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Creatine overview

Creatine is a nitrogenous organic acidhave absorption rates tens of times
that naturally occurs in vertebrates andhigher than regular creatine
helps to supply energy to muscle cells.monohydrate, by several supplement
Creatine was identified in 1832 whencompanies. Once ingested, however,
Michel Eugene Chevreul discovered it ascreatine is highly bioavailable (easily
a component of skeletal muscle which hemeasured by its plasma appearance
later named creatine after the Greekkinetics and urinary excretion), whether
word for flesh, Kreas.it is ingested as the crystalline
Function Creatine functions as part ofmonohydrate form, the free form in
the cell's energy shuttle. The highsolution, or even in meat.
energy phosphate group of ATP isCreatine salts will of course become the
transferred to creatine to formfree form when dissolved in aqueous
phosphocreatine in the followingsolution. With studies repeatedly
reaction: Cr + ATP PCr + ADP. Thisreporting an upper maximal range for
reaction is reversibly catalysed bymuscular creatine concentration it is
creatine kinase, also referred to asunlikely that the form of creatine
creatine phosphokinase. At sites of highingested results in increased or altered
energy usage, e.g. at the site of musclefinal gains. Creatine monohydrate ($400
contraction or in the tail of a spermmillion in annual sales in the United
cell, creatine kinase transfers the highStates alone) remains the most used form
energy phosphate back fromof creatine.
phosphocreatine to ADP to reform ATP.Creatine Ethyl Ester (CEE) is not
This allows the cellular ATP/ADP ratioallowed to be sold in Germany and
to remain stable within the cell, evenFrance.
if it is undergoing rapid energyCreatine and Athletic Performance
fluctuations. Creatine kinase isCreatine is often taken by humans as a
typically located in cells that undergosupplement for those wishing to gain
high energy fluctuations, e.g. musclemuscle mass (bodybuilding). There are a
cells, cardiac muscle cells, neurons,number of forms but the most common are
the photoreceptor cells of the eye andcreatine monohydrate - creatine bonded
spermatozoa. An analogous system basedwith a molecule of water, and creatine
on arginine/phosphoarginine operates inethyl ester (CEE) – which is creatine
many invertebrates. The presence of thismonohydrate with an ester attached. A
energy shuttle keeps the ATP/ADP rationumber of methods for ingestion exist -
high, which ensures that the free energyas a powder mixed into a drink, or as a
of ATP remains high and minimizes thepill.
loss of adenosine nucleotides, whichThere is scientific evidence that taking
would cause cellular dysfunction.creatine supplements can marginally
Synthesis In the human body creatine isincrease athletic performance in
synthesized mainly in the liver by thehigh-intensity anaerobic repetitive
use of parts from three different aminocycling sprints, but studies in swimmers
acids - arginine, glycine, andand runners have been less than
methionine. 95% of it is later stored inpromising, possibly due to the weight
the skeletal muscles, with the rest ingain. Ingesting creatine can increase
the brain, heart, testes.the level of phosphocreatine in the
Creatine and the treatment of muscularmuscles up to 20%. It must be noted
diseases Creatine supplementation hascreatine has no significant effect on
been, and continues to be, investigatedaerobic exercise (Engelhardt et al,
as a possible therapeutic approach for1998).
the treatment of muscular, neurologicalSome studies have shown that creatine
and neuromuscular diseases (arthritis,supplementation increases both total and
congestive heart failure, disusefat-free body mass, though it is
atrophy, gyrate atrophy, McArdle'sdifficult to say how much of this is due
disease, Huntington's disease,to the training effect. Since body mass
miscellaneous neuromuscular diseases,gains of about 1 kg (about 2.2 pounds)
mitochondrial diseases, muscularcan occur in a week's time, several
dystrophy, neuroprotection, etc.).studies suggest that the gain is simply
Two scientific studies have indicateddue to greater water retention inside
that creatine may be beneficial forthe muscle cells. However, studies into
neuromuscular disorders. First, a studythe long-term effect of creatine
(Klivenyi et al. 1999) by MDA-fundedsupplementation suggest that body mass
researcher M. Flint Beal of Cornellgains cannot be explained by increases
University Medical Center demonstratedin intracellular water alone. In the
that creatine was twice as effective aslonger term, the increase in total body
the prescription drug riluzole inwater is reported to be proportional to
extending the lives of mice with thethe weight gains, which means that the
degenerative neural disease amyotrophicpercentage of total body water is not
lateral sclerosis (ALS, or Lou Gehrig'ssignificantly changed. The magnitude of
disease). Beal suspects that thethe weight gains during training over a
neuroprotective effects of creatine inperiod of several weeks argue against
the mouse model of ALS are due either tothe water-retention theory.
an increased availability of energy toIt is possible that the initial increase
injured nerve cells or to a blocking ofin intracellular water increases osmotic
the chemical pathway that leads to cellpressure, which in turn stimulates
death.protein synthesis. A few studies have
Second, a study by Canadian researchersreported changes in the nitrogen balance
Mark Tarnopolsky and Joan Martin ofduring creatine supplementation,
McMaster University Medical Center insuggesting that creatine increases
Hamilton, Ontario found that creatineprotein synthesis and/or decreases
can cause modest increases in strengthprotein breakdown. Again, while
in people with a variety ofhypothesized, this remains unproven.
neuromuscular disorders. The latterAlso, research has shown that creatine
paper was published in the March 1999increases the activity of myogenic
issue of Neurology.cells.
History of use as a nutritionalThese cells, sometimes called satellite
supplement In 1912, researchers foundcells, are myogenic stem cells that make
that ingesting creatine can dramaticallyhypertrophy (increase in size of cells)
boost the creatine content of theof adult skeletal muscle possible. These
muscle. In the late 1920s, after findingstem cells are simply generic or
that the intramuscular stores ofnon-specific cells that have the ability
creatine can be increased by ingestingto form new muscle cells following
creatine in larger than normal amounts,damage to the muscle tissue, or to fuse
scientists discovered creatinewith the existing muscle fibres in the
phosphate, and determined that creatinecase of exercise to permit growth of the
is a key player in the metabolism ofmuscle fibre. Following proliferation
skeletal muscle.(reproduction) and subsequent
While creatine's influence on physicaldifferentiation (to become a specific
performance has been well documentedtype of cell), these satellite cells
since the early twentieth century, itwill fuse with one another or with the
only recently came into public viewadjacent damaged muscle fiber, thereby
following the 1992 Olympics inincreasing myonuclei numbers necessary
Barcelona.for fiber growth and repair. The study,
An August 7, 1992 article in The Timespublished in the International Journal
reported that Linford Christie, the goldof Sports Medicine was able to show that
medal winner at 100 meters, had utilizedcreatine supplementation increased the
creatine prior to the Olympics, and annumber of myonuclei donated from
article in Bodybuilding Monthly namedsatellite cells. This increases the
Sally Gunnell, gold medalist in thepotential for growth of those fibers.
400-meter hurdles, as another creatineThis increase in myonuclei probably
user. Several medal-winning Britishstems from creatine's ability to
rowers also used creatine during theirincrease levels of the myogenic
preparations for the Barcelona games.transcription factor MRF4 (Hespel,
At the time, low-potency creatine2001).
supplements were available in Britain,Current studies indicate that short-term
but creatine supplements designed forcreatine supplementation in healthy
strength enhancement were notindividuals is safe (Robinson et al.,
commercially available until 1993 when a2000). Longer term studies have
company called Experimental and Appliedoccasionally been done, but have been
Sciences (EAS) introduced the compoundsmall. One such study that is often
to the sports nutrition market under thecited involved a minimum length of 3
name Phosphagen. In 1998, the launch ofmonths, but only had 10 creatine
the first creatine-carbohydrate-alphasubjects (Mayhew et al 2002). However,
lipoic acid supplement, Cell-Tech, bythere is still controversy over the use
another company called MuscleTechof creatine, and many experts believe
Research and Development, took place.that creatine should not be used by
Alpha lipoic acid enhances muscleindividuals under the age of 18.
phosphocreatine levels and total muscle[citation needed]Therefore more research
creatine concentrations. This approachis needed to be done on this supplement
to creatine supplementation wasand others like it before being used.
validated in a study performed in 2003There has been controversy over the
by Burke et al., of the Department ofincidence of muscle cramping with the
Human Kinetics at St. Francis Xavieruse of creatine. A study done at the
University. Another important event inUniversity of Memphis showed no reports
creatine supplementation occurred inof muscle cramping in subjects taking
2004 when the first creatine ethyl estercreatine-containing supplements during
supplements were launched.various exercise training conditions in
Creatine Ethyl Ester (CEE) is becoming atrained and untrained endurance athletes
widely used form of creatine, with many(Kreider R. et al, 1998).
companies now carrying both creatineCreatine use is not considered doping
monohydrate-based supplements andand is not banned by sport-governing
Creatine Ethyl Ester supplements, orbodies. In some countries however,
combinations of both. CEE is touted tocreatine is banned.



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