Creatine
Description
Creatine is an amino acid, containing nitrogen, which is produced naturally by humans and animals. It is used by the body in the energy cycle, specifically combining with phosphorus to recycle adenosine di-phosphate (ADP) as adenosine tri-phosphate (ATP).
It is estimated that 95% of the body's creatine is stored within the muscle cells.
Since 1993 it has been sought by bodybuilders and other athletes, primarily, for whom the supplement is made in the form of creatine monohydrate. It is converted to creatine phosphate in the body.
Its metabolite, creatinine, is commonly used to determine kidney function.
Method of Action
Creatine supplementation appears to follow the normal course in the body and raise levels in the muscles by as much as 20 - 30%.
Besides facilitating additional supplies of ATP, which is primarily used during anaerobic (i.e. short, term intense energy production) exercise, creatine may also buffer the build-up of lactic acid (its primary waste product). Thus, the exercising muscle and develop size and strength from additional energy and the delayed onset of momentary muscular failure, due to lactic acid build-up. This may also reduce the characteristic soreness following intense, exercise. Stiffness and soreness may be delayed by as much as 24 - 48 hours ("delayed onset muscular soreness": DOMS).
In summary, creatine appears to be useful by promoting the following enhancements to the energy cycle:
1. More energy is available for muscular work;
2. Muscular work can continue for a longer period of time (i.e. the onset of fatigue is delayed);
3. Muscular strength increases;
4. Muscular growth is facilitated;
5. Muscular recovery is enhanced both short- and long-term.
6. This benefits the tone of the muscle, enhancing its pliability;
7. The muscles are less prone to injury.
Therapeutic Approaches
Besides athletes and bodybuilders, who would not usually be considered in need of therapeutic intervention, several diseases, involving muscular fatigue may benefit from creatine supplementation.
Athletes may enjoy a rather specialized medical intervention, under the category of an ergogenic aid to enhance sports performance. Medical intervention is usually reserved for more intensive and invasive protocols, like anabolic steroids, or blood doping.
Research is still in the early stages but levels of creatine phosphate are know to be reduced, for example, in Parkinson patients, who have resting tremor which fatigues their forearm musculature.
Creatine has also shown usefulness as a lipid-lowering agent.
Toxicity Factors
No negative effects have been noted in the research.
Nevertheless, some formulations, or protocols, can lead to gastrointestinal upsets.
A popular bodybuilding protocol consists of a loading phase and a maintenance does.
Upon starting to supplement with creatine monohydrate, in order to increase lean body mass and energy, the bodybuilder is advised to take one teaspoon 4 to 6 times daily, mixed with warm water, or non-acidic fruit juice. This will add up to about an ounce, daily.
After a week (5 - 7 days) of this, the supplement is taken before and after workouts (1 or 2 oz per week).
The long term safety of such dietary manipulations has not been determined.
A study has been done, in which the subjects went off creatine supplements for a month and levels returned to baseline.
References
Barnett C et al: Effects of oral creatine supplementation on multiple sprint cycle performance. Aust J Sci Med Sport 1996 Mar;28(1):35-9.
Clarkson PM: Nutrition for improved sports performance. Current issues on ergogenic aids. Sports Med 1996 Jun;21(6):393-401.
Earnest CP et al: High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin Sci (Colch) 1996 Jul;91(1):113-8.
Earnest CP et al: The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol Scand 1995 Feb;153(2):207-9.
Febbraio MA et al: Effect of creatine supplementation on intramuscular TCr, metabolism and performance during intermittent, supramaximal exercise in humans. Acta Physiol Scand 1995 Dec;155(4):387-95.
Rossiter HB et al: The effect of oral creatine supplementation on the 1000-m performance of competitive rowers. J Sports Sci 1996 Apr;14(2):175-9.
Stockler S et al: Creatine deficiency in the brain: a new, treatable inborn error of metabolism. Pediatr Res 1994 Sep;36(3):409-13.
Watsuki, T. et al: Changes of contractile properties of extensor digitorum longus in response to creatine-analog administration and/or hindlimb suspension in rats. Jpn J Physiol. 1995, 45(6): 979 - 989.
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