What is creatine? Creatine is an amino acid (amino acids are the building blocks of protein) which is made in the body by the liver and kidneys, and is derived from the diet through meat and animal products. Creatine (creatine monohydrate) is a colorless, crystalline substance used in muscle tissue for the production of phosphocreatine, an important factor in the formation of adenosine triphosphate (ATP), the source of energy for muscle contraction and many other functions in the body. What does creatine normally do in the body? In the body, creatine is changed into a molecule called "phosphocreatine" which serves as a storage reservoir for quick energy. Phosphocreatine is especially important in tissues such as the voluntary muscles and the nervous system which periodically require large amounts of energy. Why do athletes take creatine? Studies have shown that creatine can increase the performance of athletes in activities that require quick bursts of energy, such as sprinting, and can help athletes to recover faster after expending bursts of energy. Creatine is best for the serious bodybuilder. It helps increase muscle mass, rather than muscle endurance, so it’s not well suited for athletes participating in endurance activities. However, the increase in muscle mass may be due to water retention and not an increase in muscle tissue. Why have I been hearing so much about creatine and neuromuscular disorders? Two scientific studies have indicated that creatine may be beneficial for neuromuscular disorders. First, a study by MDA-funded researcher M. Flint Beal of Cornell University Medical Center demonstrated that creatine was twice as effective as the prescription drug riluzole in extending the lives of mice with the degenerative neural disease amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). Second, a study by Canadian researchers Mark Tarnopolsky and Joan Martin of McMaster University Medical Center in Ontario found that creatine can cause modest increases in strength in people with a variety of neuromuscular disorders. Beal's work was published in the March 1999 issue of Nature Neuroscience and the second paper was published in the March 1999 issue of Neurology. I want to start taking creatine -- is it safe? For the most part, athletes haven't experienced adverse side-effects from taking creatine, although recently there have been a few reports of kidney damage linked to creatine usage. No consistent toxicity has been reported in studies of creatine supplementation. Dehydration has also been reported to be a problem while taking creatine. Athletes generally take a "loading dose" of 20 grams of creatine a day for five or six days, then continue with a "maintenance dose" of 2 to 5 grams of creatine a day thereafter. What are the side effects? Little is known about long-term side effects of creatine, but no consistent toxicity has been reported in studies of creatine supplementation. In a study of side effects of creatine, diarrhea was the most commonly reported adverse effect of creatine supplementation, followed by muscle cramping.18 Some reports showed that kidney, liver, and blood functions were not affected by short-term higher amounts or long-term lower amounts of creatine supplementation in healthy young adults. In a small study of people taking 5–30 grams per day, no change in kidney function appeared after up to five years of supplementation. Muscle cramping after creatine supplementation has been anecdotally reported in some studies. Benefits • increases athletic performance • increases muscle mass • beneficial for muscular disorders