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Over the past two decades, there has been much research conducted on the use of creatine supplementation as an ergogenic aid. The use of creatine has been widely accepted by the bodybuilding industry and is manufactured by various distributors under names such as the pill form (for example: Purple K) and as a powder (creatine monohydrate).  In a recent publication by Richard B. Kreider (2003), he states that over 500 research studies have been conducted to evaluate the use of creatine on muscle physiology, and exercise capacity and potential.

What is Creatine?

Creatine is a natural molecule that is found within all cells of the body.  It serves as an immediate energy source for the cell, primarily for muscle tissue.   How does creatine serve as an energy source for the body?

Phosphocreatine System

Energy within all cells is derived from the breakdown of adenosine triphosphate (ATP) to adenosine diphosphate (ADP).  The cleavage of a phosphate from ATP is an energy releasing reaction.  The amount of ATP within a muscle tissue is approximately 2-5nM, which would only allow for muscle contractions to occur for a few seconds.  Creatine increases the pool of available phosphate by binding to intracellular phosphates, creating a molecule known as phosphocreatine (PCr).  ATP is rapidly synthesized from ADP and PCr through a reversible reaction using creatine kinase (CK) to increase the amount of immediate energy available.  The concentration of PCr in skeletal muscle ranges from 20-35nM or more, thus increasing the amount of potentially available ATP for energy.  At the end of intense exercise, PCr is depleted by 80% of its initial resting value.  Furthermore, during the recovery phase, ATP and PCr levels return back to 80% complete after a 5 minute rest.

Below is a simple breakdown of the chemical process:

ATP → ADP + Pi

Pi + Cr ↔ PCr

ADP + PCr ↔ ATP + Cr

Creatine Supplementation

Creatine supplementation has been used as an ergogenic aid in sports by many athletes.  By definition, an ergogenic aid is a technique or practice that increases performance capacity, increases efficiency to perform work, improves quality of training, and improves recovery from exercise.  Does the current state of literature demonstrate that creatine possesses these characteristics?

Creatine supplementation has been shown to increase the availability of PCr and total creatine by about 15-40%, thus enhancing the phyosphocreatine system during high intensity exercise.  Past and present research has also shown that creatine supplementation can increase strength, power, and work performed over multiple sets of maximal effort.   Additionally, some studies have demonstrated a reduced amount of work decay between sets of maximal effort and short duration following short term supplementation. The majority of research supports the notion that creatine supplementation can improve athletic performance during short, high intensity intervals.  Therefore, creatine supplementation deserves the title of an ergogenic aid as it fits the definition quite nicely.

Training Adaptations

Not only does creatine supplementation improve performance, it can also increase maximal strength after 10 weeks training.  It has also been shown that it can increase body mass, fat free mass, and ones three repetition maximum.  Moreover, it can also slow the rate of decay of training adaptations during 10 weeks of ‘detraining.’

Many researchers believe that the initial weight gain associated with creatine supplementation is associated with increased water retention, however the review by Kreider (2003) illustrates that long term creatine supplementation increases fat free mass and muscle fiber diameter – without the increase in total body water, thus suggesting that the majority of weight gain is lean, fat free tissue – muscle.

Good Or Bad?

No clinically significant side effects were identified in this paper. However, some reported side effects from external sources include kidney and/or heart problems, muscle cramps, dehydration, and diarrhea.  Thus, it may be a good idea to get medical clearance from a medical professional before starting creatine supplementation to air on the side of caution.  The kidneys naturally filter creatine therefore it does not seem impossible that kidney problems may occur due to high initial amounts of creatine ingestion – Similar to having an excess amount of vitamins or minerals.

 In conclusion, creatine supplementation has been proven to work as an ergogenic aid for short, high intensity exercise and increase training adaptations such as increase fat free mass (muscle), decreased recovery time, decrease rate of detraining, and increased strength.

Reference

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