Creatine

Mechanisms:

• Increases phosphocreatine stores in muscle
• Enhances ATP regeneration during high-intensity exercise
• Increases cell hydration (draws water into muscle cells)
• May increase IGF-1 and satellite cell activity
• Crosses blood-brain barrier; supports brain ATP

Key studies:

• Rawson & Volek (2003): Meta-analysis showing 8% greater strength gains vs placebo
• Branch (2003): Meta-analysis confirming increased lean body mass
• Avgerinos et al. (2018): Review showing cognitive benefits, especially under stress

Effect sizes:

• Strength gains: 8-14% greater than training alone
• Lean mass: 1-2 kg greater over 4-12 weeks
• Power output: 5-15% improvement
• Cognitive: Small to moderate effect under stress/sleep deprivation

Limitations:

• Non-responders exist (~20-30% see minimal benefit)
• Weight gain from water retention (1-2 kg)
• Most research on young males; less data on older adults
• Cognitive benefits need more research

Standard protocol:

1. Take 3-5g creatine monohydrate daily
2. Timing doesn't matter - consistency does
3. Take with food or without - absorption is similar
4. No cycling needed - take continuously

Loading protocol (optional):

• 20g/day split into 4 doses for 5-7 days
• Then maintain with 3-5g/day
• Reaches saturation faster but not necessary

For cognitive benefits:

• Same dose: 3-5g daily
• May take 4+ weeks to see effects
• Benefits most apparent under stress or sleep deprivation

Common mistakes:

• Underdosing (need 3-5g, not 1-2g)
• Inconsistent use (daily is key)
• Expecting immediate results (takes 2-4 weeks)
• Buying expensive forms (monohydrate is best)

Known risks:

• Weight gain (1-2 kg from water retention)
• Possible GI discomfort if taken without food
• Anecdotal reports of muscle cramps (not confirmed in studies)

Contraindications:

• Pre-existing kidney disease (consult doctor)
• No evidence of harm to healthy kidneys despite myths

Debunked concerns:

• Does NOT cause kidney damage in healthy individuals
• Does NOT cause hair loss (no quality evidence)
• Does NOT cause dehydration (opposite - increases hydration)

Interactions:

• Caffeine may reduce some ergogenic effects (conflicting data)
• No significant negative drug interactions known

Ideal for:

• Anyone doing resistance training
• Athletes in power/strength sports
• Older adults wanting to preserve muscle
• Vegetarians/vegans (lower baseline creatine stores)
• Those seeking cognitive edge under stress

Should skip:

• Those with kidney disease (consult doctor first)
• People who can't tolerate water weight gain
• Those in weight-class sports near competition

Best responders:

• People with lower baseline creatine (vegetarians, vegans)
• Those doing high-intensity training
• Individuals under 40 (though older adults still benefit)

What to measure:

• Body weight (expect 1-2 kg increase initially)
• Strength on key lifts (bench, squat, deadlift)
• Training volume (reps x sets x weight)
• Subjective recovery between sets

Tools:

• Workout log to track lifts
• Scale for body weight
• Optional: DEXA scan for body composition

Timeline:

• Weight increase: Within first week
• Strength gains: 2-4 weeks
• Visible muscle fullness: 2-4 weeks
• Cognitive effects: 4+ weeks

Signs it's working:

• Increased weight (water + muscle)
• More reps on later sets
• Faster recovery between sets
• Muscles feel "fuller"

Recommended (monohydrate):

• Thorne Creatine - NSF certified, high purity
• Creapure - German-made, gold standard
• NOW Sports Creatine - Good budget option
• Bulk Supplements Creatine - Best value

What to look for:

• Creatine monohydrate (not other forms)
• Third-party tested (NSF, Informed Sport)
• No unnecessary additives

What to avoid:

• Creatine ethyl ester (less effective)
• Liquid creatine (degrades quickly)
• Overpriced "buffered" or "advanced" forms
• Products with excessive fillers

Budget ($10-15/month):

• Bulk Supplements - ~$0.03/g
• NOW Sports - ~$0.04/g

Mid-range ($15-25/month):

• Creapure brands - ~$0.05/g
• Optimum Nutrition - ~$0.05/g

Premium ($25-40/month):

• Thorne - ~$0.08/g (NSF certified)

Cost-per-benefit assessment:

Creatine offers exceptional value. Even premium brands cost under $1/day. Budget options are equally effective - you're paying for purity testing, not better creatine.

Researchers:

• Andy Galpin, PhD - Muscle physiology expert
• Layne Norton, PhD - Evidence-based nutrition

Practitioners:

• Andrew Huberman, PhD - Protocols and mechanisms

Reddit communities:

• r/supplements - Frequent creatine discussions
• r/fitness - Wiki recommends creatine
• r/naturalbodybuilding - Staple supplement

Common positive reports:

• "Most noticeable supplement I've ever taken"
• "Definitely stronger on my later sets"
• "Muscles look fuller, especially when training"
• "Helps me push through tough workouts"

Common complaints:

• "Gained water weight initially"
• "Didn't notice anything dramatic" (non-responder)
• "GI issues when taking on empty stomach"

Pairs well with:

• Resistance training - Required to see benefits
• Carbohydrates - May enhance uptake (not required)
• Beta-alanine - Complementary mechanisms
• Protein - Both support muscle protein synthesis

Timing considerations:

• Timing doesn't matter - just take daily
• Some prefer post-workout with protein shake
• Can take with or without food

Stacks with:

• Caffeine (conflicting data on interaction)
• Beta-alanine (different mechanisms, additive benefits)
• HMB (for older adults or during calorie restriction)