NUTRITION

Athletic Enhancements

Creatine: The safe alternative to anabolic steroids

The use, or more correctly, the misuse of anabolic steroids has been creating concern worldwide among the sport and medical fraternity.  The banning of these substances by the sporting bodies seemed to only have exasperated the problem by causing the users to go underground.  Meaning that they are still using the steroids, often from dubious sources and unsupervised in unregulated dosages.  The danger of this can not be over emphasised.  To find a safe and natural form of assisting sportsmen and women to reach their goals should therefore be considered.

In this regard, Creatine is a naturally occurring molecule, usually synthesised in the liver from three amino acids:  Glycine, Arginine and Methionine.  Methionine also plays an important role in the formation and utilisation of Creatine.  Creatine has been identified in playing an important role in energy supply to and development of muscle.  To understand this the body energy system has to be considered.

The energy for driving most biochemical reactions in the body is derived from the hydrolysis of the substance; Adenosine Triphosphate (ATP).   However, to permit bursts of activity, a large amount of phosphate is stored as phosphocreatine, which has about the same free energy of hydrolysis as ATP.  This transfer of phosphate from ATP to form Creatine Phosphate takes place during periods of rest and is again regenerated to ATP when needed for energy by the enzyme Creatine Kinase.   The elevation of Creatine Kinase appears to be a normal response to the stress of an increased training load.  After Creatine ingestion, muscle peak torque production was increased in all subjects tested, compared to their results before Creatine supplementing.  This may be an consequence of a Creatine-included acceleration of skeletal muscle phosphocreatine resynthesis.

Creatine monohydrate is the more stable and therefore better absorbed form of Creatine.  After formation or absorption Creatine diffuses into the vascular system and is transported by the plasma and erythrocytes to the muscles where it is in equilibrium with Creatine phosphate.  This is responsible for the energy transport in muscle fiber according to the so-called "Creatine phosphate shuttle".  Approximately 95% of all Creatine found in the body is stored in the muscle cells, this retention of Creatine due to additional supplementation can possibly also lead to temporary increase of the muscle cell water content.  This volumising, can lead to better definition and a more favorable environment for protein synthesis and growth in the muscle.  Creatine is also said to buffer lactic acid production, thus possibly playing a role  in combating muscle fatigue and after utilisation is excreted by the kidneys in the urine as Creatine.

Studies show that Creatine given as a supplement to normal subjects is absorbed and results in an increase in the total Creatine pool in muscle if continued.  A single 5g dose corresponds to the Creatine content of 1.1kg of fresh, uncooked steak.  Uptake into muscle is greatest during the 1st two days of supplementation.  First of all it should be emphasised that no official RDA (recommended daily allowance) has yet been established for Creatine Monohydrate and though generally considered safe, no significant long term toxicology studies have been done, especially in children.  The only rough guideline at this stage is the fact that the average adult person loses approximately 2g of Creatine per day, it should however be considered that a percentage of this Creatine will be replaced by dietary intake in most people.  The recommended levels used by Australia, New Zealand Food Authority, Sports Food Standards Code for use as a nutritional supplement is only 3g per day.

Most of the studies that have been done with sportsmen in regard to performance enhancement were done with Creatine loading of 20g per day and maintenance dosages of 5g per day.  Conflicting results were found.  Some studies reported increase in performance, with a faster recovery time and a decrease in general fatigue, where as other studies showed little to no improvement.  Certain athletes do show definite benefits from using Creatine especially in short duration, high intensity type exercise / training.  Such high dosages, as were used in most of these studies, should however be used under medical supervision.  Creatine is widely used by athletes world wide and is not banned in South Africa or any other international sporting federation.

In summary, Creatine does seem to play an important role in the energy supply to muscle and possibly assists the muscle growth and definition, with no side effects noted at this stage and as such, definitely presents us with a safe alternative to anabolic steroids.  Creatine should however be seen as a supporting supplement and not a miracle drug, thus supplying  the body with what it needs to reach its peak.  No drug or supplement should be seen as a replacement for an good exercise program.

Acknowledgement:  Dr.  R van Brummelen - B.Pharm, M.Sc, Ph.D.

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