Supplement review: Creatine

August 19, 10:08 AMBoston Diets and Exercise ExaminerChristopher Nogiec

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This is the first of an ongoing series reviewing commonly used supplements in the fitness industry.  These reviews will cover effective and non-effective supplements.  Efficacy and dosage will be based on peer reviewed research.  Research from a corporation and anecdotal stories will not be included.  The author welcomes supplement suggestions and has been asked many times what supplements he recommends.  Those can be found at www.nogiec.com/supplements.html. 

Conclusion
Creatine monohydrate supplementation is a safe, natural way to increase muscle mass and strength and  is most effective when combined with proper resistance training.  It is useful for men and women.

Image source: Wikipedia

Supplement: Creatine monohydrate

How much to use: 2 g per day
What it's used for: Muscle growth, increase in strength and performance
Does it work: Yes
What is untrue about it: Weight gain is due to water; causes nausea; impairs renal function

How it works in the body
Creatine monohydrate (Cr) is naturally found in the body.  When combined with a phosphate (P) group, it forms phosphocreatine (PCr).  PCr is used as a quick energy source for exercises that last 2-30s (Williams & Branch, 1998).  Muscle contraction (concentric and eccentric) requires P from the molecule adenosine tri-phosphate (ATP).  ATP donates its P and becomes adenosine di-phosphate (ADP).  However, there is only a limited amount of ATP available to the muscle cells and lasts only a few seconds.  In order for the muscle to continue to contract, the ATP supply needs to be replenished from the ADP.  The first and quickest way this is done is through PCr’s donating its P to ADP to form ATP.  However, PCr supply is also limited.  An individual’s amount of PCr depends on his/her diet and nutrition.  People who eat a lot of meat tend have more PCr than those who don’t (Williams & Branch, 1998).  Another way to increase one’s supply is through PCr supplementation (Hultman, Soderland, Timmons, Cederblad, & Greenhaff, 1996) (Mihic, MacDonald, McKenzie, & Tarnopolsky, 2000).

What the research shows
There has been much research done on the efficacy and side effects of PCr.  Consistent PCr supplementation shows improved strength (Kreider, et al., 1998) and muscle hypertrophy  (growth) (Mihic, MacDonald, McKenzie, & Tarnopolsky, 2000).  Anecdotally, many people believed it was due to increase in water weight, but Kreider, et al showed that water percentage did not increase with increased body mass (1998).  Also, many anecdotal side effects have been reported with PCr supplementation.  These side effects were studied using a double blind controlled experiment, and the only statistically significant side effect was lean body mass weight gain--which is a good thing!  There was no significant difference in renal function (Poortmans & Francaux, 1999), nausea, gastro-intestinal discomfort, or diarrhea between the PCr and placebo groups (Groeneveld, Beijer, Veldink, Kalmijn, Wokke, & van den Berg, 2005).

Recent research shows that creatine could be helpful treating muscular disorders (Kley, Vorgerd, & Tarnopolsky, 2007).  Also, in addition to increasing energy supply, creatine may actually help increase muscle mass during the recovery phase.  Compared to protein supplementation, creatine was better at increasing muscle satellite cells and myonuclei which supports enhanced muscle fiber growth (Olsen, et al., 2006).

References

Groeneveld, G. J., Beijer, C., Veldink, J. H., Kalmijn, S., Wokke, J. H., & van den Berg, L. H. (2005). Few adverse effects of long-term creatine supplementation in a placebo-controlled trial. InternationalJournal of Sports Medicine , 26 (4), 307-313.
 

Hultman, E., Soderland, K., Timmons, J. A., Cederblad, G., & Greenhaff, P. L. (1996). Muscle creatine loading in men. 81 (1), 232-237.
 

Kley, R. A., Vorgerd, M., & Tarnopolsky, M. A. (2007). Creatine for treating muscle disorders. Cochrane Databse System Review , 24 (1).
 

Kreider, R. B., Ferreira, M., Wilson, M., Grindstaff, P., Plisk, S., Reinardy, J., et al. (1998). Effects of creatine supplementation on body composition, strength, and sprint performance. Medicine & Science in Sports & Exercise , 30 (1), 73-82.
 

Mihic, S., MacDonald, J. R., McKenzie, S., & Tarnopolsky, M. A. (2000). Acute creatine loading increases fat-free mass, but does not affect blood pressure, plasma cratinine, or CK activity in men and women. 32 (2), 291.
 

Olsen, S., Aagaard, P., Kadi, F., Tufekovic, G., Verney, J., Olesen, J. L., et al. (2006). Creatine Supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced my strength training. (534, Ed.) The Journal of Physiology , 273 (2), 525.
 

Poortmans, J. R., & Francaux, M. (1999). Long-term oral cretine supplementation does not impair renal function in healthy athletes. Medicine & Science in Sports & Exercise , 31 (8), 1108-1110.
 

Taylor, A., Gollnick, P. D., & Green, H. (1990). Energy metabolism and fatigue. In D. Hultman, J. Bergstrom, L. Spreit, & K. Soderlund, Biochemsitry of Exercise VII (pp. 73-92). Champaign: Human Kinetics.
 

Williams, M. H., & Branch, J. D. (1998). Creatine Supplementation and Exericse Performance: An UPdate. Journal of the American College of Nutrition , 17 (3), 216-234.

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