The Basics of Creatine Supplementation - Part II

Heather Pettingill, BSc, BPHE, BEd

Are there any side effects or risks associated with supplementing creatine?

We've already discussed the positive side effects of creatine in terms of performance. Another positive effect of Cr supplementation that has been suggested is that supplementing Creatine (Cr) over several weeks may boost level of good cholesterol or HDL ( Applegate, 2001). We also briefly introduced the idea that weight gain is associated with creatine supplementation. Depending on your status as an athlete, this effect could be construed as positive or negative. We know definitively that creatine supplementation causes weight gain through water retention, but the jury is still out to say whether creatine is directly responsible for weight gain due to muscle hypertrophy. It does appear possible for creatine to "assist" in muscle growth since creatine supplementers can increase training volume and intensity, which over time can lead to muscle growth. However, to think that one will "magically" grow muscles simply by consuming creatine, without training intensely, is not possible. As discussed in the previous section, weight gain can be detrimental to certain athletes. However, in athletes such as football or hockey players, increased weight could be advantageous.

As for potential negative side effects of creatine, you may have heard of a news report, or a friend commenting that their Cr supplementation has caused them muscle cramps, or digestive issues. However, to date, these suggestions remain anecdotal, and in well-controlled scientific trials, there has been found no direct cause and effect relationship between Cr supplementation and these or other negative side effects. Bembem and Lamont's review of creatine literature surmised that there appears to be no strong scientific evidence that supplementing creatine causes any adverse effects. In their 2004 study, Bizzarni and De Angelis found no evidence linking Cr supplementation to deterioration of gastrointestinal (digestive system), cardiovascular(heart and lungs), muskuloskeletal (muscles), renal (kidneys) or liver function.

However, it must be acknowledged that there are few long-term studies to determine the effects of long-term Cr supplementation. I was able to find two studies whose goal was to determine the long-term effects of Cr supplementation. One study focused on professional male basketball players who injested 5g of Cr daily over three competitive seasons running from Sept through June from 1999 to 2002, and another study followed Division 1A collegiate football players who took Cr either not at all, for 0-6mos, 7-12mos, and 12-21 mos. In both studies, results indicated that "long-term" creatine supplementation did not appear to adversely effect markers of health status in comparison to those athletes not supplementing with creatine. Bizzarnni and De Angelis found that "controlled studies made to integrate the existing knowledge based on anecdotal reports on the side effects of creatine indicated that in healthy subjects, oral supplementation with creatine, even with long-term dosage may be considered and effective and safe ergogenic aid.

However, despite the "all clear" that the scientific research appears to give creatine supplementation, it is still imperative that those who consider supplementing creatine are educated on proper dosing, and it is also recommended that you to talk to your doctor before taking creatine. It was beyond the scope of this article to investigate issues such as whether there are any drug interactions that might occur with creatine supplementation or whether there is a minimal age one should be before safely supplementing creatine.

How do you Supplement creatine?

Let's say that you've talked to your doctor, and maybe even shared this article with him or her and you have been given the go ahead to supplement creatine. The most common method involves an "initial loading phase of 20g/day for 5-7 days followed by a maintenance phase of 2-5 g/day for anywhere from 1 week - 6 months." In order to maximize the amount of Cr that is absorbed by the body, creatine should be taken with about 40g of carbohydrate. Many supplement companies sell creatine as a mixture that already incorporates carbohydrates. If you use this type of Cr supplement, read the container of the product to determine how big a scoop of powder you require to obtain the desired amount of Cr (which depends whether you are attempting to "load" or "maintain"). Mix the scoop with 2-3 cups of water until dissolved. It is not recommended that you take Cr right before a workout.

In addition to the Cr carbohydrate mixtures, isolated Cr is also available. If this is the product you use, make sure you take the Cr with a simple, easily digestable carbohydrate such as juice to aid absorption.

Do your own research

In addition to my university notes and the book "Eat Smart, Play Hard," most of the research I used to write this article was by doing a web search on PubMed which is a great tool to find scientific literature on any topic. *PubMed is an American service of the National Library of Medicine, including over 15 million citations from abstracts from biomedical articles from MEDLINE and additional life science journals. I caution against doing a random "google" search as you will bombarded with links to too many "questionable" and biased sources of information.

I highly recommend that you do your own research and draw your own conclusions on creatine or other health, exercise and nutrition information that interests you.

References

Bemben MG, Lamont HS. Creatine supplementation and exercise performance : recent findings. Sports Med. 2005;35(2):107-25.

Terjung RL, Clarkson P, Eichner ER, Greenhaff PL, Hespel PJ, Israel RG, Kraemer WJ, Meyer RA, Spriet LL, Tarnopolsky MA, Wagenmakers AJ, Williams MH. American College of Sports Medicine roundtable. The physiological and health effects of oral creatine supplementation. Med Sci Sports Exerc. 2000 Mar;32(3):706-17.