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The case for creatine

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Dr. Spencer Nadolsky is a practicing medical physician. He is based in Suffolk, Virginia.

Creatine is a nitrogen-based organic acid that occurs naturally in all vertebrates. It increases the formation of adenosine triphosphate (ATP), which supplies energy to all cells in the body, including muscle. Therefore, creatine improves the ability of muscle cells to cope with intense exercise.

There is a great deal of strong research behind its safety as a supplement and its ability to improve muscular power output. It also increases anaerobic endurance by acting as fuel for your cells. Muscle cells will use creatine for energy before burning glucose, which helps your muscles perform under pressure and crank out those last few reps.

Another advantage is that creatine is not only safe but cheap, and the muscle growth and general physical performance benefits it offers make it one of the first supplements to consider when putting together any performance-enhancing supps stack.

The best form of creatine to supplement is creatine monohydrate. Other forms of creatine may be more expensive, but studies have found them to be less effective.

Non-responders
One issue with creatine is that some people are non-responders, which means it is unable to pass from their blood to their muscles. More research is needed to find a proven way to circumvent creatine non-response. Some evidence suggests it helps to take creatine with a meal high in both protein and carbohydrates close to your workout. If you think you are a non-responder consider taking creatine with a meal either before or after a workout.

One initial and short-term side effect is that creatine supplementation will cause a slight water weight gain in the first few weeks of use, but its ability to improve performance will cancel out any temporary downsides of increased water weight. After prolonged creatine supplementation, the water weight will be replaced with muscle.

The only other potential side-effects are nausea, cramping, and diarrhea from too large a dose, but there are ways to limit your risk of these outcomes.

How to take it The standard daily dose for creatine is 5g, which has been found to be enough to improve power output. People with more muscle mass may benefit from a higher daily dose, as much as 10g, but this claim is not fully supported by the evidence. To supplement 10g, split it into two doses of 5g, taken twice a day.

Creatine should always be consumed with water, and timing isn’t important, though you may want to take it with a meal to reduce the risk of an upset stomach. If you are especially sensitive to creatine’s digestive side-effects, which include nausea and cramping, consider supplementing micronised creatine, which may be gentler on the digestive system.

You may have heard of creatine-loading, which is taking higher doses of creatine for a short period of time when you first start supplementation, then moving down to a smaller maintenance dose, which can be taken indefinitely. This is not necessary for effective supplementation, and although loading may result in benefits appearing slightly faster, results normalise after a few weeks.

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