It seems as if every time an exciting new performance-enhancing ingredient is introduced, it’s not long before it’s banned by professional sports organizations. Creatine, however, has been around for years and is still allowed by the International Olympic Committee, the National Collegiate Athletic Association, and professional sports organizations.
Creatine is a chemical found in muscles, made by the body and obtained through food. Now, there is overwhelming evidence that obtaining creatine through supplements improves exercise performance and increases muscle mass. Additionally, it may also treat certain muscle-wasting diseases.
Are you interested in supplementing with creatine? Read on to find out how.
Using Creatine to Improve Athletic Performance
Creatine supplementation improves exercise performance in both males and females. In one clinical trial, creatine enhanced anaerobic cycling power by 3.7% and dorsi-flexion MVC torque by 6.6% in both genders. 
The spark behind creatine’s performance-enhancing power comes from its ability to convert ADP into ATP. When your body needs quick energy, it taps into ATP stores. But, there is only so much ATP available. That’s where creatine comes in: it transforms ADP into ATP to increase the amount of available energy. 
Another way in which creatine prolongs performance is by reducing muscle fatigue. Creatine may delay lactic acid buildup in muscles, allowing professional athletes and weekend warriors alike to exercise for a longer time than they normally might. 
Taking creatine for athletic performance may be a tricky business, though, because experts recommend different dosing regimens.
Some experts recommend an initial loading phase, where users take a greater amount of creatine for 5 to 6 days, followed by a maintenance dose. Yet, others believe creatine is just as effective without a loading phase.
The following dosing regimens are recommended, according to WebMD:
• A loading phase of 20 grams per day for 5 days, followed by 2 or more grams per day
• A loading phase of 9 grams per day for 6 days, followed by 2 or more grams per day
• 3 grams creatine per day, without a loading phase 
Some suggest basing creatine supplementation off the individual’s weight. For example, one study used 0.3 grams creatine per kg body mass. 
As there’s no proof one dosing regimen is superior for everyone, choose the dosing regimen that works for you, with the advice of a physician.
It’s generally recommended you take creatine about an hour before your workout. Some supplement companies recommend taking it several times throughout the day. 
Some experts also suggest cycling off creatine to make sure your body doesn’t stop producing it. You may want to take creatine for 8 weeks, and then take a 4 week break before restarting supplementation. 
Using Creatine to Improve Muscle Mass
Next to improving performance, building muscle is probably the most desirable goal of athletes everywhere. And, creatine helps with this, too, by increasing the amount of water in your muscles. As muscles fill with water and creatine, the muscle tissue is enlarged.
In one study, creatine increased lean body mass at a greater rate than placebo; this tells us weight gain from creatine comes from muscle growth, not fat gain. 
When you begin to take creatine with your weight lifting routine, you will probably gain between 3 to 5 pounds. A greater lean muscle mass may allow you to burn more calories, even while at rest. 
Recommended Doses and Times
The creatine dosages for increasing muscle are generally the same as those recommended for athletic performance.
Using Creatine to Prevent Muscle Wasting
Creatine’s muscle-enhancing abilities have also caused it to be a proposed treatment for various conditions involving muscle weakness. Creatine has shown to be effective at improving muscle strength in those with muscular dystrophy, slowing symptoms in Parkinson’s disease, and improving symptoms of McArdle’s disease. It may also increase strength and endurance in those with heart failure.
The recommended dosages for various conditions include the following:
• Heart failure: 20 g per day for 5 to 10 days
• Parkinson’s disease: Either 10 g a day, or a loading dose of 20 g/day for 6 days followed by 2 g/day for 6 months, then 4 g/day for 18 months
• Improving resistance training for those with Parkinson’s: a loading dose of 20 g/day for 5 days, followed by 5 g/day
• Gyrate atrophy: 1.5 g/day
• Muscular dystrophies: 10 g/day for adults, 5 g/day for children
• McArdle’s disease: 150 mg/kg daily for 5 days, followed by 60 mg/kg per day 
Which Type of Creatine Should You Use?
Deciding to supplement with creatine may be easy, but selecting a creatine type is more complicated, as there are dozens of creatine forms all fighting for your attention.
It’s important to remember creatine monohydrate is the most extensively studied creatine form and the one most used in supplements. Other forms are claimed to be more easily digested or to have better chemical properties than creatine monohydrate, but there isn’t much evidence these forms are more effective or safer than creatine monohydrate. 
Nevertheless, here’s a run-down of some of the creatine types you will run across:
• Creatine monohydrate: the most researched and promoted creatine form
• Creatine citrate: creatine molecule with a citric acid molecule; said to be digested easier and to promote energy metabolism
• Creatine malate: Creatine bound with malic acid; said to dissolve easily and cause less gastrointestinal problems
• Creatine anhydrous: creatine with the water molecule removed; said to provide more creatine per serving
• Creatine ethyl ester: creatine bonded with an ester; said to enhance absorption and is taken at a lower dosage
• Creatine alpha-ketoglutarate: creatine with AKG as a transport molecule; said to absorb faster
• Micronized creatine: A finer powdered version of creatine monohydrate; said to cause fewer side effects 
As supplement companies are constantly trying to create the latest and greatest creatine form, there are plenty of other creatine types available. Be aware company claims may be exaggerated.
Creatine Side Effects
Creatine is made naturally in the body, but that doesn’t mean creatine supplementation comes without side effect risk. Creatine might cause stomach pain, nausea, diarrhea, or muscle cramping.
When used in doses higher than recommended, creatine could harm kidney, liver, or heart function. Don’t take creatine with medications that could harm the kidneys. This includes anti-inflammatory drugs like ibuprofen.
Do not combine creatine with caffeine or ephedra, as this might increase chance of serious side effects.
Be sure to drink at least 65 oz. water per day while taking creatine, as creatine uses water from inside your body. Without replenishing this water supply, you may become dehydrated. 
Using Creatine: The Bottom Line
For a safe, effective supplement to improve performance, creatine is a good bet. Nevertheless, creatine might still cause side effects. Using creatine in the proper dosages will help you reap the
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