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A lot of creatine experts are sick of the way we talk about creatine. Some are tired of cotton candy-flavored energy drinks hawking “super creatine” on neon cans, protein bars infused with the supplement, social media posts confusing creatine with steroids. Others are tired of the slew of “before and after” TikToks in which trim young men show off bulging muscles after a handful of weeks taking the supplement, or women display rippling abs they attribute only to the powder.
“I don’t know why people make up things about this particular supplement,” said Jose Antonio, an associate professor of health and human performance at Nova Southeastern University in Florida who has studied creatine. The world of creatine is rife with misinformation, he said, in spite of the large — and growing — body of evidence that the supplement can improve short bursts of athletic performance and enhance muscle mass.
Is the powder a miracle workout supplement, or is the hype overblown? Here’s what to know.
What even is creatine?
Creatine is formed in the body from compounds similar to amino acids, the building blocks of proteins. It serves as a type of fuel for your skeletal muscles, and can promote muscle growth when paired with exercise. It’s produced in the liver and kidneys, but you likely get creatine through your diet, too — red meat, fish and chicken contain it.
Throughout the day, your body naturally replenishes creatine in your muscles, but supplements can help “top up the tank,” said Eric Rawson, a health, nutrition and exercise science professor at Messiah University in Pennsylvania.
Creatine monohydrate — the form of creatine typically found in commercial powders — has been rigorously studied. “There’s probably more data on creatine monohydrate than any other supplement in existence,” Dr. Antonio said.
The Facts Behind 5 Supplements
Collagen. Collagen, is one of the most abundant proteins in the body and helps form our skin, bones, muscles, tendons and ligaments. As we age, we naturally start reducing its production. Some studies show that taking collagen supplements can reduce signs of aging, increase bone density and improve joint, back and knee pain. But many of these studies are small and funded by the companies behind such products, increasing the opportunity for bias. Certain products also have flaws that reduce the likelihood of their efficacy: Topical creams, for example, are unlikely to make it into the deeper level of the skin where collagen is produced.
There are more than twenty different formulations of creatine, Dr. Rawson said, including creatine hydrochloride and creatyl-l-leucine, but only creatine monohydrate has strong evidence behind it, so he would recommend against consuming another form of the compound.
What are the benefits of creatine?
Creatine has specific, focused benefits for exercisers. The supplement can power you through short bursts of activity, like lifting a weight or dashing through a short race. If you’re in the middle of a Peloton workout, for instance, you might be able to increase your speed for a sprint, said David Creel, an exercise physiologist and a psychologist and dietitian in the Bariatric and Metabolic Institute at the Cleveland Clinic.
But the effect is usually small. Creatine makes the most sense for certain competitive athletes eager for a split-second advantage, said Samantha Heller, a senior clinical nutritionist at N.Y.U. Langone Health. “For your average gym-goer, someone who’s a cyclist, someone who plays soccer on the weekends — they don’t need this,” she said.
Scientists have studied creatine and exercise performance since the early ‘90s. A recent review of 35 studies found that creatine supplementation, combined with resistance training, increased lean body mass — the body’s weight, minus fat — by more than two pounds in adults, regardless of age. The difference is small, but significant, although men reported higher gains than women. Vegetarians and vegans are more likely to have a larger response to the supplements, since they don’t get as much creatine in their diets, Dr. Rawson said.
Creatine may provide a small boost in muscle mass, but “whether it’s a 2 or 3 or 4 percent gain, no dietary supplements compare to proper training and sleep and nutrition habits,” Dr. Rawson said. Still, the increase could have a notable effect on older adults in particular, he said. “A very, very small improvement in strength could be the difference between a fall and not a fall.”
And emerging research suggests that creatine could have cognitive benefits, potentially enhancing memory and attenuating symptoms of concussions or traumatic brain injuries, although that data is much more limited than studies on creatine and muscular fitness.
Are there side effects to creatine?
“There really doesn’t appear to be any major hazards to it, which is kind of unique for a supplement,” said Dr. Creel. People who take the supplement, especially in large quantities, might experience some gastrointestinal distress, said Ms. Heller. People may also bloat or experience weight gain.
There are some claims floating around social media that creatine causes hair loss, but doctors said there was not significant research to verify that. And you won’t get any kind of high from creatine — it’s not like the jolt of energy you get from downing an espresso, Dr. Creel said.
The supplement is popular with teenagers, but there isn’t data on prolonged long-term use, especially in people who are still growing, said Dr. Pieter Cohen, an associate professor of medicine at the Cambridge Health Alliance, who studies supplements. Out of an abundance of caution, he suggested that teens refrain from using the supplement.
What to keep in mind before taking creatine
As with any supplement, you should talk to your primary care doctor before you start taking creatine. And just like other dietary supplements you can pull off the shelves, creatine is not tested by the Food and Drug Administration, said Dr. Cohen. That means there’s no guarantee that a powder you’re buying actually contains the amount of creatine it claims, or even any at all. The Department of Defense’s Operation Supplement Safety program recommends four third-party companies that test and evaluate dietary supplements, which you can use to ensure you’re really getting creatine. 
You should also stick with the recommended dose, which is usually around three to five grams per day. There isn’t substantial data for how long people can safely take the supplement beyond five years.It’s also important to come up with specific goals before taking the supplement, Dr. Cohen said, and to determine what the pill or powder could actually help you achieve — keeping in mind that it’s not a guaranteed ticket to building muscle. “People think creatine’s a steroid,” Dr. Antonio said. “That’s like saying water is fire.”
Source: What is Creatine? Understanding its Benefits and Side Effects – The New York Times
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Critics to Creatine:
Creatine was first identified in 1832 when Michel Eugène Chevreul isolated it from the basified water-extract of skeletal muscle. He later named the crystallized precipitate after the Greek word for meat, κρέας (kreas). In 1928, creatine was shown to exist in equilibrium with creatinine.[3] Studies in the 1920s showed that consumption of large amounts of creatine did not result in its excretion. This result pointed to the ability of the body to store creatine, which in turn suggested its use as a dietary supplement.[4]
In 1912, Harvard University researchers Otto Folin and Willey Glover Denis found evidence that ingesting creatine can dramatically boost the creatine content of the muscle.[5][non-primary source needed] In the late 1920s, after finding that the intramuscular stores of creatine can be increased by ingesting creatine in larger than normal amounts, scientists discovered phosphocreatine (creatine phosphate), and determined that creatine is a key player in the metabolism of skeletal muscle. The substance creatine is naturally formed in vertebrates.[6]
The discovery of phosphocreatine[7][8] was reported in 1927.[9][10][8] In the 1960s, creatine kinase (CK) was shown to phosphorylate ADP using phosphocreatine (PCr) to generate ATP. It follows that ATP, not PCr is directly consumed in muscle contraction. CK uses creatine to “buffer” the ATP/ADP ratio.[11]
While creatine’s influence on physical performance has been well documented since the early twentieth century, it came into public view following the 1992 Olympics in Barcelona. An August 7, 1992 article in The Times reported that Linford Christie, the gold medal winner at 100 meters, had used creatine before the Olympics. An article in Bodybuilding Monthly named Sally Gunnell, who was the gold medalist in the 400-meter hurdles, as another creatine user. In addition, The Times also noted that 100 meter hurdler Colin Jackson began taking creatine before the Olympics.
At the time, low-potency creatine supplements were available in Britain, but creatine supplements designed for strength enhancement were not commercially available until 1993 when a company called Experimental and Applied Sciences (EAS) introduced the compound to the sports nutrition market under the name Phosphagen.[14] Research performed thereafter demonstrated that the consumption of high glycemic carbohydrates in conjunction with creatine increases creatine muscle stores.
Creatine is a naturally occurring non-protein compound and the primary constituent of phosphocreatine, which is used to regenerate ATP within the cell. 95% of the human body’s total creatine and phosphocreatine stores are found in skeletal muscle, while the remainder is distributed in the blood, brain, testes, and other tissues. The typical creatine content of skeletal muscle (as both creatine and phosphocreatine) is 120 mmol per kilogram of dry muscle mass, but can reach up to 160 mmol/kg through supplementation.
Approximately 1–2% of intramuscular creatine is degraded per day and an individual would need about 1–3 grams of creatine per day to maintain average (unsupplemented) creatine storage.[18][19][20] An omnivorous diet provides roughly half of this value, with the remainder synthesized in the liver and kidneys.
Creatine is not an essential nutrient. It is an amino acid derivative, naturally produced in the human body from the amino acids glycine and arginine, with an additional requirement for S-Adenosyl methionine (a derivative of methionine) to catalyze the transformation of guanidinoacetate to creatine. In the first step of the biosynthesis, the enzyme arginine:glycine amidinotransferase (AGAT, EC:2.1.4.1) mediates the reaction of glycine and arginine to form guanidinoacetate.
This product is then methylated by guanidinoacetate N-methyltransferase (GAMT, EC:2.1.1.2), using S-adenosyl methionine as the methyl donor. Creatine itself can be phosphorylated by creatine kinase to form phosphocreatine, which is used as an energy buffer in skeletal muscles and the brain. A cyclic form of creatine, called creatinine, exists in equilibrium with its tautomer and with creatine.
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