**Creatine Safety**

[hepennypacker52]

This thread is for everybody who questions whether or not creatine is safe or not (especially teen safety, there's a lot of threads about that). This thread will also take parts from the Creatine Facts thread by FortifiedIron. Here we go...

Effects of Long Term Creatine Use

Long Term Creatine Use
Is creatine safe?

Title: Effects of Long-term Creatine Supplementation on Liver and Kidney Functions in American College Football Players.

Researchers: Mayhew DL, Mayhew JL, Ware JS

Institution: Exercise Science Program at Truman State University, Kirksville, MO 63501 and the Athletic Department at Truman State University, Kirksville, MO.

Summary: The purpose of this study was to determine the effect of long-term Cr supplementation on blood parameters reflecting liver and kidney function.

Methods: Twenty-three members of an NCAA Division II American football team (ages = 19-24 years) with at least 2 years of strength training experience were divided into a Cr monohydrate group (CrM, n = 10) in which they voluntarily and spontaneously ingested creatine, and a control group (n = 13) in which they took no supplements. Individuals in the CrM group averaged regular daily consumption of 5 to 20g for 0.25 to 5.6 years. Venous blood analysis for serum albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, bilirubin, urea, and creatinine produced no significant differences between groups.

Results: Creatinine clearance was estimated from serum creatinine and was not significantly different between groups. Within the CrM group, correlations between all blood parameters and either daily dosage or duration of supplementation were nonsignificant.

Conclusion: Oral supplementation with CrM has no long-term detrimental effects on kidney or liver functions in highly trained college athletes in the absence of other nutritional supplements.

Discussion: Questions about creatine's safety are probably the most frequently brought up by people who don't like (and usually don't understand) supplements. This study by Mayhew and colleagues is a welcome addition to the already growing body of creatine safety research. (1,2,3,4,5,6,7)

Most questions revolve around the effects of creatine supplementation on the liver and kidney. These are the two organs are involved in "processing" creatine once it is ingested. The Liver breaks it down and the kidneys excrete it. >From this study, and others before it, we see that long term supplementation with creatine in doses usually taken by bodybuilders (5-20 grams) for extended periods of time do not lead to dysfunction of either organ, nor does it cause abnormalities in the indicators of liver and kidney function.

Considering that fact that creatine supplementation has been shown to enhance anaerobic exercise performance by increasing power output (8), muscular strength and work (9,10,11), and muscle fiber size (12), and to top it off, completely safe even with long term supplementation, its no wonder this is one of my first tier recommendation for effective and safe supplements for putting on muscle size.



Additional References:


1: Poortmans JR, Auquier H, Renaut V, Durussel A, Saugy M, Brisson GR. Effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol Occup Physiol. 1997;76(6):566-7.

2: Poortmans JR, Francaux M. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc. 1999 Aug;31(8):1108-10.

3: Terjung RL, Clarkson P, Eichner ER, Greenhaff PL, Hespel PJ, Israel RG, Kraemer WJ, Meyer RA, Spriet LL, Tarnopolsky MA, Wagenmakers AJ, Williams MH. American College of Sports Medicine roundtable. The physiological and health effects of oral creatine supplementation. Med Sci Sports Exerc. 2000 Mar;32(3):706-17.

4: Robinson TM, Sewell DA, Casey A, Steenge G, Greenhaff PL. Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function. Br J Sports Med. 2000 Aug;34(4):284-8.

5: Poortmans JR, Francaux M. Adverse effects of creatine supplementation: fact or fiction? Sports Med. 2000 Sep;30(3):155-70.

6: Schilling BK, Stone MH, Utter A, Kearney JT, Johnson M, Coglianese R, Smith L, O'Bryant HS, Fry AC, Starks M, Keith R, Stone ME. Creatine supplementation and health variables: a retrospective study. Med Sci Sports Exerc. 2001 Feb;33(2):183-8.

7: Benzi G, Ceci A. Creatine as nutritional supplementation and medicinal product. J Sports Med Phys Fitness. 2001 Mar;41(1):1-10.

8: Earnest CP, Snell PG, Rodriguez R, Almada AL and Mitchell TL (1995) The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition. Acta Physiol Scand 153: 207-209

9: Casey A, Constantin-Teodosiu D, Howell S, Hultman E and Greenhaff PL (1996) Creatine ingestion favorably affects performance and muscle metabolism during maximal exercise in humans. Am J Physiol 271: E31-E37

10: Vandenberghe K, Goris M, Van Hecke P, Van Leemputte M, Vangerven L and Hespel P (1997) Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 83: 2055-2063

11: Volek JS, Duncan ND, Mazzetti SA, Staron RS, Putukian M, Gomez AL, Pearson DR, Fink WJ and Kraemer WJ (1999) Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc 31: 1147-1156

12: Volek JS, Duncan ND, Mazzetti SA, Staron RS, Putukian M, Gomez AL, Pearson DR, Fink WJ and Kraemer WJ (1999) Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc 31: 1147-1156

[hepennypacker52]

Creatine and Side Effects


This is clearly the most frequently asked question about creatine. Understandably, the risks associated with the use of creatine monohydrate concerns many. Numerous side effects have been attributed to creatine use. Some of these side effects have been substantiated in the scientific literature while other side effects have not. Most of the side effects associated with creatine have to do with its propensity to draw water into body compartments where it is located, namely the intestine and skeletal muscle. As a result dehydration is a real concern while supplementing with creatine. Drink at least 1 ounces of water per pound of bodyweight while taking creatine.

Is creatine safe for women, children, the pregnant or the elderly?

Children:
Whether creatine is safe for children (preadolescents) is our secondly most frequently asked question. Naturally, what are creatine's side effects is the first. Since the long-term consequences of creatine supplementation are not well understood, it is best to avoid supplementation during childhood. Furthermore, a recent panel of creatine experts has concluded that creatine may be less effective children.

Elderly:
Interestingly, this same panel of experts also suggested that creatine may be less effective in the elderly (greater than 70 years of age). Changes in muscle fiber composition (or mass) may underlie any difference in creatine-sensitivity in the elderly.

Women:
The vast majority of creatine studies have been conducted on males between the ages of 18 and 35 years old. Nevertheless, a couple of studies have also demonstrated enhanced exercise performance in women supplementing with creatine, which actually makes sense since creatine's basic mechanism of action wouldn't be expected to differ in women. Nevertheless, differences do exist in how creatine benefits men and women.

Pregnancy:
Since it is not known whether creatine levels increase in breast milk following supplementation, creatine use should be avoided in nursing women.

Volumizing:
Weight gain is the most commonly reported creatine side effect. As much as 3 kilograms (6.6 pounds) of increased weight within the first few weeks has been reported in response to creatine use. This is due mainly to the movement of water from the blood into skeletal muscle. This form of muscle growth has also been termed Volumizing because of the increase in muscle volume that ensues. This side effect may be beneficial in certain sports such as, body building, but be less desirable in other sports such as, distance running or other endurance sports. Also see dehydration.

Dehydration:
It's imperative to remain well-hydrated while taking creatine. This concern is valid since much of our body water follows creatine into skeletal muscle, possibly depriving our remaining tissues of fluid. As a consequence urine output often decreases during creatine supplementation. Down the road this may lead to impaired thermoregulation and subsequent heat exhaustion, especially if training heavily in hot environments. This precaution is especially important in combative sports (in particular, wrestling) where athletes strive to make weight before competition. Weight loss under these circumstances is often achieved through fluid restriction which, in combination with creatine use, could lead to excessive dehydration.

Gastrointestinal Distress:
Reports of gastrointestinal distress, stomach cramps, nausea and diarrhea have also been attributed to creatine use, especially when taken in large doses. These side effects are most likely due to undissolved creatine drawing water into the intestine and can often be circumvented by completely dissolving creatine in at least 16 ounces of water or juice. The large amounts of sugars often taken with creatine may also complicate gastric emptying. These side effects are rarely observed when taking smaller doses of creatine.

Muscle strains, cramps and tears:
There have been reports of muscle pulls, strains and cramps following creatine use. These injuries may be related to an electrolyte imbalance as a result of dehydration. Drink plenty of fluids while taking creatine!

Renal Stress:
There is also some concern that creatine supplementation may place undue stress on the liver and kidneys. These concerns are most valid when creatine is taken is large quantities. For example, during the loading phase. Under these conditions the kidneys would have to work harder to clear unabsorbed creatine from the blood stream; there is much more creatine in the urine of person's consuming large amounts of creatine. Persons with pre-existing kidney disorders should probably abstain from creatine use.

Blood Pressure:
There was some concern that the fluid retention as a result of creatine use could increase a person's blood pressure. This issue was recently a topic of a scientific study that found that blood pressure did not increase following 5 days of creatine use.

Cholesterol and Protein Synthesis:
Creatine may have some positive side effects. For example, creatine may improve our cholesterol levels independently of its effect on exercise. In addition, volumizing may in itself stimulate the production of new muscle proteins. Both these effects, however, need to be further substantiated by additional scientific research.

Rumors:
There are many misconceptions and rumors surrounding creatine use. Most of these stem from creatine being wrongly associated with hormonal means of increasing muscle mass. These unsubstantiated side effects include breast formation in men, a reduction in penis size, hair loss in men, hair growth in women and stunted growth in children. Unexplained incidences of aggression and acne have also been linked to creatine use. Furthermore, some of these unexplained side effects may arise from other agents taken with, or in addition to, creatine. To reiterate, creatine increases exercise performance at the level of muscle energetics. Creatine does not substantially alter hormone levels to induce muscle growth, such as is the case with anabolic steroids.

Long term consequences of creatine use?
Since it is a realtively recent practice very little is known of the long term consequences of creatine use. However, some of its alleged side effects may have long term ramifications, especially at the elevated doses typically prescribed for athletics. For example, the time required for transporter function to fullly recover after prolonged exposure to elevated creatine levels is simply not known for humans. This is why creatine we do not advise creatine use for children or pregnant women (see ABOVE).

There are, however, clinical situations for which low doses of creatine have been used over a period of years with no signs of adverse side effects. For example, Gyrate Atrophy is a disease of the eye (retina) that is characterized by progressive narrowing of the visual fields. A secondary component of the disease is a deficiency in creatine synthesis. Consequently, this disease is also characterized by a reduction in the size of fast muscle fibers (see Question #5). Creatine supplementation has been shown to alleviate the muscular symptoms associated with this disease although the visual symptoms persist. Of interest to us; other than mild weight gain, low doses of creatine (1.5 grams/day) when administered for the duration of a year produced no obvious adverse effects.

Does creatine cause cancer?
There has recently been alot of talk about the possible risk of creatine causing cancer. The concern arises from the fact that certain cancer causing agents (AIAs) are produced when meat is cooked at high temperatures. The production of these cancer causing agents correlates with the initial creatine (and creatinine) content of the meat; meats with higher creatine content produce more of these cancer causing agents when cooked. It has thus been hypothesized that by increasing our muscle creatine content, we also increase our chances of getting cancer. It remains, however, to be clearly demonstrated that these same cancer causing agents are produced within the animal under physiological conditions. In other words, in an animal that isn't cooked this effect of creatine may not be manifested.

Finally, since creatine increases the growth rate of some types of tumor cells, it has been suggested that creatine may increase our chances of getting cancer. However, other experiments shows no effect of creatine on tumor cells. Whether creatine has a similar effect on normal cells is still an open issue.

Is it true that creatine might help those with Muscular Dystrophy?
Creatine has been used in clinical trials for several classes of Muscular Dystrophy. Our muscles can become weakened as a result of injury or disease. This is the case for several forms of Muscular Dystrophy. Although creatine would not be expected to cure Muscular Dystrophy, creatine supplementation may improve the quality of life of persons experiencing muscle weakness as a result of these diseases. In fact, preliminary studies have indicated that creatine supplementation improves strength in those inflicted with certain forms of Muscular Dystrophy as well as other Neuromuscular disorders. For more information see the Muscular Dystrophy Association's "Answers to frequently asked questions about creatine".

[hepennypacker52]

VIII. CREATINE SIDE EFFECTS: An interview with Professor Jacques R. Poortmans

Background
Dr. Jacques Poortmans of the Free University of Brussels in Belgium is one of the world's foremost creatine experts. His articles examining the consequences of creatine supplementation have appeared in many of the premier sport medicine journals. For this issue of the Creatine Newsletter I was fortunate to be able to interview Dr. Poortmans. I’m sure you’ll find it as enlightening as I did.

NSN: A common concern is that creatine supplementation places undue stress on renal function. Is there any truth to this?

JRP: No, as long as renal functions are normal before any creatine supplementation. We, and others, have given published evidences that in healthy individuals short-term, medium-term and long-term oral creatine monohydrate supplements are safe for the kidney. Of course, one has to be certain that the product is PURE (by analysis) since there are, apparently, many commercial products which do not satisfy the quality imposed by the FDA.

NSN: It is known that creatine absorption by our muscles decreases dramatically after a week of loading and that afterwards most of the ingested creatine is cleared from the body by the kidneys. Given this information, is there harm any in extending the loading phase past one week?

JRP: No, if one respects the loading doses: about 20 grams per day for 5 days and thereafter a 2-3 gram doses per day. One has to know that about 60% of the ingested doses are not taken up by the muscles and are cleared into the urine. What a waste of money!

NSN: What effect does creatine monohydrate have on liver function?

JRP: None. Again, we and others did not observe any impairment of liver tests after oral creatine supplements in healthy subjects (men and women).

NSN: Who should avoid creatine use? Diabetics who are predisposed to renal complications, for example?

JRP: Certainly those patients as well as anyone suffering from ANY kidney impairment. Heavy creatine supplements still remain an extra load on the renal filtration process.

NSN: Is taking creatine with protein a mistake?

JRP: Recent investigations by us and another research team did not observe a difference between creatine alone or creatine protein as far as muscle composition is concerned. What seems important is to provide enough daily protein intake (about 1.2-1.3 g/kg body weight, no more) to sustain protein synthesis.

NSN: I often get asked about secondary sexual side-effects associated with creatine use. As far as you know is there any basis for this concern?

JRP: There is no reason to believe that there is a relationship between creatine and sexual behavior (or capability). But, as usual, it might be of some help for those who sentimentally believe in anything. However, as said before, be careful with the purity of the product. We know that some commercials add anabolic steroids to creatine. This conduct cannot be tolerated. Excess anabolic steroid substances can have negative effects on sex and general health care

[hepennypacker52]

Adverse Effects - (from here)

Anecdotal reports have linked creatine supplementation with cramping,
dehydration, diarrhea, and dizziness.[2] The Food and Drug Administration
(FDA) has warned consumers to consult a physician before beginning creatine
supplementation.[10] The Association of Professional Team Physicians has
cautioned that creatine may cause dehydration and heat-related illnesses,
reduced blood volume, and electrolyte imbalances,[64] and some athletes drink
large quantities of water hoping to avoid such effects.[2] Creatine is known
to be osmotically active, so that higher intracellular creatine levels may
redistribute body water from extracellular fluids or from the general
circulation into muscle cells.[46] Judging from the short-term clinical
trials performed to date, however, creatine appears to be well tolerated.
No adverse effects were noted in clinical trials, although many trials
reported increased body mass in the subjects receiving supplementation.9,11,12
,14,16,21,30,38,40,43,44,46,48,50,51,54,57,63 It was previously hypothesized
that weight gain observed in subjects using creatine might result from an
increased rate of contractile protein synthesis,[12] but most researchers now
agree that the additional body weight results from water retention. Hultman
and colleagues[65] reported significant reductions in urinary output in the
initial stages of creatine supplementation. Other researchers have reported
increases in skeletal muscle volume, total body water, and intracellular
fluid volume after a few days of supplementation. The weight gain observed
ranged from 0.7 to 2.0 kg following 5 to 14 days of supplementation.[10] This
much weight gain may hinder athletes engaged in endurance sports.
Creatine is broken down and excreted by the kidney as creatinine. Creatine
supplementation has been shown to increase 24-hour creatine, creatinine, and
urate concentrations.[66] At least one study has found that creatine
supplementation increased serum creatinine levels significantly, although
levels remained between 1 and 1.5 mg/dL, a normal range for people undergoing
intense physical training.[11] The lack of any adverse renal effects in
clinical trials to date suggests that subjects with normally functioning
kidneys can eliminate the increased creatinine load that results from
creatine supplementation; however, some experts have warned that long-term
creatine use could decrease kidney function, and recent case reports[67,68]
suggest that not all patients are able to sufficiently process excess
creatinine.
The April 25, 1998, issue of the Lancet[67] reported a case of renal
dysfunction following creatine use. The patient was a 25-year-old man
receiving cyclosporine for steroid-resistant focal segmental
glomerulosclerosis. Although his cyclosporine levels had been stabilized
within the therapeutic range, his renal function declined between
appointments in June 1997 and mid-October 1997. Between the two dates, serum
creatinine concentrations increased from 1.2 mg/dL to 1.8 mg/dL, with a
corresponding decrease in creatinine clearance from 93 mL/minute to 61
mL/minute. The patient denied use of nephrotoxic medications, but reported
initiating creatine supplementation with a loading dose of 5 grams 3 times
per day for 1 week, and a maintenance dose of 2 grams per day. Renal function
returned to baseline 1 month after creatine supplementation was discontinued.
A second case report[68] describes interstitial nephritis in a previously
healthy 20-year-old man using creatine. The patient had begun using 5 grams
of creatine 4 times per day approximately 4 weeks prior to the onset of
symptoms. He presented to the hospital with a 4-day history of nausea,
vomiting, and bilateral flank pain, and was found during physical exam to be
dehydrated and experiencing diffuse abdominal tenderness. Laboratory studies
revealed a serum creatinine level of 1.4 mg/dL, and 4+ protein and 1+ blood
in the urine. While the patient was hospitalized and treated with pain
medications and intravenous fluids, his blood pressure rose from 140/90 to
160/100 mm Hg, his serum creatinine reached a peak of 2.3 mg/dL, and his
urinary protein excretion was 472 mg per day. Renal biopsy demonstrated acute
focal interstitial nephritis and focal tubular injury. The patient's
laboratory values and symptoms eventually normalized.
The studies included in this review reported no serious adverse effects, but
few included a mechanism for formally assessing adverse effects, and they all
involved short-term administration to young, healthy volunteers. It is not
known what effects may be produced in other patient populations. Derek Bell
from the Houston Astros was hospitalized twice in 1998 for renal dysfunction,
and has publicly blamed creatine for his ailments.[1] It cannot be stated
unequivocally that creatine is harmful to the kidney, but until the
relationship is clarified it would be prudent to avoid creatine
supplementation in all patients with impaired renal function and to advise
patients to seek medical attention immediately if they experience flank pain,
hematuria, nausea, or vomiting while using creatine.
There are no controlled toxicology studies using the doses recommended to
enhance athletic performance. In fact, although most creatine manufacturers
recommend loading with 20 to 30 grams per day for 5 to 7 days and then
cutting back to a maintenance dose of 2 grams per day, some athletes choose
to "mega-dose" creatine. Brady Anderson of the Orioles told reporters that he
uses 10 times the recommended dose.[1] Yet, even the maintenance dose
recommended by manufacturers has not been proven safe for long-term use.
All nutritional supplements carry a risk of contamination with impurities,
because their manufacturers are not bound by the same manufacturing practices
that FDA requires for drugs. The high doses recommended for creatine
supplementation, and the even higher doses used by some individuals, could
increase exposure to a toxic impurity.[8] Contamination, like that reported
with tryptophan and 5-hydroxytryptophan, is possible. Unsubstantiated reports
on the Internet claim that some creatine products are contaminated with
dicyandiamide and dihydrotriazine, which have unknown effects,[69] and others
claim that some creatine powders are mixed with baking soda, or certain
impurities such as rat hairs.[2] Studies should investigate whether
contamination causes adverse effects.

Conclusion

Although many trials have studied the effects of creatine, high-quality
research is lacking. Studies have employed very small sample sizes and
produced variable results. Furthermore, the results observed in highly
trained athletes cannot necessarily be extrapolated to the general public. It
is also not clear whether individual variations in baseline creatine levels
affect the efficacy of supplementation. Little information exists on the
short-term or long-term safety of creatine. Drug interactions with most
supplements, including creatine, have not been studied.
Commercially marketed creatine supplements do not meet the same rigid
quality control standards as pharmaceuticals, because they follow looser
DSHEA rules. Therefore, it is difficult to apply efficacy and safety results
from published trials to general practice. The dose delivered by a
commercially available product may be more or less than that suggested by the
labeling. This could influence the effectiveness of creatine. The lack of
adequate quality control could result in impurities in creatine supplements,
which could lead to unexpected adverse effects.
Although creatine is becoming increasingly popular, the evidence of its
benefits is limited at best. Large-scale, well-controlled studies must show
the positive effects of creatine supplementation before pharmacists can
recommend it. Patients should understand that based on its mechanism of
action, creatine may possibly enhance their performance of high-intensity,
short-duration (i.e., < 60 seconds) exercise such as sprinting or
power-lifting, but that benefits have not been proven in the clinical trials
to date. Patients engaged in endurance sports should know that there are few
data supporting creatine use for lower-intensity, longer-duration exercises,
and that the weight gain associated with creatine supplementation may be
detrimental to their performance. Pharmacists should advise patients to
consult with their physician before beginning creatine supplementation, and
to immediately report adverse effects, such as nausea, vomiting, dizziness,
or flank pain. Because of the potential risks and the questionable benefits,
pharmacists should warn patients with renal dysfunction to avoid creatine
supplements. If consumers choose to use creatine supplements, they should be
counseled on the variable efficacy data and the unknown risks of toxicity.
The authors declare no conflicts of interest or financial interests in any
product or service mentioned in the manuscript, including grants, employment,
gifts, and honoraria.

[hepennypacker52]

(cont'd from above)

Table 1. Studies of Creatine's Effects on Isotonic Exercise, Isokinetic Torque, and Isometric Force

Reference No.
Subjects Design Dose/Duration Outcome Variables Results
Effects on isotonic exercise
14 34 RDBPC 3 g/day x 14 days VJ, lower body strength, bench press 1-RM
+
(VJ)a
15 20 RDBPC 25 g/day x 7 days Elbow flexion torque 0
16 36 RDBPC 0.3 g/kg/day x 42 days VJ 0
17 24 RDBCP 10.5 g/day x 51 days Bench press 1-RM, VJ 0
43 23 DBPC 20 g/day x 7 days Bicep curl 1-RM +
44 8 RDBPC 20 g/day x 14 days Bench press 1-RM, reps at 70% 1-RM +
45 18 RPC 20 g/day x 6 days Knee extension, CEW +
(eccentric)a
46 14 RDBPC 25 g/day x 7 days Jump squat 10-RM +
Effects on isokinetic torque
15 20 RDBPC 25 g/day x 7 days Shoulder rotation velocity, CEW 0
18 9 RDBPCX 40 g/day x 6 days Voluntary contractions +
19 20 RDBPC 20 g/d x 4d, 5 g/day x 10 days Elbow flexion power 0
45 18 RPC 20 g/day x 6 days Knee extension, CEW +
47 12 RDBPC 20 g/day x 5 days Voluntary contractions +
(peak torque)a
Effects on isometric force
18 9 RDBPCX 40 g/day x 6 days Static quadriceps force production 0
20 5 SGRM 5 g/day x 14 days Grip strength +
48 7 RDBPCX 20 g/day x 5 days Ankle extensions +
49 10 DBPCX 10 g/day x 5 days Voluntary contractions +

CEW = concentric and eccentric work; DB = double blind; g = grams; PC =
placebo controlled; R = randomized; RM = repetition maximum; SGRM =
single-group repeated measures; VJ = vertical jump; X = crossover; + =
positive results; 0 = no differences.

[hepennypacker52]

The Safety of Creatine

In this article we look at the issue of safety and creatine. We will review potential short term and long term side effects. Everyone should read The Beginners Guide To Creatine before starting this article


Is creatine dangerous?
This is the question we will examine in this article. We will make one very basic assumption throughout this article - you are not abusing creatine. By this we mean you are taking or thinking about taking creatine within the recommended dosage (described in the Dosage article). This is an important distinction to make, because anything can become dangerous if you take to much of it. Vitamin C can have very harmful effects if you take too much of it - but that does not mean it is unsafe.

So, for the rest of this article when we discuss potential side effects and safety we will assume that you are taking the recommended dosage of creatine.

Are there any short term side effects of creatine?
There have been hundreds of studies done on creatine that all show that it is a safe supplement. There are really very few side effects reported with creatine use but they include: upset stomach, muscle cramping, diarrhea and dehydration. Most of these side effects can be minimized by drinking plenty of water when taking creatine. In addition, people tend to have more side effects when taking the powder as opposed to a more direct delivery method like serum or effervescent powder.

It is important to understand that creatine does not effect your hormone levels. This means you do NOT get side effects like bad skin and mood swings. It is also important to note that everyone is different. While 95% of the people may have no problems with creatine - it may just really bother your stomach. In the end if you find that creatine causes you problems then it makes sense not to take it.


Are there any long term side effects of creatine?
This is the most hotly debated question out there. We touch on this in our article on Teenagers and Creatine. The problem is there have not been enough long term studies done on creatine use as a supplement. With a lack of clear data people tend to speculate and that leads to controversy.

Many scientist agree that when taken within normal dosage, creatine in theory should pose no long term health risks. On the other hand, other people like to have data saying that it has been tested over a long period before they will say it is safe. They will point to the fact that no study has studied creatine use for over 3 months. Luckily that is all changing now.

On November 12, 1999 at the 19th Annual Southwest American College of Sports Medicine Meeting, two long term creatine studies were presented from the Exercise & Sport Nutrition Lab at the University of Memphis*. Both studies showed that 9 months of creatine supplementation (taking an average of 5 grams per day) in athletes had no negative effects on markers of renal function or muscle and liver enzymes in comparison to athletes not taking creatine.

* Here are the actual studies referenced above

1.Kreider R, Rasmussen C, Ransom C, Melton C, Greenwood M, Stroud T, Cantler E, Milnor P, Almada A, Greenhaff P. Long-term creatine supplementation does not affect markers of renal stress in athletes.
2.Almada A, Kreider R, Ransom J, Melton C, Rasmussen C, Greenwood M, Stroud T, Cantler E, Milnor P, Earnest C. Long-term creatine supplementation does not affect muscle or liver enzyme efflux in athletes.


In fact some studies have shown that creatine can help reduce your chances of heart disease and adult on-set diabetes. It was found that after 51 days of taking creatine the study group had a 22% decrease in VLDL-cholesterol levels and a 23% decrease in blood triglyceride levels. VLDL-cholesterol and triglycerides are risk factors for heart disease and adult on-set diabetes.

We make this point to show that as more studies are done it may be that more benefits of creatine are discovered. Studies don't always just show negative long term effects. A classic example of this has been the recent discoveries with alcohol. New studies show that 2 drinks a day can have very beneficial effects in reducing your chance of heart disease. Of course, like creatine - if you abuse alcohol it can have negative effects.


So, are you guaranteeing that creatine is safe?
Of course not - there are only two guarantees in life - death and taxes. New studies are being done all the time. The best we can do is operate with the data we have in front of us. Your decision on whether to take creatine should be done with your doctor. It may be that you have an existing condition that could be harmful if you took creatine. You may be taking a drug that would have a negative interaction with creatine. There are many variables that come into play.

In the end, everyone can interpret studies in a different way. From our view, nothing is out there to indicate that creatine has long term negative effects. Everyone is entitled to their own opinion - but that is the way we feel.


What is this I hear about liver and kidney damage with creatine?
This can be a problem if you abuse creatine. Any creatine your body does not use is excreted as a waste product called creatinine. If you take 20 grams a day of creatine - your body will not be able to use most of it and will have to excrete the excess. Over time this constant excretion of creatinine can put a lot of work on your kidneys and liver. If you force them to work to hard that can lead to serious problems.

Is creatine safe for teenagers to take?
Please read our our article on Teenagers and Creatine.

Is one form of creatine safer than another?
Not really. It is true that you need to take less creatine when using a creatine serum over a creatine powder - so this helps minimize any excess work by the liver and kidneys. In that way, serum can be safer. In the end, you want to be able to take the smallest amount possible and still achieve positive effects. If one form has a better absorption rate, than you need to take less creatine - and this can help further minimize any potential risk.

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Safety Considerations

Creatine can be used safely by all adults. [6] A person diagnosed with hypertension (high blood pressure) is advised to consult a health care professional before starting any exercise program, whether or not it includes creatine supplementation.

There is no known level of toxicity. Because the human body and human muscles limit maximum levels of creatine, supplementation of large doses (for example, above 20 grams per day) will be readily eliminated through urinary excretion. Occasional side-effects among some individuals have been noted, such as headaches.

Clinical tests are available for determining creatinine levels as a measure of kidney function, where the normal readings are 0.6 to 1.3 per 100 cc of serum. [7] A harmless side effect of creatine supplementation is increased creatinine levels in urine, which can give a false positive result for some tests of kidney problems. Similar false-positive results are found with vitamin C supplementation. Within a few days after creatine supplementation is stopped, the creatinine levels in the muscle, blood, and urine return to normal levels, resulting in normal test results. Creatinine tests also are useful in determining proper levels of glutathione (GHS) in an individual. [8]

When taking creative supplements, individuals should increase their daily consumption of water to 10 to 12 eight-ounce glasses. The consumption of coffee (a diuretic) seems to hinder creatine's effectiveness.

References

[1] Klatz, D.O., Ronald with Kahn, Carol, Grow Young with HGH (New York: 1997, HarperCollins Publishers, Inc.), page 270. ISBN 0-06-018682-8

[2] Powers, S.K. and Howley, E.T., Exercise Physiology: Theory and Application to Fitness Performance (Burr Ridge, IL: 1994, Brown and Benchmark Publishers, a division of McGraw-Hill). ISBN 0697126579.

[3] European Journal of Applied Physiology, 1994, pages 268-76, cited in Cooper, M.D., M.P.H., Kenneth H., Advanced Nutritional Therapies (Nashville: 1996, Thomas Nelson, Inc. Publishers), page 188. ISBN 0-7852-7302-6

[4] Clark, Ph.D., ATC, J.F., Dept. of Biochemistry, University of Oxford, "Creatine Monohydrate: A Review of Its Uses in Sport" (revised July 18, 1997) at http://www.netstorage.com/hon/summary.html

[5] Derived from the works by Pierre Dahl (nutritionist at the Nutrition and Soft Tissue Center in Stockholm, Sweden) and Professor Hultman (at Huddinge Hospital in Stockholm, Sweden) as cited in Smeets, Mark, "Creatine FAQ" website (updated June 17, 1996) at http://193.171.51.226/opul/crfaq.htm

[6] Lamm, M.D., Steven and Couzens, Gerald Secor, Younger at Last: The New World of Vitality Medicine (New York: 1997, Simon & Schuster), pages 211-12. ISBN 0-684-83438-3

[7] Pearson, Durk and Shaw, Sandy, Life Extension: A Practical Scientific Approach (New York: 1980, Warner Books), page 452. ISBN 0-446-38735-5

[8] Pressman, D.C., Ph.D., C.C.N., Alan H. with Buff, Sheila The GSH Phenomenon: Nature's Most Powerful Antioxidant and Healing Agent (New York: 1997, St. Martin's Press), page 50. ISBN 0-312-15135-7

[hepennypacker52]

CONTRAINDICATIONS, PRECAUTIONS, ADVERSE REACTIONS

CONTRAINDICATIONS
Creatine is contraindicated in those with renal failure and renal disorders such as nephrotic syndrome.

PRECAUTIONS
Creatine supplements should be avoided by children, adolescents, pregnant women, nursing mothers and anyone at risk for renal disorders such as diabetics. Those taking creatine should have serum creatinine levels monitored.

ADVERSE REACTIONS
The deaths of three American college wrestlers had been linked to the use of creatine supplements. However, results of post mortem tests led to the conclusion that the deaths were caused by severe dehydration and renal failure, and were not due to creatine. Apparently, the wrestlers were trying to lose enough weight through perspiration to allow them to compete in lower-weight classes. Typical adverse effects are gastrointestinal and include nausea, diarrhea and indigestion. Also common are muscle cramping and strains. Weight gain may occur from water retention. During a five day loading period, weight gains of 1.1 to 3.5 pounds have been reported. There are reports of elevated serum creatinine, a metabolite of creatine and a marker of kidney function, in some who take creatine and have normal renal function. This is reversible upon discontinuation of creatine.

Anecdotal reports of adverse events to FDA have included rash, dyspnea, vomiting, diarrhea, nervousness, anxiety, migraine, fatigue, polymyositis, myopathy, seizures and atrial fibrillation.

INTERACTIONS
There are as yet no known drug, nutritional supplement or herb interactions. Caffeine (in coffee, tea and caffeinated beverages) appears to interfere with any beneficial effects of creatine supplementation.

DOSAGE AND ADMINISTRATION
The typical form of creatine available is a creatine monohydrate powder.

The dosing for those who use creatine to attempt to improve performance in brief, high-intensity activities, is a loading dose of 20 grams or 0.3 grams per kilogram in divided doses four times a day for two to five days, followed by a maintenance dose of no more than 2 grams daily or 0.03 grams per kilogram. Those who use creatine supplements should take them with adequate water, six to eight glasses per day.

LITERATURE
Feldman EB. Creatine: a dietary supplement and ergogenic aid. Nutr Rev.1999; 57:45-50.

Greenhoff PL. Creatine and its application as an ergogenic aid. Int J Sport Nutr. 1995; 5:S100-S110.

Juhn MS. Oral creatine supplementation. Phys Sports Med. 1999; 27;47-45..

Klivenyi P, Ferrante RJ, Matthews RT, et al. Neuroprotective effects of creatine in a transgenic animal model of amyotrophic lateral sclerosis, Nat Med. 1999; 5:47-350.

Koshy KM, Griswald E, Sneeberger EE. Interstitial nephritis in a patient taking creatine. N Engl J Med. 1999; 340:814-815.

Miller EE, Evans AE, Cohn M. Inhibitions of rate of tumor growth by creatine and cyclocreatine. Proc Natl Accd Sci USA. 1993; 90:3304-3308.

Poortman JR, Augier H, Renaut V, et al. Effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol. 1997; 76:566-567.

Sipila I, Rapola J, Simell O, et al. Supplemental creatine as a treatment for gyrate atrophy of the choroid and retina. N Engl J Med. 1981; 304:867-870.

Tarnopolsky M, Martin J. Creatine monohydrate increases strength in patients with neuromuscular disease. Neurology. 1999; 52:854-857.

Toler SM. Creatine is an ergogenic for anaerobic exercise. Nutr Rev. 1997; 55:21-23.

Vandenberghe K, Gillis N. Van Leemputte M, et al. Caffeine counteracts the ergogenic action of muscle creatine loading. J Appl Physiol. 1996; 80:452-457.

Williams MH, Branch JD. Creatine supplementation and exercise performance: an update. J Am Coll Nutr. 1998; 17:216-234.

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Creatine side effects: Supplementation with creatine is safe - but it works best for men

Despite the extensive use of creatine monohydrate for performance enhancement, few studies have examined the potential side effects of supplementation and none has directly compared the response to supplementation in men and women. This gap in knowledge has now been filled by a Canadian study of young, healthy, physically active men and women, which showed no adverse effects of short-term treatment but greater body-building benefits for men than for women.
Fifteen men and 15 women were randomly assigned to five days' supplementation with 20g per day of either creatine monohydrate (CrM) or a similar-looking inactive substance (placebo) after extensive pre-trial checks, including measurement of body composition, blood pressure and maximal strength. On day six they returned to the lab for retesting. Blood pressure was unaffected by supplementation, and blood tests suggested there were no effects on kidney function. Plasma levels of the muscle enzyme creatine kinase, which is thought to have potentially damaging effects at increased levels, was unaffected by treatment.

As far as body composition was concerned, there was no effect of treatment on percentage body fat but clear increases in both total body mass (TBM) and fat-free mass (FFM). However, these changes were much smaller for women than for men: men increased both TBM and FFM by 2%, while for women the respective increases were only 0.8 and 1.0%. CrM treatment had no effect on grip strength during forearm tests and no significant effect on resting and post-exercise blood lactate levels. The implication of these findings is that creatine monohydrate may be less useful as a performance-enhancing aid for women than for men. 'It was not anticipated a priori that such large sex differences would exist in response to CrM loading, given that the subjects were matched for age and training status,' explain the researchers. They point out that it is possible the women had higher muscle concentrations of total creatine before supplementation, which might have reduced its effectiveness.

In terms of safety CrM gets the thumbs-up, although the potential side effects of long-term supplementation have yet to be examined. In addition to its benefits for athletes, CrM could also be used to treat people with muscle atrophy and other wasting conditions.

Med Sci Sports Exerc 2000 Feb 32 (2) 291-6

Isabel Walker

[hepennypacker52]

Distorted Report by French "Scientists" Claims Creatine Causes Cancer.

Is it safe? Does it increase the risk of cancer? Does it cause kidney problems?

By Paul Cribb B.H.Sci.HMS.Honors. Exercise Physiologist


Ashock wave went right through the international sporting and athletic community on January 23rd 2001, when the Agencies Francaise de Securite Sanitaire des Aliment (AFSSA), (French Agency for Medical Security for Food) commissioned by the French government, issued it's report on the safety and effectiveness of the supplement creatine monohydrate. Not only did the French report state that creatine as a supplement is ineffective, but that it also increases the risk of cancer. As usual, without bothering to check the facts the media ran with it better than Emmit Smith 30 yards out, ever could.

Up to 75% of NFL players use some form of creatine supplement, it's also used by the US Navy SEALS(1). Reports reveal that over 90% of US bodybuilders and weightlifters are devoted users of creatine(2). While a survey in England showed that over 57% of elite British athletes use creatine regularly(3).

Unlike athletes, journalists don't concern themselves with letting other teammates down. They are never accountable for their actions. Because of the media's gross irresponsibility and now even the so called French scientists, many coaches and team medical staff of various sports are now concerned about the consequences of encouraging creatine use by their athletes.

If anyone had bothered to translate the 50 page French review of creatine complete with over 230 references, they would find it to be one of the greatest scientific literature atrocities of the modern age. The entire review is misinterpreted research, downright lies, and complete fabrications about the science on creatine supplementation. It even questions the character and integrity of expert American scientists (page 16) whose research has demonstrated beneficial effects with creatine. In fact, according to AFSSA and the French government, the rest of the world is under a "creatine spell"(4).

Could this have anything to do with France's tyrannical attempt to control their athletes? They demonstrate this with their Nazi-like approach every year during the Tour de France. They raid athlete's rooms in the middle of the night. They force them to take drug tests with threats of arrest if drugs are detected. This is the police that force the athletes to take drug tests beyond what the governing cycling organization mandates. And you thought this type of tyranny and propaganda went out out with fall of the Berlin Wall.

I encourage everyone to look at the French literature, translate the report, then examine the references cited by AFSSA. What you will find are gross inaccuracies and outlandish interpretations (and I'm being polite). If you believe the French scientists report; not only is creatine totally ineffective, but it should drop anyone stone dead that uses it, and leave his or her family with the plague! In all seriousness, I have not seen such an example of blatant propaganda since a little fool with a funny mustache started invading European countries in the early 1940s.

I'm a scientist and to see "colleagues" obtain media recognition for what clearly is manipulated research interpretation to further a scientifically invalid agenda greatly disturbs me. It's no different than screaming "fire" in a crowded theater when there is none.

The Bogus Cancer Claims

In an attempt to cut through the BS I contacted Dr Jean-Louis Bertha, the food and safety expert at AFSSA and asked to be provided the exact research regarding creatine supplements increasing the risk of cancer. These are the study references quoted by DR Bertha via email on Thursday, February 8th 2001, 3:44pm, regarding creatine supplements increasing the risk of cancer.

Laser Reutersward, A., Skog, K., Jagerstad, M. 1987. Mutagenicity of pan-fried bovine tissues in relation to their content of creatine, creatinine, monosaccharides and free amino acids. Food Chem. Toxicol 25: 755-762.

Anari M.R., Josephy P.D., Henry T., O'Brien P.J. 1997. Hydrogen peroxide supports human and rat cytochrone P-450 1A2-catalyzed 2-amino-3-methylimidazo (4 5-f) quinoline bioactivation to mutagenic metabolites: significance of cytochrome P-450 peroxygenase. Chem Res Toxicol 10: 582-588.

Felton J.S., Gentile J.M. 1997 Special issue "Mutagenic: carcinogenic N-substituted aryl compounds". Muta Res 376: 1-272.

Hammons G.J., Milton D., Stepps K., Guengerich F.P., Tukey R.H., Kadlubar F.F. 1997. Metabolism of carcinogenic heterocyclic and aromatic amines by recombinant human cytochrome P450 enzymes. Carcinogenesis. 18: 851-854.

Wyss, M., Kaddurah-Daouk, R. 2000. Creatine and creatinine metabolism. Physiol Rev 80: 1107-1125.
Obviously, DR Bertha must think everyone else on this planet is an idiot. If you read these reports, it is clear that they have nothing to do with creatine supplementation increasing the risk of cancer. These reports don't even mention the matter. In fact, these reports have nothing to do with creatine supplementation whatsoever.

These reports actually discuss the various mutagens (amino-imidazo-azaarenes or AIAs) formed during the cooking (frying) of meats. Meat is a naturally high source of creatine. According to these reports AIA mutagens are formed when meat is fried at 200 degrees C for 3 minutes.

Now, I may not be the smartest guy, but, what the hell does frying meat at 200 degrees C have to do with athletes taking creatine supplements? Absolutely nothing.

Incredibly, these research papers quoted by the French scientists demonstrate that these AIA mutagens are not carcinogenic as such, they are metabolically inert and must be activated by a series of enzymatic processes to exert any active effect (Wyss page 1164; Hammonds et al. pages 851-854).

Further examination of these reports reveal that the AIA mutagens were in fact generated from invitro (lab dish and model) experiments, not humans. Similar mutagens have been found performing experiments with sugars and various amino acids(5).

I'll just be polite at this point and suggest the scientists at AFSSA don't know how to interpret literature very well.

Incidentally, for those that love their steak and are truly concerned, not frying foods and using marinades and oil instead of butter can minimize generation of AIAs(5). A more recent calculation based on extensive literature review of levels of AIAs in cooked foods and mean food consumption figures in the US indicate an incremental cancer risk of 0.00001% (6,7). You were at a higher risk of being knocked down when crossing the street this morning. This is the carcinogenic evidence the French scientists are putting forward regarding creatine supplements.

By no stretch of the imagination could this data be applicable to athletes consuming creatine monohydrate supplements. Is this dishonest, deceitful and extremely pathetic on AFSSA part? Indeed.

Not only are there no studies whatsoever indicating in even the wildest possible interpretation that supplementing with creatine could even remotely cause cancer, but their literature support for their statements does not even involve creatine.

The sad part of all this is that the media will report this through thousands of news outlets throughout the world effectively propagating an outright lie. It stinks.

[hepennypacker52]

(cont'd from above)

Bogus Toxicity Claims

The report put forward by the AFSSA scientists instills such a fear for concern regarding toxicity from creatine supplements you would think ingestion of a teaspoon full would have you oozing green slime while falling down dead in your tracksuit. However, once again their quoted scientific evidence comes up short, real short. And their knowledge of clinical applications of biochemical pathways is sadly lacking.

Of the 230 odd studies cited by the French scientists in their report, not one indicates, let alone demonstrates any form of toxicity regarding creatine use in healthy people. Not a single one. The only straw these scientists could grasp at was a biochemical pathway for the nitrosation of creatine and creatinine (the waste product of creatine) that is of concern only to those with chronic renal (kidney) disease. However, they couldn't even get the biochemistry right on this one (8).

Of the 230 odd references cited by the French scientists in their report, not one controlled study indicates, let alone demonstrates any form of toxicity regarding creatine use in healthy people. Not a single one.

N-nitromethylamine (a carcinogen) is the end product of a series of several nitrite reaction sequences of creatine to form N-nitrosarcosine. Sarcosine is not a toxin as the French report suggests. Nitrosation of creatine and creatinine has so far mostly been examined invitro systems (lab dish stuff) and it has only been suggested to be formed in uremic (chronic renal failure) patients due to the unique characteristics of this disease(5,8).

A comprehensive and recent review (ironically, also cited by the French) on creatine and creatinine metabolism demonstrates this nitrosation pathway to be inconsequential to a healthy body(5,8).

This is how far these so called scientists were willing to stretch research findings to deceive the athletic community and regulatory agencies and it sickens me. These are supposed to be scientists yet they ignore and even worse, distort the science.

Bogus claims about creatine and renal function.

Without citing any controlled research the French report warned of the dangers of kidney malfunction from creatine use and even attributed the onset of some kidney diseases to creatine supplementation. However, the French scientists forgot to mention the research conducted on athletes that directly assessed renal function.

Several studies demonstrate creatine supplementation does not increase or alter glomerular filtration rates(9) or any indices of renal and liver function for that matter(10). Also, long-term creatine supplementation (up to 5 years) does not impair the kidney function of athletes in any way(12).

Long-term research with athletes using creatine supplements shows their creatinine levels stay within a normal, healthy range. (Just the same as people not using creatine(31)). These studies examined glomerular filtration, tubular reabsorption and glomerular membrane permeability and none were affected by taking creatine supplements in real-life dosages that are used by athletes (20 grams a day for 5 days, then 3 to 10 grams every day there after).(13)

The Facts

How did this misinformation all start? In 1998, a single case report published by two British nephrologists in the journal Lancet documented the case of a 25-year-old man with an 8-year history of focal segmental glomerular scleosis (a chronic renal condition) with frequently relapsing corticosteroid-responsive nephrotic syndrome(14). The man was also being treated with cyclosporin, an immunosuppressive drug that is well known for its nephrotoxicity(11). He started taking a creatine supplement, 15 grams a day for 7 days, and then 2 grams a day for 7 weeks. His glomerular filtration rate dropped by 50% but returned to normal upon cessation of the creatine supplement.

Three days after this publication the French sports newspaper L'Equipe reported that creatine is dangerous for the kidneys in anyone that uses it. (15) This "news" was then taken up by several other European newspapers that claimed creatine induces renal and liver malfunction and even death(16-18). Completely untrue.

If anything positive could come out of this disgraceful sham disguised in a thin vale of scientific shenanigan is the importance of understanding your degree of health. If you have a preexisting renal dysfunction or you are at high risk of renal disease (diabetes or a family history of kidney disease), it is recommended that you are monitored regularly. It is also important to note that many athletes do not know if they have a preexisting kidney condition. All athletes should have their kidney function assessed. Ask your physician for an excess albumin excretion (>20mg/min) in urine collected under resting conditions, i.e. after 20 minutes of physical inactivity(11).

More fodder (Australian slang for "bull****") for the media was cultivated from the death of three wrestlers who performed very extreme fluid restriction and other weight loss strategies. The Center for Disease Control concluded in their report that the regimen of chronic fluid restriction and intense exercise in the heat and not creatine is what resulted in hyperthermia/vascular collapse that contributed to the wrestlers deaths(19).

Creatine and Cardiovascular Complications.

The French report extracted a few anecdotal reports of hypertension among athletes using creatine from the US FDA database. Anecdotal is defined as untrustworthy and unreliable and regarding scientific investigation, this is exactly what the FDA and its database are demonstrated to be (see The Ephedra Report). Very unreliable and even manipulated to further their specific agendas.

Once again the French review ignored the real research on this matter. The scientific research. Double blind, tightly controlled studies demonstrating that high dose, short-term creatine loading (20 grams a day for 5 days) did not effect systolic, diastolic, or mean blood pressure in men or women (20). Other research has demonstrated the same thing with long-term creatine supplementation as well(21). It also important to note that creatine supplementation did not alter blood pressure in patients with congestive heart failure(22,23). Heart pump function was directly assessed in one of these studies and the creatine supplementation did not alter cardiac performance(23). Why the French ignored this research in favor of unreliable anecdotal grasps only strengthens the assumption of an ulterior motive for their distortion and their lies.

Heat Stress and Cramping.

There have been reports of muscular stiffness, strains, and cramping in athletes taking creatine. However, in controlled studies the evidence shows that creatine supplementation does not cause muscular dysfunction and/or complication in healthy people(24,25) or patients with various neuromuscular diseases(26). In fact, one recent study went so far as attempting to induce cramping in athletes by exercising them to varying degrees of dehydration(27). No differences were reported between those taking creatine and those taking a placebo. This study clearly demonstrated that there was no greater incidence of cramping associated with creatine use in athletes even under various dehydrated states.(27)

Conclusion

The clear facts are these, many scientists from around the world have independently published extensive reviews on creatine supplementation. Ira Jacobs of Canada(28), Jacques Poortmans and Marc Francaux of Belgium(13), Richard Kreider from the US(29), Markus Wyss of Switzerland(30) and a roundtable discussion of the literature written for the American Collage of Sports Medicine by thirteen of the worlds leading experts on creatine(31). Each review has examined well over 100 research studies on creatine use. (I urge you to read them.) Each review validates the effectiveness and safety of creatine supplementation, particularly when used in dosages that are shown to increase muscle mass and performance.

These French scientists are obviously puppets used to further France's desire to control the actions of their athletes and falsely influence athletes and regulatory agencies around the world. All through ignoring or distorting the real science.

The scientific and medical community has been dealt a serious blow to their credibility by this shameful and disgraceful manipulation of the facts by these scientists. And their actions are a spit in the face of the true scientists that have devoted their time, energy, and efforts in quest for the truth so we can advance our knowledge, our performance, and our health.

[hepennypacker52]

(cont'd from above)

References

1. Schneider K, Harvig L, Ensign WY. Med Sci Sports Exerc.30:S60,1998

2. Williams MH, Kreider RB, Branch JD. Creatine: the power supplement. Champaign (IL):Human Kinetics,1999.

3. Harris N, Arthur C. The independent, Dec8:4 1998.

4. Miquel P. Le Monde. Aug14:15 1998.

5. Wyss, M., Kaddurah-Daouk, R. Physiol Rev 80: 1160-1167.2000.

6. Layton DW et al. Carcinogenesis. 16:39-52,1995.

7. Gold LS et al. Cancer Lett.83:21-29,1994

8. Wyss, M., Kaddurah-Daouk, R. Physiol Rev 80: 1173-1176.2000.

9. Poortmans JR, Francaux M. Eur. J. Appl. Physiol.76:566-7,1997.

10. Robinson TM et al. Br.J. Sports Med.34:284-288,2000.

11. Poortmans JR, Francaux M. Lancet (reply letter);352:234,1998.

12. Poortmans JR, Francaux M. Med. Sci.Sports Exerc.31:1108-10,1999.

13. Poortmans JR, Francaux M. Adverse effects of creatine supplementation: fact or fiction. Sports Med.30(3):155-170,2000.

14. Pritchard NR, Kalra PA. Lancet.351:1252-3,1998.

15. La creatine dangereuse? L'Equipe. April28:10,1998

16. Nau JK. Le Monde Nov.21:24,1998

17. Daulouede C. Sport et Vie. Nov 58,1998.

18. Haget H. Le Vif/L'Express. Oct 30:114,1998.

19. Control CFD. MMWR 47:105-108,1998.

20. Mihic SJR, et al. Med.Sci.Sport Exerc.2000.

21. Peeters BM, Lantz CD, Mathew JL. J.Strength Condit. Res.13:3-9,1999.

22. Andrews R, et al. Eur. Heart J. 19:617-622,1998.

23. Gordon A, Hulman E, Kaijser L. Cardiovas. Res.30:413-418,1995.

24. Kreider RB, Ferreira M, Wilson M et al. Med.Sci.Sports Exerc.30:73-82,1998

25. Vandenberghe K, Gaoris M, et al. J.Appl Physiol.83:2055-63,1997.

26. Tarnopolsky M, and Martin J. Neurology. 52:854-857,1999.

27. Vogel RA, Webster MJ, Erdmann LD and Clark RD. J. Strength Condit. Res. 14(2):214-219.

28. Jacobs I. Dietary creatine supplementation. Can.J.Appl.Physiol.24(6):503-514

29. Kreider RB. Creatine: The next ergogenic supplement? http://www.sportssci.org/traintech/creatine/rbk.html

30. Wyss, M., Kaddurah-Daouk, R. Creatine and creatinine metabolism. Physiol Rev 80: 1107-1213.2000.

31. Terjung RL, Clarkson P, Eichner ER, et al. The physiological and health effects of oral creatine supplementation. Med.Sci.Sports Exerc.32(3):706-717,2000.

[hepennypacker52]

Long-term creatine supplementation does not significantly affect clinical markers of health in athletes.

Kreider RB, Melton C, Rasmussen CJ, Greenwood M, Lancaster S, Cantler EC, Milnor P, Almada AL.

Exercise and Sport Nutrition Laboratory, Department of Human Movement Sciences and Education, The University of Memphis, Memphis, TN, USA. Richard_Kreider@baylor.edu

Creatine has been reported to be an effective ergogenic aid for athletes. However, concerns have been raised regarding the long-term safety of creatine supplementation. This study examined the effects of long-term creatine supplementation on a 69-item panel of serum, whole blood, and urinary markers of clinical health status in athletes. Over a 21-month period, 98 Division IA college football players were administered in an open label manner creatine or non-creatine containing supplements following training sessions. Subjects who ingested creatine were administered 15.75 g/day of creatine monohydrate for 5 days and an average of 5 g/day thereafter in 5-10 g/day doses. Fasting blood and 24-h urine samples were collected at 0, 1, 1.5, 4, 6, 10, 12, 17, and 21 months of training. A comprehensive quantitative clinical chemistry panel was determined on serum and whole blood samples (metabolic markers, muscle and liver enzymes, electrolytes, lipid profiles, hematological markers, and lymphocytes). In addition, urine samples were quantitatively and qualitative analyzed to assess clinical status and renal function. At the end of the study, subjects were categorized into groups that did not take creatine (n = 44) and subjects who took creatine for 0-6 months (mean 4.4 +/- 1.8 months, n = 12), 7-12 months (mean 9.3 +/- 2.0 months, n = 25), and 12-21 months (mean 19.3 +/- 2.4 months, n = 17). Baseline and the subjects' final blood and urine samples were analyzed by MANOVA and 2 x 2 repeated measures ANOVA univariate tests. MANOVA revealed no significant differences (p = 0.51) among groups in the 54-item panel of quantitative blood and urine markers assessed. Univariate analysis revealed no clinically significant interactions among groups in markers of clinical status. In addition, no apparent differences were observed among groups in the 15-item panel of qualitative urine markers. Results indicate that long-term creatine supplementation (up to 21-months) does not appear to adversely effect markers of health status in athletes undergoing intense training in comparison to athletes who do not take creatine.

PMID: 12701816 [PubMed - indexed for MEDLINE]

[hepennypacker52]

Ok...now I'm done

Enjoy.

[hepennypacker52]

bump

[Sp1ke]

Beautiful.......Now we have something that we can print to show silly parents that creatine is not dangerous to the liver or any organ.

[hepennypacker52]

Beautiful.......Now we have something that we can print to show silly parents that creatine is not dangerous to the liver or any organ.

Which was mostly the point of this thread. Thanks.

[hepennypacker52]

Shamless bump #2...did this help anybody else?

[Diab0lic]

Shamless bump #2...did this help anybody else?

Bump away, this is good info. More people need to read this. Perhaps it could be made a sticky one day?????

Everytime I hear people say that creatine gives you cancer, brain damage & destroys your kidneys, I laugh out loud. They obviously are either misinformed, incompetent, have a vested interest in what theyre saying or have misinterpreted their data.

Now hopefully people will read what youve posted.

[DaRkShaDE]

just so you guys know,


http://forum.bodybuilding.com/showthread.php?t=100831

[hepennypacker52]

just so you guys know,


http://forum.bodybuilding.com/showthread.php?t=100831

Yeah, that's basically everything about creatine. I just wanted to focus on safety, because that is a major concern for a lot of people. There's always at least 5-10 threads every week saying "Hey guys I wanna take creatine, but my parents thinks is not safe, what can I show them?". Hopefully they will show them this. I could even show my parents this, but they're too stubborn and won't listen to anything.

[hepennypacker52]

Another lovely bump.

[EricTheRed]

I suggest this be a sticky

[hepennypacker52]

I suggest this be a sticky

I would add this to the sticky I made, but I can't edit any old posts. Sucks.

[hepennypacker52]

Bumpity ump for someone who wanted studies.

[Supernothing]

thanks alot.

[hepennypacker52]

thanks alot.

Yup.

[Dante^]

I get high blood pressure when I use it.

[hepennypacker52]

Itty bitty bump.

[Bignbuff]

Itty bitty bump.

A well deserved one at that.

[BurgerPimp07]

Bump....

I'm seeing people post new threads everyday that can be answered here. Hopefully this becomes a sticky....some day...

[j_squeeze]

great post...this needs to be stickied and labelled: for those to lazy to research: a printable guide with FACTS about creatine for your parents

long title but hey, it should pretty much get rid of any posts like that. But hey i've learned already (and i've only been taking creatine for a week) that its simple, some tells u its gonna mess u up, i just reply. "Yup, its gonna mess me up , make me real big ". I can understand the parents concern, my parents were concerned, its natural for parents to care. So this info would be a great sticky.