Conquering Creatine Myths with Science

Ever since we (EAS) first introduced good ol' creatine monohydrate powder into the U.S. market in early 1993, legends, myths, and folk tales have circulated through the pages of muscle magazines and the floors of gyms like a wind-whipped wildfire. Almost all are the whims and wishes of people who are scientifically-challenged. Let's probe what I consider the most common myths.

Myth 1: Creatine is poorly absorbed.

Ever since Dr. Roger Harris and his lab pals showed in 1992 that creatine monohydrate powder supplementation means more creatine in muscles, creatine retention has been measured (the amount kept in the body). Harris showed that the vast majority of creatine powder consumed is absorbed-about 95% of the dose. A recent study showed that 20 grams of creatine powder per day over 5 days (100 grams total) yielded a total of 46.8 grams of creatine excreted in the urine (if it's in the urine it had to be absorbed!). This means 53.2 grams were retained in the body (primarily muscle), with older men showing similar results. Lastly, absorption stays high even after loading, but the uptake/retention of creatine by muscle is reduced. Special treatments and "delivery systems," such as micronization, effervescent powder, or sublingual sprays have never been shown to produce more retention or absorption than creatine powder. Fact: Straight creatine monohydrate powder is very well absorbed.

Myth 2: Creatine is instantly destroyed by acid, either in the stomach or in juice.

Let's take a common sense pill. If this myth was true, then anytime someone took creatine powder (on an empty stomach, with food, whenever) the stomach acid would destroy it, converting it to creatinINE. Then how do we get 95% absorption into the blood and all of the muscle-specific effects (mass, strength, speed)? What about the early studies that showed creatine retention and increased performance when they took creatine powder mixed into coffee or tea, two quite acidic beverages? It's been known for almost 80 years that creatine degrades more quickly over time as the acidity of a solution it is mixed in increases. But in fruit juices, coffee, tea, or any other typically consumed beverage (where the acidity is not extreme) creatine can easily survive for as long as it takes to mix in and drink. However, ready-to-drink liquid creatine beverages on the market (which add acids like citric acid) are unstable due to the many months it sits on the shelf before consumption. Fact: Creatine easily survives stomach acid and can be mixed with acidic beverages if you consume them shortly after mixing.

Myth 3: Creatine causes muscle cramps and other injuries

Where are the studies showing creatine causes muscle cramps, pulls, and tears? They don't exist. But long-term studies (up to THREE years) led by Drs. Rick Kreider (now at Baylor University) and Mike Greenwood (U Arkansas) have shown that daily creatine monohydrate supplementation to NCAA athletes (football and baseball) training in hot and humid conditions have no more side effects and injuries than those getting carbohydrate drinks. Fact: There are no well-designed studies showing creatine promotes muscle cramps and injuries.

Myth 4: Creatine use by children and teenagers is unsafe.

When it comes to statements like "The effects of creatine supplementation in children are unknown" I'd like to grab its contributor by the ear and drag them down to the nearest medical library. Studies with infants who take almost double the loading dose of an adult (expressed according to body weight) daily, for up to TWO years straight, have shown only positive effects. No liver or kidney damage. No seizures. No cramps. In collaboration with Dr. Kreider's lab we have done short-term (9 days) studies in teen swimmers (boys and girls), showing only improvements in performance. Creatine use in children should not be discouraged from a safety perspective. Fact: All of the available evidence indicates creatine is safe in children and teens (and adults!).

Myth 5: Any amount of sugars boosts creatine retention during loading

This myth is mythical only in the context of the amount of sugars needed to boost creatine retention during the first week loading phase. Not 25 grams, not 50, but 90 plus grams with each dose of creatine. Lower amounts have never been shown to boost creatine retention, and likely do not because they don't produce a big enough insulin "spike."

Newer research has shown that cutting the sugar load by half and replacing it with protein produces the same boosting effect. One can load this way for 1-2 days and get the same (or perhaps greater) muscle creatine retention boost that 5 days of "normal" loading (creatine only) produces. Many forget that protein itself can increase blood insulin-combined with carbs it often is more potent than carbs alone. During "maintenance" (after week 1), an ideal strategy would be to take approximately 5 grams of creatine 1 to 2 times a day with a meal or post-workout meal. To date, no studies have compared the effectiveness of taking 'creatine alone' compared with taking 'creatine with carbs' during "maintenance." Fact: Ninety+ grams of sugars are required to boost creatine retention during a loading period. Half this amount, with an equal amount of protein, works just as well.

A graduate of UC Berkeley, Anthony Almada is a nutritional and exercise biochemist and is the co-founder and past-president of Experimental and Applied Sciences (EAS). He has collaborated on over 25 university-based creatine studies. He is the president and chief scientific officer of IMAGINutrition, Inc.