Elite athletes have been using creatine since the mid sixties, but now its widespread use has put creatine at the top of the sports supplement list. The combination of its popularity and the public's lack of knowledge about creatine has lead to several misunderstandings and misperceptions, particularly in the media. What is creatine?

In 1832, creatine, a nitrogenous molecule, was identified in meat by the French scientist Chevreul. Later, in 1847, Lieberg concluded that the accumulation of creatine in the body is directly involved in producing muscle work. The investigation of creatine supplementation began in the early 1900's using creatine extracted from meats. Synthetic creatine production began in the early 1960's as did it's use for anaerobic benefit, mainly in the Eastern block countries of the former Soviet Union. Several British Olympic athletes were, reportedly, supplementing with creatine before the 1992 Olympic games in Barcelona. The Olympic games in Atlanta were jokingly referred to "The Creatine Games" as a number of athletes supplementing with creatine were awarded gold medals. High profile, professional athletes, such as St. Louis Cardinals' slugger Mark McGwire and Denver Broncos' quarterback John Elway, have also shown their devotion to this sport supplement. Why? Because it works.

To date there have been over 72 research articles published about creatine in various journals, as well as a number of papers presented at various meetings such as the National Strength and Conditioning Association's Creatine Symposium. Simply put, with the exception of carbohydrates, creatine is the most extensively studied nutritional sports supplement available to today's athlete.

To fully understand creatine, we need to start with adenosine triphosphate (ATP). ATP is the fuel that is necessary for each and every muscle contraction. From getting out of bed in the morning to sprinting after the bus, ATP is responsible for all of the muscle action that we take for granted. Only limited stores of ATP are immediately available in our muscles, and, therefore, our bodies must continually produce it.

In order to produce ATP, the body utilizes three different mechanisms: (1) Creatine kinase (anaerobic); (2) Glycolysis (anaerobic); and/or (3) Oxidative phosphorylation (aerobic). The initial, most powerful energy production is accomplished by creatine kinase which involves a non-oxygen dependent process that is responsible for all maximal/near maximal muscle contractions. Creatine kinase rapidly converts the initial stores of ATP to energy and is responsible for any high intensity, short duration activity such as sprinting, lifting, or the like. As ATP is "burned," it looses a phosphate molecule and becomes adenosine diphosphate (ADP) which is useless until it can be converted back into ATP. This is where creatine plays its major role. Creatine is initially stored in the muscle as creatine phosphate. As creatine phosphate, it can donate its phosphate to ADP and convert it back into ATP which is then available to fuel additional muscle work.. Creatine is repeatedly converted back into creatine phosphate during rest and becomes available to convert ADP back into ATP during the next explosive bout of activity.

Glycolysis is the second mechanism for producing ATP and is less efficient than creatine kinase. During glycolysis, a glucose molecule is broken down into two pyruvic acid molecules, yielding two ATP molecules in the process. Glycolysis, however, requires more steps than creatine kinase which results in a slower yield of ATP. Even though glycolysis provides the energy to perform intense exercise, it has two important consequences. First, it consumes large amounts of nutrient fuel to yield ATP molecules which, in turn, rapidly depletes the muscle's glycogen stores. Second, the end product of anaerobic glycolysis is lactic acid.

The third mechanism is oxidative phosphorylation which is an aerobic process fueled by glucose or fatty acids, depending on the duration and intensity of the activity. This is the slowest process for producing ATP because of the number of steps involved and its dependency on a constant supply of oxygen. Oxidative phosphorylation sometimes works in conjunction with glycolysis. The type and duration of the exercise dictates which of these energy processes will be used.

In short, anaerobic-maximal/near maximal-fast twitch exercise is enhanced with creatine supplementation, which provides the increased supply of creatine phosphate molecules needed to turn ADP back into ATP. Also, by increasing the body's store of creatine phosphate, creatine supplementation prolongs the creatine kinase process. This delays the need for oxidative phosphorylation and glycolysis, which ultimately reduces lactic acid buildup and muscle soreness. In research to date, creatine supplementation has not been shown to effect aerobic activity.

Creatine is naturally synthesized in the liver, pancreas, and kidneys from the precursor amino acids arginine, glycine, and methionone. Dietary creatine is also available in meats and fish, but creatine content is depleted rapidly when foods are cooked. There is approximately 2 grams of creatine per pound of raw, red meat. Most people, through diet and synthesis, only store about 60-80% of their potential creatine levels. Supplementing with creatine enables an individual to elevate their creatine stores an average of 30%. This additional creatine gives the body the necessary ingredients to reproduce more ATP during the creatine kinase process and to ultimately generate more work. The formula is simple: More work equals more muscle and more muscle equals more work. Creatine does for the sprinter what carbohydrate loading does for the long distance runner. It provides more energy producing materials which enables more work to be generated.

A person's ability to store creatine can be compared to the gas tank of your car. Once your creatine tank is full, it will not hold any more, no matter how much more you consume. Extra creatine is removed from the body by the kidneys via diffusion, which is a low energy dependent process. The key to proper creatine usage is to find maximum benefit from the lowest dosage. Currently there are no dosage amounts set in stone, although there are some common theories. One of the most popular is the loading phase, which consists of taking approximately five grams 3 or 4 times a day for a period of five days. This is followed by a maintenance phase, which consists of 2-5 grams per day thereafter. Another theory suggests that the loading phase is unnecessary and wasteful. An individual supplementing with only the maintenance phase (2-5 grams/day) will have the same muscle saturation in 2-3 weeks as the individual who loads. Creatine absorption is quickened when taken with a substance that increases insulin levels, like dextrose. This increased absorption can be achieved by taking creatine with grape juice or any other beverage high in dextrose. Ingesting creatine with a meal will also provide the same effect due to the increased insulin production. Some studies have also shown that exercised muscle will absorb about 12% more creatine than a non-exercised muscle. It follows that taking creatine directly after a workout maybe more helpful, although not necessary to achieve benefits.

In addition to creatine's athletic applications, it has also been reported to positively affect lipid profiles in middle-aged hypertriglyceremic patients with high cholesterol. One study reported that 28 days of creatine supplementation reduced total cholesterol 7%. Another study of patients undergoing heart valve replacement suggested that creatine could provide a significant benefit in the response to postoperative medications by enhancing myocardial protection to a point where the need for postoperative medication was greatly reduced. Creatine has also been used successfully to treat gyrate atrophy of the choroid and retina as well as extrapyramidal movement disorder and other creatine related deficiencies. Future possibilities for creatine supplementation will include prevention of muscle atrophy in older, health conscious individuals who may also take advantage of creatine's cardioprotective qualities and cholesterol lowering capabilities.

The only side effect from creatine supplementation reported in clinical studies has been a mild weight gain (2-5 lbs) due to water retention, 80% of which is intracellular water. There are some unsubstantiated anecdotal reports of cramping or muscle pulls. There is some concern about long term supplementation with creatine. To date, the longest study has been a five year follow-up study of creatine used for gyrate atrophy of the choroid and retina which was done at the University of Helsinki, Finland (1984). The only reported side effect in this study was the initial mild weight gain (2-5 lbs) reported in the female subjects. Longer studies involving athletic applications are currently being researched. Preliminary data from a long term study presented at the 1998 American College of Sports Medicine by Dr. Mike Stone reported no adverse effects after 2 years of supplementation. As previously mentioned, there have been over 72 research articles published about creatine in various journals as well as papers presented at various scientific meetings such as the Creatine Symposium at National Strength and Conditioning Association's meeting in Nashville this year. With the exception of carbohydrates, creatine is, indeed, the most extensively studied nutritional sports supplement available to the athlete.

Any negative literature pertaining to creatine has been primarily generated by the media and most often by people with little or no knowledge of the current research. The controlled studies by leading research centers give a drastic contrast to these articles.

Is all creatine created equal? No. Creatine use has generated a huge market that is highly competitive. In order to gain a marketing edge, some companies will purchase lower quality creatine in order to increase their profitability and ability to compete with larger companies that are buying quality creatine. The key to purchasing creatine is to determine who is the actual manufacturer. Because creatine is a supplement, the manufacturing process in not regulated and, as a result, there is a lot of questionable creatine being imported from overseas and well as some domestic creatine that is suspect as well. Finding a reputable creatine supplier requires a little investigative research.

Ask questions and look for the following:

• Is the creatine in the bottle that you buy manufactured in a cGMP (current Good Manufacturing Practices) facility? A company may achieve cGMP only by complying with strict manufacturing practices including stringent quality control.
• Is the creatine certified for its purity and quality? A creatine manufacturer supplies a signed certificate of analysis attesting to its purity. Ask for it and make sure that it shows no impurities such as dicyandiamide or dihydrotriazine. Don't accept unsigned certificates or certificates that are not directly from the manufacturer.
• Is the creatine manufacturer an FDA registered pharmaceutical manufacturer? This is a big plus. Even more so if they have registered a Drug Master File with the FDA covering the production of creatine.
• And finally, is the creatine manufactured in the United States? US manufacture is not a guarantee but, if it is US made and the answers to the preceding questions are yes, you have a winner.

Not only is creatine effective, it is very affordable. An athlete can supplement with creatine for a mere 12 cents a day, less than ¼ the price of one can of soda. The NutraSense™ Company offers CREATEAM® brand Pure Creatine Monohydrate to athletes ranging from professional organizations to high school teams. CREATEAM® Creatine is unsurpassed in quality and effectiveness. Not only is CREATEAM® Pure Creatine Monohydrate manufactured in the United States in a cGMP (current Good Manufacturing Practices) facility, its manufacturing process is registered with the FDA via a Drug Master File. A Certificate of Analysis from the manufacturer is sent with every order.

So where does creatine go from here?

Creatine is nothing new. Elite athletes have been using it since the mid 1960's and there is a very real reason why creatine usage has increased dramatically over the last 5 years. It is not because it's a fad or because of a lot of advertising hype and unsubstantiated claims. It is because it works. It works by increasing the overall energy level and improving recovery time. Whether you are young and trying to achieve maximum athletic benefit, middle-aged and maintaining an active lifestyle, or elderly and trying to either overcome muscle atrophy or take advantage of its cardioprotective qualities, creatine may be the best way to supplement a healthy diet and to increase your ability to exercise.

For more information on creatine please call The NutraSense™ Company at 1-800-350-7017.