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Is Creatine Supplementation a Viable Dietary Option for Exercise Management?

Dr. Khalid is a health researcher and science writer with a Ph.D. in clinical research.

Chemical structure and biochemical pathway for creatine synthesis

Chemical structure and biochemical pathway for creatine synthesis

Why do Fitness Trainers recommend Creatine Supplementation for Athletes?

The recommendation of creatine supplementation to sportspersons is based on the health performance benefits of creatine monohydrate. Creatine supplementation not only improves physical strength but also increases sports persons’ weight-bearing capacity while increasing their muscle resistance. The prolonged consumption of creatine enhances the training adaptations and performance outcomes of athletes and other individuals who routinely attend the gym to enhance their fitness and physical strength. The increase in the creatine pool or creatine uptake increases exercise performance of individuals in a variety of ways. Health care professionals recommend systematic resistance exercise schedules to expand the benefits of creatine supplementation among fitness aspirants. The regular intake of 25g/d of creatine for an initial duration of one week along with appropriate exercise is highly recommended to increase muscle strength and lean body mass. The fitness aspirants require consuming 5g of creatine for several weeks to improve their muscle tone and strength for an extended duration. The maintenance dose of creatine triggers ATP (adenosine triphosphate) production in muscles that eventually elevates their resistance and adaptability. The athletes or fitness aspirants who follow a strict creatine regimen during their training sessions maintain greater training intensity and workout quality as compared to the athletes who rely on natural products to increase their muscle strength. The admixture of heavy resistance training and creatine loading improves muscle morphology and elevates recovery, muscle activity, as well as isometric elbow flexion force. Interestingly, creatine consumption also improves the performance outcomes of individuals who rely on anaerobic exercise for their fitness enhancement. Creatine intake with maltodextrin triggers voluntary muscle contractions even in individuals who follow a loose exercise schedule. Creatine intake improves the overall function of the Ca2+ ATP pump while inducing the sarcoplasmic reticulum’s reuptake of calcium ions. Creatine supplementation also elevates the actomyosin bridge detachment rate that enhances the muscle tone and overall physical capacity to many folds. The systematic consumption of creatine supplementation elevates the level of IGF-1 growth factor in muscles based on their increased metabolic demand. The consumption of a diet rich in amino acids with creatine supplement elevates the high energy phosphate and protein levels in muscles. These processes potentially trigger muscle hypertrophy and physical resistance of creatine supplement consumers. Scientific literature provides strong evidence related to the elevation in lactate threshold following the consumption of creatine supplementation in scenarios where the fitness aspirants engage themselves in aerobic exercise.

Creatine supplementation elevates actomyosin bridge detachment rate that enhances the muscle tone and overall physical capacity to many folds.

How Does Creatine Supplementation Interfere with Body Physiology?

The regular intake of creatine supplementation alters the creatine monohydrate’s concentration in muscles, serum, and urine. However, creatine supplementation does not interfere with the physiological processes based on protein expression or mRNA transportation in muscular males. Creatine supplementation influences microcirculation while increasing the vascular reactivity and minimizing the levels of plasma homocysteine. Creatine supplementation induces the concentration of acetylcholine that predominantly elevates microvascular conductance and systemic endothelial-dependent microvascular reactivity. Creatine supplementation also elevates the folic acid levels of its consumers, thereby increasing their red blood cell concentration and oxygen-carrying capacity. Creatine supplementation elevates the recruitment of endothelium-dependent capillaries and the density/function of baseline skin capillaries in hyperhomocysteinemic and normohomocysteinemic athletes. The increase in microvascular reactivity following the administration of creatine supplementation reveals its high influence on the circulatory system. However, the short-term administration of creatine enhances the following activities in athletes, sportspersons, or fitness aspirants.

  1. Repetitive sprint performance
  2. Single-effort sprint performance
  3. Maximal strength, power, and contractility of muscles
  4. Elevation in energy substrate re-synthesis and availability
  5. Overall work potential during stressful activities
  6. High-intensity performance

The ergogenic effects of creatine are variably reported among different individuals. The differences in creatine supplementation benefits rely on the following attributes.

  1. The exercise repetition frequency
  2. The type of exercise schedule
  3. Genetic predisposition
  4. Length of creatine supplementation
  5. Dosage and schedule of creatine supplementation

The evidence-based research literature also reveals neuromodulator action of creatine supplement that helps to reduce the clinical manifestations of schizophrenia and anxiety disorders. The clinical literature testifies the therapeutic benefits of creatine supplements in terms of treating skeletal muscle diseases including idiopathic inflammatory myopathies and muscular dystrophy. However, the increased serum creatine levels lead to a marked reduction in T3 concentration and type-II deiodinase activity. Research studies also reveal blood pressure reduces the ability of creatine supplementation; however, it still cannot be used therapeutically to control the systolic and diastolic blood pressure levels of hypertensive patients.

Is Creatine Supplement the Best Option to Increase Your Physical Strength, Muscle Mass/Endurance, and Overall Health/Wellness?

The performance-enhancing potential of creatine supplements is widely acknowledged in various peer-reviewed research papers. Bodybuilders and athletes rely on creatine supplementation to increase their physical strength and performance in various sporting activities. Creatine supplement, however, is not the preferred choice for fitness aspirants with a clinical history of acute renal failure. The damaging effects of creatine monohydrate on the kidney function of acute renal failure patients are well-recognized in the medical literature. Contrarily, creatine supplement proves to be a safe performance enhancement option for healthy individuals due to their high capacity to excrete 90% of the ingested creatine monohydrate through urine. The research studies do not substantiate claims that support the use of buffered creatine with a routine diet for improving muscle mass. The safety, efficacy, bioavailability, and chemical/physical properties of creatine monohydrate substantiate its regular utilization by bodybuilders or fitness aspirants. The delayed conversion of creatine to creatinine despite temperature and pH variations proves beneficial to healthy bodybuilders since they rarely encounter renal function disruption after consuming creatine monohydrate supplementation. However, the intake of creatine supplement is recommended with a high pH/alkaline diet, since a basic environment in the stomach reduces the creatine’s intramolecular cyclization to creatinine. Accordingly, the consumption of creatine supplementation with alkaline foods including grains, meats, eggs, dairy products, legumes, seeds, and nuts helps to minimize the risk of kidney complications among bodybuilders, athletes, and fitness aspirants. The combination of creatine supplementation with vegetables and fruits also reduces the risk of strokes, muscle wasting, and other chronic disease conditions. The other health benefits of creatine include the following.

  1. Neuroprotection of spinal cord
  2. Rehabilitation
  3. Thermoregulation
  4. Injury prevention
  5. Concussion prevention
  6. Post-exercise recovery
  7. Reduction in injury severity
  8. Load tolerance level
  9. Prevention of neurodegenerative diseases
  10. Prevention of depression, ischemia, aging, fibromyalgia, osteoarthritis, and diabetes

The muscle enhancement potential of creatine supplement is substantiated by the following benefits.

  1. Satellite cells’ activation
  2. Regulation of calcium homeostasis
  3. Reduction in oxidative stress
  4. Reduction in the inflammatory response

Creatine supplementation reduces oxidative stress while decreasing the concentration of superoxide dismutase, malondialdehyde, and catalase. It reduces the inflammatory responses while decreasing the functionality of prostaglandin and tumor necrosis factor-alpha. The creatine-induced satellite cell activation relies on elevated differentiation and proliferation of cytoskeletal remodeling genes and satellite cells. These findings affirm creatine monohydrate’s potential to reduce exercise-induced muscle damage in bodybuilders, fitness aspirants, and athletes.

What are the Adverse Effects of Creatine Supplementation?

Creatine supplementation could increase your risk of the following disease conditions; however, this claim is substantiated by anecdotal rather than clinical evidence.

  1. Gastrointestinal disturbances
  2. Muscle cramps
  3. Liver dysfunction

Individuals with pre-existing kidney disease must not opt for creatine supplementation for improving their muscle strength. However, other healthy people who do not have any pre-existing kidney disease or physical disability may select the appropriate creatine supplementation under the supervision of qualified health care professionals or fitness trainers. So far, creatine monohydrate proves to be a safe and reliable performance enhancement dietary option for healthy individuals.

Does Creatine Supplementation Improve Health with Exercise Performance?

The concomitant administration of creatine supplementation with muscle training offers the following benefits.

1. The ergogenic benefit of creatine for a sportsperson relies on elevation in explosive exercise performance and power output

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2. Creatine supplementation improves muscle conditioning while enhancing the overall stamina of athletes

3. Creatine supplementation increases the ATP or energy storage capacity of muscles, thereby improving the high-intensity exercise potential of athletes

4. The regular consumption of creatine supplementation increases the concentration of myostatin in muscle cells to elevate their strength and endurance

5. Creatine supplementation helps to improve fatigue resistance and brain performance to many folds

6. Creatine supplementation increases the water content of muscles, thereby increasing their stamina, toughness, sustainability, and stress tolerance

7. The consumption of creatine supplementation by sportspersons reduces their risk of Parkinson’s disease, epilepsy, spinal cord strain, and Alzheimer’s disease

8. Medical literature provides some evidence of the effectiveness of creatine supplementation in terms of improving glycemic control

9. Creatine supplementation accelerates brain performance while elevating the energy levels of the cerebrum and cerebellum

10. Creatine supplementation increases cognition and memory without deteriorating the physiological processes of the vital organs

Can You Imagine the Power of Creatine?

Creatine potentially influences body physiology by strengthening the functionality of the musculoskeletal system. The following evidence affirms the beneficial effects of creatine on physiological processes (Riesberg et al., 2016).

1. The neuroprotective effects of creatine are well-recognized in clinical literature. The prolonged consumption of creatine improves the healing mechanisms in patients affected with brain trauma, cerebral ischemia, amyotrophic lateral sclerosis, and Huntington’s disease.

2. Creatine modulates inflammatory processes that assist the healing of injured muscles.

3. The immunomodulatory action of creatine improves the recovery patterns in proinflammatory conditions.

4. Evidence-based clinical literature emphasizes the therapeutic effect of creatine on arthritis and related complications.

5. The engagement of creatine in the arginine biosynthesis pathway helps to enhance ATP/energy production in muscles.

6. Creatine monohydrate helps to elevate the muscles’ phosphocreatine levels that improve the performance outcomes of athletes following their high-intensity exercise or short-term physical activities.

7. The small intestine’s interaction with creatine monohydrate triggers the production of sodium/chloride creatine transporter that eventually increases the expression of creatine in vital organs and the brain.

8. 20 grams/d loading dose of creatine monohydrate followed by a regular dosage of 1-10 grams/d potentially increases the phosphocreatine levels in muscles to many folds.

9. The muscles encounter the highest load of creatine monohydrate during its initial two days of administration.

10. The creatine kinase reaction consumes the hydrogen and lactate ions in muscles after rigorous exercise. Eventually, the modification of pH and enhancement of energy levels of muscle fibers elevates their overall working capacity.

11. The ATP accumulation in the brain after creatine monohydrate intake reduces the risk of mental retardation and developmental delays.

References

Andre, T., McKinley-Barnard, S., Gann, J. & Willoughby, D., 2015. The effects of creatine monohydrate supplementation on creatine transporter activity and creatine metabolism in resistance trained males. J Int Soc Sports Nutr, 12(1), p. 43.

Bavel, D. V., Moraes, R. D. & Tibirica , E., 2019. Effects of Dietary Supplementation With Creatine on Homocysteinemia and Systemic Microvascular Endothelial Function in Individuals Adhering to Vegan Diets. Fundamental and Clinical Pharmacology, 33(4), pp. 428-440.

Bird, S. P., 2003. Creatine Supplementation and Exercise Performance: A Brief Review. J Sports Sci Med, 2(4), pp. 123-132.

Cooper, R., Naclerio, F., Allgrove, J. & Jimenez, A., 2012. Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr, 9(33), pp. 1-11.

Davani-Davari, D., Karimzadeh, I., Ezzatzadegan-Jahromi, S. & Sagheb, M. M., 2018. Potential Adverse Effects of Creatine Supplement on the Kidney in Athletes and Bodybuilders. Iranian Journal of Kidney Diseases, 12(5), pp. 253-260.

de-Moraes, R., Bavel, D. V., de-Moraes, B. S. & Tibiriçá, E., 2014. Effects of dietary creatine supplementation on systemic microvascular density and reactivity in healthy young adults. Nutrition Journal, 13(115).

Kim, J. et al., 2015. Role of creatine supplementation in exercise-induced muscle damage: A mini review. J Exerc Rehabil, 11(5), pp. 244-250.

Kreider, R. B. et al., 2017. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr, 14(18).

Laron, Z., 2001. Insulin-like growth factor 1 (IGF-1): a growth hormone. Journal of Clinical Pathology, 54(5), pp. 311-316.

PubChem, 2020. Creatine monohydrate. [Online]
Available at: https://pubchem.ncbi.nlm.nih.gov/compound/Creatine-monohydrate
[Accessed 17 06 2020].

Riesberg, L. A. et al., 2016. Beyond muscles: The untapped potential of creatine. International Immunopharmacology, Volume 37, pp. 31-42.

Schwalfenberg, G. K., 2012. The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? J Environ Public Health.

Taner, B., Aysim, O. & Abdulkadir, U., 2011. The effects of the recommended dose of creatine monohydrate on kidney function. NDT Plus, 4(1), pp. 23-24.

Wang, C. C. et al., 2018. Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sports Performance. Nutrients, 10(11), p. 1640.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2020 Dr Khalid Rahman

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