Creatine? Is It Worth the Risk?

Athletes are always on the lookout for a little edge, and you don't have to search far to find creatine. Creatine supplements are flying off the shelves at health food and vitamin stores, and Internet supplement vendors sell more of the stuff than we'll ever know. Its popularity stems from the belief that creatine increases strength and muscle mass. Hence, it is classified as an ergogenic aid.

Creatine's first documented use was in the Soviet Union during the 1960s, when a professor of exercise biochemistry researched creatine supplementation in elite athletes. His experiments were thought to have played a role in the Soviet Union's unprecedented success in power lifting, wrestling and gymnastics in the Olympic Games from 1964 to 1994.

Creatine is an amino acid derivative found naturally in the body. Concentrated in the muscle, it is produced by the body from amino acids and is consumed in meat and fish. It functions as an essential part of muscle contraction.

Athletes and body builders take creatine supplements to try to increase the pool of creatine in muscle, so the muscles can work harder and recover faster.

Does creatine work?

Many studies have been performed to determine the effectiveness of creatine supplementation in athletes. It has been shown to improve performance in bicycling sprints and weightlifting. Studies involving bicycle sprints found that creatine supplementation increases in total work performed. Most studies evaluating weightlifting or specific muscle group activities suggest that taking creatine helps increase lifting strength.

There is a limit to how much creatine supplements can increase muscle creatine levels. The muscles have a saturation limit. Most people produce and consume enough creatine for their muscles to contract efficiently, so taking more creatine may not help. People who do not have high creatine levels in their body, such as vegetarians, may benefit more from creatine supplementation than the rest of the population.

There is no indication that use of creatine gives any benefit in sports such as running and swimming. Studies indicate that creatine does not enhance endurance.

One study involving a 6K run found that subjects taking creatine ran more slowly than the group that didn't. It may have been that creatine supplementation caused weight gain, which results in slower running times.

How much is needed?

Most studies use an initial daily dosage of 20 to 25 grams for five days, followed by a maintenance dosage of 2 to 5 grams per day. However, a daily dose of 3 grams for 28 days appears to achieve the same level. Some recent studies suggest that maintenance dosages of greater than 2 grams per day have no additional benefit and may increase the workload on the kidneys.

Any side effects?

Creatine supplementation can cause weight gain, which is primarily due to water retention within muscle cells. With long-term use, some of the weight gain may be due to increases in muscle fibers. While this weight gain may be great in some sports, such as power lifting, bodybuilding, and football, it is a concern for women in sports such as running, swimming and gymnastics.

More serious is the finding that creatine supplementation increases the workload on the kidneys. Kidneys may be damaged if users take too much creatine or already have kidney problems. There is one report of a 25-year old athlete with a kidney disease whose kidney function worsened within 16 weeks while taking creatine daily during soccer training.

Twenty reports of adverse reactions in people taking creatine have been filed with the Food and Drug Administration (FDA). The reactions included seizures, cardiac arrhythmias, blood clots and death. The FDA has not yet pointed the finger at creatine, but there are definitely some questions.

Another concern is that high school and collegiate athletes frequently take much more creatine than recommended. High dosages increase risk to the kidneys, and may affect growth. In one recent study of male baseball and football players for a NCAA Division I school, 39 of the 52 athletes exceeded the recommended maintenance dose of 2 to 5 grams per day. The most common dosage was 6 to 8 grams a day, with three players using 17 to 20 grams a day for maintenance.

The bottom line

Using creatine supplements is an individual decision. As with many other supplements, the long-term side effects are not known. Dehydration and kidney impairment are short-term risks. Runners, swimmers and other endurance athletes have little to gain from using creatine, because it doesn't improve endurance. Taking creatine may actually worsen performance in endurance sports because of weight gain and dehydration.

Strength and short-distance athletes may benefit from taking creatine, as it generally results in increased strength and increased muscle mass.

If you are taking creatine, or considering it, discuss it with your physician, who knows your medical history and the type of medications you are on.

Avoid taking creatine if you have any kidney problems or diabetes; the workload on your kidneys may be too much.

Drink plenty of water to avoid dehydration.

Do not exceed the recommended daily dose of 2 grams or 0.3 grams per kg body weight.

If you discover any side effects, discontinue creatine and report the symptoms to your doctor.

As always, staying safe and healthy will allow you to train better and longer, and you won't have to risk illness for that little edge.

For more information, receive "Sports Nutrition for Endurance," a comprehensive, 20-page packet designed to help you improve your nutrition knowledge and apply it to your sport. Includes food record worksheets and training meal plans, plus how to calculate how many calories you require. Mail to: Nancy Ling, P.O. Box 1118, Beverly Hills, CA 90213, with check for $15 (includes shipping).

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