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creatine

QUESTION: “Hi Dr. Neal, Happy New Year! As part of my resolutions, I'm aiming to build more muscle mass with increased resistance training this year. Beyond increasing protein intake, I heard that using creatine is ‘key for big muscles.' Is this true? What does creatine do? Should I be using it to get a more muscular body composition in 2021? Thanks for your wisdom and hard work as always.”

DR. NEAL: Thank you so much for your question, long-time listener. Happy New Year to you as well!

Hmm… is it too late to still wish you a Happy New Year? I know that comedian and co-creator of the television show “Seinfeld” and “Curb Your Enthusiasm” has very strong opinions about when it’s appropriate to wish someone a happy new year and when it’s too late. According to Lar, the statute of limitations is 3 days, so I’m way beyond that window.

But I feel like because you wished me a happy new year, I should return those wishes.


Listen to Dr. Neal address this topic on Episode 1253 of the podcast Optimal Health Daily.


Disclaimer: Research the Manufacturer Before Buying a Supplement

Anyhoo… back to your question. Well, actually, let me delay one more time: before I discuss creatine and its effectiveness on performance and muscle growth, I’ll start with a quick disclaimer: I am not sponsored by any food or supplement manufacturer.

My goal as always is to tell you the truth to the best of my knowledge.

Seeking easy ways to improve your health and fitness? Join our free 5-day email course to get started.

More often than not, my information comes from published research studies. By doing this, I’m hoping that what I report to you comes from a minimally biased perspective.

This is because when we rely on other people’s experiences with supplements, meal plans, or workout routines, there’s a really high probability that what they’re doing may not work for you at all. This is why we need well-designed studies–so we can try and figure out if creatine supplements, for example, work for most. Also, please know that each supplement manufacturer is different: some follow strict quality and purity standards; others don’t. So, before you buy a supplement, it’s best to research the manufacturer first.

Ok, NOW (finally) let’s get to it.

What is Creatine?

You asked about creatine and what it is.

Creatine is a compound that the liver naturally produces. It’s a really interesting compound because some researchers call it an amino acid, whereas others refer to it as a “metabolite.”

Either way, here’s what we can agree on: most animals (any animal with a liver), including us humans, make creatine naturally. The term “creatine” is actually a shortened version of creatine’s full name: creatine phosphate (or, phospho-creatine).

When you buy creatine as a supplement, you may see it called “creatine monohydrate.” I’ll discuss why that is in a bit. Basically, after the liver makes creatine (in the form of creatine phosphate), it gets sent to the muscles.

Because this same process occurs in animals, if at any point we consume animal flesh (like beef, chicken, fish, pork, etc.), we consume small amounts of creatine.

What Does Creatine Do?

So, what does creatine do when it’s in our muscles or when we eat it. Well, creatine helps our muscles generate energy.

More energy in the muscles may mean more strength and endurance, both of which we want when we’re working out or competing. This is why creatine supplementation is so common.

You asked whether creatine supplementation is necessary for building large muscles, which is one of your New Year’s resolutions. No, supplementation is not necessary.

This is because the most important factor when building bigger muscles is simply using them. All the protein and creatine supplements in the world won’t help unless you create a demand for those nutrients. You have to make the muscles hungry for those nutrients.

Without that, all of that extra protein and creatine won’t be used to build bigger muscles – instead, the body will probably just excrete them.

To create this demand, we have to work the muscles. As the muscles get bigger, they’re able to store more creatine.

How to Create the Demand

For training purposes, the American College of Sports Medicine recommends aiming for a range of 3-5 repetitions. This is designed to help you increase muscular strength. If you can perform more than 5 repetitions, the weight might be too light. You can perform multiple sets of this same exercise with the goal of achieving 3-5 reps per set. Just know that when you lift heavy, you need a longer break in between sets to recover and regain your strength. So, rest those muscles for 2-3 minutes in between the sets.

On the other hand, if you’re not very experienced, trying to lift a heavy weight only one time (what we often refer to as your 1-rep max) can lead to injury. That’s why it’s often not recommended for beginners.

If you’re more advanced, you can work up to performing 1-rep maxes.

What Types of Exercises Will Help?

What exercises should you perform to help with bulking up? Well, compound exercises seem to help the most. These are moves that use multiple muscle groups at the same time.

Examples of compound exercise include:

  • bench presses (because they require you to use your chest, shoulders, and triceps)
  • pull-ups (target your lats, shoulders, forearms and biceps)
  • squats
  • deadlifts
  • rows
  • military presses
  • lat pull-downs

These are the key moves that will help stimulate muscle growth. I will also mention that you don’t want to perform these types of heavy lifts day after day, week after week. You want to mix in some cardio — maybe after a couple of weeks of lifting heavy — and throw in some lighter sets.

Variety is important to avoid imbalances and injury.

Supplementing with Creatine: The basics

Now, if you and your healthcare provider do decide that using creatine supplements is right for you, then you want to be sure that the type of creatine supplement seems to play an important role. The body seems to respond best when supplementing with creatine monohydrate (as opposed to its other forms like creatine pyruvate). Studies have found that for most people, creatine supplementation is safe, provided that the product is free of impurities and dosing instructions are followed.

For those with pre-existing kidney disease, creatine supplementation is not recommended. This is because, again, any excess or unused creatine in the body has to be removed by the kidneys, which may place them under stress.

The Bottom Line

The bottom line is that all the creatine supplements in the world will probably not help someone build larger muscles. Remember that anytime we eat animal flesh or, animals’ muscle tissues, we consume small amounts of creatine. Either way, placing consistent demands on the muscle cells so that they are able to use the proteins and creatine we consume in our diets is key. That means, performing some resistance training and ideally, incorporating some heavy, compound lifts.

Listen to Dr. Neal address this topic on Episode 1253 of the podcast Optimal Health Daily.

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Neal Malik

Dr. Neal Malik ("Dr. Neal") has a Doctorate in Public Health with emphases in disease prevention and nutrition. He is also a Registered Dietitian and Certified Health Education Specialist. He is currently an assistant professor at California State University, San Bernardino. Dr. Neal has published peer-reviewed scientific research and been featured as a nutrition and wellness expert in over 70 media outlets including Parade and The L.A. Times. Send in your health related question and Dr. Neal will answer it on the Optimal Health Daily show!
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