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Creatine and Sports Performance: Considerations for Athletes

Updated: Nov 20, 2023

Introduction 

Creatine is a naturally occurring nutrient that plays a crucial role in various physiological processes within the body. It is formed from three amino acids: arginine, glycine, and methionine. (1) Creatine can be produced by the liver and kidneys, and obtained from dietary sources such as fish, beef, poultry, or as a supplement. (1) 


Luckily for us athletes, creatine is one of the most well-studied, cost-effective, and safe ergogenic aids within the sports nutrition market. In this article, I will explore the considerations and benefits of creatine supplementation specifically for female athletes.


The Role of Creatine in Sports Performance 

Creatine works through several different mechanisms. Primarily, creatine is stored in skeletal muscle where it functions as fuel by regenerating ATP used during high-intensity exercise; “...as much as 80% of ATP is produced via the creatine kinase reaction.” (2) Additionally, creatine aids in glycogen uptake which is needed during intense exercise, as well as, decreases inflammation and oxidative stress which can help promote muscle recovery post-exercise. (1) Currently, it is recommended by the IOC as a result of strong scientific support for use in sports performance. (1)




Benefits of Creatine Supplementation 

  • Improved strength and power output when combined with strength training

  • Enhanced muscle recovery

  • Increased lean muscle mass when combined with strength training

  • Enhanced high-intensity performance

  • Enhance brain function and is neuroprotective (creatine also exists in the brain!)


Further Considerations

1. Dosage and Timing: Several strategies can be implemented:

  • A loading phase is not necessary; however, the process is 20 grams per day for 5 days followed by 5 grams per day. 

  • Taking at least 5g/d and skipping the loading phase works just as well but will take a couple of weeks longer depending on one’s starting natural creatine stores. 

  • Dr. Scott Forbes is a world-renowned researcher who investigates the effects of creatine supplementation on athletic performance and he recommends 0.1g/kg/d to take into account differences in body mass. 


2. Population Groups: Groups with lower starting creatine stores may see a greater benefit when supplementing with creatine. Muscle creatine storage increases by 20–40% compared to 10-20% in those with already relatively high creatine stores. (5) 


These groups possibly include:

  • Vegetarians/Vegans

  • Children and adolescents 

  • Older adults

  • Females across their entire life span including during menses, pregnancy, and menopause.

**PMID: 33800439 cites females exhibit 70-80% lower endogenous creatine stores compared to their male counterparts. (6) 


3. Menstrual Cycle: First, there is currently no evidence to suggest that creatine uptake during different phases of the menstrual cycle worsens common premenstrual symptoms like bloating and cramping. (4)  Second, within various stages of the menstrual cycle, there may be an impact on creatine balance “...due to the cyclical nature of sex hormone regulation” as shown in a theoretical model below. (6)  Additionally, there is a decrease in serum creatine kinase activity during pregnancy and after menstruation years. (6) Females particularly with low estrogen concentrations in the follicular phase, amenorrhea, during pregnancy, and within the timeline of menopause are of interest to research in regards to the implication of creatine supplementation. (6) 



4. Individual Differences: Gut tolerance is an individual factor to consider when choosing a dosing/timing strategy. Personally, I’ve noticed taking a high-quality creatine monohydrate post-exercise with the presence of glucose + protein increases my tolerance to creatine supplements. The literature supports taking creatine pre or post-exercise in the presence of insulin to maximize absorption and utilization. 


5. Quality of the Supplement: Choose a reputable brand that undergoes third-party testing to ensure purity and quality. This will help reduce the risk of consuming any contaminants or impurities that could jeopardize health or athletic performance. I use Creapure!



The Big Question: Will I gain weight? 

For athletes in weight-class sports, this question is 100% valid. The answer is possibly due to short-term water retention (this is a positive indicator of cell swelling that signals muscle growth, btw) during a significant loading phase. However, utilizing a loading phase is not necessary and you can still reap the benefits of creatine supplementation by utilizing a steady and small dosage per day strategy starting several months in advance if you need to cut weight. 


Try my go-to post-workout drink: 8oz tart cherry juice + 1 scoop vanilla whey protein + 5g of creatine monohydrate!


Conclusion 

Creatine supplementation can provide significant benefits to female athletes in terms of improved sports performance, enhanced muscle recovery, increased lean muscle mass, and greater high-intensity performance. As always, it is wise to consult with a healthcare professional to determine the suitability and appropriate usage of creatine for individual needs. With proper consideration and guidance, female athletes can harness the advantages of creatine to take their performance to new heights. 


Resources

  1. Making weight and creatine: What you need to know with Dr. Scott Forbes. (n.d.). Retrieved November 16, 2023, from Thefightdietitian.com website: https://thefightdietitian.com/making-weight-and-creatine-what-you-need-to-know-with-dr-scott-forbes/

  2. Rawson, E. S. (2018, December). The safety and efficacy of creatine monohydrate supplementation: What we have learned from the past 25 years of research. Retrieved November 16, 2023, from Gatorade Sports Science Institute website: https://www.gssiweb.org/sports-science-exchange/article/the-safety-and-efficacy-of-creatine-monohydrate-supplementation-what-we-have-learned-from-the-past-25-years-of-research

  3. Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., … Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18(1). doi:10.1186/s12970-021-00412-w

  4. Eckerson, J. M. (2016). Creatine as an ergogenic aid for female athletes. Strength and Conditioning Journal, 38(2), 14–23. doi:10.1519/ssc.0000000000000208

  5. Buford, T. W., Kreider, R. B., Stout, J. R., Greenwood, M., Campbell, B., Spano, M., Ziegenfuss, T., Lopez, H., Landis, J., & Antonio, J. (2007). International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4, 6. https://doi.org/10.1186/1550-2783-4-6

  6. Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine supplementation in women’s health: A lifespan perspective. Nutrients, 13(3), 877. doi:10.3390/nu13030877






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