Is Creatine Safe? Part 2 in the Creatine Series

People on vegetarian diets seem to have a greater response to creatine, theoretically due to the lack of dietary creatine intake. From this, it can be inferred that individuals who consume large amounts of protein on a daily basis, especially red meat, will have a less significant response to creatine supplementation to the amount being ingested through typical dietary means. It is interesting to note that most creatine research uses the standard protocol of 5 g / d for "maintenance".

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Anecdotal evidence suggests a high rate of success with creatine supplementation. This same evidence indicates that doses in the field are much higher than the established research protocol or recommended label amounts.

This may account for a higher anecdotal rate of success and perceived effect in the field as opposed to what is suggested in the literature. Anecdotal evidence is not a substitute for scientific research, but should be taken into account. What happens in "the real world" is much more important than what occurs in isolated, scientific trials when trying to make a "real world" application of creatine supplementation.

The majority of studies indicate that supplementation with creatine for prolonged periods of time using large doses are safe. One study concluded that supplementation from nine (9) weeks up to five (5) years did not adversely affect renal function . Yet another study examined muscle damage, hepatic (liver) and renal (kidney) function, and found no adverse effects from creatine supplementation.

There is potential cause for concern, however. The by-product of creatine use in the muscle is creatinine. Creatinine is typically harmless, and is flushed by the kidneys. When the kidneys are not functioning properly, however, any type of excess strain can cause problems. Creatinine levels are typically used to monitor kidney function, and creatine supplementation will raise these levels. A study done on animals with existing kidney problems showed that creatine supplementation aggravated and increased the acuteness of these conditions. Therefore, creatine supplementation may not be wise for individuals with renal disease or dysfunction.

The largest safety concern with creatine is most likely the quality of the product. Creatine is manufactured from sarcosine and cyanamide. During the production of creatine, contaminants such as dicyandiamide, dihydrotriazines, creatinine, and various ions are produced. Supplementation with large doses for prolonged periods of time with a product that has not been sufficiently screened for contaminants could be cause for concern. Finding a reputable company that provides quality creatine product is very important when considering creatine supplementation.

Creatine is mainly discussed with reference to its effect on anaerobic output, specifically in the ATP-CP and glycolytic range of muscular energetics. It is important to note that a few studies do support ergogenic effects on oxidative (aerobic) systems as well.

One study showed that creatine supplementation reduced the "oxygen cost" of activity, meaning that less strain was placed on the cardiovascular system when performing aerobic work after creatine supplementation. Another study, performed on animals, concluded that creatine supplementation increases the oxidative potential of cardiac muscle. Both of these studies seem to indicate increased aerobic capacity.

For an individual concerned with fitness, this is very important information. If creatine increases aerobic capacity, creatine supplementation could potentially increase the amount of workload performed during cardiovascular sessions. This would mean more caloric output. Combined with resistance training and proper nutrition, the end result would be a net loss of body fat (combined with an increase in lean muscle mass as evidenced by the other effects of creatine supplementation). This is a powerful combination of effects!