Not long after creatine appeared on the market in 1993, questions arose about the best way to take it. Later research showed that creatine uptake occurs maximally in muscle if you take it with simple carbohydrates. The mechanism behind that reaction involves an increased secretion of insulin. Simple carbs are known to elicit the greatest insulin release of all nutrients. Insulin, in turn, aids creatine uptake in muscle by stimulating a creatine carrier. Creatine activates the sodium-potassium cellular pump mechanism, which powers the muscle-creatine carrier. The process is said to be sodium dependent.
Adding simple carbs to a creatine supplement increased creatine uptake by 60 percent over creatine without the simple carbs. The problem was that it took a large amount of simple carbs to work effectively, since the insulin-promotion effect only kicked in with a high level of insulin release. The suggested dose was 94 grams of simple carbs for each five grams of creatine. So, if you followed the suggested loading protocol of five grams taken four times a day, you'd also be getting a whopping 376 grams of simple sugar.
Although a few commercial creatine manufacturers used those findings in formulating their products, anecdotal evidence indicates that the products never became popular, most likely due to the large amount of simple carb'and the nearly repulsive degree of sweetness. Other ingredients suggested as creatine-uptake boosters, such as alpha-lipoic acid, simply didn't work, since they didn't promote the level of insulin release needed to maximize creatine absorption.
One frequently asked question is whether combining creatine with protein is an effective strategy. Some self-styled experts decried that notion, basing their opinion on the fact that protein requires an acid environment in the stomach for optimal absorption and that such a high acidity would degrade the creatine if it were taken simultaneously with protein. That theory, however, was never tested, and the experience of many bodybuilders and athletes who combined creatine with protein supplements clearly indicates that it has no deleterious effect on creatine uptake.
Now a new study confirms that, if anything, creatine is totally synergistic with protein.1 In fact, it shows that combining creatine with protein produces the same degree of insulin release as you get with more than 90 grams of simple sugar. The study involved 12 men who took five grams of creatine four times a day under the following conditions:
' With five grams of carbohydrate
' With 50 grams of protein and 47 grams of carb
' With 96 grams of carb
' With 50 grams of carb
The results showed no differences between the simple carbs and the protein-carb combination in relation to creatine muscle uptake. Previous studies have shown that combining protein with carbs produces a greater insulin release than carbs alone and thus more effectively stimulates muscle glycogen synthesis after exercise, a process promoted by insulin release.
Another interesting finding was that the insulin-stimulated creatine uptake was blunted after the first 24 hours. I would interpret that as meaning that you don't need to worry about taking creatine with carbs or protein after the first day of a creatine load, as it doesn't make any difference by then. On the other hand, taking the creatine with a protein drink won't diminish creatine uptake and may be more convenient for many people. That's also good news for people on low-carbohydrate diets. You might be wise to begin using creatine on a high-carb cheat day, in which you eat equal portions of simple carbs and protein, such as 50 grams apiece, with each five-gram serving of creatine. That would take advantage of the initial insulin boost of creatine uptake. Since the effect only lasts one day, on succeeding days you can take your creatine alone or with a low-carb protein supplement. IM
1 Steenge, G.E., et al. (2000). Protein- and carbohydrate-induced augmentation of whole-body creatine retention in humans. J Applied Physiology. 89:1165-1171.