One of the things I determined never to do when I started weight training was to take any supplements other than low dose vitamins and minerals. The dangers of steroid abuse, highlighted by some fairly lurid newspaper reports, seemed to show that the downside of using many supplements far outweighed any gains made.
Then I heard about creatine. Gains in muscle mass and strength through using a safe supplement; where was the downside in that? Well, supplement taking is a risky business. Remember Tryptophan? Before you put anything in your mouth, ask yourself some questions. Is it safe? Does it work? Are the people who recommend it to be trusted? It sounds cold, but it's usually a good policy to let others take the risks of being early adopters when it comes to new drugs or treatments. And it's as well to remember that some people can have an adverse reaction to any new supplement. Medical approval is not to be confused with perfect safety, as some UK men who volunteered for drug trials a few years ago can attest.
Creatine is a natural amino acid. The body needs about 2g of creatine per day to replace the amount that is broken down. Meat eaters get around 1g per day from their diet, the main sources in our diet being meat and fish. The rest is naturally produced in the human body from amino acids, mostly in the kidney and liver. It is transported in the blood for use by muscles. Manufactured creatine in the form of creatine monohydrate can be absorbed from oral supplements and seems to be treated by the body pretty much like natural creatine. It's an important energy source in high-intensity exercise, aiding rapid recovery.
Although the main use of creatine has been by athletes who want to build muscle or increase strength and power, it may have some other important uses. When taken together with high-carbohydrate meals, after endurance exercise has depleted the glycogen stored in muscles, creatine stimulates glycogen synthesis. This aids recovery for athletes after hard training, which matters when there is little time between competitions.
Does it help? Well, boosting the muscle stores of creatine seems to enhance the the ATP and phosphocreatine system, which is used in brief bouts of exertion, for up to twenty seconds. Using supplements increases the amount of creatine and creatine phosphate in the muscles and improves performance in strength and power events. It may also bulk up muscle size and improve strength. Water accumulation in muscle could account for some of this bulk and weight gain. This has an obvious appeal for bodybuilders and strength trainers, but creatine has also been found to improve muscle function in the elderly and in individuals suffering from muscle wasting diseases. In sport, it has proved of most benefit in explosive events like sprinting, jumping and weight lifting. This may result from creatine supplements providing the capacity to train harder and more often. They have not proven to be beneficial for endurance sports such as marathon running or cycle road racing. And not everyone is affected by them. Some sports medicine authorities estimate that around a third of users see no beneficial effect.
So is it safe? Creatine has been used extensively over the last ten years, and studied in depth. Few side effects have been reported from short-term use with approved quantities. Whether it could prove a health hazard for long term regular users is still unknown. Kidney and liver function has been studied for possible toxicity, but no important effects have been shown to occur at recommended doses. Case reports and animal studies do suggest possible adverse effects on the kidney, with reports of kidney damage such as interstitial nephritis. It would be wise not to take creatine if kidney disease is present or suspected. Some overweight people have chronic, undiagnosed kidney disease. Using creatine in a weight loss or bodybuilding program would be unwise for them. In theory, creatine may affect the activities of insulin. Patients with diabetes or hypoglycemia, and those taking drugs, or supplements that affect blood sugar should be cautious when considering using creatine.
There are reports of creatine causing muscle compartment syndrome and other serious muscle conditions. Surgeons reported sudden kidney failure and muscle breakdown during knee surgery in a footballer who was taking 10 grammes of creatine supplement a day. In another case, a 30-year-old creatine supplement user showed up at an emergency room with heart arrhythmia. The medical staff knew this was rare in a young person without any other underlying heart condition. They reported knowledge of other cases of arrhythmia suspected to be associated with creatine taking.The Mayo Clinic claims that creatine has been associated with asthmatic symptoms and warns against consumption by persons with known allergies. Side effects can include loss of appetite, stomach discomfort, diarrhea, and nausea.
Extensive research over ten years has shown that taking creatine supplements orally at a rate of 5-20 grammes a day appears to be very safe and largely without adverse side-effects, while improving the physiological response to resistance exercise and increasing muscular strength. Current studies indicate that short-term creatine supplementation in healthy individuals is safe, although those with renal disease should avoid it due to possible risks of renal dysfunction, and before using it healthy users should bear these possible risks in mind. Small-scale, longer-term studies have been done and seem to demonstrate its safety.There have been reports of muscle cramping with the use of creatine, though this may be due to dehydration. Extra water intake is recommended when using it.
While studies continue to indicate that supplementation is extremely safe, anecdotally there have been reports of some scary health consequences. Why the discrepancy? Well, the studies which repeatedly find no creatine dangers typically use a high quality pure creatine monohydrate with no additives. With the rise in the supplement's popularity, some manufacturers have resorted to cheaper manufacturing processes for economic reasons. This can mean that you are getting more than you know when you embark on a course of creatine supplementation. And that extra stuff can be bad.
Want to know how bad? Google Travis Starkovich. Read his story. And make up your own mind about using creatine supplements.
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