“Bro, try some of this.”
Scary words when uttered in a high school/middle school boys’ locker room.
But, I had the underdeveloped prefrontal cortex of an 8th grader, so I reached out my hand and asked, “what is it?”
“Creatine,” the sophomore responded. “It’ll get you jacked.”
I drank it, then walked to the car as my mom picked me up after a lifting session.
I told her about my new-found secret sauce and her eyes widened.
Momma bear was not happy.
She told me how dangerous that was and that I was never allowed to do that again.
I was scarred and figured that creatine was essentially the same thing as injecting steroids with shared needles.
Turns out the sophomore was on to something.
What is it?
Creatine is a substance that’s made naturally in our bodies (in the liver and kidneys) and can be consumed via diet or supplementation.
It plays a critical role in fueling our muscles.
Why does it matter?
Creatine has repeatedly been shown to increase strength, lean muscle mass, muscle size, and power output when combined with heavy lifting more than heavy lifting alone.3,7
Cool, so we know creatine will help you get strong, explosive, and jacked.
But, more importantly, is it safe?
Taking anabolic steroids/ testosterone will make you even faster, stronger, more explosive, and more jacked, but it’ll also shorten your lifespan, destroy your current quality of life with health issues, and drive psychotic episodes.
So we all agree, steroids are bad. Don’t take steroids, regardless of what your local gym bro friend says he saw on TikTok or listened to on a podcast.
Good news, though- creatine is really safe.5
Sorry, mom. You were wrong on this one.
Despite societally perpetuated myths, creatine supplementation:5
– does not increase the risk dehydration/cramping
– does not increase the risk of injury
– does not destroy the body’s ability to create its own creatine naturally
– does not increase the risk of kidney issues
– does not have any long-term detrimental effects
There’s not as much research about creatine use in adolescence as there is around adult populations.1,2,4,5 Logistically, there’s a lot more red tape around doing research on kiddos than autonomous grown-ups.
Some people argue that people under 18 years old shouldn’t take creatine, because there are warning labels on creatine packaging that say it is unsafe for them.
Here’s what the International Society of Sports Nutrition (ISSN) says about that: “It’s important to understand that this is a legal precaution and that there is no scientific evidence that children and/or adolescents should not take creatine.”5
Thanks again, litigious Americans.
There is no other supplement that has been shown to be nearly as effective and safe as creatine for improving speed and strength outcomes.
How does it work?
The short version:
Increasing creatine levels allows us to train harder at a higher intensity, which results in better performance results.
The longer version:
The energy currency in our body is something called ATP.
If we want to make a muscle move, we need to donate some ATP.
Our body has three main pathways to make this energy currency: the aerobic system, the glycolytic system, and the phosphocreatine system (PCr).
When we need rapid energy, like a short sprint, a heavy lift, or an explosive jump, we rely on the PCr system.
We store PCr right in our muscles, so that it’s ready to use in a moment’s notice.
However, the PCr system burns out pretty quickly with the limited stores of phosphocreatine in the body.
Our body naturally makes creatine and then we get some more in through our diet (red meat and fish).
However, supplementing with additional creatine can raise the amount of phosphocreatine that is stored in the muscle.
The more phosphocreatine that is stored, the longer that the PCr system can be used.
Because our PCr system is great at fueling high intensity, explosive exercise, making this system more efficient allows us to have higher quality high intensity training sessions for a longer period of time.
More high quality, high intensity training = better results and training outcomes.
How can you use it?
I don’t make inferences on nutritional topics, as that’s not my primary domain.
I follow the research, straight up.
Important note, this research refers to 100% creatine monohydrate.
There are other forms of creatine on the market, but they’re a scam.
Basic creatine monohydrate is all you need.
Here’s what the ISSN recommends:
“The quickest method of increasing muscle creatine stores may be to consume ~0.3 g/kg/day of creatine monohydrate for 5–7-days followed by 3–5 g/day thereafter to maintain elevated stores. Initially, ingesting smaller amounts of creatine monohydrate (e.g., 3–5 g/day) will increase muscle creatine stores over a 3–4 week period, however, the initial performance effects of this method of supplementation are less supported.”5
For kids under 18, here’s the ISSN’s stance (that I strongly agree with) on whether or not it’s okay to use:
“For this reason, it is our view that creatine supplementation is an acceptable nutritional strategy for younger athletes who:
a.) are involved in serious/competitive supervised training;
b.) are consuming a well-balanced and performance enhancing diet;
c.) are knowledgeable about appropriate use of creatine;
and d.) do not exceed recommended dosages.”5
It’s of special note that if you have pre-existing kidney issues, being especially cautious and consulting with your nephrologist is important.
With ANY supplement you ever take, make sure the creatine that you take is NSF Certified for Sport.
This means that a 3rd party company tests them to make sure that the ingredients label matches what’s actually in the packaging.
My thoughts
Creatine = good.
Not many things are black and white in this field.
This is.
Fun facts
Are you kid(ney)ing me?
The biggest concern around creatine supplementation is centered around the kidneys.
It’s perpetuated by a failure to understand the first lesson in Stats 101:
Correlation ≠ Causation.
Creatinine is a main blood marker used as a proxy to assess kidney health.
High creatinine levels suggest kidney damage.
However, creatinine is also a byproduct of creatine breakdown.
So, athletes who supplement with creatine will have elevated creatinine levels.
But, those levels didn’t become elevated by damaged kidneys.
If you want to read more, this information comes from Is It Time for a Requiem for Creatine Supplementation-Induced Kidney Failure? A Narrative Review. and the other reviews4,5,6,7 listed in the references.
Context is king.
That’s it!
As always, make sure to consult a qualified healthcare provider before making any changes to your diet or supplementation. In this instance, contact your registered dietitian or physician. Nothing in this article constitutes medical advice. Be smart.
Best,
Zach
References:
1. Gregory A. Metzger, Peter M. Minneci, Alison Gehred, Alexis Day, Kevin E. Klingele, Creatine supplementation in the pediatric and adolescent athlete– A literature review, Journal of Orthopaedics, Volume 38, 2023, Pages 73-78, ISSN 0972-978X, https://doi.org/10.1016/j.jor.2023.03.010.
2. Jagim AR, Kerksick CM. Creatine Supplementation in Children and Adolescents. Nutrients. 2021 Feb 18;13(2):664. doi: 10.3390/nu13020664. PMID: 33670822; PMCID: PMC7922146.
3. Butts J, Jacobs B, Silvis M. Creatine Use in Sports. Sports Health. 2018 Jan/Feb;10(1):31-34. doi: 10.1177/1941738117737248. Epub 2017 Oct 23. PMID: 29059531; PMCID: PMC5753968.
4. Jagim AR, Stecker RA, Harty PS, Erickson JL, Kerksick CM. Safety of Creatine Supplementation in Active Adolescents and Youth: A Brief Review. Front Nutr. 2018 Nov 28;5:115. doi: 10.3389/fnut.2018.00115. PMID: 30547033; PMCID: PMC6279854.
5. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. Published 2017 Jun 13. doi:10.1186/s12970-017-0173-z
6. Is It Time for a Requiem for Creatine Supplementation-Induced Kidney Failure? A Narrative Review. By: Longobardi, Igor, Gualano, Bruno, Seguro, Antonio Carlos, Roschel, Hamilton, Nutrients, 20726643, Mar2023, Vol. 15, Issue 6
7. Creatine supplementation with specific view to exercise/sports performance: an update. By: Cooper, Robert, Naclerio, Fernando, Allgrove, Judith, Jimenez, Alfonso, Journal of the International Society of Sports Nutrition, 15502783, December 2012, Vol. 9, Issue 1