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Supplementing with Creatine Monohydrate

June 2, 2006 Print This ArticleShare

Author: Trainer-X

Nowadays, when it comes to any serious athlete’s diet and supplement regimen, it is probably easier to ask who has not tried creatine versus who has. Introduced in 1993, it is the most popular supplement on the market. But still many people have a phobia of it. Should we have one? Is it safe? Is it a steroid-like drug or a supplement? What about long term safety? Is it effective for every athlete? Are there other uses? Here we will investigate these and other questions that science has answered thus far.

What is it?

Creatine is found naturally in the body. It is primarily in skeletal muscle (95%), but is also found in heart, brain, testes, retina, and other tissues. The body synthesizes 1 to 2 grams of creatine a day, primarily in the liver, kidneys, and pancreas. Dietary sources, such as fish and meats, supply an additional 1 to 2 grams. For example, one pound of fresh uncooked steak contains about 2 grams of creatine. But once it is heated and cooked, that same 2 grams of creatine is destroyed and it does nothing for you and becomes obsolete. Creatine is eventually metabolized in the body and excreted by the kidneys as creatinine.

How does it work?

In our body there exists three major energy systems: the oxidative or aerobic system (which primarily uses fat), the glycolytic or anaerobic system (which primarily uses carbohydrates) and the phosphocreatine system (which uses creatine). All of these produce energy in the form of adenosine triphosphate (ATP).

The phosphocreatine system is involved in explosive energy movements and quickly depleted within the first 10 seconds of activity. However, it takes approximately another 3 minutes to refill these same phosphocreatine energy stores; this is significant when it comes to creatine supplementation. Here’s how.

Creatine in skeletal muscles exists in dynamic equilibrium with phosphocreatine. Body stores of phosphocreatine in skeletal muscle serve as a precursor to ATP. Higher levels of creatine have been shown to enhance the ability to renew ATP for short 10-20 second energy bursts and improve resynthesis of phosphocreatine during recovery from intense exercise.

Creatine supplementation (in the form of creatine monohydrate) enhances both creatine and phosphocreatine concentrations within the skeletal muscle, providing a larger total creatine pool. Therefore, creatine supplementation reduces recovery time, delaying fatigue and allowing the individual to exercise or perform at a higher intensity. This has been shown to work better than orally ingesting more carbohydrates, ATP or phosphocreatine.

What are its Uses?

Orally, creatine is ingested as creatine monohydrate and used for improving exercise performance and increasing muscle mass in athletes and older adults. Creatine is also used orally for congestive heart failure (CHF), neuromuscular disease, mitochondrial cytopathies, gyrate atrophy of the choroid and retina, and hyperlipidemia. It is also used orally for slowing the progression of amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease), rheumatoid arthritis, McArdle disease, and for various muscular dystrophies.Intravenously, creatine is used in cardiac surgery and for congestive heart failure.

High-intensity Exercise:

Taking creatine orally seems to enhance muscle performance during repeated bouts of brief, high-intensity exercise. Numerous studies suggest that creatine is beneficial for certain types of high-intensity exercises; however, for other exercises, creatine appears to offer no benefit. Creatine seems to be more effective for increasing muscular power in healthy young adults during repeated, short, maximal energy bursts than for single event performances. It might also be beneficial for exercise of longer duration with the intensity alternating between anaerobic and aerobic metabolism. Many variables seem to determine the effect of creatine on performance, including the subject's training status, the type of sport being tested, diet, age of the subject, and the dose regimen of creatine.

Aerobic Exercise:

Creatine does not seem to improve performance in aerobic exercises, or benefit older individuals. Additionally, creatine doesn't increase endurance or improve performance in highly trained athletes. It is possible that the benefit in certain sports is offset by weight gain from creatine supplementation.

How do I use it?

Acute creatine loading may be more effective than chronic continuous use. Most studies have used 20 grams daily for 5 – 7 days for creatine loading with 5 grams as a maintenance dose; however, various other regimens have been studied. One study used 9 grams daily for 5 days and was beneficial in weight lifters, while another study used 20 grams daily for 3 days and was not beneficial for single sprints in cyclists.

Dosage:

Due to the variety of study methodologies and some conflicting findings, it has yet to be determined exactly who can benefit from creatine supplementation and what dosing schedule might be most effective. An ideal dose appears to be dependent on individual differences in diet composition, muscle fiber type distribution (i.e. the number of fast-twitch muscles versus slow twitch), sex, age, and initial total muscle creatine concentrations. All studies have been limited by small sample size – fewer than 40 subjects, and most were fewer than 25.

Side Effects and Safety

People who have lower initial total creatine, such as vegetarians, are more likely to respond to supplemental creatine, while people with higher initial levels may not respond. More fit athletes may not respond just because their training has “maxed out” their muscle creatine stores, therefore, additional creatine is unused or unnecessary. These people are also labeled “non-responders”.

Excess supplementation increases urinary creatine and creatinine. Exogenous creatine supplementation also appears to reduce endogenous creatine production; whether this has any clinically significant negative effect on metabolic regulation within the liver is unknown. After discontinuing supplementation, natural, physiological creatine production and creatine levels typically return to baseline within 28 days.

Some Benefits:

Preliminary research suggests creatine might increase the activity of muscle precursor cells called satellite cells, causing an increase in muscle size (i.e. hypertrophy). However, most clinical evidence supports increased cellular water retention as the primary cause of creatine-induced muscle gain. The muscle enlargement due to increased water retention is short term. However, muscle enlargement from strength training results in an increase in muscle fibers.

Some Risks:

There is some concern that combining caffeine, ephedra, and creatine might increase the risk of serious adverse effects. There is a report of ischemic stroke in an athlete who consumed creatine monohydrate 6 grams, caffeine 400-600 mg, ephedra 40-60 mg, and a variety of other supplements daily for 6 weeks . Caffeine might also decrease creatine's beneficial effects on athletic performance. Some researchers think caffeine can inhibit phosphocreatine resynthesis, but this is still controversial.

More common anecdotal reports of the side effects of creatine are muscle strains/pulls, muscle cramping and dehydration. However, none of these have been documented in the literature.

How Much do I Take?

For improving physical performance, several dosing regimens have been tried. Creatine is typically acutely loaded with 20 grams per day (or 0.3 grams per kg bodyweight) for 5 – 7 days followed by a maintenance dose of 2-5 grams (0.03 grams per kg bodyweight) daily. Some experimentation may be needed for you. During creatine supplementation, the water intake should be 64 ounces per day.

Is it Legal?

Today, the International Olympic Committee, National Collegiate Athletic Association (NCAA), and professional sports allow their athletes to use creatine. However, the NCAA no longer allows colleges and universities to supply creatine to their students with school funds. It is sold throughout the world at retail stores. Athletes are allowed to buy creatine on their own and the NCAA has no plans to ban creatine unless sufficient medical evidence indicates that it is harmful. With current testing methods, detection of supplemental creatine use would not be possible.

Creatine use is widespread among professional and amateur athletes and has been acknowledged by well-known athletes such as Mark McGuire, Sammy Sosa, Barry Bonds and John Elway.

Finally, California is considering legislation that would ban the sale of creatine and other supplements frequently used in sports performance-enhancing products to anyone under the age of 18. The bill, which received Senate approval and is now in the Assembly, would also require warning labels about the adverse effects of creatine.

Summary

There has not been a supplement more scrutinized and studied to date than creatine. It has been available to society for over 10 years now. Many would argue that if there was any form of toxicity or adverse reaction to it, scientists would know by now; even with the heavy dosages that some athletes report ingesting. Some approved pharmaceutical drugs have been reviewed and scrutinized by the FDA, approved, and soon pulled from the market because of the negative side effects. For example, Viox by Merck was pulled after 5 years for because of the negative side effects after 18 months of use.

Anybody wanting to get stronger, put on muscle mass, and/or perform better at anaerobic sports (such as sprinting, football, soccer, baseball, etc.) may want to try it. It is not effective for endurance sports.

Thus far, creatine monohydrate supplementation in prescribed doses could be summarized as safe, natural and effective.



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