting systematic review concluded a negative correlation between creatine monohydrate supplementation and VO2 max. The authors acknowledge a risk of bias with the study designs due to a need for more clarity over randomization with nearly all studies included. Only three of the nineteen studies thoroughly detailed the assessment of VO2 max.
One reason for VO2 max reduction could be due to creatine’s potential cause of fluid retention and weight gain. VO2 max is measured as milliliters of oxygen used in one minute per kilogram of body weight (mL/kg/min). So as weight goes up, VO2 max goes down. While creatine appears to impair VO2 max, it may result from slight weight change.
The study features a wide range of participants’ training statuses from amateur to elite, with more than 80% being males. Nonetheless, the study findings warrant further investigation to determine if there are specific reasons why any adverse effects on VO2 max might occur.
Ensuring that the supplementation protocol and training and testing processes are repeatable, reliable and valid is essential for future research. If you’re concerned about this, I recommend monitoring your VO2 max at baseline and through subsequent testing.
2. Fluid Retention and Weight Gain
One concern often associated with creatine monohydrate supplementation is fluid retention, which may result in temporary weight gain. This is often undesirable for athletes aiming to maintain a lean physique. This was one of the primary negative consequences highlighted in an article published in Sports Medicine. However, it’s crucial to note that the weight gain is primarily due to increased intracellular water rather than fat accumulation, as proven in other research.
Without a loading protocol (20g/day for the first five days), this gain in water weight is often less noticeable and negligible over time. This varies from athlete to athlete, though. If weight gain through fluid retention is an issue, stop taking creatine 1-2 weeks before racing to offset fluid retention while retaining increased creatine stores.
3. Gastrointestinal Distress
Some people experience gastrointestinal discomfort when taking creatine, such as bloating, cramping, or diarrhea. This is more common when taking higher doses, or not letting it fully dissolve in water before ingestion.
It’s important to note that not everyone experiences gastrointestinal distress while taking creatine, and it can often be managed by adjusting the dosage or taking it with meals, as outlined by the International Society of Sports Nutrition. Additionally, the form of creatine can influence GI complaints. It’s recommended to use it in powder form.
4. Renal/Kidney Stress
Concerns about the long-term effects of creatine monohydrate supplementation on renal (kidney) function have been raised. However, studies done by the International Society of Sports Nutrition and Sports Medicine show that short-term and long-term use of creatine monohydrate within recommended dosages doesn’t risk renal function in healthy individuals. Be sure to stay within the recommended dosage guidelines and consult a healthcare professional if you have pre-existing kidney conditions.
Other Considerations
Individual Variability
The response to creatine varies among individuals. Genetic factors, training status, diet, and baseline creatine levels all influence your response. Some athletes might experience significant performance benefits, while others might not notice any discernible improvements, as explained in an article published in Sports Medicine.
There appears to be a training status effect associated with creatine monohydrate. This may be due to the additional benefits of increased training through supplementation not being as enhanced for those athletes. Plant-based athletes and vegans are likely to benefit more than other athletes (regardless of training status) since most naturally occurring sources of creatine are derived from animal sources.
Controversy with Nil Effect
A recent systematic review and meta-analysis published in May 2023 threw some controversy into the mix, concluding that “Creatine monohydrate supplementation was shown to be ineffective on endurance performance in a trained population.” It should be noted that the study reviewed 13 studies that involved 277 highly trained, elite, national or international athletes. The ages of the participants included in the studies were all under 35, with most being in their mid-twenties. Eight of the studies involved a loading phase (shorter phase with much higher dosages) and the duration of supplementation ranged from five to 70 days. Seven studies only had athletes take creatine for seven days or less. Despite this, four studies significantly improved the 8-mmol/L lactate threshold, time to exhaustion and/or time trial performance.
Interestingly, the study that showed the most significant effect was the only study where athletes supplemented for over fifty days (70 days total), which were found in rowers only. None of the studies investigated triathletes.
The adverse effects reported in the studies related to weight gain. As mentioned, most of the studies utilized a higher-dose loading protocol (20g+/day) in a short period that could be offset and avoided through a lower dose (such as 5g/day) for an extended period.
This isn’t to say that the review should not be considered. It highlights that not all athletes benefit from creatine monohydrate. Secondly, creatine loading can result in weight gain that might be otherwise undesirable by endurance athletes. Finally, the duration of creatine supplementation may play a crucial role in its effectiveness.
Is Creatine Right For Me?
Consider your “why” before deciding whether you believe creatine monohydrate is right for you. More than 85% of 2000+ athletes surveyed in the EventBrite “Endurance Sports Participant Study” cited getting involved in endurance sports to improve their health and physical performance. Sure, being competitive is high on many athletes’ agendas, but health and having fun are frequently quoted as priorities among triathletes.
Let’s look at the main benefits of creatine monohydrate. There is strong, reliable research showing that creatine improves health. Insurmountable evidence supports increasing lean muscle mass, increasing strength and power, adding repetitions, reducing time to exhaustion, improving hydration status, and benefiting brain health and function. All of these benefits will incrementally reward your health and improve your “healthspan” as you age. Ultimately, isn’t this what we all want? Along the way, I bet that for most athletes, using creatine monohydrate will improve their training and race performance.
However, it is essential to consider individual variability and potential side effects, such as fluid retention and gastrointestinal distress. Be sure to adhere to recommended dosages to reduce the possibility of undesirable side effects. And as with any dietary supplement, it’s best to consult with a healthcare professional or sports nutritionist before incorporating creatine monohydrate into your training regimen to ensure it aligns with your specific needs and goals as an athlete.