Oral Creatine Supplementation: Separating Fact from Hype
Source: Juhn MS, et al. Phys Sportsmed 1999;27(5):47-50ff.
Juhn and colleagues provide an excellent review of the current thinking with regard to use of oral creatine supplementation to enhance athletic performance. Juhn et al notes the small number of good scientific articles that exist in the literature. While there is some evidence that these supplements can enhance performance in repeated short bursts of stationary cycling and weightlifting, there is no evidence to support an ergogenic effect on other sporting activities such as running, swimming, or even cycling on the road. Juhn et al clearly identifies some potential complications from the use of creatine as a dietary supplement. It has been repeatedly shown that a modest weight gain occurs after the typical loading dose is taken over a five-day period and that this weight gain is probably due to water retention and not to an acute gain in muscle mass. Muscle cramping, gastrointestinal complaints, renal dysfunction, and dehydration all have been reported as complications of the use of creatine. The weight gain due to water retention may decrease performance, offsetting any potential ergogenic effect of the creatine. Juhn et al conclude this excellent review by stating, "the evidence that creatine improves running and swimming performance is not convincing[and]creatine has not been shown to be ergogenic outside the laboratory setting."
Comment by James D. Heckman, MD
This is an excellent review of a controversial subject. The enthusiastic endorsement of creatine dietary supplements by celebrity athletes has led to their common consumption among athletes at all levels. Juhn et al provide a comprehensive list of references that will facilitate anyone’s study of this subject. The actual number of well-performed clinical studies on the effect of oral creatine supplementation is quite sparse, and little is known about the specific ergogenic mechanisms if, indeed, they do exist. Juhn et al clearly point out that there have been no studies performed in the pediatric population with regard to the effect of creatine oral supplementation. Yet, young athletes may be more susceptible to the influence of the advertising campaigns and take the supplement despite the fact that there is little or no evidence that it can be helpful. This is an article that should be read by all trainers and sports medicine physicians who wish to be informed about the benefits and effects of creatine in their athletes.
Dr. Heckman is Professor and Chairman, Department of Orthopaedics, University of Texas Health Science Center, San Antonio, TX.
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