Creatine - A Lot More Than Solely A Fitness Supplement!

Creatine has come a long way to being the most researched supplement ever. I think it also says something to almost everyone, especially among athletes.

And that’s no wonder regarding its essential benefits to our bodies. As we will see, creatine is a necessary substance that has been with us humans for a long time. So necessary, in fact, that we can make it ourselves – but that doesn’t mean dietary creatine is unnecessary.

So before we look at creatine’s functions and its role in food, let’s first take a block at its biochemical aspects in the body. Don’t worry, nothing too wild. Also, let’s look at the most popular myths. I still remember my first point of contact with creatine:

A classmate in high school started taking it at 16.
He achieved good results and cycled it as well, which was the usual way back then.
All this looked to us young naive as if he was on dope!

Of course, creatine is nothing of the sort. So, let’s explore this exciting substance and clear up all the bro-wisdom surrounding it!

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What exactly is Creatine?

Creatine is an amino acid. It is found not only in humans, but all vertebrates. It is built by your liver through the GAMT enzyme using arginine, glycine, methionine & S-adenoyl-L-methionine. Per day it is about 1-3g, which in turn are then fed into energy-hungry body cells, such as the muscles and the brain.

The important thing to remember here is that guanidinoacetate N-methyltransferase (GAMT) requires SAMe, and a LOT of it. SAMe is the end product of methylation. About 60% of the SAM’s produced is needed just for creatine synthesis. Therefore, if you eat enough creatine, a lot of SAMe will be freed up for other important functions. You can read more about this here in my methylation post.

Creatine does its work in the so-called creatinergic pathway, which we will look at in a moment. Once consumed, it then travels to the kidneys where it can be partially recycled or end up as creatinine in the urine. So that’s the life of a creatine molecule. Not particularly exciting, but important ¹.

Creatine’s Role for Nutrition

In our diet, we find creatine exclusively in animal sources, especially in the energy-hungry tissues like muscle, heart & brain. It clearly falls into the group I call zoonutrients.

Unlike plants, animals function differently, run on a different operating system if you want to look at it that way. Kind of like Mac vs. Windows or Android vs. Apple. Similar, but fundamentally different in detail. On the following table you can see where the most creatine can be obtained from²:

Foods	Creatine per kg
Beef Poultry Pork Lamb Deer Salmon Hering Cod Brain Raw Cheese Raw Milk Heart	5g 3.0 – 3.5g 3.5g 4.0g 4.5g – 5.0g 4.0g 3.2g 1.4 – 2.3g 0.5 – 0.7g up to 2.5g 0.3g 3g

All these are approximate values, but you can see the clear trend.

Accordingly, creatine is also one of the many substances that plant-based eaters do not get enough. No way! The body’s own synthesis will not be enough, especially for those who exercise. Instead, it eats away at the body’s essential SAM groups, keeping them from other important tasks.³

What Functions does Creatine fulfil in the Human Body?

The creatinergic Pathway

This image shows the creatine pathway within your body with the use of creatine kinase. — That’s how creatine works for all my nerds (& me).

The creatinergic pathway is one of three ways your body can provide energy.

Besides it, glucose can be burned or fats can be burned to produce ATP.⁴ This is also called glycolysis and fat oxidation. The main difference of the three is their energy yield:

Creatine exists in cells as a buffer for enormously rapidly available energy. The buffer form is called creatine phosphate. (PCr)
Creatine phosphate donates phosphorus to ADP to regenerate ATP.
This transfer of phosphorus from creatine phosphate to ADP is done by the enzyme creatine kinase (CK).

Creatine kinase works both ways, so it can build up and break down as needed. Some blood tests test directly for this enzyme as an indicator of muscle damage or kidney problems.

The Energy Yield of Creatine

This enormously fast recycling of ADP to ATP is important for maximum performance – either thinking or muscle work. After about 10-15s, however, the stores are used up and other energy supply systems take over:

The creatinine pathway does a lot of work for a short time. So you can maintain 80-90% of your maximum force for ~10s.
After that, glycolysis dominates for about 60-80% of your maximum force for 30-60s.
Fat oxidation then predominates for a very long duration, but only at an intensity of ~60%.

As you can see, with continuous load, one becomes weaker, or the energy output. Somehow, logically. As a side note, these are only approximate values and with training you can improve them. Also, it applies differently to ketogenic-adapted athletes.
Creatine also acts as a buffer against rising acid levels in the form of H+ ions in the cells. This effect is often cited as why it also has effects on processes outside of maximal strength, such as thinking performance or endurance capacity.

As you can see, creatine fulfills fundamentally important roles in the metabolism of all vertebrates. No wonder, then, that we all share this substance. Against the background of these mechanisms, the rest becomes much more logical.

What does Science say about the Benefits of Creatine?

Creatine for Power & Sports Performance

In weight training creatine found its original genesis.

No wonder, then, that many sports such as weight training, sprinters, and jumpers rely on it. Not only is this effect interesting for athletes, but also for older people who are increasingly struggling with muscle loss. Strength & muscle mass are two important factors for longevity – a definite reason for steaks in old age.

The literature shows a 4-10% increase in performance. Compared athletes with empty & filled creatine stores. Supplementation (or sufficient creatine from food) showed clear increases in strength and muscle mass:

Additionally, creatine inhibits myostatin, a peptide that breaks down muscle mass.⁵

Also, creatine stimulates conversion to dihydrotestosterone (DHT), through a known enzyme – 5-alpha-reductase. DHT is the most potent testosterone.⁶

Creatine for optimal Endurance Capacities

In addition to strength, creatine also shows effects on the performance of runners. Both in sprinters, but also on long, low-threshold loads.

This begs the question ‘why?”! Most likely the effect is related to H+ buffering, as well as the ongoing support from creatine phosphate even at quite low load intensity. Also, of course, it helps when endurance athletes build stronger muscles.⁷

Creatine and Brain Health

5% of the total creatine in your body is in your brain. With increased creatine intake, these levels also increase. No wonder, then, with the energy-hungry brain.⁸

Few people think that a ‘power supplement’ improves thinking performance. But it does, in fact. Also, it has been clearly shown that people who are deficient in creatine, such as vegans or the elderly, lose mental performance and derive clear benefits from creatine.

In addition to mental performance, creatine also had positive effects on other things such as mental problems, Parkinson’s disease, and neurodegenerative diseases. For example, creatine helped Parkinson’s patients maintain their strength & muscular fine control longer. Presumably, this happens because creatine can turn certain genes on and off by manipulating ADP/ATP rates in the right direction.⁹

Creatine for Strong Bones

Bone health is important – and we know that strength training with the right diet does wonders here. Creatine can also help, as it helps to move more weight and build stronger muscles. These two, of course, consequently put more stress on the bones, which, on the other hand, will adapt to the new stress by increasing bone mineralization.
It has also been proven that creatine can turn on certain genes that positively influence the activity of the bone-building cells, the osteoclasts.

Yet another reason for creatine in older people – preferably through red muscle meat.

Creatine’s Role for Functional Methylation

Methylation is the process by which your body shifts methyl groups from A to B. Methyl groups can be thought of as cellular currency – they can turn genes on and off, are important for detoxification and the function of ~300 enzymes called methyltransferases.

The two biggest consumers of methyl groups are the transferases GAMT & PEMT. GAMT makes creatine, while PEMT makes phosphatidylcholine, an important building block for cell membranes.

So if you eat too little creatine (also applies to choline), you force your body to upregulate GAMT. As a result, a lot of methyl groups are lost, which are needed elsewhere. Effectively, you are down-regulating 298 other enzymes involved in detoxification, DNA repair, neurotransmitter synthesis and many others. It also increases your need for collagen, B12, folate and many others. NOT good!

In my opinion, this is a survival mechanism, a backup. If we didn’t have muscle meat available, we still needed choline & creatine. GAMT & PEMT allowed us to maintain them – but at the expense of other processes.

Creatine Myths and Bro-Truths

Creatine makes you flabby!

Y, creatine draws water into your muscle tissue. Therefore, you weigh about 1-2kg more with full stores. But since it goes into the cells and not the interstitial spaces, you will hardly look like the mascot of the tire company Michelin.

What happens is that your muscles look bigger. No problem if you ask me, unless you have to make weight as a martial artist. Then you do. Myth busted!

Creatine shoots your Kidneys!

Kebab skewers grilled on the Barbie. Meat of all sources should be a staple of each carnivore diet. — That’s where you get creatine in your nutrition from.

A known kidney value is called creatinine, it is the breakdown product of creatine. And yes, creatinine can increase when you take creatine. Does that mean your kidneys are shot?
Nope. Since you simply have more creatine in your body, more has to come out. Also remember that lab value ranges are always based on data from the population we are measuring in – however, our population is large scale sick and for our purposes eats little creatine. Therefore, the values themselves should also be viewed critically.

Also, creatinine is only one of many markers that indicate renal dysfunction. It is never a diagnosis! But only an extract from a point in time when you have been pricked. Blood creatinine is also known to be inaccurate, so alternative measures exist such as creatine calculated from cystatin-C and glomerular filtration rate (GFR). ¹⁰

Kreatin leads to Hair Loss!

Creatine affects 5-alpha-reductase (5-AR) and thus increases the levels of dihydrotestosterone (DHT). DHT is the form of testosterone most strongly related to hair loss because hair follicles have receptors. Sounds very convincing, doesn’t it?

But it’s only a hypothesis so far, and it hasn’t been confirmed. Just correlational epidemiology, if you will. Also, the question is how strong the increases or inhibition of 5-AR is and whether it is not physiologically counter-regulated. In addition, DHT is also produced and used locally by cells, not just systemically.¹¹

Very complex, and we lack answers so far. I wouldn’t worry about it, since correlation is far from causation – as the well-known saying goes.

Creatine needs to be supplemented in Cycles!

Creatine cycles are so 1990. Plus, it feels like you’re on dope or methadone replacement therapy.

While cycles are not harmful, they are totally unnecessary. Daily use is simpler and more natural. And you also get to full stores, even if it takes 1-2 weeks longer to get there. But who cares? In return, you also avoid the negative consequences that 30g of creatine can have on your intestines…

How should I take Creatine?

Yes. I firmly believe in it, so yes. But contrary to what you think – do not supplement, but through food. It should be mandatory in your diet. For optimal levels it should be 3-4g per day, we’ll look at the exact dietary guidelines later. Before that, let’s talk about supplementation and why it’s not a good choice – except for those who don’t eat enough, have genetic abnormalities, play competitive sports, or just don’t eat meat.

Why you should NOT supplement with Creatine

You’ll get more than enough from the diet – provided you eat enough muscle meat. Or brain, if you get fancy.

With 300-500g of muscle meat per day you get 2-3g of creatine. The sweet spot in my opinion is 400-1kg of meat per day – depending on your weight, gender, genetics and activity level. The best sources are red meat from ruminants and also fish. Of course, it’s not just the creatine, but you’re taking in many more minerals, vitamins & zonutrients!

Does supplementing Creatine make Sense at all?

For certain groups, supplementing Creatine is very useful. — For certain groups, supplementing is very useful.

In my opinion, the diet should clearly be the first adjusting screw. And 98% will be successful with this and take in many other nutrients in addition to creatine with a quantity of ~500g meat per day, plus or minus a few grams.

However, there are certain groups that will have problems with this:

obviously vegetarians and vegans
People with methylation polymorphisms, such as in the MTHFR or GAMT genes
Elderly people who have difficulty eating, whether due to poor gastric acid status, loss of appetite, or other comorbidities

I don’t think you can make the first two diets healthy without endless amounts of pills per day. Even then, it is far from optimal. But it is everyone’s choice. And respect it. Still, I can’t sugarcoat it. Creatine should be supplemented here along with many other things.

Polymorphisms in the various genes involved in the methylation process may not be noticeable at all or may be a serious problem. In this case, only a genetic test of the corresponding genes helps to know which ones are affected and how severely. Creatine supplementation is very useful here, as it frees up additional methyl groups or SAMe and makes them available for other tasks. The same is true for many other nutrients like riboflavin, methylfolate & methylcobalamin.

How much Creatine should you take in these Cases?

You can either take creatine cyclically or permanently. I leave out the old-fashioned cycle variant, because it does not bring any advantages:

Daily it should be ~3-5g of creatine depending on the characteristics you bring.
Even 5g, 4x a week is fine.
There are no side effects, you might only notice a little more thirst.

Which Form of Creatine is the best to supplement?

If you’ve been to a supplement store once in your life, you’ve surely seen the cabinets full of all the daring brand names. So too with creatine, there are countless forms promising all sorts of things. Bullshit, in my opinion.

Good old creatine monohydrate is the best researched, cheap, exists in regulated standards, and works. Other forms promise a few percent of optimized effect, whatever that means. Most of the time, they are also poorly supported by data. The only thing these premium forms bring is a premium price tag.

So don’t get screwed and buy good ribeye instead. Or if you must, creatine monohydrate.

Creatine – essential for all Animals & Us

Meat is full of other animal nutrients rather than just protein and fats as the common conception goes. — Meat is so much more than protein and fat.

As mentioned before, I think you are getting enough creatine from food. ~500g of meat per day should be enough, sometimes more, sometimes a little less. Case closed.

Not only creatine, but many other zoonutrients are covered by it, like CoQ10, carnitine, carnosine, anserine, taurine, and so on. With organs you cover many more.

If you eat like your ancestors, things just work. You don’t need a PhD for that, everything comes together. Even though I like to get lost in the nerdy details (as you can probably tell), it’s not absolutely not necessary. The beauty of Ancestral Health is just that – simplicity. Your diet should cover all the nutrients in the forms your body needs, no supplements necessary.

Creatine in a Nutshell – the TL;DR!

You most likely don’t need to supplement creatine:

Eat enough muscle meat, preferably ~500g per day, more if you like.
Good sources & pasture fed preferred.
IF you need to supplement, take ~3g per day of creatine monohydrate. Fix your diet first though.

Ancestrally Healthy Ancestrally Healthy