Creatine Part III (dosage)

 

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Creatine Supplementation Dosage

A typical diet containing meat products provides about 1–2 g of creatine per day. According to research, this results in muscle creatine stores being approximately 60–80% full. Therefore, creatine supplementation may increase muscle creatine and phosphocreatine (PCr) levels by 20–40%. (Casey et al. 1996, Hultman et al. 1985, Green et al. 1996, Harris et al. 1992, Kreider et al. 2003, Greenhaff et al. 1993)

Loading Phase or Not?

As mentioned, creatine can be consumed either with or without a loading phase. A creatine loading phase typically involves consuming 20–25 g per day for 5–7 days (Casey et al. 1996, Greenhaff et al. 1994, Harris et al. 1992, Hultman et al. 1985). It is recommended to divide the daily dose into smaller portions taken 4–5 times a day, as doses exceeding 10 g may cause gastrointestinal discomfort, such as diarrhea (Ostojic et al. 2008). The loading phase can also be performed relative to body weight, such as 0.3 g/kg/day for 5–7 days. Research suggests that a loading phase significantly increases creatine stores—or at least does so more quickly than supplementation without a loading phase. (Casey et al. 1996, Greenhaff et al. 1994, Harris et al. 1992, Hultman et al. 1985)

Alternatively, a person can take 3 g of creatine monohydrate daily for 28 days (Hultman et al. 1985), though this method leads to a slower saturation of muscle creatine stores compared to the loading phase. As a result, training and performance improvements may also be delayed initially. However, smaller daily doses of 3–5 g per day are well established in scientific literature for increasing muscle creatine stores (Kreider et al. 2018). Although effective, this method delays the time required to reach maximal muscle creatine storage. In the study by Hultman et al. (1985), muscle creatine content increased by approximately 20% with both smaller and larger doses over different periods. In that study, participants consumed either 3 g/day for 28 days or 20 g/day for six days. The current recommendation is to take around 3–5 g of creatine daily for at least four weeks to achieve similar muscle creatine saturation.

If an athlete aims to maximize creatine’s performance-enhancing effects in a short time (under 30 days), a loading phase is recommended. However, if long-term supplementation is planned, beginning with a maintenance dose is sufficient. This approach may also help avoid the potential weight gain associated with creatine loading.

Maintenance Phase

Following the loading phase, a maintenance dose of 3–5 g per day is typically used. (Hultman et al. 1985, Casey et al. 1996, Greenhaff et al. 1994) However, some studies suggest that larger athletes may require as much as 5–10 g per day to maintain creatine stores. (Casey et al. 1996, Hultman et al. 1985, Green et al. 1996, Harris et al. 1992, Kreider et al. 2003, Greenhaff et al. 1993)

There is no research evidence indicating that muscle creatine levels drop below baseline after stopping supplementation (Kreider et al. 2003, Kim et al. 2011). Studies suggest that creatine levels return to baseline within approximately 4–6 weeks (Hultman et al. 1985, Greenhaff et al. 1993, Vandenberghe et al. 1985). Both short- and long-term creatine supplementation (up to 30 g/day for five years) appears to be safe and well-tolerated. Moreover, significant health benefits may be achieved by ensuring a habitual low dietary creatine intake (e.g., 3 g/day) throughout life. (Kreider 2017)

Personally, I wouldn’t recommend continuous creatine supplementation to everyone. A 20% increase in creatine levels in the body does not directly translate to a 20% improvement in performance, as the energy utilization mechanisms of creatine are more complex. However, even a small improvement—such as one extra repetition or an additional kilogram or even 100 g lifted—can be meaningful in competitive settings, making all legal performance-enhancing strategies worthwhile. On the other hand, some may find pure joy and satisfaction in simply adding one extra repetition to their training sets. 😊

Does Timing Matter? What About Carbohydrate Intake?

The timing of creatine intake relative to exercise might be significant (Antonio et al. 2013, Candow et al. 2008 & 2015) From a circulatory perspective, blood flow increases within one second of muscle contraction initiation. Exercise itself can increase skeletal muscle blood flow up to 100 times compared to resting levels. In theory, this could enhance creatine transport and storage in muscles. Thus, an optimal timing window might be 30 minutes before or after exercise. However, current research provides little evidence that creatine timing has a significant impact on performance. Some weak evidence suggests that post-exercise creatine supplementation may be slightly more beneficial, but the effect is marginal. The research on this topic is highly variable, with numerous confounding factors, and more definitive studies on the effects of creatine timing on absorption and performance outcomes are needed.

When taken with carbohydrates or a combination of carbohydrates and protein, creatine has been shown to be more effectively stored in muscles. (Green et al. 1996, Kreider et al. 2003, Steenge et al. 1985, Greenwood et al. 2000)

Personally, I would recommend the amount which is relative to body weight. Then the loading phase would be 0.3 g/kg/day for 5–7 days if the results will be needed sooner. If there is not that kind of need, the smaller dosage might be suitable. For an athlete of 70 kg, the daily need for the loading would be 21 g, in five smaller dosages. Maintenance is then 0,05-0,1 g/kg/day (3,5 g- 7 g) depending on persons activity level and sport activities. It is also good to remember that good, nutrition full food is basis of all.

Photo: Kuva: https://unsplash.com/photos/a-bottle-of-creatine-next-to-a-spoon-on-a-table-e333ulMOZ_o?utm_content=creditShareLink&utm_medium=referral&utm_source=unsplash

Reference: 

Antonio J, Candow DG, Forbes SC, Gualano B , Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS & Ziegenfuss TN (2021): Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?

Antonio J & Ciccone V. (2013): The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength

Bangsbo J & Hellsten Y (1998): Muscle blood flow and oxygen uptake in recovery from exercise

Candow DG, Vogt E, Johannsmeyer S, Forbes SC & Farthing JP (2015): Strategic creatine supplementation and resistance training in healthy older adults

Candow DG & Chilibeck PD (2008): Timing of creatine or protein supplementation and resistance training in the elderly

Candow DG, Zello GA, Ling B, Farthing JP, Chilibeck PD, McLeod K, Harris J & Johnson S (2914): Comparison of creatine supplementation before versus after supervised resistance training in healthy older adults

Casey A, Constantin-Teodosiu D, Howell S, Hultman E & Greenhaff PL (1996): Creatine ingestion favorably affects performance and muscle metabolism during maximal exercise in humans

Cordingley DM , Cornish SM & Candow DG (2022): Anti-Inflammatory and Anti-Catabolic Effects of Creatine Supplementation: A Brief Review

Green AL, Hultman E, Macdonald IA, Sewell DA & Greenhaff PL (1996): Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans

Greenhaff PL, Bodin K, Soderlund K & Hultman E (1994): Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis

Greenhaff PL, Casey A, Short AH, Harris R, Soderlund K & Hultman E (1993) Influence of oral creatine supplementation of muscle torque during repeated bouts of maximal voluntary exercise in man

Harris RC, Soderlund K & Hultman E (1992):Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation

Hultman E, Soderlund K, Timmons JA, Cederblad G & Greenhaff PL (1985): Muscle creatine loading in men

Joyner MJ & Casey DP (2015): Regulation of increased blood flow (hyperemia) to muscles during exercise: A hierarchy of competing physiological needs

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Jäger R, Harris RC, Purpura M & Francaux, M (2007): Comparison of new forms of creatine in raising plasma creatine levels

Kim HJ, Kim CK, Carpentier A & Poortmans JR (2011): Studies on the safety of creatine supplementation

Korthuis RJ (2011): Exercise Hyperemia and Regulation of  Tissue Oxygenation During Muscular Activity. In Skeletal Muscle Circulation

Kreider RB (2003): Effects of creatine supplementation on performance and training adaptations

Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL & Lopez HL (2017): International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine

Kreider RB, Melton C, Rasmussen CJ, Greenwood M, Lancaster S, Cantler EC, Milnor P & Almada AL (2003): Long-term creatine supplementation does not significantly affect clinical markers of health in athletes

Marshall RB, Droste J-N, Giessing J & Kreider RB (2021): Role of Creatine Supplementation in Conditions Involving Mitochondrial Dysfunction: A Narrative Review

Ostojic SM & Ahmetovic Z (2008): Gastrointestinal distress after creatine supplementation in athletes: are side effects dose dependent?

Rawson ES, Clarkson PM, Price TB & Miles MP (2002): Differential response of muscle phosphocreatine to creatine supplementation in young and old subjects

Ribeiro F, I Longobardi I, Perim P, Duarte B, Ferreira P, Gualano B, Roschel H & Saunders B (2021): Timing of Creatine Supplementation around Exercise: A Real Concern? 

Roberts PA, Fox J, Peirce N, Jones SW, Casey A & Greenhaff PL (2016): Creatine ingestion augments dietary carbohydrate mediated muscle glycogen supercompensation during the initial 24 h of recovery following prolonged exhaustive exercise in humans

Schedel JM, Tanaka H, Kiyonaga A, Shindo M & Schutz Y (1999): Acute creatine ingestion in human: Consequences on serum creatine and creatinine concentrations

Steenge GR, Simpson EJ & Greenhaff PL(1985): Protein- and carbohydrate-inducedaugmentation of whole body creatine retention in humans

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Wallimann T, Hall CHT, Colgan SP & Glover LE (2021): Creatine Supplementation for Patients with Inflammatory Bowel Diseases: A Scientific Rationale for a Clinical Trial