Creatine: The Good, the Bad, and the Ugly

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Part 1: How to Utilize Creatine Safely and Effectively by Dr. Jeffrey Ruterbusch

Creatine mono hydrate is perhaps the most widely researched and utilized sports supplement. Clearly, there is no more debating it’s utility and efficacy as an ergogenic aid. However, more recently, this sports supplement has been found to have even greater therapeutic value due to it’s ability to stave off neurocognitive decline.

In addition to Creatine’s ability to maximize cardiac reserve in congestive heart failure, increase insulin sensitivity, and help stave off age-related sarcopenia, it has now been shown to enhance “mitochondrial function”. It achieves this function by significantly lowering the accumulation if a recognized marker of aging called “lipofuscin”.

Creatine-fed rats lived an average of 9% longer than control animals. If extrapolated to humans, this would be equivalent to more than seven years for the average person. Creatine plays a key role in cellular energetics and it functions in the mitochondria, or “powerhouse” of the cell. Aging leads to the accumulation of dysfunctional mitochondria.

This loss of mitochondrial function can cause a buildup of aging pigments known as lipofuscin. Lipofuscin builds up when a cellular “garbage-disposal system” (I.e., auto phage) breaks down. Eventually, the increased lipofuscin increases oxidative stress, decreased energy production, and ultimately, cell death.

Creatine has been shown to help boost cellular energy in the brains of aging mice by the same mechanism just described. Creatine also helps maintain adequate levels of high-energy phosphate-containing molecules in tissues with especially high energy consumption, such as the heart, brain, and muscle. High levels of Creatine support the body’s production of ATP, the universal energy-transfer molecule, when ATP itself is used up by these power-hungry tissues.

Ultimately supplementing with Creatine helps restore the energy loss that is at the root of many age-related diseases. Given Creatine’s amazing non-toxic profile, with numerous studies supporting it’s use as a safe supplement with known numerous benefits, I consider the use of this supplement an interesting addition to the growing pharmacopeia of the anti-aging or age-management practitioner.

I would however, still recommend that people with a history of renal disease and/or taking nephrotoxic medications see their doctor before contemplating use. Also, if you are supplementing with Creatine, it would be prudent to advise your physician of this since it may cause a transient increase in urinary Creatinine levels, which may then act as a false indicator of renal dysfunction.

Part 2: Dr. Bell’s thoughts on Creatine: “Recommended, but with Strong Caution” by: Dr. Jim Bell

Creatine has been the most widely researched supplementation in history. Since it has a direct impact on the Adenosine Tri Phosphate – Creatine Phosphate (ATP-CP) Energy system it has a direct impact on increasing strength, speed, power and may increase Anaerobic Endurance. Any anaerobic athlete would probably benefit from Creatine supplementation, but I do not recommend it for the young athletes and I recommend caution on using it on the more mature population.

Human physiological systems are not fully mature until about the age of 21 for males and 18 for females. Giving Creatine to those under this age group has not been researched.

While I do not have any knowledge of scientifically researched side effects, my instincts tell me that we should all wait till at least 6 months past the onset of puberty in a child before we give them Creatine or any other supplement for that matter.

Even with older children, if you decide to give them supplements, understand that you are treating them as laboratory rats and subjecting them to experimental risks. I also recommend you look out for potential side effects in the more mature populations.

Anyone over the age of 45 or beginners can experience various muscle, joint, tendon and ligament strains and injuries. This results from rapid strength increases inside the anaerobic muscle fibers: Type IIB, which makes up approximately 15% of all your bodies muscle fibers and type IIA, which make up approximately 40% of all your bodies muscle fiber. Creatine will have far less impact on your type I, Aerobic fibers, which make up approximately 45% of all your bodies muscle fiber since they rely on Krebs Cycle for ATP production.

Creatine can cause muscle fiber to get strong very rapidly without allowing adequate corresponding adaptation to increase strength inside fascia, ligaments, tendons and joint capsules. This process makes the “Former Athletes or Strength Trained Individuals” who are currently out of shape even more susceptible to injury.

Muscle Memory works, so when a de-conditioned, formerly strength trained individual begins to strength train again; they will get bigger and stronger much faster than someone starting from scratch. Couple Creatine supplementation with Muscle Memory and your fascia, ligaments, tendons, and joint capsules can easily be overwhelmed and injured.

Another cautionary note for the older population concerns their blood pressure. While little research has been done on this effect, Creatine Supplementation has been shown to elevate blood pressure (BP) in older clients.

Normal BP is 120/80 or lower. Creatine has been shown to increase BP substantially where normal BP clients can become hypertensive (140/90) and hypertensive clients can elevate to Stage 2 HBP: 160/100 or higher! Stage 3 180/100 or higher is a Hypertensive Crisis requiring emergency medical care when the patient is performing normal, day-to-day activities.

The goal of any fitness program should be to improve health and lower BP. To get your BP as low as possible: eat a healthy diet, keep sodium intake to less than 1500mg of Sodium/day, exercise regularly (preferably daily), maintain a healthy weight, manage stress, avoid tobacco smoke, limit alcohol consumption ( one drink/day women, two drinks/day men).  Generally, (one drink = 12 oz beer, a 4 oz glass of wine, 1.5 oz of 80 proof liquor or 1 oz of hard liquor (100-Proof).

Creatine can be a highly effective supplement for anaerobic athletes, but please be forewarned of the potential injuries that could occur.

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