Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week we are going to talk about CREATINE. I get a lot of questions about this supplement, especially on our LIVE Q&A Show. I take it myself everyday and find it to be very effective.
Before we get started, I want to clarify the difference between creatine and creatinine (a common question on the show). Creatine is a supplement. Creatinine is a waste product. Creatinine is a serum blood test that is a marker for kidney function.
Can creatine raise your creatinine? (another great question) A lot of people get confused thinking that if you take creatine it’s going to raise your creatinine. Yes it can, but barely. Many people fear taking creatine because it may harm your kidneys, but it really doesn’t.
With that said, let’s dive into creatine.
Creatine
The supplement creatine is very popular among high school, college and professional athletes, as well as those who exercise on a regular basis. Weight lifters take it to improve their performance, increase lean muscle mass, and help with recovery afterwards.
Creatine is a compound found naturally in fish and red meat. It’s also produced in your liver, and stored in your muscle. It is composed of three amino acids:
- Arginine
- Glycine
- Methionine
What does it do for the body? It pulls water into the muscle. Some people worry about this, but they really shouldn’t because 70% of your muscle is water anyway. If you’re trying to get stronger, this is going to help. Note: You’re not going to get stronger or build muscle unless you workout. Think of creatine as an osmolyte, something that draws water in. It’s also anabolic, but it’s not an anabolic steroid.
Does it affect testosterone levels? It does NOT affect testosterone levels, although it could slightly increase DHT levels.
Does it cause hair loss? It’s never been shown to cause hair loss. That’s not a worry.
Think of creatine as a source of muscle energy. I like to call it a high phosphate energy donor. What that means is that it increases your ATP. It donates phosphate to form ADP. ADP increases muscle contractions. Note: Interestingly, this form of creatine gets into the muscle faster than ATP does.
Creatine increases the volume of water in the cell. That means your cell is more hydrated and functions better. It also clears metabolic waste out. In addition to creating this energy, it increases your lean muscle mass. The benefits are there. Now let’s talk about how to add it to your routine.
How To Supplement With Creatine
What type of creatine do I buy? There are different types of creatine on the market, the best is creatine monohydrate.
What form of creatine monohydrate? There are several options (i.e. powder, tablets, capsules) all equally effective, but I prefer the micronized powder form in water.
How much and how often? Take 5 grams every day, even if you’re not working out. Note: If you’re really muscular and weigh around 250 pounds, you may need to take more creatine to get the benefits (i.e., 8 grams a day, versus 5 grams a day). For the average person, 5 grams a day is sufficient. If you weigh under 120 pounds, 3 grams per day is sufficient.
What time of day? The timing is not that important, it’s just remembering to take it once a day, every day. That’s important.
Do I need to load it up? No. It would get in quicker, but you don’t need to load it. Note: The one side effect I see with creatine loading is GI upset (bloating and nausea). I rarely see any side effects using a normal dose of 5 grams per day.
Concerns About Creatine
Back to the question: Can it increase your creatinine?
It might increase your creatinine just a little bit, but it’s important to remember that this is a very inaccurate measurement for people who workout. Usually people who are fit, muscular, and workout a lot, are going to have a slightly higher creatinine blood marker. When you build muscle, it pops that up just a little bit (so could creatine).
The creatinine blood marker is really not a good measure of your kidney function. In those situations, neither is the GFR (Glomerular Filtration Rate). You have to look at the person in front of you and say, “That’s a healthy person, they’re active, their creatinine is 1.35 (which is on the high normal side), but that’s a healthy person. Just look at them.”
Note: In some cases you may want to follow it (creatinine). You should probably follow it anyway. For those that are worried, look at your Cystatin C. This is a much better marker for kidney function than creatinine, or GFR. I will sometimes look at Cystatin C, because it’s not influenced by muscle mass, sex, race, or anything else. It’s very accurate.
Do you need to cycle off of creatine? Not really. You could if you wanted to, but I don’t think you need to.
Do I take creatine with food? I usually take it with food, because it could cause a little nausea or bloating, but I never see that at the recommended dose of 5 grams. I mix it with my protein supplement. Note: You should hydrate. Most people who work out a lot should drink a gallon of water per day. I think the powder is the best absorbed.
Does it harm your kidneys? That’s what everybody worries about. No. It does not. At first, it was thought to elevate it a little bit, but it does not harm your kidneys.
What about people with diabetes? Studies have shown it to be helpful for Type 2 diabetes. The Glut 4 Transport System really enhances insulin function. It has not been shown to adversely affect Type 1. It may even help. Note: With diabetes you’re going to keep an eye on these markers anyway. When you’re on chronic medication (such as insulin), every 6 months to a year, you should check a CBC and CMP to look at your renal function, liver function, blood count, etc.
Benefits Of Creatine
There are lots of positive benefits from taking creatine. It is…
- Very neuroprotective.
- Helps with anxiety and depression.
- Helps with PTSD and TBI. Note: If someone had a concussion, I would immediately tell them to get on creatine, if they weren’t already on it.
- Has no calories in it.
- Does not affect your fat metabolism.
There have been hundreds of studies done on creatine. It’s one of the more maligned, misunderstood supplements out there. Note: Once again, it does not increase your testosterone levels, nor does it cause hair loss.
It may be more effective for women than men. Women have more hormonal shifts, and they naturally have lower levels of creatine in their brains (particularly the frontal lobes that control your mood, cognition, memory, and emotion).
Contraindications
- TAGAMET (Cimetidine), a medication that reduces the amount of acid in your stomach, can also cause gynecomastia, so I hardly ever use it. Note: There are benefits of Tagamet, but you don’t want to take it with creatine.
- DIURETICS, medicines that help reduce fluid buildup in the body (sometimes called water pills) can affect water balance. You may want to think twice about taking diuretics when taking creatine.
- NSAIDS, a class of drugs used to treat inflammation, mild to moderate pain, and fever (i.e., aspirin, ibuprofen, naproxen). If you have prolonged use of NSAIDS, it can affect your kidney function. Note: It is important to keep an eye on your kidney function.
- PROBENECID, a medication used to treat gout. I don’t use it much, but it could have an interaction with creatine.
Closing Thoughts
I really like the effects of creatine. Both Dr. Andrew Huberman and Dr. Peter Attia (two of my favorites) say positive things about it. It’s a safe, inexpensive and helpful supplement, but if you’re not going to workout, you’re not going to gain muscle. For creatine to be beneficial, you need to workout.
The goal is optimal health. If you workout, lift weights, want to get stronger, want to enhance your brain, think about the supplement CREATINE. Note: Always follow up with your blood markers and check with your doctor to make sure it’s ok with them, before taking creatine.
Stay educated. Stay healthy.
Till next week.
*This is not medical advice. The intention of this article (and all my other content) is simply to open your eyes to see what’s out there and available.