Sports Medicine

Performance Enhancement: Creatine

Creatine supplements were first described in the 1830s and are approved by the FDA as a dietary supplement. Initially it was used for problems of serious malnutrition. Its use as an athletic enhancement drug began in 1981 and was studied extensively in the early 1990s.

Use of standard creatine dosing (a loading phase of 20 grams per day for five days, followed by a three week maintenance dose of 1 to 2 grams per day) allowed significant improvement in athletic performance. This enhanced performance however has been limited to short anaerobic bursts of energy. Use of creatine for long distance running and other aerobic exercises has been shown to be ineffective.

Physiologically, creatine, when given orally, allows the increase of high energy molecules within muscle fibers. The above dosages can increase total creatine in the body by 20 percent and theoretically increase muscle strength by 20 percent. However, trained individuals and 20 to 30 percent of individuals overall do not respond to creatine supplements. The biggest effect has been demonstrated in malnourished, untrained individuals who might lack creatine in their diets.

At this time, no serious significant adverse effects have been found. The Association of Professional Team Physicians has cautioned that negative renal effects may occur and that no long-term studies on creatine supplementation have been performed. The FDA has reported 20 cases of dehydration and subsequent cramping which may have been due to creatine supplementation. Several epidemiologic and prospective trials are currently underway at UConn Health Center. These are being performed to better understand who might benefit from creatine supplementation and who may be at increased risk from its use.

Creatine can be bought over the counter at various pharmacies and organic food stores. The price via mail order has been found to be between $12 to $36 for approximately a 90 day supply. More expensive formulations can also be found.

In summary creatine phosphate is an FDA approved dietary supplement. It has been shown in multiple studies to have a positive effect in improving short burst maximal energy type activities. For the untrained individual who is a casual athlete, inconsequential gains only are possible. However, for the trained athlete or untrained athlete who is about to commence on a vigorous training program, the gains can be significant. It must be remembered, however, that 20 to 30 percent of people overall have not shown any effect. It is also important to remember that no long-term studies have been performed and therefore long-term adverse effects can not be ruled out.