Is Creatine Safe?

Creatine is one of the most frequently used athletic enhancement supplements.  It is a naturally occurring chemical in the body, created by the liver and kidneys, and 95% of it is stored in the skeletal muscles and the rest is circulating in the bloodstream. In the 1970's some Soviet scientists found that oral creatine supplements improved brief intense athletic periods (such as sprinting), and then in the 1990's it was reported that oral creatine supplementation actually increases your body muscles creatine content (seems like a silly statement, but that it actually builds up and stays in your muscles- it isn't just absorbed then excreted by the body). Besides creatine created by your body and oral supplementation, the other ways to ingest it is to eat red meat and fish.  So, it is a naturally occurring substance, that may enhance your workouts, but how does it work and is it safe for you?

What does creatine do?
Basically, creatine is involved in making the energy that muscles need to work. Normally, when you eat carbohydrates (and other food) your foodstuffs are broken down in the stomach, then further broken down with the help of the liver and made into a usable energy source by the body, such as ATP (Adenosine Triphosphate), which transports energy within cells. When the ATP sources are depleted in your muscles, they become tired because there is no energy source left within the cells of your muscles, your body will try to create energy from food sources, but it always ends up failing when needed for high energy needs, quickly. Then creatine comes into play: creating that is stored in your muscles, converts into creatine phosphate and reacts with ADP ( adenosine diphosphate- a non unusable form of energy) to makes more ATP and boost your muscles energy .  Thus for longer workouts, creatine supplementation is enhanced when taken with carbohydrates; your muscles get an extra boost of immediate viable energy.

How do you take it?
It comes in powders, drinks, pills....and some people will split doses and take it three times during the day, whereas others will take it an hour before working out and then 1 to 3 hours after working out to replenish the stores in the muscle.  There are plenty of theories, but most people tend to take a loading dose (high level for a short period of time to raise the amount in their system and saturate their muscles with creatine) of 9 to 20 grams per day for 6 days, then 2 grams a day from then on.  One other thing to note is that most athletes "cycle" their creatine supplementing so that they test their bodies with and without the supplement, so their body doesn't ever get lazy; they will usually take the supplement for 8 weeks, off for 4 weeks, then back on.

Does it actually work?
Here's the rub, a lot of professional and non-professional athletes take creatine supplements, and people report feeling like they have more energy and have better workouts, but the research is mixed because your muscles do have a saturation point with creatine.  On the other hand, it is really hard to eat a diet high in creatine, basically to get 3 grams a day, you would have to eat a little over 3lbs of raw red meat a day...which I can't see very many people doing.  There are some very high quality studies that do show an increase in muscle mass with using supplementation, thus increasing lean muscle mass.  So, I would say that it does work for performance athletes, I don't think that someone who sits around all day and might lift a 5lb dumbbell a couple times a week will look like Arnold Schwarzenegger, but if you work out hard, and are looking to increase your muscle mass quickly, this will help you, and give you more energy at the beginning of your workout to lift more.

Are there any side effects?
Most notably, when people first start taking creatine they can have some stomach upset (nausea, vomiting, diarrhea) and you WILL gain weight, because you are gaining muscle, and possibly a little bloat at the beginning, but as your body gets used to the creatine, it will even out.  People with renal disease or diabetes (at risk for renal disease) ned to be really careful as creatine is excreted through the kidneys, and a build-up of creatine has been shown to put a lot of stress on your kidneys, so if they are already at risk or not working optimally, the supplement can put an unneeded risk on them (there are studies that go both ways with this topic).  Also, people with liver disease (or at high risk for liver disease) should definitely talk to their HCP before starting creatine supplements.  If you have any doubt, or even if you don't, I suggest going to your HCP and getting a physical with some blood work to check your liver and kidney function, just to be safe, before starting this supplementation.  And follow-up with your HCP if you notice anything different about your body (besides building extra muscle because that's the whole point, right?) Just remember, these supplements are still undergoing testing for long term use AND they are not FDA approved, so you never know exactly what you are ingesting.....

Give it a go, work out hard, and see where it leads you!

Yours in Good Health
B