Buying creatine with the best absorption

The added value of expensive, supposedly more effective forms of creatine has barely, if at all, been proven. It is wise not to be tempted by flashy advertising from manufacturers claiming to have developed an even better version of creatine. The "old reliable" creatine monohydrate remains unbeaten when it comes to value for money. Even if you are willing to pay four times as much for creatine, you should ask yourself whether that adds anything at all to the effect of "normal" creatine monohydrate.

There are circumstances in which creatine monohydrate is not fully absorbed into the bloodstream and therefore cannot be fully effective in the muscles because it never gets there. Manufacturers of special forms of creatine claim to have modified their creatine as a solution for this reduced absorption. In the article below I will first describe the circumstances under which creatine is not fully absorbed. More importantly, I will show how you can easily adjust those circumstances so you can benefit optimally from creatine monohydrate. As a result, you do not need more expensive variants of creatine at all.

In the second part of this article I will also discuss some of the special forms of creatine, how they are supposed to provide better absorption, and why this does not appear to be the case in practice. In fact, many of these forms are absorbed worse or are already partly broken down before the creatine has even been taken.

Small pie and a lot of eaters

"Everybody wants a piece of the pie"

And in this case that pie is called "creatine monohydrate". Creatine is one of the most researched supplements [1,2]. Its possible effects have been demonstrated repeatedly, which also makes it one of the most popular supplements. The supplement industry is a multibillion-dollar industry [3,4]. So there is good money to be made from the pie called creatine, and everyone wants their share.

Revenue from supplement sales also continues to increase. In the United States, for example, $11.5 billion was spent on supplements in 2012, 7% more than the year before [4]. New supplement brands, however, seem to appear almost weekly. So although the pie is still growing, the number of eaters seems to be growing faster. To prevent everyone from eventually having to settle for a few crumbs, you could of course try to make the pie even bigger. But then you are promoting creatine in general, while you only benefit from that partly and allow competitors to ride along for free. Claiming a larger share for yourself through smarter marketing of your own product is another possibility. But those marketing costs naturally come at the expense of your profit.

So a few smart people thought: "We will just bake a new, tastier pie*. Instead of trying to get our share in the market for creatine monohydrate, we will create a "better" creatine. Then we can eat our fill until other parties follow our example and start eating with us".

I have told a similar story more often, but without making a substantive comparison based on studies. Using the research that has been done into the effectiveness and safety of other types of creatine, I will show in this article that more expensive is certainly not better.

*Those who have ever tried creatine ethyl ester malate will say that "tastier" is not entirely appropriate in this context. Indeed, that stuff is truly disgusting.

Types of creatine compared

In a 2011 study, American researchers from several institutes compared different types of creatine [5]. They concluded:

However, there is little to no evidence that any of the newer forms of creatine are more effective and/or safer than CM [ed: Creatine Monohydrate] whether ingested alone and/or in combination with other nutrients. In addition, whereas the safety, efficacy, and regulatory status of CM is clearly defined in almost all global markets; the safety, efficacy, and regulatory status of other forms of creatine present in today’s marketplace as a dietary or food supplement is less clear.

- R. Jäger, Increnovo LLC

So there is little to no evidence of greater effectiveness, and safety has also not been properly demonstrated. Let us look at how the researchers assessed this.

Amount of creatine: "dried creatine wins"

People often do not realize that if you have two tubs of, for example, 100 grams, one containing only creatine and the other containing an added ingredient, the product with the added ingredient must by definition contain less creatine. After all, the tub has not become larger and no, they are not kind enough to use the empty space in the tub for those additions. In both cases you still get 100 grams.

One of the properties you can therefore look at is the actual percentage of creatine in the product. In the table on the right we see such a comparison. Substances are often added to creatine to improve the absorption of the creatine. In all cases we see that these additions, which are supposed to improve the product, ultimately leave less creatine to do its job. While you may still wonder to what extent the creatine in these products is absorbed, you at least know for certain that there is simply less creatine available to absorb. In some cases it is even half as much.

The exception is "creatine anhydrous", although this is not because something has been added but because something has been removed. The explanation is simple. "Monohydrate" refers to the fact that one water molecule is attached to the creatine molecule, forming a crystal [5]. Because of this presence of water, creatine monohydrate is not made entirely of creatine, but partly of water. By drying creatine monohydrate further at a temperature of 100 degrees, you lose the water and are left with 100% creatine, or anhydrous creatine. "Anhydrous" means something that contains no water.

Anhydrous creatine is therefore not necessarily more effective or better. You simply get proportionally more creatine, 13.8% to be exact. That also immediately tells you whether it makes sense to buy anhydrous creatine: if it costs more than 13.8% more than creatine monohydrate, you are paying too much and are better off buying creatine monohydrate. If you want more creatine, just buy a bigger tub.

Solubility of creatine

If adding something to creatine monohydrate means you actually get less creatine, why do manufacturers do it?

The pessimistic explanation is that they assume you do not know any of the above and that you will be tempted by marketing claims about supposedly fantastic effectiveness. The optimistic, but probably naive, explanation is that they genuinely think that despite the lower amount of creatine their product really does produce better results because of the additions. That latter idea has a theoretical basis, so you could indeed believe it. In practice, however, the added value is disappointing, as the comparative study now shows [5].

First, a brief explanation of creatine solubility. If you have used creatine monohydrate, you know that it barely dissolves in water. It dissolves a little better in fruit juice, but even then it remains difficult. You can stir until you are blue in the face, but you will keep seeing the small crystals. You drink your juice and will always see a layer of crystals at the bottom of your glass, then add more juice to get that last bit down as well.

Solubility of creatine: acids, salts and bases

The extent to which creatine is absorbed into the bloodstream, after which it can do its work in the muscles, has to do partly with solubility. Solubility in turn has to do with the acidity of the water. Without going too deeply into acids and bases, it is useful to know that the acidity of neutral/normal water is pH 7. The lower the pH value of the water in which creatine is dissolved, the more creatine dissolves [5].

The additions to creatine are therefore often salts or acids that are intended to achieve this effect by making the water more acidic. At a water pH of 7 (neutral), you need one liter of water to dissolve 14 grams of creatine monohydrate [5]. However, if you manage to lower the pH value by adding pyruvate, for example (lowering the pH to 2.6), you can dissolve almost four times as much creatine in one liter.

Solubility of creatine: water temperature

At least, that is the case if the water has the same temperature of 20°C in all cases. Another important variable in determining solubility is the temperature of the water. The warmer the water, the more easily creatine dissolves. As I indicated above, at a temperature of 20°C you need one liter to dissolve 14 grams of creatine. If you increase the temperature to, for example, 50°C, you can dissolve more than twice as much, namely 34 grams [1]. The warmer the water, the better creatine dissolves.

Creatine absorption with fluid deficiency

So you need enough water in combination with the right temperature to dissolve creatine properly. But why is this important?

If you take creatine with too little fluid, a large part ends up in the stomach in powder form. In that form it cannot be absorbed, because nutrients have to be made liquid before they can be absorbed further. Two things happen in that situation:

• Part of the creatine is eliminated directly and is therefore wasted
• The stomach draws fluid from the cells of the organs involved in digestion in order to dissolve the creatine.

That the first is undesirable speaks for itself. You do not take creatine in order to poop out half of it unused. The second option is not exactly pleasant either. The amount of fluid drawn into the stomach should be removed quickly again and could therefore lead to diarrhea. Although nobody wants to sound like that idiot in the commercial who has to tell everyone he has diarrhea, I have not found studies confirming this increased risk of diarrhea. The risk from creatine appears to be only 2%, as shown in a study in which participants received 10 grams per day for a year [6]. This was taken in two portions of 5 grams with 250 ml of water. Too little to dissolve the creatine completely, but apparently enough to prevent diarrhea in the vast majority of participants.

Although the chance of diarrhea therefore appears small, moving fluid to the stomach takes time, and during that time part of the creatine can be lost.

Creatine stability: limited breakdown of creatine monohydrate in powder form

Besides solubility, the stability of creatine is important in determining how much of it is absorbed. If a large part of the creatine has already broken down into the breakdown product creatinine while it is still in the tub, that part has become useless. The breakdown of creatine monohydrate in powder form, however, is very limited. Even if it were stored at a temperature of 40°C, there would still be no breakdown after three years of storage [7]. That is much longer than creatine is usually on the shelf, since it is longer than the expiration date it is given.

In liquid, however, it is a different story. The factors that help creatine dissolve better also cause more breakdown. Creatine breaks down faster in acidic and warm liquid. For example, if you leave creatine at a temperature of 25°C for three days, then [8]:

• The creatine will remain virtually stable in pH-neutral liquid
• 4% of the creatine will have broken down in liquid with pH 5.5
• 12% of the creatine will have broken down in liquid with pH 4.5
• 21% of the creatine will have broken down in liquid with pH 3.5

In another study, creatine in water at room temperature began to show breakdown after a few days, while this was delayed if the solution was frozen [9].

Practical solutions: change the circumstances, not the creatine!

The temperature and acidity of the liquid in which creatine is dissolved are therefore important for determining solubility and absorption, but they can also cause breakdown. There are therefore simple solutions to get the most out of your creatine monohydrate.

Correct temperature for dissolving creatine

When you take creatine with a glass of fruit juice, for example, the juice is often chilled in the refrigerator. This comes at the expense of solubility because the drink is too cold, unless you compensate by increasing the amount of liquid. It is therefore wise to let the drink warm up at least to room temperature. A warm drink would be even better. Be careful, however, when mixing with drinks that contain caffeine, such as coffee and, to a lesser extent, tea. Although there is still much uncertainty about this, I wrote earlier that from more than 5-6 cups of coffee per day, the effect of creatine may possibly be negated [10].

Correct acidity for dissolving creatine, limited breakdown risk

The other variable was acidity. You hear many conflicting opinions about this, often based on an incorrect presentation of the facts.

The above shows that if you make the liquid in which you dissolve your creatine more acidic (than neutral, pH 7), the creatine dissolves better. Below you can see several drinks with their acidity. I have only listed drinks that are acidic (pH<7)[11].

• Stomach acid 2.0
• Lemon juice 2.0
• Cola 2.7
• Apple juice 2.8
• Diet Coke 2.9
• Blackcurrant soda 3.0
• Vinegar 3.0
• Orange juice 3.2
• Red/white wine 3.4
• Yogurt drink 3.8
• Beer 4.3
• Buttermilk 4.4
• Herbal tea <6.0
• Milk, semi-skimmed 6.8
• Pure water 7.0

An acidic drink is therefore better for dissolving your creatine, although breakdown should be taken into account. After all, we have seen that creatine dissolves faster in a more acidic drink. Some people say you should not mix creatine with acidic drinks because of increased breakdown. This is incorrect for two reasons:

1. As soon as creatine enters the stomach, it comes into contact with stomach acid, which is even more acidic than the drink you have consumed. It therefore makes no sense to choose a neutral drink first if it comes into contact with stomach acid a few seconds after drinking.
2. If you drink the acidic liquid with creatine immediately, there is too little time for breakdown. It takes only a few hours (with the right amount of liquid and temperature) for creatine to reach the muscles [12]. That seems insufficient time for significant breakdown if it takes three days at an acidity of pH 3.5 to break down 20%.

Bioavailability of creatine monohydrate

The only factor I have not yet mentioned here is biological availability, or bioavailability. At least, I have only covered part of it. Biological availability is the amount of a substance that ultimately arrives at the place where it is supposed to do its job. I have already described the part determined by absorption from the stomach through the intestines and then the bloodstream.

How much is then taken up from the bloodstream (by the muscle cells in this case), however, can also differ. Some people respond less or even not at all to creatine supplementation [13,14]. One explanation for this is that these people are already saturated with creatine and supplementation cannot further increase the levels in the muscles. Another possible explanation, however, is that uptake by the muscle cells is lower in these people. British researchers investigated whether forms of creatine other than monohydrate lead to better uptake by the muscles [15].

See the graph on the right: creatine citrate (CC) and pyruvate (CYP) seemed to provide slightly higher uptake than monohydrate (CM), but the study was limited by the small number of participants (only 7) and by the fact that it was measured in the blood rather than by means of a biopsy that could show what actually happens inside the muscle cell itself.

The small differences in kinetics are unlikely to have any clinically relevant effects on muscle creatine elevation during periods of creatine loading. A follow-up study including muscle biopsies would be required to conclude if the bioavailability of this specific creatine salt was indeed higher

- R. Jäger, Increnovo LLC

In this study, incidentally, the differences were around 15%. If this is actually the case at all, you may wonder whether you could not simply solve it with 15% more creatine monohydrate, and to what extent that would be cheaper than buying the more expensive variant.

Conclusion

You can therefore best take your creatine monohydrate with a warm and/or acidic drink. There seems to be insufficient time for acid-related breakdown if you drink it immediately. However, you may wonder what that means for the expensive liquid creatine sold as a solution, both literally and figuratively, for incomplete dissolving of creatine. What does it mean for the stability/breakdown of the creatine if it sits on the shelf for weeks or months in an acidic liquid?

You can ask these kinds of questions about several special types of creatine, and in the next part of this article I will do exactly that. With this part I wanted to show that you can solve the problems with reduced creatine absorption by changing the circumstances. In the next part I will show that modifying the creatine itself, as supplement manufacturers do, often actually causes reduced absorption.

References

1. Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. 2007;4:6. doi: 10.1186/1550-2783-4-6.
2. Kreider RB, Wilborn CD, Taylor L, Campbell B, Almada AL, Collins R, Cooke M, Earnest CP, Greenwood M, Kalman DS, Kerksick CM, Kleiner SM, Leutholtz B, Lopez H, Lowery LM, Mendel R, Smith A, Spano M, Wildman R, Willoughby DS, Ziegenfuss TN, Antonio J. ISSN exercise & sport nutrition review: research & recommendations. J Int Soc Sports Nutr. 2010;7:7. doi: 10.1186/1550-2783-7-7.
3. NBJ (2009) Sports nutrition & weight loss report. Nutrition Business Journal, vol XIV, September edn., Boulder
4. nutraingredients-usa.com/Markets/Supplement-sales-hit-11.5-billion-in-U.S.-report-says
5. Ralf Jäger,Martin Purpura,Andrew Shao,Toshitada Inoue,Richard Kreider. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids (2011) 40:1369–1383 DOI 10.1007/s00726-011-0874-6
6. Groeneveld GJ, Beijer C, Veldink JH, Kalmijn S, Wokke JH, van den Berg LH. Few adverse effects of long-term creatine supplementation in a placebo-controlled trial. Int J Sports Med. 2005 May;26(4):307-13. PubMed PMID: 15795816.
7. Jäger R (2003) The use of creatine monohydrate in sports nutrition, Freising, Germany
8. Howard AN, Harris RC (1999) Compositions containing creatine. US Patent
9. Ganguly S, Jayappa S, Dash AK (2003) Evaluation of the stability of creatine in solution prepared from effervescent creatine formulations. AAPS PharmSciTech 4 (2):E25. doi:10.1208/pt040225
10. Buildmybody.nl/creatine-en-cafeine-een-eind-aan-de-discussie/
11. meesterbrein.com/view.php/appelsap-heeft-een-ph-waarde-van-2-8-limonadesiroop-3-0.html
12. Anna Casey and Paul L Greenhaff. Does dietary creatine supplementation play a role in skeletal muscle metabolism and performance?Am J Clin Nutr August 2000 vol. 72 no. 2 607s-617s
13. Greenhaff P. The nutritional biochemistry of creatine. J Nutr Biochem.1997;11:610–618. doi: 10.1016/S0955-2863(97)00116-2.
14. Greenhaff P, Bodin K, Harris R, Hultman E, Jones DG, McIntyre D, Soderlund K, Turner DL. The influence of oral creatine supplementation on muscle phosphocreatine resynthesis following intense contraction in man. J Physiol. 1993;467:75P.
15. Jäger R, Harris RC, Purpura M, Francaux M. Comparison of new forms of creatine in raising plasma creatine levels. J Int Soc Sports Nutr. 2007;4:17. doi: 10.1186/1550-2783-4-17.