There have been favorable posts at Conditioning Research and The Heart Scan Blog about creatine. The research seems to be very positive in terms of physical and cognitive benefits and in terms of long term safety. The natural food source of creatine is meat but it seems to take a heck of a lot of meat to fully load the body's creatine buffers.

From a Paleo context, you're probably already eating a ton of meat so supplementing might not have as great a benefit as a non-Paleo who eats less meat might get. For example, the cognitive benefit of creatine supplementation has only been observed in vegetarians, presumably because meat eaters already get enough.

I think someone who comes from a low or no meat diet to Paleo could benefit greatly from an initial phase of creatine loading. Those who have always eaten relatively high levels of meat would benefit less. For those who want to max out muscle gains, it seems like supplementing is a good bet.

I would guess that taking creatine with a big meal encourages uptake just as much as a big sugar hit. After all, it normally comes from meat. After loading, it's just 5g a day which can be easily taken with a meal.

My purely anecdotal evidence is that creatine works very well, it's made more difference to my muscle gains than any changes in workout or diet.

I'd have thought that it would be safe in anything like reasonable quantities since it is found naturally in meat. I've never experienced any negative effects apart from when I started using it (using the recommended 'loading phase' of higher doses and wasn't dissolving it properly. This caused digestive upset and a headache, but nothing more sinister.

The thing that interests me is why our bodies would seem to be optimised for higher doses of creatine than we seem to get eating natural (high meat) diets. Is something about the meat we consume or the way we cook it reducing creatine or is something else we're doing stopping our bodies synthesising large enough amounts? Plausibly our bodies just aren't evolved to produce large amounts of muscle mass in most circumstances. McGuff argues quite convincingly that most people will never be able to become especially massive (genetically), because we have largely evolved to be lean, but not massive because of the trade-off between strength and energy requirements.

I've used creatine with great success. The creatine itself shouldn't have any metabolic impact and you don't NEED to create that insulin spike for the creatine to be effective, but it may potentiate its effects. If you're happy with your body weight, or your goal is to add some strength or muscle mass, I doubt that drinking a small glass of natural fruit juice pre or post-workout would have any detrimental effect on your health.

Don't sweat the small stuff.

Although creatine is a naturally-occurring amino acid, the creatine supplements that you can purchase are artificial synthetic products (see http://fusionnutritioninc.blogspot.com/2007/07/how-creatine-is-made.html ). Therefore, creatine is not strictly paleo. This does not mean that creatine supplements are molecularly different than naturally-occurring creatine--they aren't. Nor does it mean that creatine is harmful--it's not. Others have already mentioned benefits of creatine, which include increased strength, improved cognitive ability, and lowering some of your heart disease risk factors. The one caveat to creatine is that you should not take it if you have kidney disease. The main sources of creatine in the diet are red meat, wild game and fish. However, you can only get about 2gm per day from diet, vs. 5 to 20gm per day from supplements. If you want to take creatine, you have to decide how much of a paleo "purist" you are, since it's a non-natural, manufactured product.

One problem with creatine is that if you have a genetic predisposition to male baldness, it may increase your hair loss. And no im not making this up (http://www.ncbi.nlm.nih.gov/pubmed/19741313)

As seen in the study, creatine increases dihydrotestosterone, which is a male hormone that causes hair loss...

This question is well worded because the OP asks if creatine has a place in the Paleo regimen. We all know and have accepted that the Paleo regimen of today is not going to be a re-enactment of Paleolithic times.

Mark McManus of MuscleHack.com does not claim to eat "Paleo" that I know of and I'm pretty sure you could find some recommendations on his site that would get eaten alive on PaleoHacks. But he does promote eating healthy saturated fats, including beef and butter, eats generally low-carb, knows about the whole cholesterol misunderstanding, and is a natural bodybuilder that's more in line with Paleo than probably most other bodybuilders.

Here are a few simple to understand articles for Mark's take on Creatine with some valuable points regarding exactly what creatine is, how it is used in the body, and if it's a safe and good supplement.

http://www.musclehack.com/what-is-creatine-how-does-it-work/

http://www.musclehack.com/creatine-the-most-effective-ergogenic-nutritional-supplement/

http://www.musclehack.com/the-case-for-creatine/

http://www.musclehack.com/creatine-facts-what-is-the-best-creatine/

The short answer: Creatine is perfectly ok to supplement with for muscle gains and in fact quite effective.

Creatine for strict paleo, no. It's a supplement that wasn't around back then. You can fudge it a bit by saying it was in the meat, and people would have been consuming that much if they ate a lot of meat. However, the spirit of the thing is foods and not supplements.

That said, if you're in the camp of doing the paleo diet plus taking supplements for specific needs (muscle building for example), I think whey and creatine have a place.

In terms of Creatine, you want Creatine Monohydrate. There's a lot of variations out there (some with substantially higher costs), but the most scientific research is on Creatine Monohydrate. I haven't seen anything convincing on using the more expensive stuff for bang vs buck.

I recommend Creapure, it's a trademarked brand from a German source (you'll see it in the ingredients/logo). There was a bit of a kerfluffle a while back in the late 90's on the quality of Creatine out there. Lot of bad chemicals in trace amounts due to the manufacturing process. Creapure is trademarked and from a German source, that had verifiably good quality vs cheaper sources from China. I haven't seen anything more recent to change opinions.

http://www.brinkzone.com/articles/whats-in-your-creatine/

In terms of dose, you'll see variations, usually along the lines of high doses, dropping down to 5mg/day. The idea being that you're loading your body with Creatine to top off the stores. However, there's research saying that if you're planning on doing this long term, you can take 5mg/day over time and get the same results and avoid the side effects of high doses (gastrointestinal woes/bloating/etc). So trade off, high doses, high performance to start + gastro problems. Low doses, lower performance (but still higher than current), fewer gastro problems. Month later, same results either way.

In terms of extras, you want to take it after a workout with a sugar that spikes insulin (dextrose for example). I use Gatoraid powder as a cheap source. The liquid Gatoraids used to be High Fructose corn syrup (although they went back to sugar now). This helps shuttle the Creatine into the muscle cells after a workout. This obviously doesn't help as much without the workout.

I use a micronized Creatine, disolved in hot water, then mixed in with Gatorade (or other sugar source) and cooled down with ice. Creatine doesn't disolve quickly in water (even micronized Creatine), so it needs to be hot water. If you don't do this, it will disolve over time, but in your intestines, where it sucks in more water (more gastro problems).

You will need to drink more water (even more than regular with low carb paleo) because Creatine sucks water into the muscle cells. If you don't drink water normally, you need to learn to. Most of the injuries I've heard about with Creatine are because people aren't drinking enough water and are chronically dehydrated.

I take creatine monohydrate (ie, no added stuff), but recognize that it is not strictly paleo. Certain pursuits, like working towards 2x BW DLs, are not strictly paleo I'd say and creatine is helpful in reaching said goals.

Daniel, interesting that you take it after workouts, I have always done before workouts. Any reason for the timing?

Has anyone seen boost in intelligence with creatine??

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1691485/

I know that this is controversial but creatine killed my sex drive. It happened on two different occasions a few years apart. It also took months to recover. If you google around you'll see that various people have posted this on forums across the web but theyre always shot down and basically called an idiot.

I'm not claiming its a direct mechanism but I now stay away. Perhaps it allowed me to overwork myself? This was all pre-paleo and because of many undiagnosed food sensitivities my body was a mess (even though I "ate right" and exercised.)

For what its worth, i take it after working out about 4 times a week. Not a lot as i eat paleo about 90% of the week, in about 3gm doses. Its important to remember that protein and amino acids create their own storage response.

I believe there's some studies out there that showed the max you can absorb per day is about ~5g If anyone's worries about amounts (there's an exact ratio to body weight or lean muscle mass as well but its generally within .1-.5 g of 5 g from what I saw)

For those using it, would you recommend one product over another?

it dissolves in hot liquids, such as water, tea, and maybe coffee!