Creatine and athletes: more of the latest thinking

In last month’s article, we discussed some findings from a recent research review on creatine by a group of scientists, thus providing scientifically supported answers to some common questions and misunderstandings about its use⁽¹⁾. We also distilled those answers to make them as practically applicable as possible – to help you grasp the key concepts and make effective decisions about if, when, or how to use creatine.

This article is a follow-up to that initial article where we’ll explore answers to the remaining questions that the scientist evaluated. The goal is to provide you with practical advice and perspective that is derived from the most current scientific research. That way, you can implement creatine into your own training or the training of athletes you coach. Alternatively, you may learn that creatine isn’t appropriate for your goals. Regardless, you can rest easy knowing that your choices are backed by the best available evidence.

Q#6: Is creatine an anti-inflammatory intervention?

The importance of inflammation in disease processes has gained more and more attention over the past several years, and there is some evidence that creatine may play a role in controlling inflammation. While the effects of creatine are typically associated with short-term exercise performance, high dosages of creatine prior to extended duration endurance races have been shown to reduce post-race markers of inflammation. This indicates that creatine may reduce inflammation following long duration endurance activity, but not following short duration, high intensity training.

Q#7: Can creatine speed up recovery following injury, surgery and/or immobilization?

Unfortunately, athletes get injured, and tissue healing becomes a limiting factor when attempting to return to training and competition. As a result, any strategy that can speed healing is going to be of interest. Creatine provides energy needed for cellular function, as well as likely positively influences muscle protein breakdown by slowing it down, making it a compound of interest. There is convincing evidence in animal models that creatine can be effective at speeding healing. When it comes to human studies however, the results are mixed, with some studies showing a benefit and other failing to do so. Further research is necessary to determine which factors contribute most to positive outcomes. In the meantime, if you are facing an injury situation, creatine falls into the category of ‘can’t hurt, might help’.

Q#8: Can creatine supplementation cause cancer?

Links to creatine and cancer have been speculative rather than evidence based. The studies in question made inappropriate theoretical links or used unreasonably large creatine dosages in animal models with inherently different metabolic processing of creatine. When the research is examined in detail, there is little to suggest that creatine supplementation in the typically suggest dosages (3-5 grams per day) has the potential to cause cancer. Importantly, many of the side effects of cancer such as muscle wasting can be positively impacted by creatine supplementation.

Q#9: Will creatine intake increase urine production?

Higher water intakes are often encouraged when consuming creatine, especially during initial loading phases where larger doses of creatine are consumed. As a result, urine production typically increases. However, this is a result of greater water intakes rather than greater urine production stimulated by creatine usage.