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Creatine: More than a Sports Nutrition Supplement
Although creatine offers an array of benefits, most people think of it simply as a supplement that bodybuilders and other athletes use to gain strength and muscle mass. Nothing could be further from the truth. A substantial body of research has found that creatine may have a wide variety of uses. In fact, creatine is being studied as a supplement that may help with diseases affecting the neuromuscular system, such as muscular dystrophy (MD). Recent studies suggest creatine may have therapeutic applications in aging populations for wasting syndromes, muscle atrophy, fatigue, gyrate atrophy, Parkinson's disease, Huntington's disease and other brain pathologies. Several studies have shown creatine can reduce cholesterol by up to 15% and it has been used to correct certain inborn errors of metabolism, such as in people born without the enzyme(s) responsible for making creatine. Some studies have found that creatine may increase growth hormone production. What is creatine? Creatine is formed in the human body from the amino acids methionine, glycine and arginine. The average person's body contains approximately 120 grams of creatine stored as creatine phosphate. Certain foods such as beef, herring and salmon, are fairly high in creatine. However, a person would have to eat pounds of these foods daily to equal what can be obtained in one teaspoon of powdered creatine. Creatine is directly related to adenosine triphosphate (ATP). ATP is formed in the powerhouses of the cell, the mitochondria. ATP is often referred to as the "universal energy molecule" used by every cell in our bodies. An increase in oxidative stress coupled with a cell's inability to produce essential energy molecules such as ATP, is a hallmark of the aging cell and is found in many disease states. Key factors in maintaining health are the ability to: (a) prevent mitochondrial damage to DNA caused by reactive oxygen species (ROS) and (b) prevent the decline in ATP synthesis, which reduces whole body ATP levels. It would appear that maintaining antioxidant status (in particular intra-cellular glutathione) and ATP levels are essential in fighting the aging process. It is interesting to note that many of the most promising anti-aging nutrients such as CoQ10, NAD, acetyl-l-carnitine and lipoic acid are all taken to maintain the ability of the mitochondria to produce high energy compounds such as ATP and reduce oxidative stress. The ability of a cell to do work is directly related to its ATP status and the health of the mitochondria. Heart tissue, neurons in the brain and other highly active tissues are very sensitive to this system. Even small changes in ATP can have profound effects on the tissues' ability to function properly. Of all the nutritional supplements available to us currently, creatine appears to be the most effective for maintaining or raising ATP levels. How does creatine work? In a nutshell, creatine works to help generate energy. When ATP loses a phosphate molecule and becomes adenosine diphosphate (ADP), it must be converted back to ATP to produce energy. Creatine is stored in the human body as creatine phosphate (CP) also called phosphocreatine. When ATP is depleted, it can be recharged by CP. That is, CP donates a phosphate molecule to the ADP, making it ATP again. An increased pool of CP means faster and greater recharging of ATP, which means more work can be performed. This is why creatine has been so successful for athletes. For short-duration explosive sports, such as sprinting, weight lifting and other anaerobic endeavors, ATP is the energy system used. To date, research has shown that ingesting creatine can increase the total body pool of CP which leads to greater generation of energy for anaerobic forms of exercise, such as weight training and sprinting. Other effects of creatine may be increases in protein synthesis and increased cell hydration. Creatine has had spotty results in affecting performance in endurance sports such as swimming, rowing and long distance running, with some studies showing no positive effects on performance in endurance athletes. Whether or not the failure of creatine to improve performance in endurance athletes was due to the nature of the sport or the design of the studies is still being debated. Creatine can be found in the form of creatine monohydrate, creatine citrate, creatine phosphate, creatine-magnesium chelate and even liquid versions. However, the vast majority of research to date showing creatine to have positive effects on pathologies, muscle mass and performance used the monohydrate form. Creatine monohydrate is over 90% absorbable. What follows is a review of some of the more interesting and promising research studies with creatine. Creatine and neuromuscular diseases One of the most promising areas of research with creatine is its effect on neuromuscular diseases such as MD. One study looked at the safety and efficacy of creatine monohydrate in various types of muscular dystrophies using a double blind, crossover trial. Thirty-six patients (12 patients with facioscapulohumeral dystrophy, 10 patients with Becker dystrophy, eight patients with Duchenne dystrophy and six patients with sarcoglycan-deficient limb girdle muscular dystrophy) were randomized to receive creatine or placebo for eight weeks. The researchers found there was a "mild but significant improvement" in muscle strength in all groups. The study also found a general improvement in the patients' daily-life activities as demonstrated by improved scores in the Medical Research Council scales and the Neuromuscular Symptom scale. Creatine was well tolerated throughout the study period, according to the researchers.1 Another group of researchers fed creatine monohydrate to people with neuromuscular disease at 10 grams per day for five days, then reduced the dose to 5 grams per day for five days. The first study used 81 people and was followed by a single-blinded study of 21 people. In both studies, body weight, handgrip, dorsiflexion and knee extensor strength were measured before and after treatment. The researchers found "Creatine administration increased all measured indices in both studies." Short-term creatine monohydrate increased high-intensity strength significantly in patients with neuromuscular disease.2 There have also been many clinical observations by physicians that creatine improves the strength, functionality and symptomology of people with various diseases of the neuromuscular system. Creatine and neurological protection/brain injury If there is one place creatine really shines, it's in protecting the brain from various forms of neurological injury and stress. A growing number of studies have found that creatine can protect the brain from neurotoxic agents, certain forms of injury and other insults. Several in vitro studies found that neurons exposed to either glutamate or beta-amyloid (both highly toxic to neurons and involved in various neurological diseases) were protected when exposed to creatine.3 The researchers hypothesized that "? cells supplemented with the precursor creatine make more phosphocreatine (PCr) and create larger energy reserves with consequent neuroprotection against stressors." More recent studies, in vitro and in vivo in animals, have found creatine to be highly neuroprotective against other neurotoxic agents such as N-methyl-D-aspartate (NMDA) and malonate.4 Another study found that feeding rats creatine helped protect them against tetrahydropyridine (MPTP), which produces parkinsonism in animals through impaired energy production. The results were impressive enough for these researchers to conclude, "These results further implicate metabolic dysfunction in MPTP neurotoxicity and suggest a novel therapeutic approach, which may have applicability in Parkinson's disease."5 Other studies have found creatine protected neurons from ischemic (low oxygen) damage as is often seen after strokes or injuries.6 Yet more studies have found creatine may play a therapeutic and or protective role in Huntington's disease7, 8 as well as ALS (amyotrophic lateral sclerosis).9 This study found that "? oral administration of creatine produced a dose-dependent improvement in motor performance and extended survival in G93A transgenic mice, and it protected mice from loss of both motor neurons and substantia nigra neurons at 120 days of age. Creatine administration protected G93A transgenic mice from increases in biochemical indices of oxidative damage. Therefore, creatine administration may be a new therapeutic strategy for ALS." Amazingly, this is only the tip of the iceberg showing creatine may have therapeutic uses for a wide range of neurological disease as well as injuries to the brain. One researcher who has looked at the effects of creatine commented, "This food supplement may provide clues to the mechanisms responsible for neuronal loss after traumatic brain injury and may find use as a neuroprotective agent against acute and delayed neurodegenerative processes." Creatine and heart function Because it is known that heart cells are dependent on adequate levels of ATP to function properly, and that cardiac creatine levels are depressed in chronic heart failure, researchers have looked at supplemental creatine to improve heart function and overall symptomology in certain forms of heart disease. It is well known that people suffering from chronic heart failure have limited endurance, strength and tire easily, which greatly limits their ability to function in everyday life. Using a double blind, placebo-controlled design, 17 patients aged 43 to 70 years with an ejection fraction MORE RESOURCES: Column | What the science says about multivitamins, magnesium and 7 other supplements The Washington Post Popular Supplement Under Fire: New Research Reveals That Creatine May Not Help Build Extra Muscle SciTechDaily NAD boosters: Kendall Jenner and Hailey Bieber are into them, but do they actually stop ageing? | Antiviral The Guardian Exclusive | I’m a longevity doctor — these peptides, supplements and treatments make me 5 years younger New York Post NFH Iron Dietary Supplement Bottles Recalled Due to Risk of Poisoning; Violation of Federal Regulation for Child Resistant Packaging; Imported by Nutritional Fundamentals for Health (NFH) U.S. Consumer Product Safety Commission (.gov) Mushroom-Powered Dietary Supplements Trend Hunter British chain specializing in dietary supplements, vegan food readies entry into Romanian market Romania Insider A New Study Says Taking This Supplement Every Day Could Slow Down Aging Good Housekeeping The Natural View: NOW's Commitment to Supplement Quality & Transparency WholeFoods Magazine ‘GLP-1-boosting’ supplement launched as drug alternative FoodNavigator.com NFH Iron Dietary Supplements Recalled For Poisoning Risk Food Poisoning Bulletin Nitric Boost Ultra Reviews (ALERT) Doctor Investigates the Truth Behind This Explosive Energy Supplement GlobeNewswire Viewpoint: ‘We're trapped in an increasingly dangerous supplement hell online, all thanks to politicians. And it's probably going to get worse’ Genetic Literacy Project 11 Things to Know About Supplements and Cannabis for Breast Cancer Breast Cancer.org World Autism Awareness Day 2025: Theme, Top Supplements Uses, Benefits For Managing Symptoms Netmeds Why these supplements might be ruining your gut health The Independent Struggling with hair thinning? This Nutrafol hair growth supplement is 25% off right now - USA Today A sugar reduction breakthrough for protein – infographic SupplySide Supplement Journal The Vitamin Shoppe unveils supplement line for GLP-1 users Drug Store News Kourtney Kardashian’s Lemme falsely advertises weight loss supplement, class action alleges Class Action Lawsuits 7 Ways Chondroitin Sulfate May Benefit Your Health Verywell Health Are Pre-Workout Supplements Safe? Verywell Health Revolutionary GLP-1 Support Supplements Hit Market: Vitamin Shoppe's Doctor-Approved Solution Stock Titan Administrative supplements: What’s allowable and what’s out of bounds National Institute on Aging (.gov) Do collagen, omega-3 and whey supplements help your bones? - University of California - Davis Health Do collagen, omega-3 and whey supplements help your bones? University of California - Davis Health NBA ‘real-world learning’ experience supplements the classroom State University of New York at Fredonia RFK Jr’s HHS showing mixed signals for dietary supplement sector SupplySide Supplement Journal GlucoTonic Reviews (DOCTOR INVESTIGATED): Is This Blood Sugar Breakthrough the Real Deal or Dangerous Hype GlobeNewswire What is magnesium good for? USA Today Hiya Touts Nixing Sugar Los Angeles Business Journal DHEA supplements: Are they safe? Or effective? Harvard Health CDC warns of Listeria outbreak linked to supplement shakes distributed in long-term care facilities Centers for Disease Control and Prevention (.gov) Are Apple Cider Vinegar Pills Healthy? Prevention Should I Take Senolytic Supplements? Cedars-Sinai From A to zinc: What to know about supplements Missouri State University Evaluating the health risk of probiotic supplements from the perspective of antimicrobial resistance ASM Journals Can Vitamin C and Zinc Actually Boost Your Immune System? The New York Times Omega-3s are great for your health—but supplements may not be National Geographic From Ashwagandha to St. John’s Wort: The Risks Behind 5 Trending Supplements MedShadow Foundation 10 best menopause supplements for 2025, tested by 100 menopausal women Good Housekeeping Mitolyn Reviews (MUST-READ): What 72,000+ Consumers Just Discovered About This Fat-Burning Formula In 2025 GlobeNewswire ‘You Are Not A Clean Guy’ The Liver Doc Accuses Bryan Johnson Of Scamming With Anti-Aging Supplement Mashable India Dr. Oz Became Famous Giving Health Advice. Was It Any Good? The New York Times Medical Compass: Does increased daylight mean you can pitch your vitamin D supplements? TBR News Media The Vitamin Shoppe® Unveils First-of-its-Kind Supplement Line Formulated for GLP-1 Users PR Newswire The future of wellness: nutrition and supplement trends to watch in 2025 South China Morning Post Opinion: Rules on supplements likely to loosen under Trump Harvard T.H. Chan School of Public Health Should teens use protein supplements? Michigan Medicine |
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