International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine

Abstract

Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson’s, Huntington’s disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).

Isolated systolic hypertension — evaluation of the scale of the problem among medical students — pilot study

“…Moreover, the rest of the strength training participants, using other supplements, mainly whey protein, were NBP. Creatine supplements are considered by many authors to be safe [28]. However, their influence on the inhibition of physiological increase of parasympathetic system activity, caused by intensive physical activity has been proved [29].…”

Effects of Low-Dose Creatine Monohydrate on Muscle Strength and Endurance

“…The result of the reaction, which is extremely fast, is adenosine diphosphate (ADP), which is rapidly regenerated by the phosphocreatine (PCr) through another enzyme, i.e., creatine kinase (5,29). Thus, creatine is a vital source of chemical energy for muscle contraction because of its capacity for phosphorylation, with the consequent formation of PCr and reversion and with the donation of the phosphate group to ADP, which in turn gives rise to a new ATP.…”

“…In terms of administration protocols, a loading phase of 20 g/day for 5 days followed by a maintenance phase of 2 or 3 g/day is common for creatine monohydrate (5,16). The saturation phase is used to achieve an adequate increase in muscle creatine stores.…”

“…In a standard omnivorous diet with an intake of 1 -2 g of creatine per day, the intramuscular creatine stores are between 60 and 80% saturated. Therefore, creatine monohydrate supplementation aims to saturate the remaining 20 to 40% (5). Oral creatine monohydrate supplementation could increase the total amount of muscle creatine, which in turn could also increase free creatine and phosphocreatine (PCr) (1,6).…”

Beyond sports: Efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscle

“…Creatine has a well‐known capability to increase muscular strength and resistance in athletes, by whom it is largely used as a nutritional supplement …”