Modern (1940’s-present)

70 The Benefits of Creatine Mono-hydrate Supplementation

Jarod Dragoo and Kamil Czerkas

Introduction

Creatine monohydrate is celebrated for its notable enhancements in muscle strength, cognitive functions, and neurological health. Despite its benefits, the use of nutritional supplements, particularly in exercise and diet contexts, often faces divisive opinions due to health risk concerns and the variability of effects among different individuals. This chapter explores the nuanced relationship between scientific research, advancements in supplement technology, and societal health perspectives. It emphasizes the importance of inclusivity in research demographics, particularly highlighting the progress in integrating female-focused studies which have been historically underrepresented. The following discussion will address the concerns associated with potential risks for individuals with kidney disease, high blood pressure, and liver disease, while advocating for the broader use of creatine monohydrate based on its wide-ranging health benefits. These benefits extend beyond enhanced brain health and muscle growth, potentially reducing the frequency of muscle, bone, and nerve injuries, as well as decreasing dehydration and muscle cramping. The chapter aims to foster a deeper understanding of creatine’s role in health and exercise, promoting personalized supplementation strategies that reflect individual health profiles and the latest scientific developments.

Creatine’s COnnection to STS – Scientific Basis

Creatine monohydrate has a solid reputation as an athlete’s supplement, showcasing remarkable benefits in cognitive function and potential therapeutic areas. A wealth of scientific evidence substantiates its role in optimizing muscle mass, enhancing strength, and facilitating cognitive and neurological health. Creatine monohydrate’s influence within the realms of Science, Technology, and Society (STS) is profound, primarily due to its established efficacy in boosting athletic performance and enhancing cognitive functions. As a supplement, it is well-documented for optimizing muscle mass and strength, and recent studies extend its benefits to cognitive and neurological health, underscoring its potential in therapeutic applications beyond mere physical enhancement. This dual capability highlights the significance of ongoing scientific research in exploring creatine’s multifaceted benefits. For instance, creatine monohydrate has been shown to surpass other forms in improving muscle performance, which emphasizes the need for continuous innovation and research in nutritional science to enhance both athletic and general health outcomes. Additionally, emerging research revealing its neuroprotective properties and ability to boost cognitive abilities further expands our understanding of creatine’s role in comprehensive health maintenance. This integration of scientific advancements with practical health applications illustrates the dynamic interaction between science, technology, and society, where ongoing research and technological development in supplements like creatine can lead to improved health strategies and outcomes, reflecting broader societal benefits.

Key Effects:

  • Muscular Health and Efficiency: Studying different types of creatine shows that creatine monohydrate is better at improving muscle performance. This is significant because  it highlights the importance of continuously researching how to use creatine to improve both athletic performance and health. Creatine monohydrate is the most extensively studied and widely used form of creatine supplementation, having been found to effectively overall enhance muscle performance (Brudnak, 2004).
  • Cognitive and Neurological Benefits: Emerging studies highlight creatine’s potential in boosting cognitive abilities and providing neuroprotection. These insights expand the understanding of creatine’s benefits beyond physical fitness, suggesting its role in comprehensive health maintenance (Brudnak, 2004).
    “Creatine Synthesis” by author ChemDoc 2010 in the public domain. This image shows the chemical synthetization of creatine.

Technological Innovations in Creatine Supplementation

The evolution of creatine supplementation, marked by technological advancements, aims at improving bioavailability, safety, and efficacy. This progress broadens the spectrum of creatine’s applicability, catering to diverse groups including athletes, older adults, and individuals with specific health considerations. Creatine supplementation has been studied in various clinical applications involving neurodegenerative diseases, diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy (Andres et al. 2017). Additionally, creatine supplementation has been used in combination with resistance training as a strategy for increasing lean tissue mass and muscle strength in older adults, although results across studies are equivocal (Jagim & Kerksick, 2021). Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations (Clarke et al., 2020). Meta-analyses suggest that the combination of creatine supplementation and resistance training has the potential to mitigate sarcopenia (Kreider et al., 2022). Furthermore, it has been speculated that creatine supplementation combined with exercise training could result in additional improvements in glucose metabolism when compared with each intervention separately, potentially offering benefits for individuals with diabetes (OSKROBA et al., 2023). Moreover, despite the new clinical success of supplemental creatine, there is little scientific insight into the potential effects of creatine on cardiovascular disease (CVD), the leading cause of mortality (Clarke et al., 2021). Additionally, research suggests that creatine supplementation can function as an adjunctive therapeutic intervention with other anticancer agents, indicating potential applications in cancer immunotherapy (Butts et al., 2017). Furthermore, the evidence base supporting the therapeutic benefits of creatine supplementation for a plethora of clinical applications in both adults and children continues to grow, highlighting its potential impact across diverse age groups (Kreider et al., 2017). Studies have also explored the potential benefits of creatine supplementation for vegetarians compared to omnivorous athletes, with mixed results on its impact on exercise performance in vegetarians (Ostojić et al., 2019). Additionally, creatine supplementation as an adjunct to exercise training seems to augment the muscle adaptive response to the training stimulus, potentially through increasing capacity for higher intensity exercise, and/or by enhancing post-exercise recovery and adaptation, which may be particularly relevant for addressing muscular atrophy and sarcopenia in the elderly (Ostojić et al., 2019). However, it is important to note that extended creatine supplementation may lead to insulin resistance, indicating the need for careful consideration of its use in specific populations (Lugaresi et al., 2013).

Embracing Diversity in Creatine Research – Missing Voices

Creatine monohydrate, a compound naturally synthesized in the body, is well-regarded in sports nutrition for its capacity to boost muscle strength, cognitive function, and neurological health (Andres et al., 2017). It enhances intramuscular phosphocreatine stores, which supports rapid ATP re-synthesis during intense exercise, improving performance in short-duration, high-intensity activities (Pekar et al., 2021). Furthermore, numerous studies confirm that creatine supplementation, particularly when paired with resistance training, significantly increases strength gains and muscle hypertrophy (Andres et al., 2017). Additionally, it is suggested to enhance cognitive functions such as short-term memory and reasoning, especially under stress, and offer neuroprotective benefits, potentially reducing the risk of neurodegenerative diseases and cognitive decline with aging (Ryan et al., 2021).Despite these benefits, safety concerns remain, particularly for vulnerable groups such as individuals with pre-existing conditions like kidney disease, high blood pressure, and liver disease, who may face complications from creatine use (Schoch et al., 2006). While the link between creatine supplementation and renal dysfunction is not robust, caution is advised for those with compromised kidney function. Individuals with hypertension or cardiovascular issues, as well as those with compromised liver function, are recommended to consult healthcare professionals before beginning supplementation.

Historically, creatine research has favored male subjects, leading to a notable gender bias. Recent studies, however, are more inclusive, involving both male and female participants, addressing the need for gender-specific research, especially since estrogen may influence creatine uptake and retention in m

Graphical abstract of the study of creatine in women (de Guingand et al.., 2020).

uscles (Sulistiani et al., 2019). Such research is critical as it may affect creatine’s efficacy in female athletes and underscores the importance of developing gender-specific guidelines for supplementation. This shift towards a more inclusive research approach also extends to studying creatine’s effects on the elderly and individuals with specific health challenges, aiming to develop effective nutritional strategies that accommodate a broader population. This commitment to inclusivity in research is pivotal in comprehensively understanding creatine’s impact across different life stages and conditions, especially for women, enhancing their sports performance, bone, and cognitive health.

At the heart of creatine research lies scientific inquiry into its effects on the human body. Researchers investigate questions like how creatine enhances muscle performance, its impact on cognitive function, and potential therapeutic applications. Through controlled experiments, data analysis, and peer-reviewed studies, scientists build a body of evidence that informs our understanding of creatine’s benefits and risks. This scientific foundation provides the basis for developing guidelines, recommendations, and products related to creatine supplementation. The evolution of creatine supplementation is closely intertwined with technological advancements. From the development of creatine formulations with improved bioavailability to innovations in manufacturing processes, technology plays a pivotal role in shaping how creatine products are created, distributed, and consumed. For example, advancements in formulation technology have led to the creation of different types of creatine supplements, such as creatine monohydrate, creatine nitrate, and polyethylene glycosylated creatine, each with its own benefits and applications. Additionally, technological innovations in research methodologies, such as imaging techniques and biochemical analysis, enable scientists to explore creatine’s effects on the body in greater detail. The societal dimension of creatine supplementation encompasses a wide range of factors, including cultural attitudes towards fitness and health, economic considerations related to the supplement industry, and ethical implications of its use. Societal norms and values influence who uses creatine, how it’s marketed, and the regulations governing its sale and distribution. Moreover, societal factors shape research priorities and funding decisions, determining which questions are explored and which populations are studied. Increasingly, there’s a recognition of the importance of inclusivity in creatine research, with efforts to understand its effects across diverse demographics, including women, older adults, and individuals with specific health conditions. This shift towards a more inclusive approach reflects broader societal trends towards equity and diversity in health research and practice.

Conclusion

The exploration of creatine supplementation epitomizes the synergistic interplay between scientific inquiry, technological innovation, and societal dynamics in the ever-evolving landscape of health and nutrition. In an era characterized by relentless pursuit of optimal performance, longevity, and well-being, creatine emerges as a beacon of promise, offering multifaceted benefits that transcend conventional boundaries and cater to the diverse needs of individuals across the globe. The journey of creatine supplementation begins with rigorous scientific investigation, probing the intricacies of cellular metabolism, neuromuscular physiology, and cognitive function. Through meticulous experimentation, researchers elucidate the mechanisms underpinning creatine’s efficacy, unraveling its profound impact on muscular health, cognitive performance, and neurological resilience. With each discovery, the scientific community gains deeper insights into the intricate web of interactions that govern human physiology, paving the way for innovative interventions and therapeutic strategies. Advancements in formulation technology, delivery systems, and bioavailability enhancers herald a new era of creatine supplementation, characterized by heightened efficacy, safety, and convenience. From micronized creatine for enhanced solubility to buffered formulations for improved gastrointestinal tolerance, technological innovations optimize the pharmacokinetic profile of creatine, maximizing its bioavailability and efficacy. Furthermore, synergistic combinations with other nutrients and ergogenic aids amplify the benefits of creatine, catering to the evolving needs of athletes, fitness enthusiasts, and health-conscious individuals worldwide. In a world marked by demographic diversity, inclusivity emerges as a guiding principle in health and nutrition research. Recognizing the inherent variability in human physiology, genetic predispositions, and lifestyle factors, researchers strive to elucidate the nuanced effects of creatine supplementation across different age groups, genders, and health conditions. By embracing inclusivity, creatine research transcends traditional boundaries, informing tailored interventions that cater to the unique needs of women, older adults, and individuals with specific health considerations. In doing so, creatine supplementation emerges as a universal tool for promoting health, performance, and overall well-being, irrespective of demographic differences. At its core, creatine supplementation embodies a holistic approach to health and performance optimization, empowering individuals to unlock their full potential and thrive in every aspect of life. Whether striving for peak athletic performance, cognitive acuity, or simply striving for a healthier lifestyle, creatine offers a versatile solution that transcends the confines of traditional dietary supplements. By harnessing the power of scientific discovery, technological innovation, and inclusive research methodologies, creatine supplementation becomes a catalyst for transformation, catalyzing positive change on a global scale. As we look to the future, the exploration of creatine supplementation embarks on a trajectory of continual discovery, innovation, and enlightenment. With each scientific breakthrough, technological advancement, and inclusive research initiative, the boundaries of human potential are pushed ever further, unlocking new realms of possibility and promise. By embracing the dynamic interplay between science, technology, and societal needs, creatine supplementation transcends its status as a mere supplement, evolving into a symbol of resilience, vitality, and human ingenuity. In this journey of exploration and empowerment, the comprehensive benefits of creatine illuminate the path towards a brighter, healthier, and more vibrant future for all.

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IMage References

Creatine Synthesis” by author ChemDoc 2010 in the public domain.

de Guingand, D. L., Palmer, K. R., Snow, R. J., Davies-Tuck, M. L., & Ellery, S. J. (2020). Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis. Nutrients, 12(6), 1780. Figure Number. Description of the figure. https://doi.org/10.3390/nu12061780

AI Acknowledgment

We acknowledge the use of ChatGPT [https://chat.openai.com/]  and Assistant by scite.ai [https://scite.ai/assistant] to brainstorm and organize thoughts based on the articles researched for this chapter. Additionally, both of these AI assistants helped to facilitate the majority of the writing within this paper and provide additional support in citing sources.

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