KIAN PHILLIPS -- Training - Fitness

CREATINE
A Complete User's Guide:

Chemical name: methyl guanidine-acetic acid

What is creatine?
Creatine is a compound which is made up of three amino acids - Arginine, Glycine and Methionine - and is produced primarily by the body's liver or is introduced in the form of food (meat or fish) or as a synthesised version in the form of a supplement.

Where is creatine stored?
About 95-98% of available creatine within the body is stored within muscle tissue.

How much creatine do you have in your body?
The average human has between 3.5 and 4 grams of creatine per kilogram of muscle. (1.59 to 1.81 grams per lb. of muscle)

What happens to excess creatine in the body?
Excess creatine will eventually be excreted from the body in the form of creatinine. (note the different spelling)

What does creatine do?

Provides additional energy to your muscles:
When you perform an action such as lifting a weight or sprinting, your body needs a very quick response supply of energy. This energy comes from a molecule called Adenosine Triphosphate (ATP for short) when it is transformed into ADP (Adenosine diphosphate). Your body doesn't have an endless supply of ATP and so you are only able to exert yourself for a short period of time. When Creatine is introduced into your body in the form of a supplement, it transforms the ADP back into ATP and thus provides you with an additional energy source.
Cellular Hydration:
Creatine acts as a volumising agent by pulling water into the muscle tissue and increasing the volume of muscle - a 'pumped up' look.
Lactic Acid Buffer:
When you exercise over a long period your muscles will start to become fatigued and you will feel 'the burn'. This is a process of lactic acid building up within the muscles. Creatine has been shown to delay the build up of lactic acid and allow the user to extend their normal period of strenuous activity.
Enhances Protein Synthesis:
It is believed that creatine places the body in a more anabolic state which is ideal for protein synthesis to occur and greater muscle (mass) development. The development of mass, however, is also reliant upon resistance training and proper nutrition.

Do I need to take creatine to add muscle (mass)?
No. Creatine is just one of the many supplements currently available to assist you in developing your physique.

If I take creatine but don't perform any resistance training (weights) will I add muscle (mass)?
No. Refer to what creatine does, above.

As a supplement, what form is creatine available?
As a supplement, creatine is available in powder, capsule, tablet, bar, chewable gum or liquid form and is odourless and tasteless in its natural state. Although advances have been made with the introduction of a serum based creatine product, it is still considered that creatine is unstable in a liquid form.

How will you see creatine listed on ingredient labels of supplements?

Creatine Anhydrous
Creatine Citrate
Creatine HMB
Creatine Malate
DiCreatine Malate
Creatine Monohydrate
Creatine Phosphate
Creatine Pyruvate
Creatine Tartrate
Creatine Titrate
Magnesium Creatine
Micronised Creatine
Monocreatine-Malate
Effervescent Creatine
Liquid Creatine
Creatine Serum
2CM (diCreatine malate)
CHMB (creatine HMB)
CM2 (creatine ethyl ester HCL)
TriCreatine (blend of mono & di creatine salts 3:1)
TriCreatine Citrate (3 parts creatine to one part citric acid)
Tricreatine-Fusion (Dicreatine-Malate, Monocreatine-Malate, Creatine Anhydrous)
CVT (cell volumising technology)
CEM3 (creatine ethyl ester malate)
CEE (creatine ethyl ester HCL)
C2 (creatine ethyl ester HCL)
CrE2 (creatine ethyl ester HCL)
CEM-AKG (creatine ethyl ester HCL, malic acid, creatine anhydrous, glycine, alpha ketoglutaric acid)
CR100 (creatine anhydrous)
Creatine Alpha-ketoglutarate (AKG)
Kre Alkalyn Creatine
Purple K

What things should I look for when purchasing creatine?
A good starting point is to look for products which carry the trademarked symbol 'CREAPURE'. This is a trademark of the German manufacturer SKW Trostberg AG (the largest manufacturer of creatine). SKW merged with a company called Degussa-Hüls AG in 2001 to form Degussa AG, so newer creatine supplements will no longer carry the SKW wording but they will still carry the 'CREAPURE' logo.

The product should list the batch number, bottle number, and purity assay results. If you are concerned about the possibility of any impurities (see below for a detailed description) then contact the manufacturer directly and request the HPLC (High Performance Liquid Chromatography) results for the following: Dicyandiamide, Creatinine, Dihydrotriazine and Sodium. A reputable company will supply this to you. They are, however, in the case of mixed supplements, only able to report on the purity of the creatine. Unfortunately, there are very few supplement manufacturers, suppliers, and/or distributors who will actually stand behind their products when they are questioned so you will have your work cut out for you. If a particular company is unwilling to assist you then look elsewhere. Do not support an industry which refuses to support you.

The container should list the manufacturer and the expiry date of the product. The ingredient(s), quantity, serving size, user instructions, and purity should be listed. You should also be able to contact the company easily by regular mail, telephone or by e-mail with any questions regarding their product.

Refer to the ingredient panel and make sure that it clearly shows that the contents are free of other additives. If other ingredients such as dextrose, maltodextrin, sucralose, acesulfame K, FD&C Red#40, etc., are listed then look for another product. Although the dextrose/maltodextrin are beneficial at increasing the absorption rate of creatine, they can be purchased separately at a significant saving. This will also ensure that each serving of creatine which you remove from the container infact contains creatine and not 80% dextrose and 20% creatine or any other combinations.

A good example of this would be with MuscleTech's CellTech Fruit Punch (just a random example as there are many similar products out there). Although it is a creatine monohydrate based supplement, it only contains 200 grams (total) of creatine monohydrate per 2020 gram container. This means that over 1800 grams of powder contained within this one container is not creatine monohydrate. So when you take out 2 of the recommended scoops (101 grams) ... are you getting the full 10 gram serving of creatine or is it more or less or none at all. Due to the manufacturing process, mixing, distribution, settling, transport, and handling, the makers cannot guarantee that the contents will be evenly distributed. For those of you who are already using creatine in this manner, it may explain why on one day you had an amazing workout with a good pump but the following day produced no pump whatsoever. Conversely, you may be following the directions but you experience gastrointestinal problems, unknowingly due to too much creatine. The chances for the actual dosage rate to be non-uniform is higher in this manner.

Another thing to consider is price. Creatine is not an expensive supplement. When it first came out, it was incredibly expensive but with so many brands on the market to chose from, prices have dropped. Monohydrate is still one of the cheapest forms. Expect to pay a bit more for creatine in Phosphate, Magnesium, HMB, Micronised, or Ester forms. Expect to pay even more if it is mixed with a delivery system (dextrose/maltodextrin) or a secondary supplement.

Impurities found in low grade creatine supplements:

Dicyandiamide:
Dicyandiamide is normally found in creatine products as it is a derivative of cyanamide - one of the starting chemicals used in the production of creatine. At high levels, the presence of Dicyandiamide is the result of incomplete or inefficient production techniques. Quality creatine products should have a Dicyandiamide content in the range of 20-50 ppm (parts per million) or less. Dicyandiamide is also used in the production of fertilisers, explosives, fire proofing compounds, cleaning compounds, soldering compounds, stabilisers in detergents, modifiers for starch products, and as a catalyst for epoxy resins.
Creatinine:
Although creatinine is a naturally occurring by-product of creatine metabolism in the body, it is also present in all creatine based supplements. It should not exceed a level of 100 PPM Products with higher levels than this should be regarded as being the result of inefficient production techniques.
Sodium:
Although sodium content may be at low levels, even in poorly manufactured creatine based products, it should not be part of the ingredient list.
Dihydrotriazine:
Very little information is known about Dihydrotriazine other than it belongs to the family of chemicals called 'triazines' which can easily be absorbed through the gastrointestinal tract. Triazines are found in the pesticide/herbicide industry. As a result, levels of Dihydrotriazine should not be detectable, upon analysis, for the product to be considered a quality source of creatine.

The nutritional label says 5 grams of creatine per serving but is that what I am getting?
The short answer is, NO.
In the case of, for example, creatine monohydrate, it is comprised of 88% creatine and 12% water. This means that for every 5 gram serving of creatine monohydrate, you will be consuming 4.40 grams of actual creatine.

Actual creatine content per 5 gram serving:

Creatine Anyhydrous - 4.70 grams
Creatine Monohydrate - 4.40 grams
Creatine Tartrate - 3.50 grams
Creatine Phosphate - 3.115 grams
Creatine Citrate - 2.00 grams

Types of Creatine:

Creatine Monohydrate:
One of the original forms of creatine introduced in supplement form, monohydrate has been the type most widely researched and promoted.

Pro:
one of the lowest priced forms of creatine
available in a wide variety of supplements
Con:
unless it has been micronised, the chances of gastrointestinal problems will be higher due to the larger particles

Creatine Citrate:
This is one creatine molecule with the addition of one molecule of citric acid. The addition of citric acid is believed to help in energy metabolism.

Pro:
dissolves easily due to its solubility
Con:
only contains 2 grams of actual creatine per 5 gram serving
sour taste

Creatine Phosphate:
This became very popular due to the addition of the phosphate molecule. Before creatine can be utilised by the body it must first bond with a phosphate molecule. The belief was that by adding the phosphate molecule externally that the creatine phosphate would, when consumed, be utilised more quickly. However, this theory has never been proven.

Pro:
n/a
Con:
more expensive than monohydrate
very few products are currently available

Creatine Malate:
This is one molecule of creatine bound with one molecule of malic acid. Malic acid is commonly found in fruits and vegetables but it is also produced internally by the human body. It plays a part in deriving adenosine triphosphate (ATP - refer back up to 'what creatine does') from food.

Pro:
dissolves easily
less chance of gastrointestinal problems
Con:
supporting research is hard to find

Creatine Pyruvate:
Pyruvate is a by-product produced in the body during the normal metabolism of carbohydrates and proteins. It is also present in foods such as red apples, cheese, and wine. When glucose breaks down, it produces two molecules of pyruvate. If oxygen levels in the body are high, the pyruvate breaks down into carbon dioxide through a series of reactions as part of the Krebs Cycle (a series of chemical reactions within all living cells that utilise oxygen as part of cellular respiration). If oxygen levels in the body are not sufficient, then the pyruvate is broken down, anerobically, to form lactic acid. As lactic acid levels in the body increase, performance levels decrease. As mentioned earlier, creatine has lactic acid buffering properties and so is believed to extend this process and the user's ability to workout longer. Pyruvate also stimulates glucose extraction from the bloodstream and into muscle tissues.

Pro:
increased endurance
Con:
high intakes of pyruvate can trigger gastrointestinal problems such as gas, bloating, and diarrhoea

Creatine Tartrate;
This is one molecule of creatine bound to one molecule of tartaric acid. Tartaric Acid is found in wines and is used in foods to produce a sour taste or as an antioxidant. This is one of the newer forms of creatine currently available but very little is known about its future. Refer to the last point under 'Con:'.

Pro:
high stability rate
Con:
very few products are currently available
tartaric acid inhibits the production of malic acid and is a muscle toxin which can cause paralysis or death at a dosage above 12 grams

Magnesium Creatine;
The presence of the magnesium is thought to protect the creatine from the acidic conditions of the stomach and thus enable more of the creatine to be absorbed and utilised. Magnesium is also utilised in the conversion of creatine phosphate into ATP. This bonded form of creatine has also been found to increase fluid uptake by muscle cells.

Pro:
preliminary research has supported all of the above claims
Con:
very expensive

Creatine Anhydrous:
This is creatine monohydrate with the water molecule removed.

Pro:
provides 4.70 grams of actual creatine per 5 gram serving
Con:
similar side effects as monohydrate

Creatine HMB
The bonding between the creatine and HMB (betahydroxy-beta-methylbutyrate) works in a similar manner as with magnesium in that it enables more of the creatine to survive the acidic conditions of the stomach and subsequently be absorbed and utilised. HMB on its own is associated with aiding muscle growth and recovery.

Pro:
enhanced absorption of available creatine
Con:
a more expensive form of creatine

Creatine Ethyl Ester HCL (hydrochloride):
In this case, creatine is bonded with an ester (ethyl alcohol). An ester is a compound formed from the reaction between an acid and an alcohol. Since creatine monohydrate is not very soluble in water, it has difficulty penetrating muscle cell membranes which are made up of lipids (fats). Also, once it comes in contact with any liquid, it gives up its' hydrogen atom which results in it being positively charged at one end and negatively charged at the other. As a result, creatine must rely on transporters to help it bridge this membrane. As it sits outside the cell membrane, it draws in more water (outside the cell), producing the bloating people associate with taking creatine monohydrate. It also begins to degrade and form creatinine. The addition of an ester means that the creatine does not have to rely on transporters to obtain access to muscle cells. Once inside the muscle cell, the ester is removed and the creatine begins to draw water into the cell.

Pro:
enhanced absorption rate
lower dosage rate
side effects associated with monohydrate are reduced
Con:
more expensive form of creatine

Kre Alkalyn Creatine:
This form of creatine has been around since 2004 and is marketed by SciFit. When creatine is exposed to a liquid, it begins to breakdown into creatinine as a result of the pH value of the liquid. The lower the pH value is, the quicker creatine will breakdown and thus lowering the amount of creatine which would be available to and utilised by the body. Conversely, the higher the pH is the less likely for creatine to breakdown. Studies have concluded that at a pH value of 12, the process of creatine breaking down into creatinine, stops. Kre Alkalyn is marketed as a buffered creatine with a pH value above 12. This would imply that in the case of Kre Alkalyn, it is 'allegedly' a completely stable form of creatine. If this is the case, then the entire serving of creatine, this time in capsule form, would be utilised by the body and levels of creatinine in the body or excreted would not show a significant change. You will also see this form of creatine under the name Purple K.

Pro:
lower dosage is required
side effects associated with monohydrate are not experienced with Kre Alkalyn
completely stable - manufacturer's claim
100% absorption/utilisation - manufacturer's claim
reasonably priced
Con:
independent studies to support these claims are not available
'allegedly' questionable marketing practices when compared to CEE (creatine ethyl ester) with the later being branded as being 'unsafe' by the makers of Kre Alkalyn.

Creatine Alpha-Ketoglutarate (AKG):
As mentioned above for creatine ethyl ester, creatine relies on transporters to help it bridge the cell membranes of muscle tissues. When an insufficient number of transporters are available, the creatine will sit outside the muscle where it will not be utilised. AKG acts as a transport molecule and thus enables more creatine to enter muscle cells and be utilised at a quicker rate. You will also see AKG used with other supplements to act in a similar manner.

Pro:
enhanced absorption rate
Con:
more expensive form of creatine

Micronised Creatine:
This is a finer powdered version of creatine monohydrate.

Pro:
less chances of gastrointestinal problems
is available in more and more products
Con:
more expensive than monohydrate

Effervescent Creatine:
This will either be a creatine monohydrate or creatine citrate with the addition of bicarbonate (sodium or potassium) and citric acid. It is the bicarbonate and citric acid which produces the reaction when water is added. The creatine is dissolved and suspended as a result of the reaction. Creatine citrate is more soluble in water than monohydrate and therefore would be the better choice of the two if using this type of a delivery system. However, the actual creatine content of citrate based creatines is low (2.0 grams per 5.0 gram serving).

Pro:
dissolves more readily
Con:
sugar content in some products can be high
actual creatine content may be low
manufacturing process and packaging of the finished product must adhere to strict guidelines
few products are currently available

Creatine Titrate:
This is very similar to effervescent creatine but without the fizzy effect.

Pro:
greater solubility by changing the pH value when added to water
Con:
few products are currently available

Liquid Creatine:

Muscle Marketing USA fined $70,000 for false claim:
Wednesday, 14 July 2004, 5:41 pm Press Release: Commerce Commission Muscle Marketing USA fined $70,000 for false claims about sports performance product Muscle Marketing USA Limited has been fined $70,000 in the Auckland District Court today for breaching the Fair Trading Act in relation to its sports performance enhancing product ATP Advantage Creatine Serum. In sentencing, Judge Everitt said that Muscle Marketing's claims about its product were so far from actual reality that it was a very bad case of a misleading statement. "The company was highly culpable. On a scale of 1-10 it was 8." The Commerce Commission investigated claims that Muscle Marketing USA was making false representations in promotional material and labelling regarding the quantity of creatine in its ATP Advantage Creatine Serum product and the benefits that people would get from using it. Creatine is a nutrient that is synthesised from food by our bodies. It provides the energy muscles need to move and is often used by athletes to improve their sports performance. Fair Trading Director Deborah Battell said that in the Commission's view, Muscle Marketing USA falsely represented that 5ml of its serum yielded the equivalent of 2500mg of creatine. "Tests conducted on the serum showed that 5mls of the product contained only around 11.5mg of creatine. This means that on the basis of Muscle Marketing USA's recommended daily dose of 5mls a day, athletes would not be able to obtain the benefits as represented. "A 150ml bottle of the serum retails for $119.95. This is a significant outlay, particularly when people are paying this price based on misleading representations" Ms Battell said. "It's another example of a product where consumers are utterly reliant on claims being made by the company because they have no realistic means of checking the actual composition or effectiveness of the product," said Ms Battell. In sentencing, Judge Everitt commented that people will always have pride in their appearance and are vulnerable to this kind of marketing. The Act is designed to create fair trading and to protect the public from "snake oil people and the like", he said.

Pro:
n/a
Con:
despite advances made in trying to suspend creatine in a liquid, it is still considered an unstable form

Creatine in a formed product source:
Creatine, of various types, is used to make a variety of convenient products ranging from nutritional bars, tablets and capsules, to chewable gums.

Pro:
very convenient form
Con:
actual creatine content may be low
actual creatine which is absorbed may be low
there is the possibility of not maintaining proper hydration when using creatine in this form

Dosage Rates:
The following values are provided for creatine monohydrate use.

General Dosage Rates:

Loading Phase:
This area is often debated but studies on individuals using creatine have shown that after a 4 week period, creatine levels in the body are almost identical between those who went through a loading phase followed by a maintenance phase and those who just consumed a set dosage without any loading. Additional studies have shown that some individuals (as high as 30%) do not respond to creatine loading with their total muscle creatine levels only rising 8% (or less) in comparison to the 20% increase by individuals who do respond to a loading phase.

However, if you wish to see quicker results in the initial period of using creatine then a loading phase will produce this. Consume 5 grams, four times per day for the first five days. Follow this with a maintenance phase. To increase the absorption rate, consume a high-glycemic carb source (dextrose) shortly after taking the creatine. Fluid intake should be a minimum of 375 ml (12 fl.oz) per serving of creatine.
Maintenance Phase:
Consume 5 grams, twice per day. On workout days, use it 30 minutes prior to and 30 minutes after your workout. To increase the absorption rate, consume a high-glycemic carb source (dextrose) shortly after taking the creatine. On non-workout days, space your creatine consumption out throughout the day. Fluid intake should be a minimum of 375 ml (12 fl.oz) per serving.

Exact Dosage Rates:

Loading - 0.3 grams per kg of lean body mass for 5 days
Maintenance - 0.03 grams per kg of lean body mass thereafter
Alternatively - 3 grams for 28 days straight (no loading phase)

*1 kilogram = 2.2046 pounds

Cycling Creatine:
As with most things you consume, your body will eventually grow accustomed to and react differently to a product. In the case of creatine, you can cycle it 4 weeks on and 4 weeks off to maintain its effectiveness.

*** Maintain proper hydration at all times when using creatine.***

What are the negative side effects of taking creatine?
You may experience a slight burning sensation of the tongue or mouth when you first begin taking creatine. Other side effects may also include muscle cramping, nausea, stomach upsets, diarrhoea, vomiting, and dehydration. Most of these result from either incorrect use or insufficient water consumption while using creatine.

Cautions:

Creatine in high doses over long periods of time may lead to kidney and liver problems.
Avoid taking creatine if you are exercising or performing strenuous activity outdoors in the heat as this may result in dehydration and/or heat exhaustion.
Creatine should not be used in combination with Non Steroidal Anti-Inflammatory Drugs (NSAIDs) such as aspirin as this may put additional stress on your kidneys.
Correct hydration at all times is extremely important when using creatine.

Interactions & Misc.:

Caffeine:
Caffeine will have diuretic properties which will result in an increase in urination. This may then lead to an imbalance in the body's water / sodium ratio and result in dehydration. Creatine, as you know now, is a cell-volumiser which is reliant upon the presence of sufficient water and also existing sodium. In moderation, the consumption of caffeine should not pose a problem. Higher rates of consumption of caffeine from all sources (i.e.: coffee, tea, soft drinks, chocolate, thermogenic supplements) will interfere with the resynthesis process of phosphocreatine and should be avoided.
Creatinine:
Creatinine is a normal by-product of creatine in the body. The amount of creatinine present in the body is dependant upon the amount of muscle mass of the individual and normal kidney functions. Individuals who exercise or consume high amounts of meats or supplement with a creatine based product will have higher levels of creatinine within their body. If you are undergoing tests for creatinine levels or creatinine clearance, then make sure you inform your physician that you are supplementing with a creatine product. An abnormally high creatinine level may be a sign of kidney problems.
PCT (Post Cycle Use):
Some people also like to load up on creatine after a steroid cycle to help maintain their gains and prevent a post cycle crash.
Disreputable Creatine Manufacturers / Suppliers / Distributors:
From the above information, you can see just how many different forms and names which are associated with creatine products currently available. This is further increased by the number of branded 'creatine based' products currently on the market. With all that competition, companies have to promote their particular brand to secure a portion of the creatine marketplace. In many instances though the presence of their product has come at the expense of quality and safety to you the consumer. Questionable or low-grade manufacturing techniques have resulted in many creatine based products currently on the market to have levels of contaminants which are considered high or, in some cases, extreme. If you are thinking that it is only the lower priced creatine products or those which are manufactured in China that are delegated to this category .... think again. Several of the most popular, most expensive brands of creatine marketed by well known companies within the supplement industry have levels of dicyandiamide which are considered extreme. (refer back up the page to 'Impurities found in low grade creatine supplements' for more detailed information) If you have any questions about any creatine based supplement, contact the manufacturer prior to purchasing the product. If they refuse to provide you with the necessary information to your questions then advise the respected manufacturer why you will not be purchasing their product. Don't support an industry which will not support you.
Use your own judgement:
Although the effects and side-effects of creatine supplementation have been studied, you have to exercise your own judgement as to how your own body responds to creatine. If you note any negative effects not covered here which you can attribute to the use of creatine, then discontinue using this supplement.

KIAN PHILLIPS -- BSc/SpSc - CPT
Copyright 2005 (Any reproduction of this article without written consent is prohibited)