Creapure®



CREATINE OVERVIEW

Creatine: a natural energy source

Creatine is a natural substance found in the human body. It is essential to life, and the average adult has 80 - 130 grams of creatine in his or her body.

Creatine plays a vital role in transporting energy within each of the body’s trillions of cells – in skeletal muscles, the heart, brain and other organs. As well as acting as an energy carrier, creatine almost certainly has other benefits that scientists do not yet fully understand. Many researchers believe creatine is important for the function of organs including the brain, and for general health.

Scientists have studied creatine for nearly 200 years. They class creatine as a “nitrogen-containing organic acid” with the formula C4H9N3O2. In biological terms creatine is a small and fairly simple molecule.

Most people get around half of their daily creatine requirement from eating fresh meat and fish, which are practically the only dietary sources of creatine. The rest is made within the body.

Anyone who does not eat a balanced diet, especially vegetarians and vegans, may have lower than normal creatine levels.

Creatine as a dietary supplement has been scientifically proven to increase physical performance. In this role creatine has been approved by health regulatory bodies and sports agencies worldwide. It is known to be absorbed easily by the body and to have no harmful effects when properly manufactured and taken at the recommended dose.

Muscle power from creatine

Approximately 90 percent of the body’s store of creatine is found in skeletal muscle – the type of muscle we normally think of as such. All living cells need energy, and muscle cells in particular consume large amounts of energy as they work. Creatine helps to provide this energy.

Muscle cells get their energy in several different ways. During prolonged exercise, for example long-distance running, the body produces energy first by using its stores of glycogen (a form of carbohydrate) and then by burning fats. Because these processes depend on oxygen from the air they are called “aerobic”.

During short-term intensive exercise such as sprinting, however, muscles need huge amounts of energy immediately. At the start of this “anaerobic” exercise, the muscles therefore have to rely on energy stores that are available immediately. These energy stores take the form of chemical substances known as ATP (adenosine triphosphate) and phosphorylcreatine (PCr).

ATP and PCr work together to ensure that the required energy is available immediately, bridging the gap until more energy can be produced by metabolizing glucose (glycolysis), glycogen (glycogenolysis) and fat (lipolysis and fatty acid oxidation).

ATP, ADP and creatine

ATP (adenosine triphosphate) is the energy currency for all biological processes – and it is backed up by creatine.

A molecule of ATP has three chemical groups called phosphoryl groups attached to a central framework. Losing one of the phosphoryl groups converts ATP to adenosine diphosphate (ADP) and releases energy to power the cell.

The body eventually turns ADP back into ATP using energy derived from food, but this takes time, and muscle cells can store only enough ATP to allow a few seconds of high-intensity work. For more sustained exercise they need a faster way to regenerate their ATP, and this is where creatine comes in.

When muscles are resting, approximately two-thirds of their creatine exists in an energetically charged form known as phosphorylcreatine (PCr). Each PCr molecule is a creatine molecule with an added phosphoryl group. Before hard-working muscles run short of ATP, an enzyme called creatine kinase (CK) strips the phosphoryl group from a PCr molecule and transfers it to an ADP molecule, converting ADP back into ATP. Since CK is one of the fastest enzymes in nature, this ATP regeneration process is very efficient and keeps ATP levels high for some seconds. Only after approximately 80 percent of the PCr pool has been used up do ATP levels start to drop.

This allows the muscles to keep on working anaerobically until the supply of PCr runs short. Once the muscles are resting again, the phosphoryl group that was taken from PCr to regenerate ATP is added back to creatine, turning it back into PCr. Once the PCr “pool” has returned to its previous level, it is ready to provide ATP during the next bout of exercise.

Creatine from food

Creatine itself breaks down slowly in the body over time (see the section on metabolism). To balance this natural loss, an average adult needs to replace creatine at a rate of around 2 - 3 grams per day.

Just like human muscle, meat and fish contain creatine. Anyone who eats a balanced diet typically gets around half their creatine requirements directly from these food sources; the rest is made within the body (see the section on synthesis).

The table below shows the average amounts of creatine found in various raw foods:
Creatine content of various raw foods (g/kg)      
Meat     3 - 7
Fish     3 - 7
Milk     0.1
Vegetables, grains and pulses     0

Cooking destroys some of the creatine content in fish and meat.

People who do not eat a balanced diet may have lower levels of creatine in their bodies. This is especially true for vegetarians and vegans who get little or no creatine directly from their diet. Thus, anyone who does not get enough creatine in their diet may benefit from taking extra creatine as a dietary supplement. This applies especially to people who feel they do not eat enough meat or fish, or who need extra creatine to build muscle, and ensure faster and more complete recovery as part of a training regime.

How the body makes creatine

The body synthesizes creatine from the amino acids glycine, arginine and methionine, which in turn come from food.

The first step of the synthesis takes place in the kidneys and pancreas. Two amino acids, arginine and glycine, are joined together by the enzyme known as AGAT to produce guanidine acetate (GA). GA is then taken up by the liver, where it is converted to creatine with the help of another enzyme, GAMT, and a form of another amino acid, methionine. Creatine is then transported out of the liver and taken up by the target organs, including skeletal muscle, the heart and the brain. This part of the process requires a specific creatine transporter (CrT) to move creatine into the cells.

A typical 70-kg man in his twenties or thirties synthesizes approximately 1 gram/day of creatine; this figure falls with age. For women, the figures are somewhat lower than those for men.

Of the three critical amino acids needed to synthesize creatine within the body, glycine is normally plentiful. Arginine and especially methionine are in shorter supply, however. Synthesizing 1 gram of creatine requires nearly 40 percent of an average person’s daily methionine intake. As a result, people whose diet is low in sources of methionine may have low creatine levels.

Bioavailability and creatine balance

The body of an average adult person typically contains 80 - 130 grams of creatine and phosphorylcreatine, stored mostly in the muscles. When this creatine is used to buffer and transport energy within the cell in the form of PCr, almost all of it is recycled through continuous conversion to phosphorylcreatine and back to creatine again.

However, each day roughly 2 - 3 grams of creatine are lost from this reserve through the breakdown of creatine to a substance called creatinine. The loss is made up from creatine in the diet (roughly 1 - 2 gram/day for non-vegetarians) and creatine synthesized by the body (roughly 1 gram/day).

Creatine has high bioavailability: when creatine monohydrate is taken as a dietary supplement, measurements confirm that, depending on the dosage, more than 95 percent can end up in the bloodstream. Creatine levels in the blood typically peak around one to two hours after creatine reaches the stomach.

People whose diet contains low levels of creatine have been shown on average to have lower creatine levels in their bodies. People who take creatine as a supplement, on the other hand, generally have higher creatine levels. Creatine supplementation eventually causes the levels of creatine in tissue to reach a maximum that it is not possible to exceed. It therefore does not make sense to take high doses of creatine for prolonged periods of time.

The actual amount of creatine stored in the body reflects a balance between the natural rate of creatine breakdown and the rate at which creatine is synthesized in the body and absorbed from the diet. Since the creatine store is large compared to the average daily rates of intake and loss, however, it changes only slowly in response to changes in creatine intake. When creatine is taken as a supplement at the recommended dose of 3 - 5 grams per day, creatine levels in the body take three or four weeks to build up to their maximum.

Metabolism, creatine and creatinine

Some creatine is always being lost from the body as creatine breaks down naturally to a substance called creatinine. Creatinine travels from cells into the blood, from where the kidneys excrete it in urine. Scientists estimate that each day an average adult loses around 1 - 2 percent of his or her creatine reserve by this route. The loss is made up by creatine absorbed from the diet and synthesized in the body.

If someone takes in more creatine than their body needs, most of the surplus is excreted into the urine. However, higher levels of creatine in the body also mean that the rate of breakdown to creatinine increases. More creatine therefore breaks down to creatinine, and the concentration of creatinine in blood and urine may rise somewhat. For the same reason, someone with a large amount of muscle mass may show raised creatinine levels compared to someone with less muscle mass. This is not a cause for concern, because the higher creatinine levels are within normal limits, and creatinine in any case has not been shown to be harmful.

Since doctors measure blood creatinine levels as a routine test for kidney disease, however, anyone undergoing kidney function tests should tell their doctor if they take creatine as a supplement. Elevated creatinine levels that result simply from taking creatine as a supplement are usually not a problem.

To be on the safe side, someone who has pre-existing kidney disease or is at risk of developing it (through diabetes or high blood pressure, for example) should also consult a doctor before taking creatine as a supplement.

Creatine in sport

Through its role in helping to transport energy in the form of phosphorylcreatine within cells, creatine is a natural choice as a dietary supplement for sportspeople. Taking extra creatine increases the reserves of phosphorylcreatine in the muscles. This in turn improves performance and aids recovery in both training and competition.

In the gym, creatine is popular because it allows athletes to train harder and so to add muscle mass faster. Without training, creatine on its own does not create muscle mass. This is quite different from the action of banned substances such as steroids.

Since the 1990s many athletes and scientists have come to see creatine as the most effective nutritional supplement for enhancing exercise tolerance, muscle strength and lean body mass. For resistance training, creatine supplementation has consistently been shown to increase both strength and number of repetitions.

These benefits in training translate to any sports that require bursts of intense muscle power. Sports players and athletes in many disciplines – including competitive cycling, sprinting, swimming and football – have taken creatine for many years with excellent results.

Creatine in the body’s natural form, creatine monohydrate, is established as proven, effective, safe and legal. The European Food Safety Authority (EFSA), for instance, agrees that creatine can increase physical performance during short-term, high-intensity, repeated bouts of exercise. This is now laid down in article 13.1 of the EC Regulation on Nutrition and Health Claims. There is also evidence to suggest that creatine aids recovery from intense exercise.

Creatine’s wider role

Creatine’s importance as an energy buffer and energy carrier in muscles is by no means the end of the story. Over the last two decades, researchers have discovered that creatine plays other important roles both in muscles and in other types of tissues and cells.

For example, creatine is believed to prevent ADP levels in the cell-liquid becoming too high and in the mitochondria decreasing too much, so it controls the ratio of ADP to ATP. This is important for oxidative energy generation within the mitochondria, the “power plants” inside the cells, and indeed may well be one of the most important functions of creatine in cellular energy metabolism. Creatine is also responsible for energy transfer from the mitochondria to the intracellular fluid – a process that is surprisingly complicated and depends on the existence of several different forms of the creatine kinase enzyme.

Creatine is known to act as an antioxidant that reduces cell damage by oxygen radicals. In addition, creatine helps to buffer the cellular pH (acidity). This is most important during intense exercise, when the intracellular fluid tends to acidify. It also plays a part in balancing the various aerobic and anaerobic energy sources available to cells, including glycolysis.

As a result of basic research, many reputable researchers tend to believe that creatine is important in maintaining general health – in muscles, bones, brain and the rest of the nervous system – especially among older people.

Creatine is certainly essential for health, as is shown by the fact that children born without the ability to make or use creatine in their bodies have serious mental and physical disabilities.

Creatine has been shown to be clinically effective for a number of muscle diseases. Although it is not curative per se, as an adjuvant therapy it can delay the onset and progression, for example, of muscular dystrophy. Creatine is now being tested in long-term clinical trials as a treatment for Parkinson’s and Alzheimer’s diseases, for multiple sclerosis (MS), ALS and others.

Creatine monohydrate, salts and mixtures

Creatine for use as a supplement is available in several chemical forms. The basic creatine molecule is always similar, but the chemical groups attached to it can vary.

The natural “standard” form of creatine, which is present in the human body, is creatine monohydrate. This form of creatine, widely used as a supplement, has been and still is the one most widely studied by researchers.

Creatine monohydrate as a powder is stable during storage, effective, safe, and easily absorbed by the body. It is the form of creatine that is typically recognized by regulatory authorities worldwide. For instance, the European Food Safety Authority’s opinion on creatine refers specifically to creatine monohydrate.

So far, peer-reviewed research has not revealed any other form of creatine that is more effective than creatine monohydrate.

Creatine monohydrate does not dissolve very well in water or other drinks, so some people prefer to take more soluble forms of creatine such as creatine citrate.

Weight for weight, these other soluble forms of creatine contain less creatine than creatine monohydrate does. For example, creatine monohydrate is 88 percent pure creatine by weight, whereas other forms of creatine may contain as less as 40 percent.

“Alkaline creatine” is another form of creatine that is claimed to be more stable than creatine monohydrate in stomach acid. The latest research on alkaline creatine shows that it is no more effective than creatine monohydrate, however.

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Apart from creatine monohydrate and related forms with improved solubility, other forms of creatine supplements are available. These have been studied much less than creatine monohydrate, and in many countries they are not legally approved. They are usually more expensive than monohydrate.

There is little scientific evidence to support the idea that novel forms of creatine work better than creatine monohydrate in any way. Some of them are not as effective as creatine monohydrate, in fact, because the core creatine molecule is modified so that it operates in different, and sometimes unknown, ways.

One example is creatine ethyl ester (CEE), in which the creatine molecule is held by covalent chemical bonds, as opposed to the ionic bonds that characterize soluble creatine salts. Whereas creatine monohydrate is known to be absorbed efficiently by the body, there is good scientific evidence that in the stomach and intestines CEE quickly degrades to useless creatinine.

Stability of creatine monohydrate

Stored as a dry powder, creatine monohydrate remains stable for years. When mixed with liquids, however, creatine monohydrate slowly breaks down to form creatinine, which is physiologically ineffective, albeit not harmful.

In mild acids such as orange juice, creatine monohydrate shows less than 5 percent degradation after eight hours, so it is fine to mix creatine monohydrate into drinks as long as these are consumed the same day. In milk or yoghurt drinks, which are alkaline, creatine monohydrate can be stored for a couple of weeks in the refrigerator without degrading significantly.

It is sometimes rumored that creatine monohydrate is quickly destroyed by acid in the stomach. This is not true: research confirms that when creatine monohydrate is taken as a supplement, more than 95 percent passes unharmed through the stomach and is taken up into the bloodstream. From here it reaches the target organs – muscles, heart, brain and others – as intact creatine.

Potential side effects and safety of creatine

Creatine monohydrate is safe to take as a dietary supplement. Compared to licensed drugs, dietary supplements face even more stringent safety rules, and the European Food Safety Authority’s endorsement of creatine reflects the overwhelming scientific position that chemically pure creatine monohydrate is safe when taken at the recommended dosage.

The only documented side effect of creatine supplementation is a slight weight gain. At first this is due to increased water retention in muscle, and later to an increase in actual muscle mass – which is generally welcomed, of course, by athletes.

It is sometimes rumored that creatine can harm the kidneys, but there is no scientifically sound evidence for this. As explained in the section on metabolism, any increase in creatinine levels is not necessarily a sign of kidney failure, but may simply show that the body is disposing of surplus creatine.

Anecdotes on the Internet suggest that some people may suffer from stomach upsets or stomach cramps when using creatine. Controlled scientific studies have failed to reproduce these supposed side effects when chemically pure creatine is taken at the recommended dosage and with enough liquid.

The vast majority of the scientific studies on creatine refer to creatine monohydrate. Other forms of creatine have been studied to a much lesser extent.

As with any dietary supplement, it is important that creatine is free from contaminants. Only use creatine from a reputable source.

How much creatine to take

Although creatine is essential to life, researchers have not yet been able to say exactly how much of it the body needs to remain healthy. Everyone probably has their own requirements, so for example a person who has a demanding training regime and eats little meat may need more creatine than someone who undertakes only moderate activity and eats a considerable amount of meat.

Taking creatine monohydrate as a dietary supplement is known to boost creatine levels in the body. We can certainly say that creatine supplementation in moderate quantities has proven benefits.

    The European Food Safety Authority says that creatine monohydrate is safe if taken at 3 grams per day.
In the USA, an expert panel concluded that an intake of up to 5 grams per day does not pose a risk to consumers.

AlzChem AG recommends a daily dose of 3 - 5 grams of pure creatine monohydrate.

Anyone who looks at the Internet will quickly find that some people suggest taking more than the recommended 3 - 5 grams per day of creatine. They may also start with a high dose for several days before reducing their intake.

However, high-dose regimes are unnecessary. Research shows that after three or four weeks at 3 - 5 grams per day, the body’s creatine levels are the same as they would be following a high-dose phase.

How to take creatine

Creatine monohydrate can be taken either mixed into a drink such as fruit juice, milk, tea or plain water, or in other forms such as powder, bars, capsules, or tablets. To ensure good hydration, creatine should always be taken with plenty of liquid. You do not need to dissolve the powder completely before drinking it; a loose suspension is no problem, because creatine dissolves quickly in the stomach.

Caffeine seems to make creatine less effective, so you should avoid taking creatine at the same time as caffeine. Both substances are metabolized rapidly, so a time lag of an hour or two between creatine and caffeine is fine.

There is some evidence that taking creatine with carbohydrates and/or protein yields synergistic effects that boost the amount of creatine available to the muscles.

Most athletes prefer to take their creatine either less than an hour before training, or immediately after a workout. If you are not using creatine as a training aid, the time of day is not important.

How to take creatine

Food supplements containing creatine

Creatine supplementation has been shown to have positive effects on the energy supply to muscle cells during and between exercises. But what is the most useful dose? We recommend taking 3–5 g of creatine per day. The most common and well-studied form of creatine is creatine monohydrate. This can be used in beverages or in other types of products such as energy bars, capsules or tablets. When taking creatine, make sure that you do so with sufficient fluids (e.g., 3 g of creatine monohydrate in a glass of water).

Taking it in powder form

Creatine monohydrate is often offered as a powder that should be dissolved in water or juice. Warm water or tea makes the dissolving process easier. Creatine monohydrate dissolves somewhat more slowly in cold water or other cold drinks but is not any less effective. Once it is taken, its bioavailability is greater than 95 percent.

It also makes sense to take creatine with sugary drinks (e.g., grape juice) or with a meal because muscles can absorb creatine more rapidly when insulin is present. Taking creatine without sugary drinks is just as effective. We do not recommend ingesting large quantities of simple carbohydrates with creatine.

Creatine and caffeine

It is assumed that there is a negative interaction between pure caffeine and creatine. However, research on this subject has remained inconclusive.  In tests, between 5 and 7 mg of caffeine per kg of body weight were used (i.e., 350–490 mg of caffeine for an individual who weighs 70 kg). Although no negative effects on creatine storage and muscle growth were observed, there may have been an effect on sprinting performance or explosive strength development. It cannot be conclusively assessed, whether the intake of caffeine should be restricted when taking creatine. For the sake of safety, one should avoid heavy caffeine consumption prior to any intense workout.

Creatine intake – capsules and chewable tablets

Taking creatine in capsule or chewable tablet form is just as effective.  Capsules usually contain  750 mg each, while  tablets  usually contain about 1 g. The daily recommended dose is 3–5 g per day.

Other forms of creatine

Even today, creatine monohydrate is the best studied and most reliable form of creatine. Apart from creatine monohydrate and common salts such as creatine citrate or creatine pyruvate, which have improved solubility, there are also other forms of creatine. However, these have not been researched as thoroughly and are not permitted in many countries. They are also usually more expensive than the monohydrate form. There is no scientific evidence that suggests that newer creatine compounds are any more effective than creatine monohydrate. An example of this is creatine ethyl ester (CEE). In contrast to soluble creatine salts, this compound does not break down into separate creatine and salt components when ingested. While creatine monohydrate is almost completely absorbed into the body, there are scientific studies that show that CEE rapidly decomposes into an ineffective form of creatinine in the gastrointestinal tract.

What are the side effects of creatine?

Creatine

Creatine occurs naturally in the body. Supplementation with creatine monohydrate has been shown to enhance physical performance.

Safety of creatine

As a dietary supplement, creatine monohydrate has an excellent safety record. A positive assessment by the European Food Safety Authority reflects the overwhelming scientific evidence that chemically pure creatine monohydrate is safe and has no side effects when used properly.

Supplementation

The only side effect that has been shown is a slight amount of weight gain. On one hand, this is caused by an increase in the accumulation of water in the muscles. On the other, this is caused by a gradual increase in muscle mass, which is exactly what many athletes want.
On the Internet, there are many reports that link creatine supplementation to stomach cramps, diarrhea, muscle cramps and an impairment of liver and kidney function. However, controlled scientific studies have not been able to confirm any of these side effects when pure creatine is taken at the recommended dosage with sufficient liquid. The vast majority of scientific studies refer to creatine monohydrate. Research on other forms of creatine has been limited.

Is creatine harmful?

Creatine as a natural substance

Creatine occurs naturally in the body. Some of it is produced by the body itself, and some of it is absorbed from the foods we eat. Dietary supplementation of 3 g of creatine per day in the form of creatine monohydrate can have positive effects on the body. Research has shown that when creatine is taken as a dietary supplement, it can improve physical performance. Health authorities and sports organizations around the world have also come to this conclusion. Creatine is easily absorbed by the body and has an excellent safety record when manufactured according to high quality standards and taken at the recommended dose.

Articles found on the Internet suggest that the use of creatine may lead to convulsions, stomach pain or dehydration. However, hundreds of studies in which subjects have taken creatine monohydrate have not provided any scientific evidence whatsoever related to these side effects.
The only side effect that has been shown is a slight amount of weight gain. On one hand, this is caused by an increase in the accumulation of water in the muscles. On the other, this is caused by a gradual increase in muscle mass, which is exactly what many athletes want.

Creatine and creatinine

If an individual consumes more creatine than is actually needed, the excess is excreted in the urine. Higher levels of creatine in the body also mean that more creatine will be degraded into creatinine. As a result, the concentration of creatinine in the blood and urine may increase to a certain extent. For the same reason, people with more muscle mass may show higher creatinine levels than those with less muscle mass. This is not a cause for concern because these “higher” levels of creatinine are still within normal limits and creatinine has never been shown to be harmful.

Can creatine go bad?

Creatine monohydrate

If stored properly, creatine monohydrate powder is stable for years.  Proper storage means that it needs to be kept in a dry, cool environment. Like any other food or nutritional supplement, creatine products have a shelf life, which means that they can be safely consumed at any point in time before their best before date expires.

Stability of creatine

When creatine monohydrate is introduced into liquids, it is slowly converted into creatinine, which is physiologically ineffective but not harmful.

In slightly acidic drinks such as orange juice, less than five percent of the creatine monohydrate is broken down into creatinine within eight hours. That means that there is no problem mixing creatine monohydrate with such drinks as long as the mixes are consumed the same day. In the case of alkaline drinks such as those made from milk or yoghurt, creatine monohydrate can even be stored in the refrigerator for up to several weeks without any significant loss in potency.

The widespread claim that gastric acid can quickly decompose creatine is simply incorrect. In fact, most of the creatine consumed passes through the stomach unchanged and is therefore absorbed. More than 95 percent of it enters the bloodstream.

Creatine Water Retention

Water retention and weight gain 

If you take creatine to support an exercise program, a slight increase in weight can occur because of an increase in both muscle mass and water intake into your muscles. An increase in fat-free body mass of up to 1–3 kg tends to occur. However, most athletes welcome this and do not consider it to be a disadvantage.

Creatine muscle growth

Creatine as a dietary supplement

By using creatine as a dietary supplement (e.g., in the form of creatine monohydrate), the amount of creatine and creatine phosphate in the muscles is increased. This improves the energy supply during periods of intensive stress on the body as well as recovery times once the exertion is over. For example, creatine increases performance during high-speed workouts when quick, intensive physical activity is required. The use of creatine can help athletes train more intensively, resulting in improved muscle growth and increased strength.

How is creatine produced?

When deciding to purchase any creatine product, information about the production and purity plays an important role.
There are several ways to produce creatine monohydrate, all of which involve chemical synthesis. AlzChem AG uses sarcosinate and cyanamide as raw materials. This production method is regarded as the best and the safest.

Purity of Creapure®

Creapure® is manufactured according to the strict standards and procedures of the German pharmaceutical and food industry. This means that it is GMP (good manufacturing practices) compliant, which generally ensures a high quality manufacturing processes. The principles of the HACCP (Hazard Analysis and Critical Control Points) approach apply. These are designed to identify and eliminate any sources of contamination or disruption in the processes.  Finally, a dedicated facility was built for Creapure® to help eliminate the risk of cross-contamination and contamination by other products.

AlzChem AG ensures the highest safety and quality standards in its Creapure® creatine product. Each batch of Creapure® is individually tested for purity before leaving the manufacturing facility.

Production in Germany in our own production plant

Creapure® is produced in Germany in a production facility specifically designed to eliminate the risk of cross-contamination and contamination by other products. Not all creatine supplements are subject to the same strict manufacturing standards as Creapure®. Look for the Creapure® logo as a seal of quality. Renowned manufacturers of food, nutritional supplements and sports nutrition products use Creapure® and other high-quality ingredients from AlzChem to produce food supplements to be sold in stores or online.

Creatine capsules

The effect of creatine capsules

Creatine monohydrate is the best-studied form of creatine and it remains the most commonly used type. Creatine monohydrate is sold in various forms: as a powder, in capsules, as chewable tablets and in energy bars. All versions provide the body with creatine, and they all provide the same nutritional benefits.

Capsules as well as chewable tablets or bars are convenient ways of creatine supplementation because the proper amount of creatine for each dose has already been measured, and each of these forms is easy to swallow. However, you should keep in mind that one capsule usually does not provide the recommended daily dose of 3–5 g. You will therefore need to take several capsules each day.

 

Which type of creatine is the best?

The type of creatine that is right for you is purely a question of personal preference. It does not matter if you take it as a powder, a capsule, a chewable tablet or an energy bar. The choice is yours. The only thing that really matters is the purity and the quality of the product. You should therefore only use creatine products that come from known and reliable sources. 

Creatine blood levels

Creatine in the body

The body of an average adult stores approximately 80–130 g of creatine. Creatine and its active form, creatine phosphate, play a crucial role in storing and providing energy for cells. By eating a balanced diet, the body obtains about half of its creatine requirements directly through food. The rest is produced by the body itself. An average man between 20 and 40 years old will synthesize about one gram of creatine per day. In women, the value is somewhat lower than for men.  In both men and women, creatine synthesis decreases with age.

Creatine blood levels

Creatine is not only found in the cells but also in the blood. However, the creatine blood level is usually not used for diagnostic purposes.

Typical levels are:
Creatine blood serum (fasting state)
Adults: 0.3–0.7 mg/dL (23–53 micromol/L)
Creatine urine (24 h collection)
Men: 15–189 mg/d
Women: 19–270 mg/d

Creatine and creatinine

Although it does have its limits, the body does break down creatine into the byproduct creatinine at a rate of approximately two to three grams per day. It excretes the excess into the urine. Because the names creatine and creatinine are very similar, the two terms are often confused. While the creatine blood level usually has no diagnostic significance, creatinine is used as a routine parameter for determining renal function.

What is creatine?

Creatine monohydrate and creatine intake

Particularly in sports, it is common to hear about creatine, creatine monohydrate, creatine supplementation, creatine phosphate, and how creatine supports muscle growth and energy metabolism. But what exactly is creatine and where can it be found in the body?

Creatine biosynthesis

Creatine is an endogenous substance that is formed from the amino acids arginine, glycine and methionine. It is primarily found in muscle cells. It is produced by the liver, kidney and pancreas. Creatine is then transported to the target organs  (e.g., skeletal muscle, heart and brain) and absorbed by them.

Creatine monohydrate

Creatine monohydrate is a type of creatine offered for use as a supplement. It contains creatine in the same form in which it occurs in the body. Numerous studies have examined the efficacy of creatine monohydrate, which is the most common form of creatine used for nutritional supplements. Creatine monohydrate is stable, safe and can be easily absorbed by the body.  It also acts reliably.

How much creatine does the body need?

An adult weighing 70 kg needs about 2–4 g of creatine per day. Approximately half of this is produced each day by the liver, kidney and pancreas. The remainder is absorbed through food (meat and fish). Supplementation with creatine can therefore make sense for vegetarians or people who eat very little meat because they consume little to no creatine. Those who want to actively increase their physical capacity during periods of intensive stress, thereby actively increasing their muscle mass, can also benefit from creatine supplementation. Taking creatine helps optimize creatine levels in the body’s tissues. There is no risk of creatine deposits becoming overloaded.

Supplementation of creatine

Scientific research has shown that using creatine as a dietary supplement improves physical performance during short, intensive and repetitive exercises. This leads to optimal muscle growth and helps to promote long term growth. Higher availability of creatine in muscles improves the energy supply to muscle cells, thereby making it possible to improve performance.

How much creatine should you take?

Each individual probably has his or her own creatine requirement. Those who regularly train but don’t eat much meat probably need more creatine than those who train less but eat more meat.

Harness the benefits of creatine with the right dosage

Supplementation with creatine monohydrate increases creatine levels in the body. The use of moderate amounts of creatine has proven benefits. We therefore recommend taking three to five grams of pure creatine monohydrate daily.

Can I take more creatine?

Regular supplementation with creatine causes creatine levels in tissues to reach a threshold that will not be exceeded. However, each day, a certain portion of the creatine pool is also converted into the biodegradable product creatinine and then excreted. This is a completely natural process. This is the part that needs to be replenished – either through the body’s own biosynthesis, consumption of food and/or nutritional supplementation. If more creatine is taken than the body actively requires, the surplus will be excreted in the urine. Therefore, it does not make sense to take unnecessarily high doses of creatine over a longer period.

Does creatine loading make sense?

Some internet articles suggest taking higher doses than the daily recommended amount of three to five grams of creatine. They recommend starting with a higher dosage and reducing it after a few days.
However, high-doses and creatine loading strategies are unnecessary. Studies show that after three to four weeks of taking three to five grams of creatine daily, the body’s creatine level is just as high as when higher doses are taken at the beginning. While the daily intake of three to five grams of creatine is considered safe, a comparable safety assessment is not available for higher dosages or for creatine loading.

How long should you take creatine?

Permanent intake – creatine in low doses

We recommend using creatine continuously. The recommended daily dose is between 3 and 5 grams. Continuous creatine intake – on exercise and training days as well as training-free days – promotes increased performance and muscle-building. The supplementation of creatine monohydrate has been proven to have positive effects on the body during the intake period and is rated as safe at the recommended daily dose.

Charging phase not recommended

Many articles can be found on the Internet which advise against the continuous intake of creatine and instead recommend a so-called charging phase, beginning with a higher dosage and then reducing the dose after five to seven days. However, charging phase strategies are unnecessary. Studies show that creatine levels in the body in the case of an intake of three to five grams daily after three to four weeks are just as high as after a higher dosage intake at the beginning. In addition, long-term administration with a daily dose of 3 to 5 g is safe.

Creatine supplementation

Why take creatine supplements?

Creatine is a natural substance that the body also produces itself. Our body absorbs the amino acids glycine, arginine and methionine contained in our food and converts them into creatine. Additional creatine can also be directly absorbed through our food, especially from fish and meat. One kilogram of fish or meat contains between 3 and 7 g of creatine.

Those who do not have a balanced diet and eat little fish and meat likely have lower levels of creatine in their bodies. This is particularly true for vegetarians and vegans, who consume little or no creatine through their diet, as well as athletes, who require additional creatine for muscle growth and faster recovery times after strenuous workouts. These groups can benefit from creatine supplementation in the form dietary supplements.

Creatine loading

Some online articles suggest taking doses higher than the daily recommended amount (three to five grams of creatine) and reducing it after a few days.
However, high-doses and creatine loading strategies are unnecessary, and we do not recommend them. Studies show that after three to four weeks of taking three to five grams of creatine daily, the body’s creatine level is just as high as when higher doses are taken at the beginning.

 
Recommended creatine intake

Taking creatine monohydrate as a dietary supplement boosts the amount of creatine in the body. There are many proven benefits of taking moderate amounts of creatine. We recommend a daily creatine dosage of 3 to 5 g. This amount (3 g) of creatine has been judged to be safe by The European Food Safety Authority. An expert panel in the U.S. has indicated 5 g. The most common form of creatine is creatine monohydrate. Depending on the preference of the individual, this can be taken as a powder, a chewable tablet or as capsules. As with any dietary supplement, purity is particularly important with creatine. Therefore, you should only use creatine products that come from known and reliable sources.

Creatinine too high

Creatinine level

Creatinine is a metabolite produced in the body from creatine and creatine phosphate. Creatinine is completely excreted via the kidneys. The amount of creatinine formed (and thus the creatinine levels found in the blood or excreted in the urine) depends on the muscle mass, the physique, the age and the sex of the individual.

 

Increased level

There are various potential causes of increased creatinine levels in the blood. Increased creatinine levels can be an indication of renal insufficiency. Muscle injuries, inflammation of the skin and muscles, burns and certain diseases can also lead to increased creatinine levels.

If the creatinine level increases following creatine supplementation, this is most likely a sign of an increase in the amount of creatine in the muscles. Because the body is storing increasingly more creatine, the proportion of creatine and creatine phosphate that has converted into creatinine will also increase.

 
Renal function

High creatinine levels in the blood can be an indication of renal insufficiency. In this case, the renal filtration rate is so severely restricted that creatinine can no longer be adequately filtered from the blood, thereby resulting in increased creatinine levels. Creatinine levels are therefore often used to assess renal function and treat kidney disease. Kidney damage can be measured by determining the creatinine level. Creatine and creatinine themselves have no negative effect on renal function.

If you have any doubts, speak to your doctor and indicate that you are taking creatine as a dietary supplement. This is important because an increase in creatine reserves following  creatine supplementation may lead to an increase in creatinine levels.

Standard creatinine level

Creatinine level

Creatinine is a metabolic product found in the body. It is a natural by-product of the breakdown of creatine and is excreted in the urine. The creatinine levels in the body depend on various factors. For more information, see What is creatinine?

Creatinine is an easy-to-determine marker for evaluating renal filtration. It can be measured in the blood or urine. The following creatinine levels are considered to be within the normal range:

Creatinine in blood serum
Men: 0.7–1.2 mg/dL (62–106 micromol/L)
Women: 0.5–0.9 mg/dL (44–80 micromol/L)

Creatinine in urine (24h collection)
Men: 1.00–2.40 g/d
Women: 0.70–1.60 g/d

There are different potential causes for altered or elevated creatinine levels. If in doubt, please consult your doctor.

Creatinine side effects

Creatinine

Creatinine is a natural metabolite of creatine and creatine phosphate. If the body cannot use any more creatinine, the kidneys excrete it completely and do not modify it in the process. If the body gets more creatinine through foods (there are certain foods that are particularly rich in creatinine), it is absorbed by the body and excreted again in an unmodified manner. Creatinine does not really benefit the body but also doesn’t harm it either.

The creatinine level in the blood is generally used as an indicator of renal function. However, because the creatinine value can also increase depending on how much creatine is ingested and any increase in the size of the creatine pool in the body, dietary supplementation with creatine can be incorrectly though to negatively affect renal function. However, there is no scientific evidence supporting any form of renal damage from creatine or creatinine.

What is creatine monohydrate?

Creatine Monohydrate is a specific form of creatine that is excellently suited for use as a dietary supplement. It is stable, effective, safe and easily absorbed by the body. Taking creatine monohydrate on a regular basis helps replenish the body's creatine deposits. Up until now, scientists have been unable to find any form of creatine more effective than creatine monohydrate.

Creatine monohydrate is by far the best-studied form of creatine. It is also the type most commonly accepted by food authorities worldwide. In its safety assessment of creatine, the European Food Safety Authority also makes explicit reference to creatine monohydrate.

Other creatine forms

Apart from creatine monohydrate and certain related salts such as creatine citrate or creatine pyruvate, which demonstrate improved solubility, there are also other forms of creatine. However, these have not been researched as thoroughly and are not permitted in many countries. They are also usually more expensive than the monohydrate form.

There is no scientific evidence to suggest that new creatine compounds are any more effective than creatine monohydrate. In some cases, the effectiveness also deteriorates over time because the nucleus of the creatine molecule has been altered in such a way that the newly-formed compound behaves differently and sometimes in an unexplained manner in the body. An example of this is creatine ethyl ester (CEE). While creatine monohydrate is almost completely absorbed into the body, studies have shown that CEE rapidly decomposes into an ineffective form of creatinine in the gastrointestinal tract.

 

 

When should you take creatine?

Taking creatine and supplementation

Creatine supplementation has been proven to have positive effects on the body and physical performance. But what is the perfect time to take creatine in order to support muscle growth?
Despite extensive research on creatine and creatine monohydrate, there are hardly any relevant studies available on the ideal time to take it.

Taking it before or after working out

Most athletes use creatine either less than one hour before or immediately after working out. Using it after exercise can be beneficial because exercising stimulates blood circulation and cells can then be supplied with creatine more quickly. Nevertheless, creatine can be taken at any time.

Taking creatine during exercise-free periods

Supplementing with creatine monohydrate is especially effective when taken continuously. The daily recommended dose of 3–5 g of creatine monohydrate should therefore also be taken during exercise-free periods. Because it is not that important when creatine is taken, it can also be taken with meals.

How does creatine work?

Muscles need energy

About 90 percent of the body’s creatine deposits are stored in the skeletal muscle. All living cells need energy. More than any other cells, muscle cells require large amounts of energy when in active use. Creatine helps make this energy more readily available.

How do muscles gain the additional energy?

In the case of short, intense exercises such as sprinting, muscles need lots of energy in the shortest possible time. At the beginning of any such anaerobic exercise (independent of oxygen), the muscles rely on energy sources that are immediately available. These exist in the form of adenosine triphosphate (ATP) and creatine phosphate.

ATP and creatine phosphate act as energy depots (i.e., a kind of battery). They help bridge the time until the biodegradation of glucose (glycolysis), glycogen (glycogenolysis) and fat (lipolysis and fatty acid oxidation) release further energy into the body.

How is energy released into the muscle?

ATP is the energy needed for all biological processes. The ATP molecule has three phosphate groups. If ATP breaks down a phosphate group, the energy released enables  muscle function. What remains is adenosine diphosphate (ADP), which the body converts back to ATP using energy present in food. However, this process takes longer and only produces enough ATP to last for a few seconds. The body can therefore regenerate ATP levels more quickly if the muscle performance required is longer and more intense.

How can creatine support muscle movement?

When a muscle is at rest, about two-thirds of its creatine capacity is available in the form of energy-rich creatine phosphate, which contains an additional phosphate group. Even before the hard-working muscles run low on ATP, the enzyme creatine kinase (CK) transfers this phosphate group to ADP and converts it back to ATP – but only as long as sufficient levels of phosphocreatine are present. This allows the muscles to work anaerobically until the supply of creatine phosphate becomes scarce. During the next resting phase, the creatine that was created is converted to creatine phosphate by the addition of a phosphate group. Once the supply of creatine phosphate has returned to its initial levels, it is then able to provide ATP during the next round of intense physical activity.

What does creatine do?

Creatine is an ideal nutritional supplement for athletes because it promotes the transmission of energy within the cell structure in the form of creatine phosphate. The storage of creatine phosphate in muscular cells can be increased through supplementation with creatine. This improves performance during periods of intense muscle use, which results in increased muscle growth and greater strength. The larger creatine phosphate pool also leads to a faster regeneration of ATP and therefore helps recovery after intensive exercise – at both the amateur and competitive level.

 

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