Creatine and Enhanced Athletic Performance

by Stephanie Sharpe

Creatine supplements have become popular in recent years as an athletic performance enhancement supplement.  For years it was only available in a white gritty powder and needed to be mixed with juice.  Today, various types of creatine come in various forms including capsules, tablets, and flavored powder.


Creatine is a combination of 3 amino acids (arginine, glycine and methionine) and is a natural substance the body produces that turns into creatine phosphate.  Creatine phosphate helps make a substance called adenosine triphosphate (ATP) which provides the energy muscles need for quick and explosive athletic movements. Creatine is also found in meat and fish.


How it works

When working out, especially when lifting weights or engaged in explosive exercise, the muscle burn you feel is actually the process of damaging your muscles.  This is a good thing.  Microtrauma, which is tiny damage to the muscle fibers, is thought to play a significant role in muscle growth. When microtrauma occurs from weight training or other strenuous activities, “the body responds by overcompensating, replacing the damaged tissue and adding more [which is muscle growth], so that the risk of repeat damage is reduced.” (Chargé SB, Rudnicki MA, 2004).


Amino Acids (the building blocks of protein) are the construction material used by the body to replace this damaged muscle tissue. Creatine’s core amino acid profile thus aids in the body’s repair of this tissue.  Creatine is thought to assist in quickening the repair process and as a result, quicken recovery which enhances athletic performance. It may also allow the body to use fuel more efficiently during exercise though studies of this are inconclusive. Increased creatine levels result in a quicker regeneration of ATP which enables athletes to maintain a more intense and higher quality workout. It has also been shown to stimulate the production of insulin like growth factor (IGF-1) which leads to muscle hypertrophy, aka, muscle growth. (Cooper, Naclerio, Allgrove, & Jiminez, 2012).



Supplementation protocol begins with a loading phase – usually one week of 20-25 grams of creatine daily. Thereafter, 5 gram daily doses are needed to maintain levels (Cooper, Naclerio, Allgrove, & Jiminez, 2012). However, some scientific circles argue the loading phase is unnecessary.  Regardless, follow the instructions for use on your chosen supplement.



There are many studies done on subjects using creatine and the results are varied. Overall it seems that creatine supplementation is a useful ergogenic (stimulating performance) supplement for some types of short-term high intensity training, but is anabolic (stimulating growth) with prolonged training (Hopkins, 1999). Power lifters or anyone using the anaerobic system (in essence, intense workouts) could benefit from creatine supplementation whereas endurance athletes who use the aerobic system may see some benefits of supplementation yet may notice a decrease of gains in time (Jenkins, 1998).


According to one study, a regular positive finding of creatine supplementation is enhanced physical performance, muscle gain, and higher fat free mass when combined with heavy resistance training (Cooper, Naclerio, Allgrove, & Jiminez, 2012 and Francaux & Poortmans, 2006).


It does seem evident that, with a combination of creatine supplementation and resistance training, an increase in maximum and endurance strength as well as muscle hypertrophy can be achieved. More noticeable effects have been seen with short duration but high intensity exercises. The key is how the supplement is used with training.  According to, “Creatine does not make you stronger or faster, you make you faster or stronger. Creatine allows you to train at a higher intensity level and to recover faster.”


Side Effects

Supplementation can cause a slight increase in creatinine levels, urinary methylamine, and formaldehyde – all of which are toxic waste products.  However, there is no progressive effect resulting in negative renal function and all levels remained in the normal and healthy range during the Cooper et. al. study. This of course, is as long as proper dosages are followed. Another side effect of creatine supplementation is an increase in intracellular water retention which can result in increased muscle stiffness and a decreased range of motion. This effect will subside once supplementation is stopped. Despite this effect, creatine can cause dehydration and thus, increased water intake is recommended when on a creatine supplement. It should be noted that some studies have found an increase in gastrointestinal complaints such as vomiting and diarrhea but determined that these symptoms were most likely due to the ingestion of incompletely dissolved creatine (Francaux & Poortmans, 2006).



In 1998 there was a health scare during which a multitude of medical problems were said to be due to creatine supplementation. These problems included: dyspnea, fatigue, grand mal seizures, intracerebral hemorrhage, vomiting, diarrhea, nervousness, rhabdomyolysis, severe stomach cramps, arterial fibrillation, and even death (Francaux & Poortmans, 2006). However, there was no real scientific evidence to back up the claims. Clearly, further research needs to be undertaken to understand the pros and cons of creatine supplementation.  Regardless, it is ultimately up to the individual whether he or she decides to use it.


The real concern as with any supplement is use by athletes under the age of 18.  Despite the popularity of creatine among young people, there has been very little research conducted in this age group. Of those studies, a few have suggested a positive effect but the overall evidence is inconclusive. In one study, teenage swimmers performed better after taking creatine; in another study, it helped high school soccer players sprint, dribble, and jump more effectively.


Researchers still don’t know the long-term effects of taking creatine supplements, especially in young people. Adolescents who take creatine often do so with a belief that if a little is good, a lot is better, which results in their taking more than the recommended dose.  This issue is of genuine concern as the prevalence of creatine and general supplement use increases among young athletes. According the, an estimated 40% of college athletes and up to half of professional athletes say they use creatine supplements.


If considering the addition of creatine or any supplementation, consult your personal trainer and physician, and always, start in moderation to check for tolerance.



Chargé SB, Rudnicki MA (2004). “Cellular and molecular regulation of muscle regeneration”. Physiol. Rev. 84 (1): 209–38.


Cooper, R., Naclerio, F., Allgrove, J., and Jiminez, A. (2012). Creatine supplementation with specific view to exercise/sports performance: an update. Journal of the International             Society of Sports Nutrition, 9(33).


Francaux, M., & Poortmans, J. R. (2006). Side effects of creatine supplementation in athletes. International Journal Of Sports Physiology & Performance, 1(4), 311-323.


Hopkins, W.G. (1999). Polarized training and hypoxic muscles: Highlights of the ACSM annual meeting. SportScience, 3(2).


Jenkins, M. (1998). Creatine supplementation in athletes: Review. Retrieved from SportsMed.  Retrieved from

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