What’s the scoop on a scoop of creatine??
Runners are always looking for an edge. One only needs to look at the covers of running publications to see the eye-catching headlines: "more power!...run faster!...get more energy!..."and on and on. Via nutritional supplements, runners and other athletes hope to gain a physiologic performance benefit via increases in strength, power, endurance, and aerobic and anaerobic capacity, as well as a psychological lift.
The latest hot commodity in performance augmentation is creatine. This is a naturally occurring substance, intimately involved in energy production. The basic unit of energy currency is adenosine triphosphate, or ATP for short. ATP is a unique molecule that is capable of storing energy within its bond to one of its phosphate groups. When muscles, as well as other tissues in the body need energy, the source is ATP. The ATP molecule is cleaved of its phosphate, leaving adenosine diphosphate (ADP), and releasing energy in the process.
To recharge the ADP/ATP battery, ADP must be reloaded with phosphate, and ATP reconstituted. One very quick and effective way this is done within muscle tissue is via creatine-phosphate. Creatine is a substance synthesized in the liver from basic protein precursors. The creatine molecule donates a phosphate to ADP, thereby recreating ATP. Creatine is normally in limited supply, and dependent upon a protein-rich diet.
The current creatine craze is fueled by the rationale that one can increase performance by increasing muscle inventory of creatine. However, despite hundreds of web sites touting its "clear-cut" advantages and "low, low sale prices", the scientific literature provides conflicting data on this hypothesis, with studies both in support of and against demonstrable benefits. Suffice it to say, any benefits reported to date are most notable during high intensity, short duration activities, like sprinting. There is evidence that best results are noted in those athletes consuming low protein diets, vegetarians for instance. Furthermore, any derived benefits are likely to be tied to enhanced concurrent carbohydrate intake.
The recommended dosage schedule is a loading dose of 20-30 grams/day for one week, followed by ongoing doses of 10-15 grams/day. To get these amounts from one’s diet, one would have to consume the equivalent of ten pounds of raw steak per day for at least ten days.
Although creatine use has its proponents, and its utilization is probably widespread, its safety margin is unknown. Muscle cramping is common, and its use may increase musculoskeletal injuries. A real possibility of kidney damage exists, especially with inadequate hydration, a real concern in runners. There is a theoretical possibility of inhibition of natural synthetic pathways with ongoing long-term use. Late adverse effects are unknown. It is not recommended for use in the recreational athlete, especially in prolonged aerobic exercise activities, like running.
Suffice it to say that for this audience, creatine should be viewed with intellectual curiosity only. It is no substitute for proper training, rest and nutrition. The risk-benefit ratio is potentially high: i.e.- risk>>>benefit. For middle-distance and long-distance runners, it is probably useless, as the body favors other energy pathways. The search for short-cuts and an energy edge will not end with creatine. Beware of deals "too good to be true".
All of my essays are now available at "www.genufix.com". I welcome feedback and suggestions for future rantings at e-mail: "genufix@aol.com". I would be happy to share your tales of woe with fellow STC members on an anonymous basis as a lead-in to discussions of interesting running related injuries and problems. However, I cannot give specific individual advice over cyberspace. A proper evaluation always includes an exam and possibly imaging studies. Always remember that pain and disability should be evaluated if persistent and/or progressive. What may sound like a common and straightforward problem may be anything but in any individual case. Don’t forget common sense. Happy and healthy running!
Dan Wnorowski, M.D.