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Thoughts about creatine monohydrate

                                                                                                               by Isobel Kleinman

Was published in "Living With TEENAGERS"   MAY, 1999 in a shorter version

As Mark McGwire blasts his way into the history books, teenagers, coaches and athletes have increased their aspirations.  Whether inspired to make their own mark on the record books, in search of personal excellence or just a groupie, they will be emulating the training habits of McGwire.  That includes his use of creatine.   Let's take a look at all sides of the story as well as the current research.

THE HYPE :

"It's like taking a mild regiment of steroids." say a marketeer of it's products, Bill Phillips.

"It's crucial for high intensity muscle contractions."  says Liz Applegate Ph.D. who explains that it is naturally created in our bodies to regenerate the "energy necessary to maintain muscle contractions."  

Brady Anderson, whose first use dates back to 1991 points to how his previously slender body changed with a regular regime of creatine supplements and weight training.  Now his sculptured physique seems to burst with the promise of explosive power.  It helped make Mark McGwire a power house.  

IT IS NATURAL:

Creatine is synthesized by the liver, kidneys and pancreas from three amino acids.  Creatine monohydrate is produced by the body in small amounts - about one gram daily.   It is found  in meat and fish.   A normal well balanced diet supplements the human body's production of creatine in small amounts.  When ingested, one pound of meat or fish yields one gram of creatine.  

THE PAYOFF:

  • After a 1 week workout:
    1-  Some weight lifters who can do 7.4 additional reps during 5 sets.
    2- There is a small but measurable improvement in explosive power.
    3- The body increases its production of ATP ( a biochemical by-product that    reduces the time muscles need to rest after powerful exertions) by 8%- 10%
     
  • After 5 weeks of working out:
    1- The expected bench pressing improvement increases 50% (from 20 lbs. to 30 lbs.) given the same training program and a creatine supplement.
    2- Researchers report a 5 to 7 lb gain in "lean tissue" measured by weight. The  "lean tissue" claim is open to speculation.  Some attribute the gain to water, EAS (who provided the research) shrugs off the skeptics by saying that muscle is 70% water anyway.

    PROS :

  • There seems to be a training advantage to its use. Athletes tire less quickly while working out. This allows longer workouts, which in turn leads to greater muscle build-up.  
  • Creatine delivers for teenagers and athletes who want to gain weight.  No one is quite sure what accounts for the gain, water or actual muscle tissue, but weight gain does occur.
  • Reports of improved strength vary with each study.  One reports a 5% increase, another a 30% improvement.  In each and every case, improved strength has been the result of the partnership between taking the supplement and committing to a RIGOROUS  training regime.
             - Vegetarians whose avoidance of meat and fish prevents their diets from supplementing creatine naturally can raise their self produced  levels by taking the mass produced commercial products available on  health stores shelves or from distributors advertising on the internet.
             - Many believe creatine is a "natural" panacea for improving athletic performance.    From a business angle this perceptions has lead to its growing popularity.  Creatine has been a huge success.  Sales have more than doubled in two years.  Dollars having been rolling in and profits are high.  

    CONS

  • Despite equal time, effort and cost some athletes will not benefit from creatine.
             - Some because their bodies simply do not respond to the product.
             - Others because creatine seems to have a negative effect on the types of performance they engage in.
  • Creatine is not effective in improving the results of endurance sports.  Its major benefit comes from its ability to help the muscle  recover from explosive contractions.  An endurance athlete gets no advantage since short bursts of energy typical of anaerobic sports are counterproductive in aerobic activities.
  • There is very little research about creatine monohydrate from unbiased sources.  Still, there has been significant documentation of it's short term side effects.          - Users have a tendency to become dehydrated.  They must increase their intake of water to avoid the failures caused by dehydration.  Creatine's use is associated with increased incidents of cramps.  This has been significant enough to cause Syracuse's football coach to eliminate its use in their training program.  Dizziness, muscle tearing, muscle pulls, general fatigue and weight gain have also been reported.
  • Those who continue to use creatine have to battle against weight gain.
  • More worrisome is the incidence of sudden death.  Several young wrestlers who used creatine died.  The cause is still unknown.   What is know is that the weight gain associated with creatine is counterproductive for wrestlers who want the benefits of increased explosive power but not at the expense of moving up in their weight classification.   While the jury is still out (The FDA is investigating but has drawn no conclusions) the tragedy has been theorized as the result of a combination of two factors:  the use of creatine while on a crash diet. Some athletes think creatine is worth the risk.  Their successes have become the headlines of the day.  Increasingly, those stories have an impact.

    THE DISCUSSION

            The home run race of 1998 is bound to have its share of influence.  On September 9th, 1998 when Mark McGwire overtook Roger Maris's home run record, a record that stood unchallenged for thirty seven years he became an involuntary commercial for creatine.  A large variety of  periodicals have followed his accent to a new record.  They describe his diet and training program.   The New York Times reported that McGwire takes androstenedione, a testosterone elevating compound not found on baseball's prescribed list.  Investors Business Daily claims he has used creatine and androstenedione.    Sports Illustrated  listed the supplements as well.  Still, McGwire insists his is not illegal.  When asked, McGwire describes creatine as nature's chemical, saying that he is not using a steroid, just a simple over the counter natural extract which compliments his intensive training program.   He attributes his success to hard work, friendly ball parks, expansionist pitchers, jet age balls and God.

            Though McGwire might not worry about his own health believing what is natural cannot be illegal or dangerous, the coach of Tampa Bay, the trainers from the Chicago Cubs and the staff of the San Diego Padres do not want their players to use it.  Their fear is that creatine may still prove to be dangerous.  Their fears may be well based.   The long term effects are still unknown and there is no quick way to learn more.  Creatine has only been marketed since 1993.  A five year horizon is far too short to draw any reliable conclusions.  One needs only a humble reminder to look back in history and remember sports nutritionists whose recommendations had adverse effects.  Remember how steroids came on the international scene?  After athletes toppled long standing records, their training programs and diet were examined and emulated.  Their training regimes were supplemented with steroids. The common quest to remain competitive practically guaranteed that steroids would become widely used.  They were.   Even weekend warriors building their physiques were not immune to its allure.  No one knew the toll it would take.  Finally research caught up with practice.  For some it was too late.   Steroids caused irreversible changes, damaging the liver, kidneys and pancreas and seriously compromising one's ability to procreate.

            For those who believe that what is natural cannot be harmful, they need be mindful of another natural substance which recently in use.  Phen-fen the 1990's natural product that lead to slimmer bodies was ingested by many dieters.  As a "natural" product, it was greeted with enthusiasm.  The usual mania leads to the usual, widespread use.   At first, phen-fen seemed harmless.  Unfortunately, over a longer period, it has proven detrimental.  Phen-fen, though a natural substance, has caused heart damage and lead to stroke.  What is more, it is not the only "natural" supplement found to be dangerous.  The  September 17, 1998 issue of  reported that the New England Journal of Medicine questioned the use of natural remedies from health food stores.   "Doctors report patients are harmed by 'natural' but dangerous products.   It seems that many remedies sold as "dietary supplements" have caused people to become very ill.  While this report did not discuss the healthy athletes' use of creatine, it proves that a basis for worry remains.  
     

            Body building magazines and some coaches are still recommending creatine for bulking up and getting stronger.   That is not all.  As the home run race heats up and the nation focuses on McGwire the popularity of using dietary supplements to defy the impossible will escalate.   Many youngsters caught up in the dream will model themselves after McGwire, trying to emulate his training program.  Clearly creatine is popular already. One only need to go on the internet (www.northernlight.com) to find fathers, students, athletes and coaches asking questions about it and discussing its most effective usage.

            And let's not forget that growing popularity breeds business competition and the ever present effort to lower the bottom line.  While this issue might seem unrelated to health, consumer issues do pose a risk.  Powders can be cut with anything. To date , creatine is unregulated.  Imports are not screened.  To keep up with demand, imports are coming in from abroad.  Samples have contained impurities.   Tests have found rat hair and baking soda in creatine imported from China.  

    OUR RESPONSIBILITY AS EDUCATORS :

    Those of us  who work with children need to know how to deal with their questions. and  answer them without turning the kids off.  We must be cognizant of the physical problems associated with its use as well as be mindful of the strong psychological motivation for taking it.   Many students have begun using creatine already, some at the request of their coaches.  Others will go ahead on their own because of information they have already come by.   Educators cannot ignore the issue.  Instead we must be prepared with answers.
    To begin with, it is important to point out the negatives without negating the positives.  We must be honest.  Then we might note that Sammy Sousa equaled McGwire's record just one week after it was made and did so without using a dietary supplement.  We could emphasize the need and value of hard work, persistence, respect, sportsmanship and common decency both players exemplified.  We could challenge the un-enhanced athlete to seek their personal limits.  

    CONCLUSION :
     
    Creatine is an expensive "training enhancer" which is not equally effective in users and  only produces positive change when coupled with vigorous training programs over prolonged periods.    Creatine's short term effects: dehydration, cramping, dizziness, weight gain, muscle pulls, muscle tears and general after workout fatigue must be anticipated.  While not serious by themselves, each reaction can lead to complications that need to be avoided.  There is widespread belief that the use of this natural product to change the balance of nature should be suspended until more is known about the long term effects.
     It should be noted that as of 1998, our government does not that require feedback about the reactions to creatine, nevertheless,  2500 cases of side effects and 79 deaths have been documented.  With that in mind, it seems clear that professionals should take a lesson from history and discourage the use of creatine until more is known.  For now let us accept that Mark McGwire and Sammy Sosa entered the record books with exemplary, gracious behavior.  Their public show of mutual respect has been applauded while the public laments the fact that it is unusual for highly paid athletes to behave so well in the modern era.   McGwire's show of respect for the man whose record he finally broke, Roger Maris and his sportsman like acknowledgement of Sammy Sousa, along with his self described work ethic, should make him a role model, not the use of creatine.

     
    BIBLIOGRAPHY

    "Androstenedione," Betterbodz @ bbodybetterbodz.com. 9/7/98.
     Applegate, Ph. D.  Liz.  "Nutrition,"  Runner's World,  November 1995.
    Bamberger,  Michael. "Magic Potion:  Performance Enhancers," Sports Illustrated, April 20, 1998.
    "Creatine Monohydrate," Peak Nutrition: Advanced American Pharmaceutical Product Information.
    "Death Raises Suspicion:  FDA begins Scrutiny of Creatine,"  USA Today December 18, 1997.
    "Diet-Drug Damage to Heart Found Common, But Small,"  Investors Business Daily  September 10, 1998.
    Gatfeld, Greg.  "Stir Up Some Muscle",   Men's Health, May 1997, V.12, N.4.
    Gower, Timothy.  "Eat Powder!  Build Muscle!  Burn Calories!," Esquire, February, 1998.
    Grady, Denise.  "Articles Question Safety of Dietary Supplements ; Use Can Endanger the lives of Ailing People,"  The New York Times: National  September 17, 1998.
    International Journal of Sports Nutrition, March, 1998.
    Mooney, Michael.  "Lab Tests of Androstenedione and Androstenediol,"   Metabolics, Volume 2, Issue No. 2
    "Natural Doesn't Equal Safe : especially in pills and potions ", USA Today,  April 30, 1997.
    Reilly,  Rick.  "The Great Father," Sports Illustrated, September 7, 1998.
    Smith, Scott.  "Home Run Hero Mark McGwire:  How He's Slugged His Way Into The Record Books,"  Investors Business Daily,  September 10, 1998.
     Vecsey, George. "Glory for McGwire, Without an Asterisk",  New York Times September 9, 1998.

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