This Health Supplement Is More Popular Than Ever. But Does It Really Work?

There are many supplements, herbs and tinctures out there that claim to bolster strength and boost endurance. Many don’t actually live up to their promises, but there are some that actually do. One of those is creatine, which claims to help with muscle gains and strength building.
“Creatine is the most commonly used performance supplement and it’s a reasonable one for a lot of our patients,” said Dr. Vijay Jotwani, a sports medicine doctor at Houston Methodist Hospital.
Jotwani said it’s reasonable to use because it’s not banned among competitive athletes ― unlike some performance-enhancing supplements ― and it also has definite benefits. Here’s what those benefits are, according to experts.
“Creatine is a natural substance found in our muscles, and it’s primarily in the form of a molecule called creatine phosphate,” said Dr. Jordan Hilgefort, a sports medicine and family medicine doctor at the University of Louisville Health in Kentucky. “Essentially, it plays a crucial role in providing energy during short bursts of intense physical activity,” such as sprinting or weightlifting.
In one study, weightlifters who supplemented with creatine were able to increase their single rep max by 20 to 30% when compared to those who did not supplement, Hilgefort said.
“So … if you were trying to bench press, that would be the difference of one athlete being able to bench press 100 pounds, and the next athlete being able to bench press 120 to 130 pounds,” Hilgefort explained. Additionally, creatine use resulted in faster sprint times for runners.
However, taking creatine and not exercising isn’t going to help your strength, Jotwani added. “I think the benefits all just come from being able to do a little bit more in the gym with it, rather than without it.”
According to Hilgefort, creatine “increases the water content that is absorbed and stored within muscle cells, in addition to stimulating protein synthesis, which are the precursors to development of muscle tissue.”
It also helps to reduce the amount of muscle breakdown that can happen with these short bursts of physical activity. “So, kind of in multiple different ways it can contribute to generating greater muscle mass and strength over time, particularly when you’re combining that with some type of resistance training,” Hilgefort said.
Think about it: If creatine helps you lift heavier weight or get in a few extra reps, your body is going to respond to that with additional gains from your exercise, Jotwani explained.
“Where the jury’s still out, is for things like distance running,” Jotwani said. As of now, it can’t be said with certainty that creatine also helps with endurance exercise.
But that may change as research evolves. “There’s some limited data that suggests that maybe there’s benefit for endurance athletes as well, with improvements in metabolism of energy and reducing fatigue,” Hilgefort said.
Creatine supplements are largely unregulated. “The quality, the purity of those substances may differ from one product that you might buy to another,” Hilgefort said. Do your research before you buy creatine.
“I would look for creatine monohydrate,” Hilgefort continued, as it’s the most commonly used and most researched creatine supplement.
Additionally, look for products that are third-party verified. These organizations “test for purity [and] for potency to basically say … is your label reflective of what’s actually in the supplement that you’re providing?” Hilgefort explained. “That can be a way to kind of safeguard what you’re purchasing and make sure that what you think you’re consuming is what you’re consuming.”
NSF, a health standards and testing organization, is one group that does this third-party verification — you can visit their website to research products before making a purchase.
“When we talk about medicines or supplements, if it has the potential for benefit, it has the potential for side effects, and creatine is no exception to that,” Hilgefort said.
As mentioned above, creatine increases the absorption of water into muscle cells, so there is an increased dehydration risk, according to Hilgefort.
“I always tell patients, if you’re going to be utilizing creatine for supplementation, [make] sure that you’re staying well hydrated … it’s a little bit easier to get dehydrated, particularly if you’re out performing high-exertional exercise,” Hilgefort said.
There have also been past concerns regarding creatine and kidney and liver issues, Hilgefort noted. If you have a history of kidney or liver problems or are on medications that interfere with your kidney or liver health, it’s important to talk to your doctor before taking creatine.
Additionally, some people deal with stomach upset. But Hilgefort added that stomach upset can generally be avoided if you take the supplement with food and are staying hydrated.
“It’s a fairly straightforward supplement and one that I don’t disagree with people taking, but there are some things definitely to watch for,” Jotwani said. “Most people tolerate it well but if there are side effects, then you want to see a sports medicine doctor that can guide you through it.”
When working with a doctor, they can help you determine if creatine is right for you and, if it’s not, can help you find something that can help you achieve your fitness goals, Jotwani added.
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