Creatine reviews, Creatine side effects and benefits
creatine supplements and facts     updated on August 25, 2011
Creatine Reviews

Creatine benefits - physical performance
Creatine supplementation or ingestion leads to increase the amount of creatine and creatine phosphate
stored in our body. This is important especially for athletes because creatine aids in the process of creating
energy usable by muscles. [1]

Creatine supplementation can also improve performance during high intensity exercise in humans and
improve muscle strength in certain myopathies. Head SI et al at University of New South Wales, Australia,
isolated the extensor digitorum longus muscle from mice and stimulated with field electrodes to measure force
characteristics in 3 different states.(i) before fatigue; (ii) immediately after a fatigue protocol; and (iii) after
recovery. The muscle was then incubated in a creatine solution and washed. In un-fatigued muscle, creatine
incubation increased the maximal tetanic force. In fatigued muscle, creatine treatment increased the force
produced at all frequencies of stimulation. Incubation also increased the rate of twitch relaxation and twitch
contraction in fatigued muscle. During repetitive fatiguing stimulation, creatine-treated muscles took 55.1±9.
5% longer than control muscles to lose half of their original force. Measurement of weight changes showed
that creatine incubation increased EDL muscle mass by 7%. [PLoS One.
2011;6(8):e22742.] ]5]

Recent reports suggest that creatine may enhance performance in hot and/or humid conditions by
maintaining haematocrit, aiding thermoregulation and reducing exercising heart rate and sweat rate. Creatine
may also positively influence plasma volume during the onset of dehydration. [2] Progressive muscle
weakness is a main symptom of most hereditary muscle diseases. In trials with 138 participants with muscular
dystrophies treated with creatine, there was a significant increase in maximum voluntary contraction in the
creatine group compared to placebo, with a weighted mean difference of 8.47% (95% confidence intervals
3.55 to 13.38). There was also an increase in lean body mass during creatine treatment compared to
placebo. [3]

Creatine benefits - Creatine phosphate (Energy Storage)
When we exercise or tense a muscle, energy is required for the muscle to function properly. The energy it
uses comes mainly from the food. The nutrients in the food are broken down to smaller compounds, e.g.
adenosine triphosphate (ATP) for energy production and storage. When muscle energy is needed, ATP is
broken down to form adenosine diphosphate (ADP). This process releases energy for muscles to contract.
Without sufficient ATP, muscles do not perform properly. [1]

Muscle can store only limited amounts of ATP. As a result, within about 5-10 seconds of muscle exertion, the
amount of stored ATP is depleted. The depletion of ATP results in fatigue. When this happens, the body tries
to restore its immediate source of ATP by borrowing a high-energy phosphate, i.e. creatine phosphate (CP).

Muscle cells can store creatine phosphate. If high intensity exercise goes beyond 10 seconds, the body will
continue to try and restore its ATP levels by a process called glycolysis. This process is complicated and is
slow to restore the ATP levels. This can be a problem when we require instant energy to maintain a sustained
muscle contraction. [1]

Creatine Phosphate Supplementation may help to recharge the creatine molecule in our body. However,
ATP or creatine phosphate cannot be ingested orally because they are digested in our GI tract. Luckily,
researchers found that creatine can be ingested and converted to creatine phosphate in our body. [1]

Creatine monohydrate, creatine citrate and creatine pyruvate are popular creatine supplements. It is supplied
in form of powder, capsule or tablets. It can be mixed or taken with water or juice. Some people athletes take
20-30 grams of creatine monohydrate a day. [1]

Creatine benefits - Neural Protection
Exogenous creatine supplementation has been shown to reduce neuronal cell loss in experimental paradigms
of acute and chronic neurological diseases. In line with these findings, first clinical trials have shown
beneficial effects of therapeutic creatine supplementation. Furthermore, creatine was reported to promote
differentiation of neuronal precursor cells that might be of importance for improving neuronal cell
replacement strategies. Based on these observations there is growing interest on the effects and functions of
this compound in the central nervous system. [A1]

Creatine synthesis makes major demands on the metabolism of glycine, arginine, and methionine. Large
doses of creatine monohydrate are widely taken creatine supplements are also taken by patients suffering
from gyrate atrophy, muscular dystrophy, and neurodegenerative diseases. Children with inborn errors of
creatine synthesis or transport present with severe neurological symptoms and a profound depletion of brain
creatine. It is evident that creatine plays a critical, though underappreciated, role in brain function. [A3]

Creatine benefits - Vs Sarcopenia
Sarcopenia, defined as the age-related loss of muscle mass, is a serious health concern. Contributing factors
to sarcopenia include physical inactivity and undernutrition. Resistance training has a positive effect on
muscle mass in the elderly. However, muscle loss is still observed in older adults who perform weight bearing
exercise; suggesting that nutrition is important. Intake of creatine has the potential to increase muscle
accretion during resistance training, although the mechanism for its ergogenic effect is unclear. Creatine has
the potential to increase cellular hydration and myogenic transcription factors and facilitate the up-regulation
of muscle specific-genes such as myosin heavy chain possibly leading to muscle hypertrophy. [A2]

Creatine benefits - Vs Cancers
Several studies suggest the anti-cancer activities of creatine. [4] The creatine/creatine kinase (CK) system
plays a key role in cellular energy buffering and transport. In the process of creatine biosynthesis several
other important metabolites are formed. Recent literature has reported low creatine content in several types
of malignant cells. Furthermore, creatine can protect cardiac mitochondria from the deleterious effects of
some anticancer compounds. Patra S, et al at Indian Association for the Cultivation of Science showed
progressive decrease of phosphocreatine, creatine and CK upon transformation of skeletal muscle into
sarcoma. The anticancer effect of methylglyoxal had been known. Patra S' work shows that this anticancer
effect of methylglyoxal is significantly augmented in presence of creatine. On creatine supplementation the
effect of methylglyoxal plus ascorbic acid was further augmented and there was no visible sign of tumor. [8]

Creatine benefits - Bone tissue
Supplementation of creatine has a positive effect on cortical and trabecular bone composition of
ovariectomized rats. [6]

Creatine benefits - Vs diabetes?
In a study of type II diabetics received either creatine (3 g) or glibenclamide (3.5 mg) for five successive days,
creatine and glibenclamide both decreased glucose concentrations vs. basal glucose. Treatment with both
creatine and glibenclamide increased insulin and c-peptide concentrations after 120 and 240 min. [7]

Creatine Side Effects
Creatine converts to creatinine at lower pHs (acidic environment). Creatinine is toxic, side effects may
include stomach cramps, edema, bloodedness and dehydration. [1] In addition, one trial reported a
significant increase in muscle pain during high-dose creatine treatment (dosage 150 mg/kg body weight) in
glycogen storage disease type V. [3]

[1] Golini; Jeffrey M. (Billings, MT) U.S. Patent 6,399,661 June 4, 2002 [2] Dalbo VJ, Roberts MD, Stout JR, Kerksick CM.
Department of Health and Exercise Science, University of Oklahoma, Putting to rest the myth of creatine supplementation
leading to muscle cramps and dehydration. Br J Sports Med. 2008 Jul;42(7):567-73. Epub 2008 Jan 9. [3] Kley RA, Vorgerd M,
Tarnopolsky MA. Kliniken Bergmannsheil, Ruhr University Bochum, Germany, Creatine for treating muscle disorders.
Cochrane Database Syst Rev. 2007 Jan 24;(1). [4] Mesa JL, Ruiz JR, González-Gross MM, Gutiérrez Sáinz A, Castillo Garzón
MJ. University of Granada, Spain, Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports
Med. 2002;32(14):903-44. [5] Head SI, Greenaway B, Chan S. Incubating Isolated Mouse EDL Muscles with Creatine Improves
Force Production and Twitch Kinetics in Fatigue Due to Reduction in Ionic Strength. PLoS One. 2011;6(8):e22742. [A1]
Functions and effects of creatine in the central nervous system.Brain Res Bull. 2008 Jul 1;76(4):329-43. Epub 2008 Mar 24
[A2]  Effect of creatine supplementation during resistance training on muscle accretion in the elderly. J Nutr Health Aging. 2007
Mar-Apr;11(2):185-8. [A3] Creatine: endogenous metabolite, dietary, and therapeutic supplement. Annu Rev Nutr. 2007;27:241-
61 [6] de Souza RA, Xavier M, da Silva FF, de Souza MT, Tosato MG, Martin AA, de Melo Castilho JC, Ribeiro W, Silveira L Jr.
Influence of creatine supplementation on bone quality in the ovariectomized rat model: an FT-Raman spectroscopy study.
Lasers Med Sci. 2011 Aug 12. [7] Ročić B, Znaor A, Ročić P, Weber D, Vučić Lovrenčić M. Comparison of antihyperglycemic
effects of creatine and glibenclamide in type II diabetic patients. Wien Med Wochenschr. 2011 Jul 29. [8] Patra S, Ghosh A, Roy
SS, Bera S, Das M, Talukdar D, Ray S, Wallimann T, Ray M. A short review on creatine-creatine kinase system in relation to
cancer and some experimental results on creatine as adjuvant in cancer therapy. Amino Acids. 2011 Jul 19.
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