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Creatines ain't Creatines

Posted on September 9, 2018

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Creatine is one of the most well-known nutritional supplements having first hit the market in the early 1990s. It is used to improve athletic performance for power sports and exercises and to support increases in lean muscle gains. Creatine supplementation brings a number of physiological  benefits. According to Paul Greenhaff, a professor at the University of Nottingham who specialises in muscle metabolism, creatine supplementation increases the rate of water uptake by muscle cells, allowing for faster protein synthesis. When creatine supplementation is combined with weight-lifting, this leads to increased growth of muscle fibres. [1] Following the ingestion of the amino acid creatine, the body converts it to phosphocreatine. This substance is stored in the muscles due to its use in the creation of ATP, an energy source used by the body for short-duration, high intensity exercise such as sprinting and weight-lifting. Some studies have shown that creatine supplements allow for increased strength during such activities. [3] Creatine supplements are most effective in those who are aged in their twenties, or whose diet does not contain high amounts of creatine, such as vegans and vegetarians. [3] Creatine also helps to reduce high cholesterol, and can be used to support the management of a number of medical conditions, such as unipolar depression. [2] It has also been shown to boost intelligence and working memory [12]. Creatine itself is a naturally-occurring tripeptide that is found in meat and fish. Omnivores tend to consume around 1 gram per day. It is also manufactured by the body at a rate of approximately 1 gram per day. [2] In addition to dietary source, there are several different formulations of creatine available for use as supplements.


1) Creatine Monohydrate

Creatine monohydrate is a well-known and well-established creatine supplementation option. Due to its long period of use by athletes, there are a number of independent pieces of research on its use and effectiveness. Multiple studies have shown that creatine monohydrate increases the levels of phosphocreatine within muscles. They have also shown that this supplement can increase the power of athletes when performing high-intensity activities, with improvements in both total amount lifted during training and per individual lift. [11] Creatine monohydrate has also been found to help patients with neuromuscular disease recover strength in their muscles, and has also been shown to improve brain performance. [9] [10]


2) Micronised Creatine Monohydrate

Micronised Creatine Monohydrate is simply creatine monohydrate that has passed through a fine mesh in order to create a small particle size. This leads to better solubility in water, which should leads to increased absorption rates, and more of this tripeptide finding its way to skeletal muscle tissue. As Micronised Creatine Monohydrate mixes more efficiently in water, less ends up hanging at the bottom of the glass or shaker after the beverage is finished.


3) Creatine Nitrate

This creatine supplement contains creatine that has been combined with nitrate to form a salt. As a nitrate salt, creatine nitrate is more water-soluble than some other formulations. The manufacturers of creatine nitrate supplements claim that the addition of nitrate allow for production of nitric oxide. In the body, nitric oxide stimulated the dilation of blood vessels, which can lead to greater uptake of creatine by muscles and improved athletic performance. They also maintain that a loading phase is not required. However, the limited research carried out on this form of creatine suggests that it is no more effective than creatine monohydrate. [6]


4) Tri-Creatine Malate

Tri-creatine malate is made up of three creatine molecules bonded with a single molecule of malic acid. [7] Malic acid is an important component of the Krebs cycle, an intermediary step in the synthesis of ATP. [8] The manufacturer's claim an increased effectiveness from this formulation due to the added effects of malic acid. Again, the impact of the malic acid is unknown at present on athletes and sports persons. However, research indicates that malic acid may benefit fibromyalgia sufferers by reducing pain and tenderness indices of the muscle. [13]


5) Creatine HCL

Creatine HCL, or creatine hydrochloride, is a relative newcomer on the market. Patented in 2009, this formulation is the hydrochloride salt of creatine. Manufactured by ProMera Health, and marketed as Con-Cret, its main benefit is an increased solubility in water, which allows the supplement to function at a lower dose than other less-soluble alternatives. One study found that it had a 59-fold increase in water-solubility over creatine monohydrate. However, this study was commissioned by the manufacturer, and so may not be an independent assessment. According to the manufacturers, these properties also mean that Creatine HCL does not require a loading phase.[5] However, loading phases are not necessary for any form of creatine. They are simply a means of maximising muscle creatine content faster. Regular doses taken over a slightly longer period of time, of any form of creatine, will eventually achieve the same outcome.  


6) Kre-Alkalyn

Kre-Alkalyn is the trademarked name of a buffered creatine monohydrate supplement. The manufacturers claim that this formulation allows for greater retention of creatine by the body, together with fewer side-effects and a lower required dose. However, these claims may not be accurate, as at least one study has found that buffered creatine supplements provide no benefits above and beyond those of standard creatine monohydrate. [4] It is also interesting to note that creatine monohydrate has a neutral pH of 7, as reported in a scientific journal called Amino Acids, 2017.Therefore supplementation will not significantly alter the pH of the body.


7) Creatine Ethyl Ester

A comprehensive clinical trial was undertaken comparing this form of creatine with creatine monohydrate, and published in the Journal of the International Society of Sports Nutrition in 2009 [14]. Subjects were supplemented with 20 grams of either creatine ethyl ester or creatine monohydrate, with serum and muscle levels (via biopsy) monitored, as was exercise level and dietary intake. The researchers found that creatine ethyl ester increased serum creatinine very significantly, which is a waste product of creatine, though it did not positively impact muscle creatine levels anywhere close to creatine monohydrate. This means that creatine ethyl ester is likely broken down in the GI tract to creatinine, making creatine monohydrate clearly the more beneficial form of this tripeptide.


Creatine supplements are not necessarily the passport to massive gains in athletic performance or lean muscle mass. However, they can make more of a difference to those who have low dietary sources of creatine, such as fish and meat. They can also give power athletes and weightlifters the small improvements they need in order to succeed in competition, or to push through plateaus in training. There are countless creatine products available on the market today, which, unsurprisingly, has led to a great amount of consumer confusion, particularly regarding product claims and formulation differences. However, the main differences tend to relate to solubility, which can dictate the size of dose required, and additive effects from other compounds, such as malic acid or nitrate. However, the original creatine monohydrate, preferably micronised, some 30 years after entering the market, is still a market leader based on efficacy, safety and value.


References

[1] http://www.menshealth.com/nutrition/creatine-side-effects-what-it-what-it-does#.

[2] http://www.webmd.com/vitamins-supplements/ingredientmono-873-CREATINE.aspx?activeIngredientId=873&activeIngredientName=CREATINE

[3] http://umm.edu/health/medical/altmed/supplement/creatine

[4] http://www.jissn.com/content/9/1/43

[5] http://www.popeyescanada.com/inf_con-cret_micro.php

[6] https://jissn.biomedcentral.com/articles/10.1186/s12970-016-0124-0

[7] http://www.biotechusa.hu/products/creatines/tri-creatine-malate/

[8] http://faculty.ccbcmd.edu/courses/bio141/lecguide/unit6/metabolism/cellresp/cac.html

[9] http://www.neurology.org/content/52/4/854.short

[10] http://rspb.royalsocietypublishing.org/content/270/1529/2147.short

[11] file:///C:/Users/grace/Downloads/CRBodyCompBenchPressConradAPS95.pdf

[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1691485/

[13] https://www.ncbi.nlm.nih.gov/pubmed/8587088

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2649889/