Creatine Supplementation

Jul 5, 2024

Lecture Notes: Creatine Supplementation

Overview

  • Creatine is a commonly asked-about supplement with high confidence in both its safety and efficacy.
  • Ideal for powerlifting and bodybuilding due to performance and lean body mass benefits.
  • Minimal side effects, with some potential mild weight gain due to water retention.
  • Generally inexpensive despite recent price increases.

Physiological Role

  • **Creatine as a High Energy Phosphate Donor: **
    • Exists in muscle as phosphocreatine.
    • Donates phosphate to ADP to reform ATP, crucial for muscle contractions.
  • **Osmolyte Function: **
    • Pulls water into muscle tissue.
    • Potentially anabolic due to hydration state of muscle cells, improving contraction and function.

Safety and Efficacy

  • Extensively studied in randomized control trials with strong safety profile.
  • **Common Concerns: **
    • **Weight Gain: ** Due to water retention in muscles, not excess body fat.
    • **Renal Function: ** Elevation in serum creatinine not indicative of kidney damage; focus on cystatin C for accurate kidney function assessment.
    • **Hair Loss: ** Weak evidence from a single study in 2009 showing DHT increase.

Usage Guidelines

  • **Dosage Limits: ** Up to 5 grams per day is effective, with limited evidence supporting higher doses.
  • **Non-Lifting Days: ** Benefits seen even on non-lifting days; accumulation is key.
  • **Loading Phase: ** Rapid saturation of muscle cells with higher initial doses but with potential GI irritation. Long-term benefits seen with a consistent dose of 5 grams per day.
  • **Supplement Timing: ** Post-workout might be marginally better, but consistency in timing is more important.
  • **Cycling Off: ** No significant benefit; creatine levels remain stable. Continual use is recommended for maintaining benefits.

Misconceptions

  • **Liver Enzymes: ** Elevated levels from lifting do not signify liver damage.
  • **Kidney Concerns: ** Elevated creatinine levels in lifters do not indicate kidney damage; recommend cystatin C testing instead.
  • **Cycling Supplements: ** Unnecessary for creatine, unlike steroids. Benefits do not wane with long-term use.

Practical Takeaways

  • Creatine is a cornerstone supplement for its proven benefits and safety profile.
  • Ideal for increasing lean body mass, strength, and possibly cognitive functions.
  • Affordable and easy to incorporate into daily routines with minimal side effects.