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Is creatine a safe supplement?

Asked by Ralph, New York

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I am a 48-year-old man who weight trains four times a week. I am thinking about taking creatine. What is your thought on this supplement?

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Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer

Hi Ralph! Weight training four times a week is terrific. I hope that you are also getting regular aerobic exercise for cardiovascular health.

To answer your question, creatine monohydrate, the most extensively studied form of creatine, is considered the most effective supplement for athletes looking to increase lean body mass and as well as enhance muscular strength, power and endurance.

Despite a few widely publicized, but mainly anecdotal reports, of kidney or electrolyte abnormalities, hundreds of studies have found that it is safe in healthy individuals and may also be effective for people with certain medical conditions, including heart patients, and on some types of neuromuscular disease or orthopedic injury if taken at recommended doses.

Creatine is produced in the liver and pancreas from the amino acids arginine, glycine and methionine. The majority of creatine is stored in skeletal muscle as phosphocreatine and free creatine.

Phosphocreatine is a critical component of energy generation in the muscle. With intense exercise, levels are depleted and therefore the ability to exercise intensely diminishes.

By increasing the amount of phosphocreatine in the muscle, this should allow you to work the muscle harder and longer, thereby increasing your muscle gains.

Long-term supplementation has shown a 5% to 15% increase in strength and performance and double the gain in lean body mass compared to placebo. Dietary sources of creatine include meats and fish, but in order to consume effective quantities, large amounts would have to be consumed.

Therefore, if you are eating a healthy diet with adequate amounts of high quality protein and training regularly, creatine may be effective if your goal is to increase muscle mass or strength.

Many sports nutrition experts suggest "loading" for three to five days with 0.3 grams per kilogram per day followed by a maintenance dose of 3 to 5 grams per day. The loading phase is not essential but may allow you to see gains more quickly.

Research suggests that combining creatine with carbohydrate or carbohydrate plus protein produces optimal results by enhancing creatine uptake and retention. There are numerous other combinations under investigation.

Dr. Jose Antonio, CEO of the International Society of Sports Nutrition and professor at Nova Southeastern University in Davie, Florida, notes that one of the more promising for increasing lean body mass and strength is the combination of creatine and beta-alanine, a nonessential amino acid that has been shown to increase skeletal muscle carnosine. Increased muscle concentrations of carnosine have been shown to enhance anaerobic exercise performance.

In summary, when used correctly, creatine can be a safe and effective performance-enhancing supplement for athletes or fitness enthusiasts who are willing to do the accompanying physical work necessary to fully benefit.

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