Sunday, August 11, 2013

Creatine Before or After the Workout? Finally the Answer is Here! Study Says: Better Take it After for Mass & Strength

The old "creatine = water retention" myth is - at least for the majority of athletes - just that: a myth and a result of the old practice of "loading" with copious amounts of creatine and even more high GI carbs. And it is certainly not a problem that's specific to cheap and effective creatine monohydrate.
In case someone of you ever asked me, whether he or she should take his or her creatine before or after a workout I will probably have answered something like: "I don't think it will make much of a difference, but I personally would suggest you split the dosage".

Now that Jose Antonio and Victoria Ciccone (the first of whom many will probably know from his old radio show on BB.com, the countless articles he wrote, his job as an editor or whatever else), published a paper in the Journal of the International Society of Sports Nutrition, it appears my new answer to the said question would be: "It looks like it's better to take your creatine after a workout." My previous suggestion to take 50% before and 50% after, on the other hand, has not yet been falsified. So maybe I will have to go back on the revised advice again and re-revise it, so to say. And you know what? That's not a problem! That's science. Any "truth" in science is only true until it has been falsified and I do already have my doubts about the universality of this new "truth" about creatine (see bottom line).

So, if after is the way to go? How do we know?

What Antonio and Ciccone did was to recruit 19 male recreational bodybuilders (mean ± SD: age, 23.1 ±2.9 years; height, 166.0 ± 23.2  cm;  body  weight,  80.2  ±  10.4  kg) with training experience of  >1 year who were obliged to stop taking any form of workout supplement or dietary aid at least 4 weeks before the study began.
The Pharmacokinetics of creatine Part I & Part II
"Subjects were randomly assigned to one of two groups: a PRE-SUPP or POST-SUPP group. The PRE-SUPP group consumed 5 grams of creatine monohydrate immediately prior to training. The POST-SUPP group consumed the same amount of creatine immediately after training. Following pre-testing data collection, participants began a periodized four-week resistance training program that was self-administered. On off-training days, subjects consumed creatine at their convenience. The total treatment duration was four weeks." (Antonio. 2013)
All subjects participated in the same standardized periodized, split-routine bodybuilding training regimen that was "geared primarily for skeletal muscle hypertrophy" (Antonio. 2013).
  • training frequency: 5x per week
  • total number training sessions: 20 
  • training duration: ~ 60 min per session
As you can see in the overview in figure 1 the training protocol used a block periodization with a change in the rep scheme after each cycle (=4 workouts, one body part is worked in the respective rep range once) and a pretty high training density, i.e. 5 workouts in a row + 2 days off.
Figure 1: Outline of the training schedule; created based on the description on the original study (Antonio. 2013)
Certainly not exactly a beginner program, but with ~60min per workout it's feasible to train like this for someone who is not getting all too stressed up in his everyday life and has the training experience to handle the CNS load.

That's the study you've been waiting for, right?

With experienced trainees, the requirements of not ingesting any other supplements (including amino acids) that would probably thwart the results, standardized strength tests, as well as random 24h dietary recalls every week, obligatory training logs and BodPod body fat measurements, this is the kind of study of which I would love to see at least once a week - not every 6 months.
Figure 2: Changes in body composition and 1-RM bench press strength, left; nutrient composition in grams/day, right (Antonio. 2013)
The results, however, point towards the main reason studies like these are rare. The chance to measure significant effects in trained individuals are much lower than they are in the average couch potato who grows and drops fat like a maniac, at the very moment he is shooed around in the gym.

In the bodybuilders in the study at hand only the changes in fat free mass and the bench press power did reach statistical significance and the superiority of the post-workout supplementation is "possible" and "likely", but by no means certain. Still, Antonio and Ciccone feel that
Additional tip: Supercharge creatine with baking soda (learn more)
"[t]he use of recreational bodybuilders in the current investigation is advantageous because it is difficult for highly trained individuals to experience an increase in FFM or muscular strength in the time frame allotted for this study." (Antonio. 2013)
Moreover, they point out that "of the 19 subjects that completed the study, 16-21% were non-responders regarding muscular strength and FFM." That's irrespective of the nutrient intake, by the was which was similar between the groups and had with 1.9g of protein per kg body weight per day more than enough protein to support muscle growth.

So is it effective or not?

For an optimal ratio of lean to fat mass loss on a diet it takes "only" twice the RDA of protein.
With respect to the effectiveness of the creatine supplement, the high protein intake could, as Antonio and Ciccone speculate even have been a disadvantage as this could mean that the subjects "could already have a high amount of creatine stored intramuscularly and this may have blunted the results" (Antonio. 2013).

How's that? Well, not only as a result from the minimal amount of creatine in beef, but also due to our bodies ability to produce creatine from L-arginine, glycine, and L-methionine - all of which the trainees should have gotten plenty in their diet.

If we also assume that some of the guys have been "on" creatine before, 4 weeks is not enough to deplete the stores if you don't resort to guanidinoproprionic acid (GPA) to deliberately deplete them (learn more about GPA).

Bottom line: The benefits may have been subtle, but in view of the fact that we do not have evidence to the contrary you better make sure you take your creatine after your workouts from now on, or all the work you're putting into your workouts is going to be lost... just kiddin', I personally still believe that it does not matter. Creatine uptake is slightly higher with some insulin floating around and the degradation is lower when it does not reside too long in the acidic millieu of the stomach etc. So, without any more specific information on whether or not the subjects consumed their creatine with a meal before or after the workout and whether there were carbs, fiber and whatever in that meal, it's really premature to say whether or not (a) the timing really makes a difference and (b) whether post-workout supplementation is the only way to go.

References:
  • Antonio J, Ciccone V. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J Int Soc Sports Nutr. 2013 Aug 6;10(1):36. [Epub ahead of print]

37 comments:

  1. Wouldn't increasing the dose slightly, negate any difference?

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    1. no, increasing the dosage has already been shown not to yield any benefits. If this effect is real it must be related to an increase in muscle stores that is facilitated by timing and not dosage

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    2. isn't that assuming a threshold level has been used? the 5g used here is not a saturation amount, is it not?

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    3. within 4 weeks you can easily achieve super-saturation with 5g of creatine

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  2. I usually take creatine 90-120mins after my big and last evening meal,paradoxically though I have concluded that i get carb cravings that way and oftenly it does sabotage my cutting diet attempt.So an alternative timing protocol would be more than helpful.How do you time your intake Adel..if you don't mind sharing.

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    1. I still take 2.5 before and 2.5 after if I am not forgetting to do it and the carb cravings are probably not in your head. Creatine shifts the metabolism more towards glucose and you need glucose energy to store it as creatine phosphate (actually to produce the ATP that's necessary to do that)

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    2. Dr Andro, have you ever done an article on this study. - http://www.ncbi.nlm.nih.gov/pubmed/17095924

      It seems to support your protocol of taking creatine before and after.

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  3. I space 15g of Creatine Mono through-out the day w/ three whole milk & whey protein shakes, making sure one of those servings is post workout. Would/Could the addition of some baking soda to that smoothie be more beneficial given the "buffering" effects that the milk and whey may provide already?

    Or does the evidence say I am just wasting my time mixing creatine w/ my smoothie in the first place? Looking through the forums at the bro-pinions doesn't give any clear preference - some say it's fine others say it's a waste of good creatine.

    I will say that coupled w/ a good training routine, adequate recovery and enough protein it really does seem to be effective for me. But obviously there are some confounding variables there.

    Thanks.

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    1. 15g of creatine is excessive and won't provide any additional benefit then taking 5g per day. Given the dirt cheap cost of mono though I am hesitant to say it is wasteful lol

      As for baking soda, what additional buffering effects are you looking for outside of training?

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    2. no, the baking soda as a buffer for creatine makes sense only, when it takes on empty

      that said the 15g are not just wasted, they are detrimental, because you cannot absorb them and your body has to deal with the waste

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    3. I should clarify: potential detrimental - usually it's no problem to clear the junk for your kidneys

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  4. Good advice, and you're right.. If there's no evidence to support any added benefit from over 5g/day, it's not only wasteful but could be somewhat of a burden to eliminate the extra 10g/day. I'll cut back to 5g/day, and on workout days I'll mix it into the post-workout meal.

    Thanks again.

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  5. What about people say that we should take 20 grams of creatine per day, because 5 gr isnt enough.

    http://athlete.io/4117/the-ultimate-guide-to-creatine-supplementation-part-3/

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    1. didn't do their homework :-) Once the levels are saturated 5g is plenty; only if you want to load from "zero" to max in 7 days you will need 20g - once you're there that's not necessary - your body does not "burn" creatine like crazy

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  6. Why is water retention a myth? I've looked at the creatine page on examine. There are 3 studies for, and 3 against. I'm not sure whether reference 357 is pro or anti. I'm also unsure of ref 358. Examine say's it is does not cause water retention, but the study mentions a significant difference in cell hydration.

    http://examine.com/supplements/Creatine/#summary18-3

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    1. To add to my above evidence based comment, I have personally noticed an increase in muscle size when taking creatine (I wasn't working out at the time either).

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    2. So are you going to go with the idea of a post only? Or pre and post still?

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    3. I have just started taking creatine again. My muscle size has gone up significantly. Either this is an increase in dry mass or water mass. I gaurantee it is not placebo, as I am vain enough to check the size of my biceps regularly. I am curious as to why you think water retention is a myth.

      I have looked at the examine page I linked, and there are a few studies that find an increase in body water. I don't think they are missing any studies.

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    4. It's not a myth, but like all things context is key. A study is only truly applicable to the people that participated in it. You may hold more water than other taking creatine, simple.

      @Winwright, either take 5g post or 2.5g pre & post, but don't take it all pre.

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    5. This comment has been removed by the author.

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    6. From what I have gathered water retention is not a myth, just misunderstood.

      The creatine pulls water into your muscles which aids in the production of ATP (the stuff that brings protein into your muscles, if I'm not mistaken). If you are not doing extra work, there would be no reason to pull in extra water. Thus, the water pulled in is used up, not stored long-term.

      This is obviously only my interpretation. If someone knows differently, please let me know. I'm just as interested as everyone else in the REAL reason, not one that I thought up in this poor little brain of mine! lol

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    7. I will post all the available evidence on this comments section later.

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    8. Okay here it is.

      Pro water weight

      http://www.ncbi.nlm.nih.gov/pubmed/10408330 3g Body water increased, as did intra-cellular water. It doesn't appear to increase water retention, despite more overall water weight being gained; due to an equal gain of dry mass in muscles. The increase in TBW and ICW was highest on day 42, but still higher at the end of the study (day 63).

      Unsure

      http://www.ncbi.nlm.nih.gov/pubmed/11581550 - 5g. I'm unsure what the results of this are, as I don't have access to the full text. It mentions a change in cell hydration with creatine.

      http://www.ncbi.nlm.nih.gov/pubmed/18309444 5g 14 weeks. Again, I'm hindered by not having access to the full text. It say's there is only one significant group by training interaction (ECW), but this could be the whey protein group.

      Anti Water Weight

      http://www.ncbi.nlm.nih.gov/pubmed/20591625 - 0.03g/kg 6 weeks no difference

      Flawed Studies

      http://www.ncbi.nlm.nih.gov/pubmed/14636103 -The dosage is very high, and the placebo and creatine contain different ingredients.

      http://www.ncbi.nlm.nih.gov/pubmed/9475647 - High dosage

      I'm hesitant to come to a conclusion, because of the two unsure studies.

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    9. Dr Andro, do you have access to the full-text for the studies in the unsure category? This would help me to come a conclusion on water weight.

      Cheers

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  7. Athletes will take steroids to give them an added advantage, and often because they want to win at all costs.

    Steroids Canada

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  8. If I take creatine too at night, I sometimes find myself unable to fall asleep. So I take 5 g when I wake up, usually before breakfast, regardless of what time of day I train, which completely eliminates this problem. Never had any other side effects taking creatine, asides from the fact that it seems to give me a mental boost, which is awesome (placeo?). Any evidence that creatine can boost the dopamine:serotonin ratio in the absence of physical exercise?

    Also, has anyone else experienced sometime similar to either of the above?

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  9. Massively so with the trouble sleeping, if I take it in the evening. I just don't feel tired and lie in bed wide awake. I also have to go to the loo a lot, if I take it at evening. Unfortunately I work out in the evening, and it should be taken post-workout.

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    1. Interesting - describes exactly how I feel. I've found a few complaints on body-building forums, but it's quite odd that it's never mentioned as a recognized side effect of creatine supplementation.

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    2. my best bet is that the two of you are not eating any carbs in the evening - that's possible?

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    3. No, I always have carbs with my main meal in the evening.

      I wonder if increases in brain ATP activity can affect sleep. I've read that brain ATP affects neurotransmitters,and atp is a neurotransmitter itself.

      Sorry, I can't find the source for those.

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    4. It's a shame I can't edit that comment, as I've just remembered the sources.

      "pools of stored creatine (phosphocreatine) immediately and constantly replenish energy as it is being used. Of significance, this reaction also occurs continually within brain cells to buffer ATP for many types of energy-requiring brain functions, especially Na+ transport, Ca2+ transport, the processing of neurotransmitters (e.g., synthesis, uptake, release), intracellular signaling, and axonal and dendritic transport (for review, see Ames, 2000)." - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340488/

      "Creatine impacts membrane potential and signalling
      activities of the central and periphal nervous sytem" - http://www.ncbi.nlm.nih.gov/pubmed/18502307

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    5. there is also a study in soldiers showing improved attention with creatine (and IIRC caffeine) could be possible, so

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    6. Nice study Kiefer, been looking for a free something like that for a long time. And I'm in the same boat as you. I have starches with dinner and pre- and post- workout usually include milk and fruit. Breakfasts are usually quite low CHO I usually don't eat lunch.

      As long as taking creatine in the morning works for me, I'm not gonna complain. I feel more mentally alert and more physically capable and stronger in the gym. Just never going to stop wondering about mechanisms. They're interesting.

      Increased ATP in the nervous system is one possibility, but what about dopamine receptor activation antagonist to prolocatin receptor activation (PRA). Can decreased PRA interfere with sleep? What about an altered Dopamine:Seratonin ratio?

      In mice creatine seems to stimulate certain dopamine receptors. http://jop.sagepub.com/content/early/2012/06/06/0269881112447989

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    7. "The view that Cr exerts its functions exclusively via effects in cellular energy metabolism [205] and by enhancing the cellular energy status [82] cannot explain a number of recently reported findings (see below). Hence, Cr is assumed to have additional functions in the CNS. For example, a direct anti-apoptotic effect of elevated cellular Cr levels has been reported. In combination with the action of uMt-CK inside mitochondria, Cr prevented or delayed mitochondrial permeability transition pore opening, an early event in apoptosis [56] and [133]. Moreover, Cr supplementation was demonstrated to have antioxidant properties via a mechanism involving a direct scavenging of reactive oxygen species [164] or alternatively, reducing the production of mitochondrially generated reactive oxygen species. The latter is facilitated by the stimulatory effects of Cr on mitochondrial respiration [101] that allows for efficient recycling of ADP inside mitochondria by uMt-CK, leading to tight coupling of mitochondrial respiration with ATP synthesis and suppression of reactive oxygen species formation [128]. Notably, protective effects of Cr against oxidant and UV stress has been detected in keratinocytes and on human skin [114]. Furthermore, Cr was reported to normalize mutagenesis of mitochondrial DNA and its functional consequences caused by UV irradiation of skin cells [23]. These findings point to effects of Cr for suppression of the generation of reactive oxygen species that lead to cell damage and inactivation of CK. Another recent study provided evidence that Cr-mediated neuroprotection can occur independent of changes in the bioenergetic status but rather by effects on cerebral vasculature leading to improved circulation in the brain [139]. Finally, a recent study demonstrated that Cr is able to protect cultured cells from hyper-osmotic shock by means of a significant increase of Cr uptake into cells, indicating that Cr can act as a compensatory osmolyte [4]. Indeed, Cr has been suggested as one of the main brain cell osmolytes based on experiments using hypo-osmotic perfusion of cortical brain tissue [33] and [34]."

      some more creatine brain interactions from

      Robert H. Andres, Angélique D. Ducray, Uwe Schlattner, Theo Wallimann, Hans Rudolf Widmer. Functions and effects of creatine in the central nervous system. Brain Research Bulletin, Volume 76, Issue 4, 1 July 2008, Pages 329–343.

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  10. I'm not sure I follow any of this, I thought creatine supplementation is used to achieve an increased saturation of creatine stores over time, and that creatine suplmentation does not have an immediate effect therefore timing is irrelevant. Will Brink told me that

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  11. We often hear that creatine gives cramps, muscle spasms and contractions. However, in a 3-year study whose aim was to see whether or not it resulted in this type of side effects, creatine has not been shown to affect injury or cramps of football practitioners.

    Thank you
    - See more at: http://www.painandmuscle.com/creatine-side-effects-real-unfounded/

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  12. We often hear that creatine gives cramps, muscle spasms and contractions. However, in a 3-year study whose aim was to see whether or not it resulted in this type of side effects, creatine has not been shown to affect injury or cramps of football practitioners.

    Thank you
    - See more at: http://www.painandmuscle.com/creatine-side-effects-real-unfounded/

    ReplyDelete