Some athletes think that "winning is everything," and take large doses of nutritional supplements to get an edge over their opponents. But many athletes have at least toyed with the idea of using this popular supplement. Creatine is the most popular sports supplement and many athletes, both professional and amateur, including some children and adolescents, take creatine supplements to try to increase strength and improve sports performance. There seems to be a lot of miss-information available on the internet and elsewhere.

History of Creatine

Creatine was discovered in 1835 when a French scientist named Chevreul discovered a component of skeletal muscle that he later named creatine after the Greek word for flesh, or Kreas. Therefore, although creatine may seem like something new, the scientific community has recognized it as a natural constituent of muscle for nearly two centuries. 

Our first indication that muscle creatine content is necessary for muscular activity came with the observation that wild animals contain disproportionately more (about 10-times more) creatine than animals kept in captivity. Near the turn of the century the first studies examining the effects of creatine feeding were conducted. It was noticed that not all the creatine fed to subjects could be recovered in the urine, indicating that the body, i.e. skeletal muscle, was retaining some of the ingested creatine. In fact, skeletal muscle, as well as being the largest sink for dietary creatine, is also the richest natural source of the nutrient. Thus, whenever we take a bite of steak (skeletal muscle) creatine is made available to our muscles for absorption. It is now estimated that most of non-vegetarians receive approximately one gram of creatine each day in our diets.

The most commonly used form of synthetic creatine is the monohydrate salt, creatine monohydrate. Creatine monohydrate is simply a molecule of creatine accompanied by a molecule of water. The first study that clearly demonstrated an effect of creatine monohydrate in humans was conducted in the lab of Dr. Eric Hultman of the Karolinska Institute in Sweden. This study found that ingesting 20 grams of creatine monohydrate daily for 4-5 days increased muscle creatine content by approximately 20%. An increase in muscle creatine content of this magnitude is more than sufficient to notice an enhancement in exercise performance during explosive bouts of exercise. Therefore, exercise tasks that benefit most from creatine supplementation are sprinting events of less than 10 seconds duration and repetitive maximal effort movements. Oh, by the way, the year this pivotal study appeared was 1992, the same year creatine made its controversial public debut in the Barcelona Summer Olympics. During these games the success of the British track team was allegedly partially due to the use of creatine; partly scandal and partly truth.

Unknown health risks

• Doctors are still studying the benefits and risks of using creatine supplements. They don’t know the long-term health effects, especially in bodies that are still growing.

• Because of unknown health risks, children and adolescents under age 18 and women who are pregnant or nursing should never take creatine supplements.

People with kidney problems should also not take creatine supplements. No matter what your age or health condition, always see your doctor for advice before taking creatine supplements.

Easy to get, widespread use

Creatine supplements come in a wide variety of brand names and products and are available over-the-counter at vitamin, drug and grocery stores and on the Internet. Creatine Monohydrate is a white, odorless crystalline powder, clear and colorless in solution. Use of creatine supplements is widespread and expected to rise. Since 1995 sales of Creatine have grown by 730%. Most of the people who use them are:

• Male, although some are female.

• In power sports (i.e., football, wrestling, hockey and bodybuilding), although some are in every sport.

• At all levels of performance – from professional to amateur, college, high school and middle school. A recent study of middle and high school students aged 10-18 by the American Academy of Pediatrics found creatine use in all grades 6-12. About 5.6 percent of all study participants and 44 percent of athletes who are seniors in high school admitted taking creatine. Another study by the Blue Cross and Blue Shield Association found an estimated one million young people aged 12-17 have taken performance-enhancing sports supplements. Use of supplements was reported by 5 percent of participants.

About Creatine and Creatine Supplements

Creatine is a source of energy for muscle contraction. The body produces its own creatine in the liver, kidneys and pancreas. You also get it in your diet when you eat meat or fish. (Vegetarians may have less creatine.) The body stores most of the creatine in skeletal muscle to use when you exercise. The rest goes in the heart, brain and other tissues.

Although people respond differently, taking creatine supplements may increase the amount of creatine in muscles.

• Muscles may be able to generate more energy or generate energy at a faster rate.

• Some people think taking creatine supplements along with training may improve performance for quick bursts of intense energy, such as sprinting and weightlifting.

Vegetarians and other people with lower amounts of natural creatine may see more of a difference from taking creatine supplements. There may be a "saturation point" that limits how much creatine muscles can store.

Supplements Not Always Safe

Although creatine is a "natural" product, it is not always safe to take creatine supplements.

• Creatine has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of creatine may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

• According to a recent Mayo Clinic study, many young athletes who take creatine supplements rely upon the advice of friends, not doctors. Some do not know how much creatine they are taking and may take more than they should.

Side effects

People who take creatine supplements may gain weight caused by muscles holding water. Other side effects of long-term use include muscle cramps, stomach cramps, dehydration, diarrhea, nausea and seizures. It may be dangerous to take creatine supplements while undergoing dehydration (i.e., for wrestling competition) or if you are trying to lose weight.

Stop taking creatine and seek emergency medical attention or notify your doctor immediately if you experience:

• No one knows what may happen to important organ systems like the heart, brain, kidneys, liver and reproductive organs if you take creatine supplements.

• An allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives)

• No one knows what may happen if you combine creatine supplements with over-the-counter medications, prescription drugs, vitamins, etc.

• Since it has the effect of fluid retention in muscle, it might increase blood pressure in the same way high sodium levels do, but this has not been established or refuted. Also, it is expensive.

• There are some anecdotal reports of other side effects, including kidney and liver damage, muscle cramps during exercise in the heat and increased number of muscle strains and pulls.

A recent survey by Blue Cross and Blue Shield Association's Healthy Competition Foundation found that 96% of the youths who used supplements were aware of the health risks. Be well informed about any supplement you choose to take and periodically check to see if any further studies have found any significant negative effects.

Medical researchers are studying the safety and effectiveness of creatine supplements. They also are studying if creatine supplements may help to treat diseases that cause muscles to shrink and fail, such as heart failure/disease, muscular/neuromuscular diseases, and stroke. 

Proper Usage

With the knowledge that many (mostly male) gymnasts do use CM, here is some information you might find handy. First, of course, read the label and any additional leaflets that come with your brand of creatine monohydrate.

Taking creatine supplements markedly increases these levels in the muscles. People who supplement may take anywhere from 10 to 20 grams per day for periods ranging from 4 to 6 days. This regimen is termed "creatine loading"; it can raise muscle creatine and phosphocreatine concentrations by more than 20%.

The benefits of supplementation on performance are limited to specific types of activities. Preliminary information suggests that high- intensity, short duration or stop and go activities may benefit from creatine supplementation. Some examples include weight training, baseball, sprinting, throwing, jumping, football, and soccer. However, only people with low levels of muscle creatine will benefit from creatine supplementation.

In contrast to high-intensity or anaerobic activities, creatine supplementation does not improve, and may even worsen, endurance performance. One study found that marathon runners had poorer performances after creatine loading.

Before taking creatine, talk to your doctor, pharmacist, or health care professional if you have any other medical conditions, allergies, or if you take other medicines or other herbal/health supplements. Creatine may not be recommended in some situations.

Usually, the use of creatine is split into a loading and maintenance phase. During the loading phase, large quantities of creatine monohydrate are taken. Because the creatine only slowly disappears from the body, a maintenance phase in which less creatine is taken will still provide the body with adequate levels of creatine. 

Some studies support creatine cycling and others do not. There are a couple of different "cycling" strategies you can try: 1. Stay on creatine all the time, but reload once every six weeks; 2. Load for a week, stay in your maintenance phase for six weeks, then stop taking creatine completely for a couple of weeks. Repeat.

It is recommended to drink lots of water while on the creatine. Powder form is generally preferred over capsules. Most users recommend a loading phase when first starting with CM. For 5 to 7 days, take a teaspoon (approx. 5 grams) 5 times per day. After that go on maintenance at 5 grams twice per day.

Note: It is discouraged to use caffeine while on creatine; while creatine makes your muscles hold water, caffeine will do the opposite, thereby reducing the effects of the creatine intake.

Though some sources report otherwise, it is generally recommended that you not mix creatine with citrus juice. Orange, grapefruit, cranberry, in fact, most fruit juices have been most recently found to neutralize the activity of creatine monohydrate. The reason is the waste product creatine develops. Many users put creatine on your tongue and drink it down with grapefruit juice. If you have taken creatine this way in the past, stop it now! You are not getting creatine, you're getting waste product.

Do mix creatine monohydrate with warm water -- in a glass. This is the only way to ensure you're getting the full benefits of creatine in its dry form. Creatine does not have to dissolve to be effective.

Do be sure to drink a full eight ounce glass of good water 8 times a day. Creatine pulls water from other parts of the body to perform its work in cell volumization of the muscle. This is what makes the muscle larger and firmer. Replenish your H2O! It has been reported that creatine may be more effective if taken with carbohydrates.

Background:

Creatine (creatine monohydrate) is generally used in the U.S. as a sports supplement. Most studies have shown it to improve performance during high-intensity exercise of short duration, such as weight lifting and sprinting. Creatine is produced in the body and is also available from meat in the diet, including poultry and fish. The activity of creatine is related to its role in the production of energy in muscle.

When creatine is metabolized in the body, it creates a waste product called "creatinine" which is normally removed from the body by the kidneys. (The amount of creatinine in the blood is often used diagnostically to evaluate kidney functioning). Creatinine may also be found in impure creatine supplements due to improper manufacturing or breakdown prior to use. Another manufacturing by-product, dicyandiamide, may also be found in impure creatine supplements. While creatinine and dicyandiamide in small amounts are not known to pose a safety risk, they are not useful to the body and must be eliminated through the kidneys. Better quality creatine products should be free of these impurities. Consequently, manufacturers often make a point of claiming their creatine products to be "100% pure," "99% pure," or "Dicyandiamide Free." Purity is particularly important for creatine supplements because doses are relatively large — exceeding 20 grams per day (approximately four teaspoons of creatine powder) in some dosing regimens.

A consumer testing facility, as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased many of the leading creatine dietary supplements sold in the U.S. and tested their quality.

Testing & Results:

In June 2000, the consumer testing facility purchased a total of 13 brands of dietary supplements containing creatine monohydrate. These were tested to determine whether 1) they possessed 100% of the claimed weight of creatine and 2) lacked contamination from creatine or dicyandiamide according to claims made by the products.

Eleven of the 13 brands passed this testing. One of the two products that did not pass testing was found to contain less than the labeled amount of creatine. The other product that did not pass failed to meet its claim of being free of the impurity dicyandiamide.

And how about this -- Creatine has shown that it also increases brain power in vegetarians. It does not seem to have the same effect in meat eaters. 

Finally, if you are interested in this supplement, continue your research. Creatine is among the most researched supplements on the market with nearly 30,000 studies maintained in the database of the National Library of Medicine conducted throughout the world -- including research done with people (clinical), on animals, and in test tubes (in vitro). Currently, though we do not advocate its use, we believe, that it seems to have minimal negative effects when taken properly. You should use your own judgment. If you choose to use creatine please follow the dosing religiously -- don't get carried away. We recommend that you continue to seek out any new information that comes about.

Here's another source -- for you to continue your education about creatine: WebMD or www.creatinemonohydrate.net