Creatine for Runners: a Guide to Creatine Supplementation for Endurance Athletes

Last Updated on December 8, 2022 by Heather Hart, ACSM EP, CSCS

It’s no secret that the sports supplement industry can feel confusing and overwhelming, to say the least. It is rife with products that promise to greatly enhance athletic performance, but rarely are these claims backed up with irrefutable scientific evidence.

Creatine, however, is one of the more thoroughly researched supplements on the market, and has proven time and time again to actually provide ergogenic benefits.

In fact, it is one of only a handful of ergogenic aids that governing bodies in the world of exercise science – like the American College of Sports Medicine and the International Society of Sports Nutrition – have actually endorsed as a strategy for improving performance in strength and power athletes.

But what do we know about creatine for runners?

Is there any evidence that creatine can benefit endurance athletes, like runners, cyclists or triathletes? And what about longer distance runners, like marathon or ultra distance athletes?

Is creatine something that you, as a runner, should consider taking?

Believe me, I get that this subject can be confusing, so I’m here to help.

(Hi, I’m Heather, exercise physiologist, CSCS, experienced running coach, and hater of the supplement industry…most of the time.)

In this complete guide to creatine supplemation for runners and endurance athletes, we’ll cover:

• What is creatine, and what does it actually do?
• The purpose of creatine supplementation for athletic performance.
• The benefits of creatine for runners
• When and how runners should supplement with creatine

…and more. My hope is that by the time you finish reading this article, I have demystified creatine for you, and helped you better understand whether or not creatine is something you want to add into your supplement routine.

What is Creatine, and What Does it Do?

Creatine is an amino acid derived, nitrogen based, organic compound that is synthesized naturally within the body. It is mainly produced within the liver at a rate of about 1-2 grams per day, but can also be formed in smaller amounts in the kidneys and pancreas.

98% of creatine within the body is stored within the muscles, with 40% being in it’s free form, and 60% in the form of creatine phosphate (also called phosphocreatine, and abbreviated as either CP or PCr). The average 150 lb male stores anywhere from 120-140 grams of creatine in their body (6).

Creatine helps supply energy to all cells within the body, and therefore, plays an essential role in energy metabolism in relation to sport and exercise.

Understanding the Phosphagen System

It’s time to get science-y! Let’s dive a little deeper into how creatine works, for those who like to have a greater understanding of these topics (I promise to still keep it as easy to understand as possible!).

Our body has a handful of energy pathways in which it turns the food we eat into a useable form of energy, to quite literally fuel our muscle cells as we perform physical activity.

The most immediate energy pathway for our cells is called the phosphagen system (often referred to as the ATP-PCr system). This system is responsible for creating energy at the onset of all physical activity, as well as providing energy for high-intensity, short duration activity (such as a 100 meter sprint, or a clean and jerk).

In this energy pathway, our body immediately turns to stored ATP (adenosine triphosphate) to create energy. In the most basic terms, a phosphate is split off of ATP, and that process creates the “energy” for our cells.

However, the body doesn’t store a ton of ATP, and further, can’t completely use up those stores, as they are needed for other basic body functions. You know, like keeping your heart beating, and breathing, and all of that good stuff.

This is where creatine comes in.

After the ATP is split, you are left with, among other things, ADP molecules (adenosine diphosphate – meaning now it only has two phosphates).

Creatine phosphate works with an enzyme called creatine kinase to give up it’s phosphate molecule, and donate it to an ADP molecule. That ADP now becomes an ATP, and voila, you have more available energy!

The process – known as rephosphorylation- can happen very rapidly, providing the energy needed for short, powerful, intense activity.

However, creatine phosphate stores in the muscle are also depleted very rapidly, meaning the body cannot rely on this awesome ATP recycling energy system for very long.

In general, the phosphagen system will only provide enough energy to sustain upwards of 10 seconds of maximal effort activity.

Research shows that during a 6 second bout of maximal exercise, CP levels within the muscle are reduced up to 57% of resting levels, and during a 30 second bout of high intensity exercise, CP levels within the muscle are reduced upwards of 80% from resting levels.

What is the Purpose of Creatine Supplementation for Athletic Performance?

We also know that as creatine phosphate levels decrease during maximal effort activity, the actual performance of that activity (speed, strength, etc.) also decreases.

Therefore, if muscle creatine phosphate concentrations can be maintained longer, the ability to sustain high-intensity activity can also be maintained longer.

Creatine supplementation allows an athlete to have extended energy in short bouts of maximal exercise before fatigue sets in. This may allow for one more repetition before failure, holding a a maximal pace for just a few more seconds before fatiguing, etc.

Various studies have demonstrated that creatine supplementation can increase the creatine content of muscles by upwards of 20%.

Is Creatine a Stimulant or a Steroid?

Creatine is not a stimulant nor a steroid. Creatine is comprised of three amino acids: L-arginine, glycine, and L-methionine, making it more closely related to protein.

A stimulant is a class of drugs that increase activity of the central nervous system, such as caffeine. A steroid is a synthetic version of a hormone designed to signal changes within the body, such as anabolic steroids, which can signal protein synthesis and muscle growth.

Now, all of that said, pre-workouts sometimes do contain creatine as one of their ingredients. So, if you are trying to avoid any sort of stimulant, be sure to read the ingredients list of the supplement you are taking.

Like a Does Creatine Help Long Distance Runners?

Since we know that creatine supplementation can increase maximal power, strength, and maximal effort muscle contractions, it makes sense that creatine may directly aid in the performance of sprint distance running.

There is far less evidence demonstrating that creatine directly benefits long distance running. This makes sense, as long distance running and endurance sports rely on glycolysis and the oxidative system, rather than the phosphagen system, for energy production.

But there is plenty of evidence of indirect benefits of creatine supplementation for long distance runners…which we will get into below.

How Effective is Creatine Supplementation?

Numerous studies have repeatedly proven that creatine supplementation is beneficial for sport performance in certain situations.

In fact, the International Society of Sports Nutrition (ISSN) even states: “Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training.”

In both well trained and untrained populations, creatine supplementation has been shown to:

• Increase muscle mass
• Increase maximal strength
• Increase muscular power

Further in more experienced strength athletes, creatine supplementation has been shown to:

• Enhance the quality of workouts
• Decrease fatigue during workouts
• Decrease muscle damage
• Enhance recovery

How Safe is Creatine Supplementation?

By and large, controlled studies have been unable to document any significant negative side effects from creatine supplementation, in both short term (a few days) and long term (upwards of 5 years) creatine use.

ISSN states in their position stand on creatine use that: “there is no compelling scientific evidence that the short- or long-term use of creatine monohydrate (up to 30 g/day for 5 years) has any detrimental effects on otherwise healthy individuals or among clinical populations who may benefit from creatine supplementation.”

Is Creatine a Banned Substance?

Creatine is not tested for, nor banned, by the U.S. Anti-Doping Agency (USADA), the World Anti-Doping Agency (WADA), the International Olympic Committee (IOC), or the NCAA.

KNOW YOUR SOURCES: While creatine has been deemed safe by most governing bodies in the sports nutrition world, AND is approved by anti-doping governing bodies, it is still a sports supplement.

All supplements come with a certain level of risk due to an often unregulated production and marketing process.  This means that it is entirely possible a creatine supplement could be contaminated with something that is either banned, or potentially harmful.

If you choose to use creatine, be sure to purchase your supplement from a reputable company that you trust.

Possible Side Effects of Creatine:

Even though we know creatine is safe for healthy individuals, there are anecdotal (19) reports of less than enjoyable side effects for some individuals. These include:

• Digestive issues (stomach cramps, gas, diarrhea)
• Bloating
• Cramping

As always, anytime you take a new supplement, you should always be cognizant of how your body reacts, and seek medical guidance if necessary.

8 Benefits of Creatine for Runners

Despite the fact that creatine may not directly improve running or endurance performance, there are a number of potential indirect benefits of creatine for runners.

Indirectly, the benefits of creatine for runners may include:

(Please note: there are a TON of studies to wade through regarding creatine supplementation. You’ll notice I use the term “MAY” instead of “CAN” in all of these, as there is still more research needed to confirm or deny many of these claims.)

1. Increased Strength & Power

Creatine supplementation, in runners who are participating in resistance training, can help improve strength and power. This can indirectly help improve running performance.

But, creatine’s effect on power may be slightly more direct.

A 2018 study published in the Medicine & Science in Sports & Exercise Journal demonstrated that creatine loading in cyclists increased power output during maximal sprint efforts in the later stages of a 120 km cycling event. (24).

So if you are running a distance that may require a competitive kick at the end, creatine may help.

2. Increased Muscle Mass

When paired with various types of training, creatine supplementation is effective at increasing lean body mass, but not contributing to an increase in fat mass.

3. Decreased Injury & Tissue Damage

Consuming creatine may help decrease your risk of tissue damage and injury. The most direct explanation for this is that increased strength and muscle mass will help better protect your joints (such as your hips and knees) from common running injuries.

But creatine may have an even more protective effect.

A 2018 study published in the American Journal of Physical Medicine & Rehabilitation looked at the effects of creatine loading on apoptosis (death and destruction of muscle and tissue cells) markers after downhill running. The results of the study showed that the runners who supplemented with creatine had less of these markers of cell damage present in their blood compared to the placebo group.

4. Increased Glycogen Re-synthesis

Running, especially longer distance running, requires a ton of glycogen – the body’s usable form of those delicious carbohydrates you consume.

A number of studies have demonstrated that adding creatine to carbohydrates (8) or creatine to carbohydrates and protein supplementation may help promote greater glycogen storage.

More specifically, creatine may enhance muscle glycogen accumulation when supplementation is combined with a glycogen depleting exercise (such as…running!).

5. Improved Recovery

Many studies suggest that creatine supplementation after exercise may enhance recovery and regenerative responses, creating a more anabolic environment to avoid severe muscle damage and improve the recovery process. 

Part of this is likely due to the increased glycogen storage (8), which can stimulate muscle protein synthesis.

In addition, creatine supplementation may also reduce the post-exercise inflammatory response. Some studies have shown that creatine may possess antioxidant effects, and can remove potentially damaging free radicals (26).

6. Decreasing Muscle Loss

Creatine has been shown to promote maintenance and mitigate the loss of muscle mass, muscular strength, and endurance (12). This is ideal not only for runners who may have been injured, but post-menopausal women and older athletes who are at a greater risk of sarcopenia (involuntary loss of skeletal muscle mass and strength due to age.)

7. Increased Lactate Clearance

A number of studies have demonstrated that endurance athletes supplementing with creatine showed significant reductions in blood lactate at submaximal intensities, as well as increases in lactate threshold (4, 23).

8. Improved Heat Tolerance While Running

Are you regularly running in heat and humidity? Creatine may help!

Studies show that creatine supplementation in athletes resulted in a decreased occurrence of muscle cramping, heat illness or dehydration, and muscle tightness when training in the heat. This is possibly due to intracellular water retention and increased plasma volume (10, 15).

Creatine for Runners FAQ:

If you’ve made it this far, you are likely now looking for more specifics reagarding creatine and running, such as how and when to use creatine, if creatine loading is necessary, and other things you may have heard about this supplement.  

What are Common Dietary Sources of Creatine?

Creatine is naturally found in most animal meat products, such as poultry, red meat, and fish. In vegetarian athletes, creatine stores could be lower which may affect their performance in high-intensity, short duration efforts (2).

Creatine synthesis requires three amino acids, methionine, glycine, and arginine. Of these three amino acids, methionine is considered an “essential amino acid”, meaning the body cannot manufacture it on its own.

Therefore, vegetarian and vegan athletes should consume foods containing methionine, such as eggs, milk, tofu, brazil nuts, white beans, or quinoa, to ensure adequate creatine production.

What is the Suggested Creatine Dosage for Runners?

Supplementing with creatine in doses of 3-5 grams per day is recommended by the ISSN.

However, one research study specifically looking at endurance athletes found that supplementing with 6 grams of creatine per day showed positive effects on short-term exercise (7).

Creatine Pills vs Creatine Powder: Which is Better?

When it comes to creatine supplements, there is no proven difference in effectiveness between creatine in pill form or creatine in powder form. So the answer to “which is better” boils down to personal preference.

What’s the Difference Between Creatine Monohydrate vs Creatine HCL?

Creatine monohydrate (CM) is a creatine molecule bonded with a single water molecule. CM is the most commercially available type of creatine supplement. It’s also the most researched form of creatine supplementation.

Creatine Hydrocloride (CrHCl) is a creatine molecule bonded with a hydrochloric acid group. According to its creators – CrHCl is 41 times more soluble in water than creatine monohydrate. That means you not only need less water to dissolve and consume it, but it may ward off any potential water retention issues.

Creatine Hal also appears to have greater absorption in the intestinal tract, which may lead to less stomach discomfort.

The research is still minimal and mixed as to which form of creatine supplement is better.

Kre-Alkalyn vs Creatine Monohydrate

Kre-Alkalyn is a patented, buffered creatine formula, which has added an alkaline powder in order to adjust the pH balance between 7-14. The purported benefits of Kre-Alkalyn creatine is that the pH-buffered formula may improve the potency of the product, as well as decrease the risk of any intestinal discomfort.

Again, there is no concrete evidence that Kre-Alkalyn is superior to Creatine monohydrate.

What is Creatine Loading?

Creatine loading is the idea that initially supplementing with higher doses of creatine will rapidly increase intramuscular creatine stores.

According to the ISSN, the quickest method of increasing muscle creatine stores is to consume 0.3 grams of creatine monohydrate PER kg of body weight per day, for 5–7-days.

After the initial 5-7 days, runners may continue to supplement with 3–5 grams per day (independent of body weight) to maintain elevated stores. 

Note: while creatine loading has been proven to be effective, it is not necessary in order to benefit from creatine supplementation. Regular dosing still works, it just may take a little longer to see the results.

Is There a Limit to How Much Creatine You Should Take?

More is not always better. Studies show that there may be a saturation limit for creatine absorption in skeletal muscle. When creatine intramuscular creatine concentrations reach 150-160 mmol/kg dry weight, additional supplementation doesn’t appear to further increase muscle creatine concentrations (9).

Should You Take Creatine Before or After Running?

Currently, there is not enough research nor evidence clearly demonstrating that timing of creatine supplementation matters.

A 2001 clinical trial demonstrated that combining glycogen loading and creatine loading before exhaustive exercise promoted greater glycogen restoration than just carbohydrate loading alone. 

This may not only help with energy availability, but allow runners to maintain optimal glycogen levels to help promote recovery (18). In this example, taking creatine before running may be more beneficial.

Is Creatine Cycling Necessary?

 Current available evidence shows that chronic supplementation of creatine does not suppress our bodies ability to create or uptake creatine, therefore there is no need to cycle creatine for it to remain effective.

Will Creatine Make You Gain Weight?

Creatine may cause the numbers on the scale to increase, however, it’s important to understand that this increase in body weight does not correlate to gaining “fat”.

Creatine supplementation has been shown in some studies to be associated with water retention during the very early stages of supplementing, which can result in a gain in overall body mass (11).

However, there are also numerous studies that show no change in body mass or water retention due to creatine supplementation.

Long term creatine supplementation has been associated with increases in body weight due to an increase in muscle mass.

Coach’s Final Thoughts: Is Creatine Good for Runners?

Is creatine something runners should consider adding to their supplement routine? Well the answer, as always, is: it depends.

There is no doubt that creatine has a number of proven sport performance benefits, and may have a number of health benefits as well.

However, it is not “magic” and it’s not going to do the work for you.

Creatine still requires an athlete to train in a progressive, effective, and smart manner in order for performance gains to happen. Therefore newer athletes can absolutely continue to make strength and endurance gains simply by continued training.

In the case of runners or other endurance athletes, creatine will be far more beneficial to athletes who are regularly engaging in strength training, sprint training, or other powerful, explosive training than those who mainly train at an easy, aerobic effort.

And as a reminder, supplementation is never without SOME risk. As always, talk to your medical provider and/or a registered dietician to see if using creatine is right for you.

Resources:

1. Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. Journal of the International Society of Sports Nutrition, 18(1), 13. https://doi.org/10.1186/s12970-021-00412-w
2. Barr, S. I., & Rideout, C. A. (2004). Nutritional considerations for vegetarian athletes. Nutrition (Burbank, Los Angeles County, Calif.), 20(7-8), 696–703. https://doi.org/10.1016/j.nut.2004.04.015
3. Bassit, R. A., Pinheiro, C. H., Vitzel, K. F., Sproesser, A. J., Silveira, L. R., & Curi, R. (2010). Effect of short-term creatine supplementation on markers of skeletal muscle damage after strenuous contractile activity. European journal of applied physiology, 108(5), 945–955. https://doi.org/10.1007/s00421-009-1305-1
4. Chwalbiñska-Moneta J. (2003). Effect of creatine supplementation on aerobic performance and anaerobic capacity in elite rowers in the course of endurance training. International journal of sport nutrition and exercise metabolism, 13(2), 173–183. https://doi.org/10.1123/ijsnem.13.2.173
5. Cooke, M. B., Rybalka, E., Williams, A. D., Cribb, P. J., & Hayes, A. (2009). Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals. Journal of the International Society of Sports Nutrition, 6, 13. https://doi.org/10.1186/1550-2783-6-13
6. Cooper, R., Naclerio, F., Allgrove, J., & Jimenez, A. (2012). Creatine supplementation with specific view to exercise/sports performance: an update. Journal of the International Society of Sports Nutrition, 9(1), 33. https://doi.org/10.1186/1550-2783-9-33
7. Engelhardt, M., Neumann, G., Berbalk, A., & Reuter, I. (1998). Creatine supplementation in endurance sports. Medicine and science in sports and exercise, 30(7), 1123–1129. https://doi.org/10.1097/00005768-199807000-00016
8. Green, A. L., Hultman, E., Macdonald, I. A., Sewell, D. A., & Greenhaff, P. L. (1996). Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. The American journal of physiology, 271(5 Pt 1), E821–E826. https://doi.org/10.1152/ajpendo.1996.271.5.E821
9. Greenhaff P. L. (1995). Creatine and its application as an ergogenic aid. International journal of sport nutrition, 5 Suppl, S100–S110. https://doi.org/10.1123/ijsn.5.s1.s100
10. Greenwood, M., Kreider, R. B., Greenwood, L., & Byars, A. (2003). Cramping and Injury Incidence in Collegiate Football Players Are Reduced by Creatine Supplementation. Journal of athletic training, 38(3), 216–219. 
11. Hall, M., & Trojian, T. H. (2013). Creatine supplementation. Current sports medicine reports, 12(4), 240–244. https://doi.org/10.1249/JSR.0b013e31829cdff2
12. Harmon, K. K., Stout, J. R., Fukuda, D. H., Pabian, P. S., Rawson, E. S., & Stock, M. S. (2021). The Application of Creatine Supplementation in Medical Rehabilitation. Nutrients, 13(6), 1825. https://doi.org/10.3390/nu13061825
13. Hespel, P., Op’t Eijnde, B., Van Leemputte, M., Ursø, B., Greenhaff, P. L., Labarque, V., Dymarkowski, S., Van Hecke, P., & Richter, E. A. (2001). Oral creatine supplementation facilitates the rehabilitation of disuse atrophy and alters the expression of muscle myogenic factors in humans. The Journal of physiology, 536(Pt 2), 625–633. https://doi.org/10.1111/j.1469-7793.2001.0625c.xd
14. Kaviani, M., Shaw, K., & Chilibeck, P. D. (2020). Benefits of Creatine Supplementation for Vegetarians Compared to Omnivorous Athletes: A Systematic Review. International journal of environmental research and public health, 17(9), 3041. https://doi.org/10.3390/ijerph17093041
15. Kilduff, L. P., Georgiades, E., James, N., Minnion, R. H., Mitchell, M., Kingsmore, D., Hadjicharlambous, M., & Pitsiladis, Y. P. (2004). The effects of creatine supplementation on cardiovascular, metabolic, and thermoregulatory responses during exercise in the heat in endurance-trained humans. International journal of sport nutrition and exercise metabolism, 14(4), 443–460. https://doi.org/10.1123/ijsnem.14.4.443
16. Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14, 18. https://doi.org/10.1186/s12970-017-0173-z
17. Kreider, R. B., Melton, C., Rasmussen, C. J., Greenwood, M., Lancaster, S., Cantler, E. C., Milnor, P., & Almada, A. L. (2003). Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Molecular and cellular biochemistry, 244(1-2), 95–104. 
18. Nelson, A. G., Arnall, D. A., Kokkonen, J., Day, R., & Evans, J. (2001). Muscle glycogen supercompensation is enhanced by prior creatine supplementation. Medicine and science in sports and exercise, 33(7), 1096–1100. https://doi.org/10.1097/00005768-200107000-00005
19. Poortmans, J. R., & Francaux, M. (2000). Adverse effects of creatine supplementation: fact or fiction?. Sports medicine (Auckland, N.Z.), 30(3), 155–170. https://doi.org/10.2165/00007256-200030030-00002
20. Rawson, E. S., Stec, M. J., Frederickson, S. J., & Miles, M. P. (2011). Low-dose creatine supplementation enhances fatigue resistance in the absence of weight gain. Nutrition (Burbank, Los Angeles County, Calif.), 27(4), 451–455. https://doi.org/10.1016/j.nut.2010.04.001
21. Ribeiro, F., Longobardi, I., Perim, P., Duarte, B., Ferreira, P., Gualano, B., Roschel, H., & Saunders, B. (2021). Timing of Creatine Supplementation around Exercise: A Real Concern?. Nutrients, 13(8), 2844. https://doi.org/10.3390/nu13082844
22. Sheikholeslami-Vatani, D., & Faraji, H. (2018). Influence of Creatine Supplementation on Apoptosis Markers After Downhill Running in Middle-Aged Men: A Crossover Randomized, Double-Blind, and Placebo-Controlled Study. American journal of physical medicine & rehabilitation, 97(11), 825–831. https://doi.org/10.1097/PHM.0000000000000977
23. Tang, F. C., Chan, C. C., & Kuo, P. L. (2014). Contribution of creatine to protein homeostasis in athletes after endurance and sprint running. European journal of nutrition, 53(1), 61–71. https://doi.org/10.1007/s00394-013-0498-6
24. Tomcik, K. A., Camera, D. M., Bone, J. L., Ross, M. L., Jeacocke, N. A., Tachtsis, B., Senden, J., VAN Loon, L. J. C., Hawley, J. A., & Burke, L. M. (2018). Effects of Creatine and Carbohydrate Loading on Cycling Time Trial Performance. Medicine and science in sports and exercise, 50(1), 141–150. https://doi.org/10.1249/MSS.0000000000001401
25. Wang, C. C., Fang, C. C., Lee, Y. H., Yang, M. T., & Chan, K. H. (2018). Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sport Performance. Nutrients, 10(11), 1640. https://doi.org/10.3390/nu10111640
26. Wax, B., Kerksick, C. M., Jagim, A. R., Mayo, J. J., Lyons, B. C., & Kreider, R. B. (2021). Creatine for Exercise and Sports Performance, with Recovery Considerations for Healthy Populations. Nutrients, 13(6), 1915. https://doi.org/10.3390/nu13061915