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- Creatine Does Three Jobs, But You've Probably Heard of One
Creatine Does Three Jobs, But You've Probably Heard of One
Issue #24 · Read Time: 5.5 minutes
Creatine is often treated as obvious. You either scoop it into your shaker or decide you’re fine without it. That decision usually feels rational. You eat well. You train. You’re not chasing shortcuts. On the surface, skipping it looks like restraint. The problem is that most people make the call without a sufficient understanding why and how creatine works underneath the hood.
What Needs to Shift?
Previously, we spelled out what creatine does for the muscle. Stronger lifts. More muscle. Snappier performance. Fewer excuses to back off when the burn kicks in.
For most people, the credits roll right there.
You're in the kitchen, eyeing the tub of white powder on the counter. The label brags about miracles. The influencer's glossed-up grin sold you. Then a splinter of doubt pricks: Do I even know why I'm doing this? Do I really need it?
Right then, your conviction starts to wobble. Because confidence you borrowed from someone else drains away when you miss a day, catch a conflicting headline, or can’t remember what lit the fuse in the first place.
Conviction isn’t delivered by decree. It takes root when the reasons, and the gears behind them, click into place.
This edition earns that conviction so that compliance naturally follows. Understand the mechanisms that drive creatine’s function, and the question flips from “Do I need this?” to “Why wouldn’t I?”
The Spare Battery: Mechanism #1
🔋 Cell Currency: Your body’s energy currency is ATP (adenosine triphosphate). Think of an ATP molecule as a fully charged battery. Every time your muscle contracts or your brain concentrates hard, it spends ATP molecules, turning them into a dead batteries—ADP.
💵 Empty Wallet: Your cells are terrible savers and runs on a cash-only basis. They do not stockpile ATP. They hold a tiny "petty cash" reserve; enough for just a few seconds of maximum effort. Once that cash is gone, the cell has to pump the brakes and "print" more money (i.e. ATP). That lag manifests as fatigue. Your reps slow down, the sprint fades, and your power falls off a cliff.
💸 Instant Transfers: Creatine acts as a "spare battery". The moment your cell spends an ATP molecule (turning it into ADP), creatine recharges it in milliseconds. This allows you to maintain maximum output without waiting for the naturally slow recharge cycle.Think of it as an instant transfer from a savings account versus calling your bank for a loan approval.
👻 Ghost Reps: You get a higher capacity ceiling, but not infinite energy. Instead of your battery dying at 8 seconds, it lasts for 10–12 seconds. This is the difference between failing at rep 8 and grinding out rep 10.

The Tent Pole: Mechanism #2
🧲 Water Magnet: Creatine is a substance that naturally attracts water. Unlike salt which can make you hold water under your skin (bloating), creatine pulls water directly inside the muscle fibers.
⛺ Deflated Tent: Cells treat volume like information. When a muscle cell is dehydrated or under stress (from heavy lifting or sprinting), it loses volume. Think of it like a deflated tent. In this "flat" state, the cell goes into conservation mode, slowing down protein synthesis and potentially breaking down existing tissue.
🪵Tent Pole: By pulling more water into muscle cells, creatine acts like the air in a balloon or the poles in a tent; it creates internal pressure. The cell interprets this stretch as a command: We are structurally sound. Start building.
🟢 Green Light: This internal pressure flips a switch inside the muscle cell to increase protein synthesis, facilitating an environment required for muscle repair and growth. For the lifter or sprinter, this improves the biophysical conditions required for growth.

The Club Renovation: Mechanism #3
🛁 Glucose Sink: Muscle is your body’s primary glucose disposal sink, responsible for clearing up to 80% of your post-meal blood glucose. When this sink clogs (i.e. insulin resistance), high glucose levels persist in the blood, damaging blood vessels and forcing the pancreas to work overtime. This failure is often the first domino in Type 2 Diabetes.
🚪Two Doors: Think of your muscle cell as an exclusive nightclub, and glucose is the crowd lined up outside that can’t just waltz in. Before glucose is allowed inside, the muscle cell must open specific doors, called GLUT4 receptors. There are two ways to get these doors open:
The Front Door (Insulin): When you eat, insulin rings the doorbell. In a healthy person, the club answers and opens the doors (GLUT4 receptors). If you are insulin resistant, the doorbell is broken. The signal rings, but the doors stay shut.
The Side Door (Exercise): Muscle contraction mechanically forces the doors open, without needing insulin. It doesn’t ring the front door; it takes a side-door.
🧰 Renovation: Creatine doesn't ring the doorbell (insulin) and it doesn't force the side-door lock (exercise). It installs more doors. Research suggests creatine increases the total count of GLUT4 receptors on the cell (by up to 40%).† This means that when the doorbell rings or you kick the side door, there are more doors available to swing open, and let more glucose into the club.
🧽 Sponge Effect: By increasing the density of these transporters, creatine turns your muscle into a more absorbent sponge. Instead of leaving sugar idle in your bloodstream—where it can provoke inflammation and vascular damage—it pulls it glucose into the muscle to fuel your next workout. You convert a liability into a productive asset.


‘Opening doors’ is a nice theory. But, does it result in improved blood glucose regulation in humans?
It depends.
As Appendix A demonstrates, creatine is likely a conditional agent that amplifies the glucose regulation benefits of exercise, but it is not a passive "glucose disposal agent" like Metformin.†‡
If you are healthy AND train: It is a subtle optimizer that reduces post-meal glucose spikes.†
If you are diabetic AND you train: The signal is promising but needs more studies. One study showed a massive drop in HbA1c (-1.1%)—a long-term diabetes marker. †‡
If you are sedentary: It does almost nothing for your glucose regulation.†
Your Next Move
Creatine gives you a bigger fuel tank and a metabolic advantage. But, the upgrade is useless if you still drive at the old speed limit. Here is how to ensure you aren't leaving the benefits in the bottle.
🔍 The Capacity Audit
Our Default: We are conditioned to train to a specific number. If the program says "8 reps," we rack the weight at 8, regardless of how much is left in the tank.
Pick one exercise this week (e.g., pushups, squats, bench press). Then, go to absolute mechanical failure and write that number down.
The Shift: If you’ve taken creatine for >4 weeks, your capacity for performance has likely expanded. That extra capacity only exists after your old failure point.
If you stop at your old targets, you are leaving the upside from creatine the table. You paid for the extra fuel; now empty the tank to get a return on investment.
Your Move: For the next two weeks, ignore your target rep count on your final set. Train to technical failure (until bar speed drastically slows). You will likely unlock 1–2 reps past your old ceiling. If you don't look, you won't find them.
⚖️ Reframe the Scale
Our Default: In a culture obsessed with leanness, seeing the scale creep up by 1–3 lbs is usually interpreted as a failure or "bad weight."
The Shift: Reframe this data point. This weight is the "receipt” that represents additional fluid being drawn into the muscle fiber. It’s not a reason for concern.
🔁 Break the ‘Cycle’ Mentality
Our Default: Bro-science says to ‘cycle off’ creatine every few months to "reset" receptors.
The Shift: Your creatine reserve leaks every day. If you stop taking it, your creatine stores deplete.
Your Move: Take it continuously. This isn't a synthetic steroid. It’s a fuel source. You don't cycle off vitamins or protein.
Your Shift In Review
Creatine rapidly recycles ATP, extending your capacity for maximal effort when you would normally hit failure.
It draws water inside the muscle cell (not under the skin), creating a hydrated state that favours protein synthesis and repair.
Creatine increases the density of GLUT4 transporters on muscle cells, helping them absorb and regulate blood glucose more efficiently through paths independent of insulin.
The supplement only provides the potential for superior performance and glucose regulation; you must train hard to convert that potential into results.
Headlines love to simplify creatine: it’s for bodybuilders, it causes bloating, or it’s a kidney killer. The reality refuses to fit into a soundbite. Creatine is an energy buffer, a structural signal, and a metabolic regulator. The naive search for the supplement that replaces the work. The informed search for the tools that amplify their effort. Creatine doesn't do the work for you; it ensures the work you do travels further. Now that you understand how it works, the question isn't 'should I try this?' It’s: 'why would I choose not to?’
One Last Pulse Check
📁 Missed an issue? The archive is where the threads connect.
◀️ The prequel: We reviewed evidence for using creatine to build muscle and delay physical fatigue.
🔍 Next issue: Why your brain demands more creatine than your biceps.
🏋🏽 Once a month I share my training logbook, what I’m testing, what I’m never doing again and the lessons that keep haunting me. Read last month’s sweat equity post, which also serves as my annual recap for 2025.
📤 If you enjoyed this read, the best compliment I could receive would be if you shared it with one person who thinks creatine is just for gym rats.
I'm a Toronto doctor caring for older adults in hospitals and nursing homes, while spending my spare time digging into longevity science. I'm here to share what I'm learning. No fancy jargon, just practical insights to help you read your body’s early signals. Think of me as your friendly guide, figuring this out alongside you. Medicine has changed, but how we practice it hasn't caught up. That's why I'm here: to help you edit your health story while the early drafts are still open.
Appendix A
Study Participants | Protocol | Signal | Translation |
|---|---|---|---|
Type 2 Diabetes — ↦ n = 25 ↦ Double-blind RCT (unreplicated) | 12 weeks of identical exercise. — ↦ Group 1: Creatine + Exercise — ↦ Group 2: Placebo + Exercise | ↦ Diabetes marker (HbA1c) dropped ~1.1% more in the creatine group versus placebo. — ↦ No change in fasting insulin. | A 1% improvement in HbA1c rivals the effect of some first-line diabetes drugs. — The Catch: This is one study. Broader meta-analyses (e.g., Delpino 2022) have not found a consistent benefit across all diabetic populations yet. |
Healthy + Aerobic Training ↦ n = 22 ↦ Double-blind RCT | 3 months of moderate aerobic training. — ↦ Group 1: Creatine (~10g/day) + Training — ↦ Group 2: Placebo + Training | ↦ Creatine group cleared post-meal glucose spikes significantly faster (AUC dropped ~11-22%). — ↦ No change in fasting insulin sensitivity. | Creatine protects glucose machinery from "rotting" when you are sedentary or injured, and accelerates the rebound when you start moving again. |
Healthy + No Training ↦ n= 17 ↦ Double-blind RCT | Group 1: Creatine (20g loading + 3g maintenance x 30 days) Group 2: Placebo (Glucose powder). No creatine. — Duration: 30+ days. No training. | ↦ No change in glucose tolerance or insulin sensitivity in either group. | If you don't exercise, creatine is likely just a water-retention supplement. This study demonstrate that loading and maintaining creatine without training has zero impact on how your body processes sugar. |
Immobilization + Rehab ↦ n = 22 ↦ Double-blind RCT | 2 weeks leg immobilization (cast) followed by 10 weeks rehab. — ↦ Group 1: Creatine + Rehab — ↦ Group 2: Placebo + Rehab | ↦ During Cast: Placebo GLUT4 density dropped ~20%; No change in receptor density in group 1. — ↦ During Rehab: Creatine group saw increased GLUT4 receptors ~40% above baseline. | Creatine protects glucose receptors from down-regulating when you are sedentary (i.e. injured), and accelerates rebound when you start moving again. Do not skip creatine just because you skipped the gym. |
Glycogen Loading ↦ n = 14 | Measured muscle fuel (glycogen) stores post-exercise. Then ate high-carb diet for 24h. — ↦ Group 1: Carbs + Creatine — ↦ Group 2: Cars + Placebo | ↦ Muscle fuel storage (glycogen) increased 82% more in the creatine group.
| If you are an athlete doing double sessions or a high-performer with limited recovery time, creatine facilitates refill muscle energy (glycogen) stores radically faster. |
Meta-Analysis ↦ 9 pooled studies | Systematic Review of creatine’s effect on glucose and insulin (mostly healthy subjects). | ↦ Signal: Neutral. No Effect.
| The meta-analysis found zero significant reduction in fasting blood glucose or insulin across all studies, but they studied mostly health individuals, not diabetics. The sample size is too small for strong conclusions. |
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