I started taking creatine supplements this past summer after I had broken my leg in the winter and had lost a lot of weight due to inactivity and muscle atrophy.
Physically, I wanted to get back to where I was before I broke my leg, but I also wanted to be bigger and stronger than what I had been before the accident. So with lots of eating, lifting and some creatine, I was on my way to becoming the Iranian Vin Diesel.
On the molecular level creatine works in conjunction with ATP or adenosine triphosphate to supply the muscle with short term energy. Creatine is a compound formed from the synthesis of two amino acids, specifically glycine and arginine. Everyone has a natural amount of creatine stored in his muscles. The energy in ATP comes from its phosphate bonds. These bonds break when ATP converts to ADP or adenosine diphosphate, releasing the stored energy. Creatine, in the form of creatine phosphate, adds a phosphate to ADP to restore the high energy form of the molecule which is ATP. Thus, supplementing with creatine would increase power and short term athletic performance rather than endurance.
There are many different companies that tout their creatine products as all natural supplements that ultimately enhance power and athletic performance.
Although the companies advise the intake of creatine differently, the basic idea is to let the creatine osmotically, or with water, enter the muscles. Hence, there is some added water weight gain that is natural with creatine supplementation. When creatine should be taken, however, is variable. Taking it before a workout provides some people with extra energy, and taking it afterwards may be more effective in terms of greater absorption into the muscles.
There is much debate on creatine because not much is known mechanistically about how creatine supplementation interacts with the body, according to the review article "Pharmacokinetics of the dietary supplement creatine," published in the recent issue of Clinical Pharmacokinetics.
Several articles, summarized in the review article "Effects of creatine supplementation on renal function" in the Journal of Herbal Pharmacotherapy claimed that creatine supplementation did not pose a serious risk of renal damage in healthy adults when used properly. Some literature, however, showed that creatine may have negative effects on a person's kidneys, liver, heart and minor effects on the gastro-intestinal tract. The studies also suggest the risks involved when creatine is taken with an excess of caffeine or carbohydrates. Interestingly, these studies used extrapolated information from a few individual cases. Therefore, they do not merit the widespread conclusions they claim.
I was not altogether convinced by the studies I found on creatine's effects on the body, so I brought my concerns to Dede Haverstick, an associate professor of Clinical Pathology at U.Va. medical school who conducts research in toxicology. Haverstick said that many of the concerns of renal damage with creatine supplementation came from a few reports of sudden acute renal failure that were "poorly" linked to creatine intake. She was not convinced of the renal damage conclusions and pointed to a study done at U.Va. in 2002, which showed that while there may be slight preliminary damage to renal function, "it is not as extensive as many case reports would cause you to suspect."
Surprisingly, according to Haverstick it is the contaminants in the creatine that may be of greater concern than the creatine itself.
Companies have different methods of making the creatine, and thus the contents of the supplements vary significantly. According to Haverstick, creatine is not controlled by the Food and Drug Administration because it is classified as a "natural" supplement. On the bright side, she pointed to a recent push by congress to monitor the production of herbals and "natural" supplements.
While many of the negative effects of creatine supplements seem ambiguous, it is clear that taking creatine is a form of self-medication.
"If you are self-medicating and something doesn't seem right, stop it and see a physician," Haverstick advised.
In other words, you do not have to be a meathead to be a beefcake - be smart and be careful about what you are doing to your body.
Omid Fatemi can be reached at of5h@virginia.edu.
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