Should ENDURANCE athletes take CREATINE?

Creatine is a molecule that is found within your cells. It is a natural, nitrogenous organic acid used primarily by muscle cells to provide quick-acting energy. 95% of the creatine in the body is stored in skeletal muscles, with the remaining 5% in the brain. Creatine is composed of three amino acids: L-arginine, glycine, and L-methionine, and it can be synthesized in the body or obtained in the diet through red meat, fish, or supplements.

Supplementing with it can increase its cellular concentration level leading to several health and performance benefits

Studies have shown that creatine can increase strength gains from resistance training by between 5-10% (Creatine Supplementation & upper limb strength performance - A systematic review and meta-analysis, Lanhers et al. Sports Med 2017 Jan). This increase will be less with a well trained individual.  These performance benefits are possibly due to creatine's important role in cellular energy production (Creatine phosphate : pharmacological and clinical perspectives, Strumia et al. Adv Ther 2012 Feb) 

Creatine needs depend on your activity level. The International Society of Sports Nutrition (ISSN) reports that larger athletes who train vigorously and intensely may need 5-10 grams of creatine per day, while smaller people and sedentary individuals will need less. Power athletes have the highest demand, as they are more likely to use up their stores of creatine on a daily basis. Additionally, individuals with certain muscular disorders, such as muscular dystrophy, may have even higher needs. Vegans and vegetarians may have more to gain by taking a creatine supplement as they don’t take in any with diet. 

Creatine is approved for use by athletes competing under the International Olympic Committee (IOC) or the National Collegiate Athletic Association (NCAA). The International Society of Sports Nutrition (ISSN) along with the American Dietetic Association, Dietitians of Canada and the American College of Sports Medicine have all stated that creatine is the best ergogenic (effective) sports nutrition supplement.  However, at very high doses (over 20g/day), there is a potential for adverse effects to the liver, kidney, or heart, along with less serious side effects such as stomach pain, nausea, diarrhea, and muscle cramping. Studies have shown that it is safe at 5g per day even if there is kidney issues (one particular study showed no ill effect with daily creatine use of 20g with an individual with kidney disease).  Pregnant women or those with severe kidney disease, hypertension, or diabetes are advised not to take creatine supplements and should seek medical advice. 

When to take and dosage?

On days you exercise you should take 3-5g shortly before and after exercise. This has been shown to be more beneficial than long before and after exercise but it is unclear if there are any benefits taking it before or after. I have read one study that suggested 0.03g/kg bodyweight is an adequate dosage. This would mean for a 70kg person that would be slightly above 2g. I now take 3g compared to the 5g I used to take. On rest days the timing is less important. If you consume caffeine before a workout then it would be best to take post workout as there have been some studies demonstrating that caffeine can effect creatine absorption negating it's benefits. There is no requirement to load up with creatine when you first start taking it. In the past it was recommended to take 15-20grms a day for the first week. It has also been shown that you don't have to cycle off creatine.

There are past studies showing no benefit for endurance athletes and more benefits shown for power and strength I feel this is too reductionist; as even endurance athletes have speed and strength aspects to their training.

“Creatine supplementation was found to have no influence on the cardiovascular system, oxygen uptake, and blood lactate concentration. The fall in blood glucose during the exercise test was significantly reduced after consumption of creatine. Although interval power performance was significantly increased by 18%, endurance performance was not influenced.” Creatine supplementation in endurance sports, Engelherdt, M, et al, Medicine & Science in Sports & Exercise, July 1998, 30 (7) 1123-1129

Creatine has traditionally been thought to be most effective for runners focused on speed and shorter distances. There is a growing amount of research indicating that taking creatine with carbohydrates post run may enhance muscle glycogen stores, making it potentially beneficial for distance runners as well. Speed work is a staple of run training even with long distance running. I give 30sec VO2 max efforts and 200m track repeats to my marathon and ultra athletes to mix training up. Going through the gears also help long distance runners work on upright form, and increased cadence.  Creatine supplementation is particularly useful for improving performance in interval training.  A 2003 study demonstrated that creatine supplementation led to a 5% increase in lactate threshold, meaning you can run at a higher pace for much longer without redlining. This would benefit long distance athletes.  Perhaps even more interestingly for endurance, some studies show creatine can actually reduce physical fatigue.

“It provides an anabolic signal so can be useful in the maintenance of muscle mass. For people with broken bones, if they take creatine it helps maintain the muscle mass within that limb….So for people injured or ill and not doing so much training, creatine can help support lean muscle mass. It means you can get back into your training quicker because you haven’t had that muscle atrophy. So it can be a tool in that nutritional case.”  Dr. Mark Tallon

Emerging research is showing creatine can benefit cognitive function including reducing mental fatigue, improving sleep patterns and improving memory, which can help any athlete from any sport feel better and make better decisions. Creatine monohydrate is a cheap and safe supplement that more athletes could be using to improve performance and general wellbeing. As always it will provide more benefit of the big rocks of the wellness wall are taken care of first. Quality sleep, appropriate training for your individual needs, a whole food plant slanted diet, and restorative habits to help cope positively with stress must be the foundation. Any supplements are just supplementing the big rock habits and their effects will be greatly dampened without having good lifestyle habits in place first. 

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Andy and I at the Tauranga Cross country champs in 2021