Creatine Crash Course: What is The Best Creatine Form?
It doesn't matter how old you are or how long you have been training. we've all had that moment where our grandma or mom gets a look at our supplement cabinet. They instantly raise an eyebrow and begin to worry about what we are taking. This is usually followed by a talk where they say they think you are taking this "weightlifting thing" a little too far.
It makes sense that they are worried though. They have no clue what any of these supplements are. To them is it is nothing but mysterious powders, potions, and pills. Their lack of knowledge can make your supplement arsenal appear to resemble Frankenstein's lab.
Related: Creatine Calculator, Daily Dosage and Maintenance Levels
It's easy for us to shake our head and laugh at their confusion but don't be so quick to joke. There are many areas that I find lifters and even serious bodybuilders are still very confused.
Creatine is one such subject. Despite being the most researched and proven supplement on the market creatine is surrounded by myths and questions. Even in my work with elite bodybuilders, I find many don't truly know how creatine actually helps with growth or what type of creatine is actually best.
Let's clear some of that up right now!
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What is creatine and how does it work?
Some people are still skeptical about whether or not creatine actually works. Some are quick to say that the gains are false because it "just makes you hold water." Others will say that it only helps with strength. The truth is that creatine is quite the multi-tasker that can help with growth and strength on many levels. In order to understand how valuable this supplement is, you have to first understand how it works.
Adenosine tri-phosphate (ATP) is the energy source used by muscle cells to fuel muscle contraction. ATP is broken down and a phosphate is released along with adenosine di-phosphate (ADP). The ADP will be recycled as a phosphate will be reattached and ATP is formed again.
The mitochondria of each cells are charged with the job of energy production. The mitochondria convert glucose, fatty acids, and ketones into ATP through the Krebs Cycle or TCA cycle.
Creatine interacts with an enzyme process called creatine kinase (CK) where it picks up a phosphate molecule and becomes creatine phosphate also called phosphocreatine (CP). Creatine kinase will then remove the phosphate molecule from CP and it is donated to ADP to create ATP.
During high-intensity activity the ATP-CP system becomes extremely important as this is the energy system that will kick in even before the glycolytic system (where glucose is used to produce ATP).  When activity begins we already have a large supply of ATP and CP, but muscle cells use up the store of ATP very quickly. This leaves ADP available which is converted back into ATP by the stores of creatine phosphate. Unfortunately, this process can leave creatine phosphate levels nearly entirely depleted. 
Creatine phosphate is needed to continue to recycle ADP into ATP and make is available for energy by the cells. This process also prevents intracellular levels of ADP from elevating which can decrease power output by decreasing cellular respiration and speeds up energy requirements. 
Here is where we get into how creatine supplementation is useful. The ATP-CP system is short lived and only provides roughly 5-10 seconds as the primary energy source during a set before the glycolytic pathway takes over the bulk of the burden of ATP replenishment. 
Beyond this point, the phosphocreatine system still provides energy but just to a lesser degree and continues to decrease as exercise continues. Creatine is effective at improving high-intensity efforts that are less than 30 seconds in duration because, at this intensity, fatigue is caused by an inability of Type II fibers to maintain the high rate of ATP resynthesis that is required to maintain a high power output.
When phosphocreatine stores are rapidly depleted, glycogenolysis is not able to make up for the decrease in energy production and power output will decrease. Creatine supplementation has the ability to delay fatigue caused by depleted phosphocreatine stores by increasing the storage of creatine phosphate. So for sets under 30 seconds creatine supplementation will enhance power output. 
Now besides the benefits of creatine as an energy source and its ability to increase power output, it also has several other benefits. Creatine has the ability to increase cellular hydration or "cell swelling". Increased cellular hydration is thought to reduce protein catabolism and increase the synthesis of DNA.  It has also been shown to increase the growth of MHC type I and type II fibers as well as act as an anti-catabolic by decreasing myostatin, which is a muscle growth inhibiting gene within the human body. 
So as you can see, creatine is WITHOUT A DOUBT an effective supplement that offers benefits to athletes and physique athletes through several mechanisms of action. There is a reason that creatine is the most researched supplement there is on the market. It has been proven to work, time and time again, and offers advantages that are multifaceted.
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This is where many people get lost. It seems that every few months there is a new "advanced creatine" that is hitting the market. They all have some amazing adjective and adverb laden name like "Super Mega Ultra Advanced Creatine Delivery Technology Breakthrough". All the marketing for these different forms claim to be the best, and all tell you that they have the scientific research to back it up. Well, let's get down to the nitty gritty and see what the research really says about some of the more popular forms of creatine.
Creatine monohydrate is possibly the most researched supplement in history. Time and time again it has been proven effective and safe. It has become the standard against which all other creatines are judged. It is rather inexpensive making it an excellent supplement option even for those on a budget.
Effervescent creatine is made up of creatine monohydrate along with citric acid and bicarbonate. It is often touted as being more stable in liquid form as well as well as having a greater retention rate in the body. Unfortunately, research has shown that it is unstable in liquids just like other forms of creatine and it also has no greater retention than creatine monohydrate. 
Creatine nitrate is creatine that has been bound to a nitrate group. Creatine nitrate has been found to be about 10x more soluble than creatine monohydrate which may allow it to cause less gastric distress to those that sometimes experience stomach issues with regular creatine monohydrate. However, the claims of creatine nitrate being more effective for increasing strength or power have not been shown to be true.
Creatine CitrateCreatine that has been bonded with citric acid. It is often claimed that creatine citrate is more absorbable and therefore more effective at increasing muscle creatine stores. However, research has shown this is not the case and only appears to be as effective as creatine monohydrate. 
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Creatine Ethyl Ester (CEE)
Creatine ethyl ester is commonly called an "advanced creatine" and that it "increases uptake" over standard creatine monohydrate. It is funny that this is the common marketing claim because the truth is that creatine ethyl ester rapidly degrades into the metabolite creatinine in the intestines, almost completely in fact.  Therefore making it FAR LESS effective than its cheaper counterpart creatine monohydrate. This is an extremely ineffective supplement. don't waste your money on this.
Buffered Creating (Kre-Alkalyn)
This is also known as Buffered Creatine. The buffer is actually sodium bicarbonate, more commonly known as baking soda. The marketing claim for buffered creatine is that you don't have to take as high dosages as regular monohydrate because more of the product will pass through the stomach and GI tract through less degradation. Unfortunately, Kre-Alkalyn is negated by stomach acid and turns into a basic creatine molecule.
The claim that regular creatine monohydrate needs to be buffered in order to prevent it from breaking down into creatinine with the body is inaccurate. High acidity environments, like in your stomach, will actually slow the conversion of creatine to creatinine. So once you take creatine there will be very little degradation. 
This makes Kre-Alkalyn no more effective than regular creatine monohydrate. In fact, one study even showed Kre-Alkalyn less LESS effective at promoting changes in muscle creatine content than regular creatine monohydrate.  This is a little disappointing when you consider it is also more expensive.
Magnesium Creatine Chelate
There is some research that shows creatine magnesium chelate enhances uptake of creatine into muscle cells as well as intracellular water.  However, at this time any performance benefits are still yet to be shown.
There is actually some mixed research on creatine pyruvate. Creatine pyruvate was found to be more effective than creatine citrate which is promising since creatine citrate appears to be as effective as creatine monohydrate.  Other research also shows that creatine pyruvate raises plasma creatine levels to a greater degree than monohydrate BUT it was no more effective in terms of absorption.  Another study also showed that creatine pyruvate intake failed to improve cycling performance both in an endurance capacity as well as sprinting. 
This is creatine that has been bound with malic acid. This form of creatine has yet to be researched to determine its effectiveness. However, malic acid may have performance-enhancing benefits on its own. 
Creatine Hydrochloride (Con-Crete)
Creatine Hydrochloride is typically marketed as being more soluble and also absorbs more rapidly in the GI tract. While it is true that hydrochloride typically bound to amines will have these abilities, this has not yet been proven to be the case with creatine HCl. There are as of yet no studies to show superior absorption of creatine HCl or improved performance.
Which Creatine Form is Best?
As you can see from reading the list above, many of the so-called "advanced creatine" products are not so advanced after all. While creatines like creatine nitrate may ease gastric distress for the few that have this issue, and magnesium chelate can enhance intracellular water, at this time there is no reason why you should use anything other than good old creatine monohydrate.
None of the other formulations have outperformed creatine monohydrate in terms of a performance aspect and all of the claims of poor absorption of creatine monohydrate are not accurate. Creatine monohydrate has clearly been shown to clear the stomach to be absorbed intact.
I know you are probably thinking, "You made me read all that just to recommend boring creatine monohydrate?" Well, now you know the truth behind all the fancy claims of each product.
Creatine Pills, Powders and Liquids? OH MY!
One last thing to consider in your choice of creatine is whether to buy it in the form of pills, powder, or liquid. Here are some things to consider.
Creatine powder is often cheapest, it mixes easily, and most forms have no taste at all (unless it is flavored). This is a very good form to buy as you can easily add it to many beverages or just drink it alone. To get an effective 5-gram dose it is typically only 1 heaped teaspoon.
Creatine capsules have the advantage of traveling a little easier if that is of use to you. They are equally effective as the powder. Sometimes pills can cost a bit more than powder, but not much more. The only other downside is that commonly it will require taking 3-5 pills to equal a 5 gram dose. For those that don't like taking a lot of pills, this is not a good option.
STAY THE HECK AWAY FROM LIQUID CREATINE! Given the fact that creatine is unstable in aqueous solution and will eventually degrade into worthless creatinine, I find it very disturbing that companies would actually sell liquid creatine. It is often claimed that this enhances absorption but the truth is that by the time you take liquid creatine, it has more than likely completely degraded into creatinine.
And If You Don't Know - Now You Know!There you have it! Your crash course on creatine is complete. You are now equipped to go out into the world and handle flashy advertising, creatine myths, and skeptical grandmas.
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