Creatine Combinations (Good Read)
John Berardi
"It's 5:00 A.M. already? Who practices at this time?" Well, for some reason or another, rowers do. And we know this because we work with several rowing teams here in Ontario. And it is not only rowers that greet the sun head on. We also know quite a few bodybuilders who have lives outside the gym. Many of them rise and shine while we're still in bed dreaming about the girl from the Horny Goat Weed ad.
Regardless of your sport, if you typically start your day off in the wee hours, you probably have only one friend this early. And his name is Mr. Coffee. If you workout, take supplements, and spend enough time with Mr. Coffee, though, you'll eventually hear something like this: "Hey, aren't you taking creatine? You shouldn't be drinking coffee". "I shouldn't?" you may ask. "No, I heard that the coffee somehow ruins the absorption of the creatine". To which you may reply, "But I love what creatine is doing for my training. I love my coffee too. Is caffeine really having a negative impact on my training by nullifying the benefits of the creatine supplementation? Should I give one up?"
These are all good questions. Questions we intend to address in this article. And after putting the creatine and caffeine issue to bed, we hope to discuss some creatine combinations that may lead to optimal results for creatine supplementation.
Creatine and Caffeine…The Forbidden Combination?
The creatine and caffeine issue has been discussed pretty extensively in both the athletic and scientific communities. However, most people don't even know why such a debate exists. What exactly is the concern? Well let's talk a little history.
The creatine and caffeine debate started about four years ago when one single scientific study concluded that "caffeine counteracts the effects of a creatine loaded muscle" (1). This statement was shocking because the purpose of the study was to see if the two agents could work together to increase exercise performance, not to see if they would interfere with each other. Researchers and athletes have long known that caffeine and creatine independently improve performance so a combination would be the next logical step.
Creatine works on the phosphocreatine and ATP systems while possibly buffering exercise produced hydrogen protons (acid), while caffeine demonstrates a powerful stimulation for the release of epinephrine. So theoretically, one could take both to gain more of a performance edge. But this study showed that maybe they don't work together. Even further, it showed that maybe they interfere with each other. So if this is the case and caffeine does counteract the effect of a creatine loaded muscle then there is no debate. The answer is to avoid consuming beverages that contain caffeine if you want your money spent on creatine to work for you.
But as usually is the case, things are not so simple. Although some individuals avoid this combination like the plague, we don't think this is necessary. So while you're here, go ahead and grab a cup of coffee. Then add your desired amount of crystals - creatine, not sugar; if you haven't already had your dose for the day. Based on further scientific data and scrutiny, you just might not have to give either one up.
A Study's Only As Good As It's Design
When looking back at the previously mentioned study, some glaring problems are evident. And these problems explain our disbelief of the conclusions. First, the study utilized a crossover design. In a crossover design, one group of lifters first takes creatine and then switches over to placebo a few weeks later. The other group first takes placebo then switches over to creatine a few weeks later. During each treatment performance tests are done. This design is a great one in most cases because researchers don't have to compare two different groups of guys, one group of lifters on creatine vs one group of different lifters on placebo. In this design, the researchers can compare the same athletes (on creatine) to themselves (on placebo) a few weeks later.
Although this is typically a great study design, when a supplement has lasting effects, a long period has to separate the time between treatments. If not, the effects of creatine will still be around when the subjects are on placebo. And that's the problem with this study. In this design, the researchers only allowed 3 weeks between creatine/caffeine and placebo. We know that this is too short of a time between treatments to allow the study participant to "return to normal". Subsequent studies have shown repeatedly that the washout period for creatine supplementation is a minimum of four weeks, it may be even be longer. So one of the take-home messages of this article is that creatine, once loaded into the muscle, takes about 4-6 weeks or more to be eliminated (2). If this is the case, we hope you realize the fact that since performance tests were conducted, the treatments could have affected both testing periods. This is a great way to ensure that the data from a study is meaningless.
Another important factor to consider in all of this is diet. Creatine containing foods, like steak and fish, may provide enough creatine to effectively maintain your initial loading. What we mean here is that after you load up for a week, you may be able to maintain a creatine-loaded state with diet alone. Many of you have heard of "maintenance doses" of creatine that usually consist of around 5 grams per day. These may be unnecessary. Since the combination of a typical non-vegetarian diet and your natural production of creatine provides about 2 grams of creatine per day, you only need an additional 2 or 3 grams per day from food to stay loaded. The research shows that diets high in red meat (1.5 or 2 lbs per day) can provide this (2).But just to be safe, we typically recommend "reloading" every few months however as you may gradually lose that super-loaded state over time.
Getting back to the science of the creatine and caffeine thing, if subjects remain loaded by dietary means, a crossover study may never give good results. Another example of this is evident in another creatine and caffeine study in scientific literature (3). This crossover study also showed no performance differences between groups that took creatine and caffeine together and those on placebo. But again, the washout problem rears its ugly head. This study only utilized a one-week washout period between the subject cross-over. We cannot really gain any information from this study in terms of creatine and caffeine interactions. This short washout again may have allowed the subjects to be creatine loaded throughout the testing even when they were performing as the placebo group.
Although the two studies seem to run counter to our advice to load your coffee up with creatine powder, I hope that you can see that a study is only as good as it's design. In addition, our argument gains some support from the following. In both studies, the loading of muscle with creatine was not hindered by caffeine ingestion. So if the muscle is loaded with creatine, then it should be able to perform like other creatine-loaded muscles or simply put, better. The only limiting factor then in these studies is the design.
One argument that other side proposes to justify their conclusions is that perhaps the coffee caused diuresis (water loss) and that inhibited the performance gain. Since it is well-know that dehydrated muscles perform very poorly and have lower protein synthetic rates than normally hydrated muscle, some have argued that maybe the coffee negated the effects of creatine due to dehydration (4). Since there is no data on this, it is merely speculation. But the most practical answer is as follows. Ask yourself if you find yourself being constantly dehydrated when you consume coffee. If the answer is no, then you know that you are ok on this front.
Although the debate seems pretty even at this point, the real clincher for our side is this. In many prior studies showing that creatine does increase performance and muscle mass, creatine was administered with…you guessed it…good old coffee or tea. Since creatine is very hard to dissolve in regular room temperature beverages, researchers had been giving creatine in warm coffee and tea to ensure dissolution of the powder and to mask the taste. Also this dissolution makes taking creatine orally easier on subjects and their digestive systems. Since there was a demonstrated effect of creatine in these studies, the coffee must not have hindered the effects of the creatine.
Although, we are pretty convinced that coffee will probably not lead to a huge reduction in the effectiveness of creatine supplementation, we have decided to go ahead and do a definitive study. In collaboration with our lab mates and lab director at the University of Western Ontario, we plan to look at the effects of creatine, creatine plus caffeine, creatine plus coffee, and placebo. This study should, uhm, dissolve this debate once and for all. Until then, we won't be kicking Mr Coffee or Mr Creatine out of our lives just yet.
Creatine - Potent Combinations
Although the first part of this article focused on the fact that taking creatine and caffeine together probably wont negatively effect your gains from creatine, here we want to talk about what can be combined with creatine to promote even greater gains. Since its introduction, creatine popularity has surged. Even with the minor discomforts associated with powdered creatine monohydrate intake such as minor gas, abdominal distention, and diarrhea, many athletes still take creatine for its muscle building and performance enhancing effects. But what if there was a way to decrease this discomfort? There may be. The answer lies in a creatine combination.
Another issue with creatine supplementation is the fact that some individuals respond very well while others do not. This may have something to do with initial creatine levels when starting a creatine cycle or it may have to do with enhanced or impaired creatine uptake in certain individuals. So what if there was a way to increase creatine uptake into the muscle to potentially enhance uptake in both responders and non-responders? Again, a creatine combination may take care of this as well.
Creatine and Solubility
If you've taken creatine, you are probably well aware of the fact that trying to dissolve creatine in regular fluid is useless. You'd be more likely to fit an elephant through a key hole. It's just not going to happen. As a result of this poor solubility, when the creatine gets to your gastrointestinal tract, the body tries to solubilize it. Why? Because nutrients cannot be absorbed if not solubilized or dissolved in a solution. They will just sit around in the pit of your stomach in powder form and eventually pass right out of you. So what the body does to remedy this is to suck fluids out of the cells of the digestive organs in order to provide enough fluid to dissolve the creatine. But what then happens is that all this fluid that's sucked into the GI tract needs to quickly be eliminated and this leads to diarrhea. So in solubilizing your creatine, the GI causes some nasty bathroom situations. Not to mention the fact that a lot of the creatine is lost during such porcelain episodes.
So what are some solutions? The first is to dissolve your creatine in a warm beverage. By doing so, due to the laws of thermodynamics, the creatine is solubilized. And when consumed, it can be absorbed much more effectively without all the GI distress. This is where the creatine coffee debate started as most guys just dumped the creatine into the coffee for convenience sake. Warm coffee, tea, or even just warm water will do just fine.
The second solution is liquid creatine. Many companies have developed liquid creatine products that contain some type of glycerin or carbohydrate-like substance to solubilize the creatine. Although there is no good data to suggest that these products are better than regular creatine, theoretically they could help absorption. This would allow for less GI stress and lower doses. But although theoretically this does make sense, creatine tends to be unstable in liquid if suspended for too long. This is because the creatine can react with the water molecules to degrade into creatinine, a useless metabolite that is simply excreted from the body. With all the brilliant chemists in this industry, we are certain that this problem can be solved. In fact, we've seen some yet unpublished data to suggest that there are quite a few liquid creatine products out there that remain stable in solution for long periods of time. Our suggestion would be to try only liquid creatine products from reputable well-established companies with a good history of quality control.
The Insulin-Creatine Connection
It is well known that although insulin is not necessary for creatine uptake, supraphysiologic hyperinsulinemia (high blood insulin well above the normal insulin levels) can help to drive more creatine into the muscle. So by jacking up insulin levels, more creatine can be delivered to the muscle in most cases. But remember, we said that these levels have to be supraphysiolgic. So just a little jump in insulin probably won't help. You need a massive influx of insulin. How can this be achieved?
There are a few ways to spike insulin. The first is the ingestion of lots of carbohydrates. In the original studies, a whopping dose of 93 grams of glucose was used to jack insulin levels way up into the supraphysiologic range and increase creatine uptake into the muscle (5). That's a lot of sugar. But that's what it took to enhance the creatine uptake. So if you're taking in less carbohydrate than this in an attempt to increase creatine uptake or your carbs have a low glycemic index, you're probably not getting insulin levels high enough to make a difference.
Now we don't know about you, but 93 grams of sugar is quite a bit too much sugar for us. Especially when taken multiple times per day during a loading phase. So should this concept be abandoned? No way. There are other ways besides high carbohydrate intake to get insulin levels high enough to make a difference in creatine uptake. First, it is well known that a meal containing carbohydrates and protein generates a much better insulin response than carbohydrates alone. How much better? Well although it depends on the protein and carb sources, it appears that while 100 grams of carbs leads to a 300-500% increase in blood insulin and 64 grams of protein leads to a 100-200% increase in blood insulin, the combination of the two leads to a 600-800% increase (6,7). Now that's supraphysiologic!
So it appears that a protein and carbohydrate combo might be best at increasing blood insulin and this may translate into better creatine uptake. A recent study confirms that indeed a meal containing 50 grams of protein and 50 grams of carbs can lead to identical increases of insulin and creatine uptake as 100g of carbs. (8). The beauty of this strategy is that you don't have to consume as much sugar if protein is part of the meal.
Another strategy for increasing insulin release and creatine uptake while at the same time minimizing the need for huge meals would be to incorporate specific amino acids or insulin secretagogues into your meal. Although this topic is beyond the scope of this article, several studies have shown that the inclusion of insulin secretagogues can lead to huge increases in insulin. In one study, athletes consuming 168 grams of carbs in 60 minutes had insulin increases of about 900% while the athletes consuming 112 grams of carbs, 56 grams of protein, and a few specific insulin secretory amino acids had insulin increases of about 1700% (9). That's almost double an already supraphysiological level of insulin.
The point of discussing this research is not to recommend the consumption of hundreds of grams of carbs and protein to enhance creatine uptake. But rather, the point is to recognize that a combination product containing moderate amounts of protein, carbs, and certain insulin stimulatory nutrients, may be the future of creatine uptake technology.
Making Your Creatine Work For You
In conclusion, there are a number of ways to get the most out of your creatine supplementation. By minimizing discomfort and maximizing uptake, one can turn a great supplement into something truly exceptional. Creatine alone can increase muscle mass, muscle strength, and potentially athletic performance. The inclusion of carbs and protein with your creatine however might even lead to greater benefit. In addition, the use of liquid creatine may allow for lower effective doses of creatine and a much more pleasant intenstinal experience. And by the way, don't let Mr. Coffee collect dust while cycling creatine. That's no way to treat an old friend.
References:
1) Vandenberghe et al. J Appl Physiol. 80(2):452-7; 1996
2) Ziegenfuss et al. Performance benefits following a five day creatine loading proceducre persist for at least four weeks. Abstract presented at ACSM 1998.
3) Vanakoski et al, Int J Clin Pharmacol Ther. 36(5):258-62; 1998
4) Barr, Can J Appl Physiol. 24(2):164-72; 1999
5) Green et al. Am J Physiol. 271(5 Pt 1):E821-6; 1996
6) Rabinowitz et al, Lancet. 2: 454-456; 1966
7) Pallotta et al, Metabolism. 17: 901-908; 1968
8) Steenge et al. J Appl Physiol. 89(3):1165-71; 2000
9) Van Loon et al, American Journal of Clincial Nutrition. 72:106-111; 2000
