Creatine Monohydrate (“Creatine”): A powerful supplement with clinical benefits beyond exercise training

By Dr. John R. Mishock, PT, DPT, DC

Creatine Monohydrate (creatine) is one of the most popular nutritional aids in America with over 9 million pounds of creatine supplement consumed annually. Creatine first gained popularity in the 1990s with body builders and athletes. Many people take this supplement to improve training adaptation to enhance sports performance. Creatine monohydrate is a naturally occurring non-protein amino acid found primarily in red meat and seafood. The body needs to replenish about 1 to 3 g of creatine per day. For athletes and individuals with ongoing disease processes the need may be greater. Often we do not reach this dosage need with diet alone. Creatine works in the mitochondria (power house of the cell) to make ADP (adenosine diphosphate) into ATP (adenosine triphosphate), simply put this reaction creates the energy needed for the function of every cell in our body. Research has shown that this supplement has far reaching benefits beyond athletes and is currently utilized to enhance physical therapy and rehabilitation. In this article I will review the key benefits of creatine as it relates to optimal body function and prevention.

Muscle injury prevention: Creatine monohydrate users experience less muscle cramping, less muscle tightness, less muscle strains and pulls, and improved recovery following training or competition. (Mol cell biochem, 2003) This supplement can be used to enhance sports performance and recovery.

Rehabilitation following immobilization or surgery: Following immobilization and surgery the body will atrophy very quickly with decreased strength, endurance, and motor control. Studies have shown that creatine users will notice less muscle atrophy and greater strength and endurance gains following Immobilization and/or surgery. (arch phys. Med rehabil., 2003)

Brain and spinal cord protection: Following traumatic brain injury or concussion utilization of creatine can protect progressive damage by up to 36 to 50%. (spinal cord, 2002). The same neurological protective benefits can help individuals following stroke, Parkinson’s disease, Huntington s Disease, Lou Gehrig’s disease. It may even help with the progression of brain atrophy found in dementia and Alzheimer’s disease. (Neuromolecular Med, 2008).

Aging: Creatine supplementation has been reported to help lower cholesterol and triglyceride levels, reduce fat accumulation, enhance blood glucose control, and reduce osteoarthritis symptoms in the knees. (J strength Cond Res, 2006; Res Sports Med. 2014; Med Sci. Sports Exerc., 2015)

Safety as a supplement: All of these positive effects of creatinine monohydrate seem too good to be true. However, creatinine monohydrate is one of the most studied supplements on the market. Creatinine became popular in the 1990s and since there has been over 1000 studies conducted and billions of servings ingested. There has only been one consistent reported side effect of creatinine supplementation in the literature, weight gain. (Jour int society of sports nutrition, 2017). Even performance related studies on adolescent athletes has shown no side effects. (Amino acid, 2012)

The recommendation is to consume 3 to 5 g of creatinine monohydrate to promote general health and fitness. (Jour int. society of sports nutrition, 2017). It is important to make sure that is the pure form of creatine monohydrate with no fillers. Those with clinical syndromes may want to increase the dosage. As always, discuss with your health care professional before consuming any dietary supplement.

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