The Myths of Creatine

     This past weekend I read over the position statement on creatine by the Journal of the International Society of Sports Nutrition (JISSN), (a top sports nutrition journal) and it had reaffirmed that the media and most people are completely off-base when it comes to this supplement.  Therefore, it is absolutely necessary to review this to clean up some myths on creatine.  In the beginning of the paper, they state 9 points regarding creatine use...a summary of the whole thing

• Creatine Monohydrate (CM) is the most effective ergogenic nutritional supplement currently to athletes to increase high-intensity exercise capacity and lean body mass.
• CM is not only safe, but possibly beneficial in regard to preventing injury and/or management of select medical conditions (heart patients, infants or patients w/ creatine synthesis deficiency, orthopedic injury, or various neuromuscular diseases!)
• No scientific evidence that short or long-term use of CM has any detrimental effects on healthy individuals
• If proper precautions and supervision are provided, supplementation in young athletes is acceptable and may provide nutritional alternative to dangerous anabolic drugs
• At present, CM is the most extensively studied and clinically effective form of creatine in terms of uptake and ability to increase high intense exercise capacity
• Adding carbohydrate or carbohydrate + protein to creatine supplement appears to increase muscular retention of creatine, although no effect on performance measures may be no greater than CM alone.
• Quickest method of increasing muscle creatine stores appears to be to consume ~0.3 g/kg/day for 3 days followed by 3-5g/day thereafter (the typical loading phase associated with creatine).  Ingesting smaller amounts of CM (2-3g/day) will increase muscle creatine stores over 3-4 week period. Supposedly, the latter method on performance is less supported
• Creatine products are readily available  as dietary supplement and are regulated by FDA.
• CM has been reported to have number of potentially beneficial uses in several clinical populations, but more research is needed in these areas

The Myths

• All weight gained is due to water retention
• Creatine causes renal distress
• Creatine causes cramping, dehydration, and/or altered electrolyte status
• Long-term effects of creatine supplementation are completely unknown
• Newer creatine formulations are more beneficial than creatine monohydrate and cause fewer side effects
• It's unethical and/or illegal to use creatine

 Medical Safety of Creatine

     The only clinical significant side effect in research is weight gain.  There are so many anecdotal claims of dehydration, cramping, kidney, liver damage, musculoskeletal injury, gastrointestinal distress, and anterior compartment syndrome.  While this may happen to those supplementing with creatine, the scientific literature that those athletes have is no greater, and possibly lower at risk of these symptoms than those not supplementing with CM.  I can remember ABC doing a story on high-school football players that had to be put into the hospital during summer practices due to compartment syndrome.  ABC even went on to say that creatine is linked to compartment syndrome.  The truth is that  the students said they had not taken any supplements, yet the TV network still made allegations on creatine. The coach also had players training in 115 degree heat in the wrestling rooms (this was over a few days for camp), yet that was not a reason for the hospital visit? Staff incompetence? Of course not, just blame it on creatine.

     If you want to read the whole paper, which takes no more than 15 minutes, I highly recommend it to get the right facts down. Here it is: Creatine Supplementation Position Paper