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What Do You Know About Creatine?

Contributor Bio

Alex Tarnava is the CEO of Drink HRW, and the primary inventor of the open-cup hydrogen tablets. Alex runs the clinical outreach program for our company, working with over a dozen universities coordinating research. Alex has also published research of his own. You can find it on his ResearchGate. Additionally, he has been interviewed for many prominent publications, such as Entrepreneur and Forbes, and on many popular Podcasts. You can find all of his interviews and articles on his media page.

What Do You Know About Creatine?


When many people hear about creatine supplementation, they think it is just for bodybuilders or athletes. Others have commented to me in the past “isn’t that a steroid?”, and many others incorrectly believe it isn’t natural. In fact, creatine is very natural; not only do we get the majority of what we need from eating seafood and red meat, our pancreas, liver, and kidneys all make small amounts of creatine endogenously from arginine and glycine. Extra creatine can aid in numerous ways. As I have considered creatine more and more over time, I have slowly started thinking about it as an “overall health supplement” first and a performance enhancing agent second. I’m not alone, as two prevalent hydrogen researchers, both of which have publications on creatine, agree (Tyler W. LeBaron and Prof. Ostojic). Watch exerts of our talks on hydrogen water where we discuss creatine, and the potential synergy between hydrogen and creatine at the bottom of this article. Actually, back in 2011, Tyler wrote an extensive article on creatine including some of his spectroscopic studies on creatine stability. He was a bit hesitant to share because he said it needs some updating. Originally, it was used to fulfill an undergraduate requirement for a generals English class and not really intended to get this much attention (


Creatine is particularly effective in anaerobic exercise; the high intensity exercises common in many sports and weight lifting. During aerobic, lower intensity, exercise, muscles use stored fuels obtained from foods, such as proteins, fats, and carbohydrates. Many of you are likely familiar with adenosine triphosphate (ATP). Increased ATP has been mentioned in conjunction with H2i and an increase of ATP while drinking hydrogen wateriihas been observed. ATP is the bodies “molecular currency” created during the Krebs cycle, also known as the citric acid cycle. Carbohydrates are the predominant fuel source for the Krebs cycle and the reactions that make up the cycle require oxygen, which is why it is also known as “aerobic” metabolism. Aerobic exercise activities, such as walking and cycling, require a great deal of oxygen to generate the energy needed for prolonged exercise (low intensity exercise).

In contrast, sports which require repeated short bursts, like high intensity exercise that leave us gasping for breath, use anaerobic (no oxygen) metabolism to enable muscles to recover for the next burst. In these forms of exercise, oxygen is not necessary and ATP is needed at rates that exceed those provided by aerobic metabolism.


Using ATP converts it to adenosine diphosphate (ADP) and ATP can only sustain a high intensity movement for a few seconds. However, this can be extended by phosphocreatine, also known as creatine phosphateiiiiv. To recycle ATP, phosphocreatine donates a phosphate group to convert ADP back to ATP, thereby extending the time we can continue under high intensity exercise. This happens regardless of creatine supplementation, as we have endogenous creatine stores. However, the hypothesis behind supplementation is to increase phosphocreatine stores to extend time in anaerobic conditions during high intensity exercise.

In the literature, only caffeine has perhaps shown to more immediately improve performance results through acute supplementation than creatine, as I discussed here. The overwhelming consensus is clear that creatine is safe and effective for improving athletic performance and muscle gain,vvi with very significant and clear benefits for increasing lean body mass.viiviii While creatine supplementation will aid in muscle gain, and increase strengthix and performance in high intensity activitiesx, it likely will give no benefit for low intensity endurance athletes,xi other than helping preserve lean muscle mass.

Sarcopenia & Muscular Diseases

Sarcopenia, or the age-related loss of skeletal muscle mass, is a strong contributor in age-related deterioration. It is also related to a deterioration of strength and function of remaining muscle tissues. There is a borderline zone between sarcopenia and some forms of muscular dystrophy with the correct diagnosis often missed.xii They share many of the same pathophysiological mechanisms and result in many of the same issues.xiiixiv

Creatine has shown some promise for both issues. While one study on mice with accelerated senescence determined that lifelong creatine use had no benefit for the risk of developing sarcopeniaxv, human studies have shown a benefitxvi and a 2019 systematic review has determined that it likely has a benefit for sarcopenia, with or without resistance training used in conjunction.xvii

For muscle disorders, a Cochrane Review conducted in 2013 that was based on 14 studies totaling 364 participants, concluded that creatine may offer benefits for this group.xviii Since this review, at least one more study showing a benefit has been published.xix


We have investigated whether creatine can improve issues with those with heart failure since at least 1995xx, with further positive results in a 2006 human trialxxi. That said, another study in 2010 showed there was no additional benefit beyond exercise alone.xxii Regarding cholesterol levels, tied very closely to heart disease, creatine has shown some evidence in positively impacting elevated or compromised cholesterol markersxxiii in humansxxiv and rodentsxxv, while showing no benefit for healthy individuals in an already normal range.xxvi Another study in young healthy participants found a benefit for many parameters, including LDL, but nothing significant for the beneficial cholesterol HDL.xxvii


Part of what excites me about creatine is its potential as a neuroprotective agentxxviiixxixxxx. Two weeks ago, I discussed the exciting potential benefits of hydrogen water on traumatic brain injury (TBI) following our case study on a pro soccer player. Creatine has also been studied in rats with TBI showing a significant benefit.xxxi

I want to make it explicitly clear that creatine supplementation as a potential therapy to treat existing neurodegenerative conditions, with the possible exception of pre-manifest Huntington’s Disease, has been an absolute failure.xxxii While creatine has emphatically failed to show a positive benefit in treating existing conditions, the hypothesis that it can offer an improvement and reduce the risk of developing them lives on,xxxiii even cited by the team concluding that creatine treatment was a massive failure. Another more recent review cast a more positive light on the benefits for creatine in neuroprotection and the elderly.xxxiv

Further, we know that sarcopenia is linked to cognitive decline, and creatine’s potential ability to maintain muscle mass could offer valuable protection. While taking a supplement doesn’t necessarily mean the individual will be more active, maintaining leg muscle could lead to more activity in the elderly. We know that one of the best neuroprotective practices is leg exercise. In a trial of otherwise healthy elderly participants, creatine seemed to increase cognitive capacity.xxxv

Hydrogen + Creatine vs Caffeine + Creatine

Interestingly, caffeine and creatine, two of the greatest allies for improved sports and cognitive performance, are not synergistic and may actually reduce benefits when used together. Specifically, caffeine may blunt the benefits of creatine when taken concurrently.xxxvi This is particularly of note to most athletes and weight lifters, as the vast majority of pre-workouts contain very high amounts of caffeine. Although some studies suggest creatine and caffeine can negate the other’s effects, Tyler W. LeBaron maintains that the primary benefits are not decreased. While caffeine and creatine both have their benefits, based on the literature perhaps they shouldn’t be taken together. However, creatine and hydrogen water? Some, like Prof. Ostojic, have suggested they may be synergistic.

Responder vs Non-Responder

Creatine has a well-established responder and non-responder outcomexxxvii. In my talk with Tyler W. LeBaron, he hypothesizes how hydrogen water may be able to allow creatine non-responders to benefit from creatine.


Just as I have stated with caffeine, Omega 3 and Vitamin D, I have no interest in dressing up creatine in slick packaging and charging large margins. That is why we have added it to our “essential” category, at a price where we technically lose money. When purchasing hydrogen tablets, or a qualifying Elite Biohacking item, simply add “CREATINE” to your cart for $6 for a jar with 300 g, 5 g per scoop. Depending on your level of use, this is a 30-60-day supply of creatine for just $6. As always, even when adding on an essential to a hydrogen water product, your first purchase comes with a no questions asked money back guarantee.