Why and How You Should Supplement with Creatine and Beta-Alanine

Beta-alanine shouldn’t be taken pre-workout

Beta-Alanine is most often marketed as a pre-workout supplement. Not surprisingly, supplement companies and marketing tricks don’t always get the facts straight.  Taking Beta-Alanine pre-workout has no known ergogenic effect (i.e. increased performance) in the next workout. Beta-Alanine works through bioaccumulation in your muscle tissue. You can take it at any time and you will receive the benefit, as the goal is to increase your intramuscular carnosine levels over time.  Now some aspects of timing may improve the efficacy of supplementing with Beta-Alanine. One way to improve absorption and uptake into your muscles is to take it with food, as that has been shown to drastically increase its uptake and efficacy (8).

Beta-alanine works well with creatine

There have been conjectures that beta-alanine works separately and synergistically with creatine supplementation. This is based upon the notion that there are two anaerobic energy systems, the phosphagen and glycolytic systems. Creatine augments the phosphagen system (see below), while beta-alanine augments the capacity of the glycolytic system. As such, beta-alanine and creatine are often stacked together and sold as an excellent combination for individuals looking to increase performance in their anaerobic training. Unfortunately, there is no good evidence to show measurable and consistent synergies from stacking them. However, as they do have separate mechanisms and are both shown to be efficacious, it is reasonable to take both.

Several, smaller doses may be better than one big dose

Consuming a single high dose of beta-alanine can induce paresthesia (aka itchy face) in some people. You can avoid this by breaking the daily dose into several smaller doses. Most research studies on beta-alanine have been conducted using doses between 2.6-6.4 grams per day. Besides paresthesia, no real negative side effects have been documented even at the highest end of the dosing spectrum.

Summary on beta-alanine

Beta-Alanine has a good amount of evidence to support its use. It may improve your training capacity and reduce fatigue, which could then help you add lean mass and reduce fat. However, the effect appears to be fairly variable from study to study. Although it is often sold as a pre-workout there appears to be no real timing component and it does not necessarily have to be taken pre-workout. Taking it post-workout with food appears to be the most optimal way to utilize it. Also, don’t waste your money on the super fancy marketing gimmicks of “advanced” delivery formulas. Just buy standard beta-alanine from a trusted supplement producer (we use this one), and take 1-2g with your meals.

Creatine

One of the ubiquitous supplements in the sports nutrition field is creatine. In the United States alone, creatine-containing dietary supplements make up a large portion of the estimated $2.7 billion in annual sales of sports nutrition supplements (9). Despite its widespread use, the efficacy and safety of creatine supplementation is still controversial amongst athletes, researchers, and clinicians.  In order for you to take a well-informed stance on creatine supplementation, we’ll review the role of creatine in the body, the research surrounding its efficacy in performance enhancement, and the potential side effects of creatine supplementation.

What is Creatine and What Does it Do?

Creatine is similar to protein in that it is a nitrogen-containing compound, but it is not a true protein.  It can be obtained from the food we eat (typically meat and fish) or formed endogenously (in the body) from the amino acids glycine, arginine, and methionine (10). Creatine is a key player in the phosphagen energy system, the primary source of ATP (the main energy substrate in our body) during short-burst, high-intensity activities. In the body, creatine exists as both free-form creatine and phosphocreatine.  Phosphocreatine functions as a “storehouse for high-energy phosphate” (11) to regenerate ATP in muscles that are rapidly contracting. When our muscles run out of creatine, our short-term, high intensity energy system shuts down and our muscles are no longer able to produce the same degree of force.

Courtesy of Advanced Nutrition and Human Metabolism (2)

Phosphocreatine and creatine do not remain in muscles for an extended period of time and are cyclized in a non-reversible reaction to form creatinine, which is then processed by the kidneys and expelled from the body in the urine. Therefore, if you take creatine and then do some blood tests, your creatinine (a marker of kidney function and muscle mass) will often increase, which is usually normal.

Creatine and Performance - What Does the Research Say?

Creatine is one of the most widely-researched sports supplements. The use of creatine as an ergogenic aid is based upon the theory that one can increase the saturation of creatine in the muscle through supplementation. Theoretically, increased creatine in the muscle will increase performance in short, high intensity exercise by increasing the capacity of our phosphagen system to regenerate ATP during short burst of high-intensity activity. While a full analysis of these studies is beyond the scope of this article, the literature is fairly conclusive with regards to the safety and efficacy of creatine as an ergogenic aid.

According to recent research, 10-40% increases in muscle creatine and phosphocreatine stores have been observed with creatine supplementation (12,13). These results were observed after a specific “loading” protocol. This protocol involves ingesting roughly 0.3 g/kg/day for 5-7 days (roughly 20 grams a day), followed by 3-5 g/day (14). It was previously thought that you need to cycle creatine on and off, but this doesn’t appear to the be the case. It also probably doesn’t matter whether you include a loading phase (15). As with beta-alanine, don’t fall for fancier types of creatine. The basic creatine monohydrate is what has been most extensively researched, and it can be bought in bulk very cheaply. However, quality matters, so make sure it is Creapure (made in Germany). We take 0.05-0.1g/kg/day of this one.

Supplementation and Performance

Creatine supplementation appears to be the most effective legal nutritional supplement currently available with regards to improving anaerobic capacity and lean body mass.  The research surrounding the ergogenic effects of creatine supplementation is extensive, with hundreds of published studies looking exactly at those two outcomes. Approximately 70% of the research has reported a significant (p<0.05 for the stats people out there) increase in exercise capacity, while none have reported an ergolytic (i.e. loss of performance) effect (16).

In both the short term and long-term, creatine supplementation appears to enhance the overall quality of training, leading to 5 to 15% greater gains in strength and performance (16, 17). In addition, Nearly all studies indicate that “proper” creatine monohydrate supplementation increases body mass by about 1 to 2 kg in the first week of loading, though largely due to increased water retention in the muscles. Increasing fluid intake with initial creatine supplementation is therefore also important.

In the International Society of Sports Nutrition position stand on creatine the authors state, “The tremendous numbers of investigations conducted with positive results from creatine monohydrate supplementation lead us to conclude that it is the most effective nutritional supplement available today for increasing high-intensity exercise capacity and building lean mass” (18). I guess the case is closed on that front.

Any other benefits?

In addition to its ability to increase muscle size and strength, creatine supplementation can have a range of other benefits. Though the evidence isn’t great, creatine use appears to result in a trend towards higher testosterone levels and a better testosterone:cortisol (T:C) ratio (19, 20). Creatine has also been shown to acutely improve sports-related skills performance after sleep deprivation in rugby players, working just as well as caffeine but without raising cortisol as high-dose (5mg/kg) caffeine did (20). However, creatine may not provide benefit in 20-30% of people (21), and one factor that may separate people into responders and non-responders is methylation status. Production of creatine in the body is very methylation-dependent (22), so we often see greater subjective benefit of creatine supplementation in poor methylators.

Is Creatine Safe?

 For years the media has portrayed creatine as a dangerous supplement, including that creatine can cause dehydration, injury, GI distress, and even kidney or liver damage. However, to date, there have been no controlled trials that have shown creatine supplementation to cause dehydration, GI distress, injury, nor kidney or liver damage. The only clinically reported side effect of creatine supplementation is weight gain, which typically, is a goal of creatine users.

The notion that long-term effects of creatine are still unknown and that the supplement is not understood is no longer valid based on the large body of data we now have supporting its use. It could be argued that “supplemental” creatine has been around since man began eating meat, which according to recent research was more than a million years ago (22).  Research on creatine actually began more than 40 years ago when it was experimentally used to treat heart disorders and improve heart function during heart attacks (23). Creatine has also been used at high doses (up to 30g per day) for many months or years in multiple clinical trials investigating its use as a potential neuroprotective agent in neurodegenerative diseases. Though it has not shown a direct neurological benefit in these patients (such as those with Parkinson’s disease), it was found to be safe with no additional harmful side effects (24). Therefore, the research has shown that creatine appears to be safe when it is used in healthy populations and taken within recommended guidelines.

To date, creatine remains the most effective legal (and safe) supplement available for increasing high-intensity exercise capacity and building lean mass, as well as having a number of other potential benefits. 

References

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2. Hoffman, Jay R., et al. "Short-duration β-alanine supplementation increases training volume and reduces subjective feelings of fatigue in college football players." Nutrition research 28.1 (2008): 31-35.

3. Kresta, Julie Y., et al. "Effects of 28 days of beta-alanine and creatine supplementation on muscle carnosine, body composition and exercise performance in recreationally active females." Journal of the International Society of Sports Nutrition 11.1 (2014): 1.

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8. Stegen, Sanne, et al. "Meal and beta-alanine coingestion enhances muscle carnosine loading." Med Sci Sports Exerc 45.8 (2013): 1478-85.

9. Jäger, Ralf, et al. "Analysis of the efficacy, safety, and regulatory status of novel forms of creatine." Amino Acids 40.5 (2011): 1369-1383.

10. Gropper, S. S., Smith, J. L., & Groff, J. L. (2005). Advanced Nutrition and Human Metabolism. Belmont, CA: Thomson Wadsworth.

11. Williams, Melvin H., and J. David Branch. "Creatine supplementation and exercise performance: an update." Journal of the American College of Nutrition 17.3 (1998): 216-234.

12. Greenhaff PL: Muscle creatine loading in humans: Procedures and functional metabolic effects. 6th International Conference on Guanidino Compounds in Biology and Medicine. Cincinatti, OH. 2001

13. Kreider RB, Leutholtz BC & Greenwood M. Creatine. Nutritional Ergogenic Aids. CRC Press LLC: Boca Raton, FL, 2004,  p 81-104

14. Stout, Jeffrey, et al. "Effect of creatine loading on neuromuscular fatigue threshold." Journal of Applied Physiology 88.1 (2000): 109-112.

15. Lanhers, Charlotte, et al. "Creatine Supplementation and Lower Limb strength performance: a systematic review and meta-analyses." Sports Medicine 45.9 (2015): 1285-1294.

16. Buford, Thomas W., et al. "International Society of Sports Nutrition position stand: creatine supplementation and exercise." Journal of the International Society of Sports Nutrition 4.1 (2007): 1.

17. Kreider, Richard B. "Effects of creatine supplementation on performance and training adaptations." Molecular and cellular biochemistry 244.1-2 (2003): 89-94.

18. Kreider, RB, Creatine in sports. Antonio, J., Kalman, D., Stout, J. R., Greenwood, M., Willoughby, D. S., & Haff, G. G. (2008). Essentials of Sports Nutrition and Supplements. Humana Press.

19. Schilling, Brian K., et al. "Creatine supplementation and health variables: a retrospective study." Medicine and science in sports and exercise 33.2 (2001): 183-188.

20. Cook, Christian J., et al. "Skill execution and sleep deprivation: effects of acute caffeine or creatine supplementation-a randomized placebo-controlled trial." Journal of the international society of sports nutrition 8.1 (2011): 1.

21. Lemon, Peter WR. "Dietary creatine supplementation and exercise performance: why inconsistent results?." Canadian journal of applied physiology 27.6 (2002): 663-680.

22. Stead, Lori M., et al. "Methylation demand and homocysteine metabolism: effects of dietary provision of creatine and guanidinoacetate." American Journal of Physiology-Endocrinology And Metabolism 281.5 (2001): E1095-E1100.

23. Domínguez-Rodrigo, Manuel, et al. "Earliest porotic hyperostosis on a 1.5-million-year-old hominin, Olduvai Gorge, Tanzania." PloS one 7.10 (2012): e46414.

24. Rovetto, M. J., J. T. Whitmer, and H. E. Morgan. "Effects of ischemia on function and metabolism of the isolated working rat heart." American Journal of Physiology--Legacy Content 225.3 (1973): 651-658.

25. Bender, Andreas, and Thomas Klopstock. "Creatine for neuroprotection in neurodegenerative disease: end of story?." Amino acids (2016): 1-12.