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Creatine Combinations
by Tomi Nieminen and John M Berardi

Rendezvous

“It’s five o’clock already?” I asked no one. “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, Canada. And it is not only rowers who greet the dawn head on. We also know quite a few bodybuilders who have lives outside the gym. They rise while most of us are still in bed dreaming about the girl from Horny Goat Weed ads.

If you start your day in the very early hours you probably have only one friend. And his name is Mr. Coffee. If you work out, take supplements and spend enough time drinking Mr. Coffee, you’ll eventually hear something to the effect of, “Hey, aren’t you taking creatine? You shouldn’t be drinking coffee”. “I shouldn’t?” you ask. “No. I heard that the coffee somehow interferes with absorption of creatine”. But I love my coffee. Does caffeine really cancel out the benefits of creatine supplementation? This is a good question – one this article intends to answer.

Creatine and Caffeine: The Forbidden Combination?

This issue has been discussed extensively in both athletic and scientific communities. However, most people don’t even know why such a debate exists. But first, how about we review some history?

The creatine / caffeine debate started about four years ago when one scientific study concluded that “caffeine counteracts the effects of a creatine loaded muscle” (1). This statement was shocking. After all, the purpose of the study was to determine if the two agents could work together to increase exercise performance, not if they would interfere with each other! Researchers and athletes have long known that caffeine and creatine independently improves performance, so combining the two seems logical, right?

Creatine works on the phosphocreatine and ATP systems, while possibly buffering exercise produced hydrogen protons (acid). Caffeine demonstrates a powerful stimulation for the release of epinephrine. So, theoretically, one could take both to gain more of an athletic edge. But the study in question showed that perhaps they don’t work well together. Further, it showed that maybe they actually interfere with each other. If caffeine does counteract the effect of a creatine-loaded muscle, then there is no debate. The answer? Avoid caffeine if you want your creatine to work

But it’s not this simple. And though some avoid the creatine / caffeine combo like the plague, we don’t think it’s necessary. So, while you’re here, grab a cup of coffee, add your creatine and read on.

A Study Is Only As Good As Its Design

Some glaring problems are evident with the study in question. And these problems explain our mistrust of the conclusions. First, the study utilized a crossover design. In a crossover design, one group takes creatine and then switches to a placebo a few weeks later. The other group does the opposite. During each treatment performance tests are done. This design is fine in most cases because researchers don’t need to compare two different groups. Researchers can compare the same athletes (on creatine) to themselves (on placebo) a few weeks later.

When a supplement has lasting effects, however, a long period has to separate treatments. If not, the effects of creatine will still be around when the subjects are using a placebo. And that’s the problem. The researchers only allowed three weeks between creatine / caffeine and placebo. We know this is too short a time to allow the study participant to “return to normal”.

Subsequent studies have shown the “washout” period for creatine supplementation is, minimal, four weeks. It may be much longer. So one of the take-home messages is that creatine, once loaded into the muscle, takes about four to six weeks – or more – to be eliminated (2). If this is the case, we hope you realize that since performance tests were conducted, the treatments could have affected both testing periods. This is a great way to ensure that data from a study is, probably, meaningless.

Another important factor to consider is diet. Creatine-containing foods, like steak and fish, may provide enough creatine to maintain your initial loading. After you load for a week, you may be able to maintain a creatine-loaded state with diet alone. Most have heard of “maintenance doses” of creatine that usually consist of around five grams per day. These may be unnecessary. Since the combination of a typical non-vegetarian diet and your natural production of creatine provide about two grams each day, you only need an additional two or three grams from food to stay loaded. Research shows that diets high in red meat (1.5 or 2 pounds each day) can provide this (2). But, just to be safe, we typically recommend “reloading” every few months as you may lose that super-loaded state over time.

Getting back to science, if subjects remain loaded by dietary means, a crossover study might never give good results. A further 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 head. This particular study only utilized a one-week washout period between the subject crossovers. 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 these two studies run counter to our advice to load your coffee up with creatine powder, you can see that a study is only as good as its design. In addition, our argument gains 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, right? The only limiting factor is the study design.

An argument can be made that perhaps the coffee caused diuresis (water loss), and that inhibited performance gain. Since it is well know that dehydrated muscles perform poorly and have lower protein synthetic rates, maybe the coffee negated the effects of creatine due to dehydration (4). But because there is no data on this, it is merely speculation. Do you find yourself being constantly dehydrated when you consume coffee? If the answer is no, then you know you are okay on this point.

The debate may seem even at this point, but keep reading. In many prior studies showing creatine does better performance and increase muscle mass, creatine was administered with…you guessed it…coffee or tea! Since creatine is hard to dissolve in room-temperature beverages, researchers had been serving creatine in warm coffee and tea to ensure dissolution of the powder and to mask taste. This dissolution also makes taking creatine orally easier on subjects’ digestive systems. Since there was a demonstrated effect of creatine in these studies, the coffee must not have hindered the effects of the creatine. And although we are fairly convinced coffee does not lead to a huge reduction in the effectiveness of creatine supplementation, we have decided to do a definitive study.

In collaboration with 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, uh, dissolve this debate, once and for all. Until the final results are in we won’t be kicking Mr. Coffee out of our lives just yet.

Creatine – Potent Combinations

The first part of this article focused on the fact that taking creatine and caffeine together probably won’t negatively affect the benefits of creatine. Now 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 minor discomforts associated with powdered creatine monohydrate use such as 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? The answer may lie in different creatine combinations.

Another issue with creatine supplementation is that some individuals respond well, while others do not. This may have something to do with initial creatine levels when starting a creatine cycle, or with enhanced or impaired creatine uptake in certain people. 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, creatine combinations may take care of this as well.

Creatine and Solubility

You are probably aware that dissolving creatine in regular fluid is rather difficult. You’re more likely to fit an elephant through a keyhole. 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 and eventually pass right out. So what the body does to remedy this is to suck fluids out of cells of the digestive organs. But then all this fluid that’s sucked into the GI tract needs to quickly be eliminated, and this leads to diarrhea.

So what are some solutions? The first is to dissolve your creatine in a warm beverage. Due to the laws of thermodynamics, the creatine is then solubilized and can be absorbed much more effectively without the GI distress. This is where the creatine / coffee debate started, as most just dumped creatine into coffee for convenience. 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. And although there is no data to support that these products are better than regular creatine, theoretically they could aid absorption. This would allow for less GI stress and, ultimately, lower doses. Theoretically this does make sense. But creatine tends to be unstable in liquid if suspended for too long. 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 this problem can be solved. In fact, we’ve seen some yet-unpublished data to suggest there are quite a few liquid creatine products that remain stable in solution for long periods of time. Try only liquid creatine products from reputable companies.

The Insulin / Creatine Connection

Insulin is not necessary for creatine uptake, but supraphysiologic hyperinsulinemia (high blood insulin) can help drive more creatine into muscle. But remember, we said that these levels have to be supraphysiologic. 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 to simply eat 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 is a lot of sugar. But that’s what it took to enhance the creatine uptake. So if you’re taking in less 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.

We don’t know about you, but 93 grams of sugar is a bit too much for us. Especially when taken multiple times each day during the loading phase. So should this concept be abandoned? No way. There are other ways to get insulin levels high enough. 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 percent increase in blood insulin, and 64 grams of protein leads to a 100-200 percent increase in blood insulin, a combination leads to a 600-800 percent increase (6,7). Now that’s supraphysiologic! So it appears a protein / carbohydrate combo may be best for increasing blood insulin.

A recent study confirms that a meal containing 50 grams of protein and 50 grams of carbs can lead to identical increases in insulin and creatine uptake as 100 grams of carbs ( 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 therefore 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 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 percent, while athletes consuming 112 grams of carbs, 56 grams of protein and a few specific insulin secretory amino acids had insulin increases of about 1700 percent (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 in hopes to enhance creatine uptake. 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

There are a number of ways to get the most from your creatine supplementation. By minimizing discomfort and maximizing uptake one can make a great supplement even better. Creatine alone can increase muscle mass, muscle strength and athletic performance. The inclusion of carbs and protein with your creatine may lead to even greater benefits. In addition, the use of liquid creatine may allow for lower effective doses of creatine and a much more pleasant intestinal experience.

And by the way, don’t let Mr. Coffee disappear from the cupboard while cycling creatine. That’s no way to treat an old friend. Bottoms up!


References:
Vandenberghe et al. J Appl Physiol. 80(2):452-7; 1996
Ziegenfuss et al. Performance benefits following a five-day creatine loading procedure persists for at least four weeks. Abstract presented at ACSM 1998.
Vanakoski et al, Int J Clin Pharmacol Ther. 36(5):258-62; 1998
Barr, Can J Appl Physiol. 24(2):164-72; 1999
Green et al. Am J Physiol. 271(5 Pt 1):E821-6; 1996
Rabinowitz et al, Lancet. 2: 454-456; 1966
Pallotta et al, Metabolism. 17: 901-908; 1968
Steenge et al. J Appl Physiol. 89(3):1165-71; 2000
Van Loon et al, American Journal of Clincial Nutrition. 72:106-111; 2000

reprinted from virtualmuscle.com
 
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