From Weight Room to Board Room: How Creatine Fuels Success

 The other day, I mentioned creatine to a patient, and he said he had heard of it, but he didn't know much about it. I thought creatine was common knowledge for men who are into nutrition and fitness, but sometimes I forget that because I run into the bodybuilding crowd and the fitness crowd, I know things that many men don't. Men who take 3 5 grams of creatine monohydrate a day can expect to experience a lot of great things. Increased strength and power, improved endurance, muscle mass gains, and faster muscle recovery. There's even some data suggesting it can improve connectivity between neurons in the brain. One other thing that we've noticed, primarily with muscle growth, is that creatine seems to raise levels of IGF 1, insulin like growth factor 1. And that's a hormone that's released in conjunction with growth hormone. IGF 1 has a myriad effects, one of which is to increase muscle growth. The creatine conversation really starts with ATP, adenosine triphosphate. It's a literal energy molecule that powers your cells. But your muscle cells only contain a small amount of ATP, so it needs to be constantly replenished as you work your muscles. When your muscles use ATP, again that's adenosine triphosphate, it loses a phosphate molecule and gets downgraded to adenosine diphosphate. But this useless ADP, adenosine diphosphate, can get recharged back to useful ATP with help from creatine, which donates its phosphate molecule. The ATP recharge rate is what limits your ability to continually perform at maximal intensity. As you use up ATP faster, you can make it as you're working really hard. So if you want more energy, you really need to increase your ATP recharge rate, which means you need more creatine in your muscles. So your body makes creatine molecules in the liver and kidneys by using three amino acids, arginine, glycine, and methionine. It's then banked in your muscle cells until you use it. Creatine is also found in several foods, particularly in seafood and red meat. One pound of raw beet or salmon provides one to two grams of creatine, but remember, a lot of that creatine is lost during cooking. So keep in mind, a typical serving of creatine is three to five grams, so you'd need several pounds of cooked meat or seafood to get enough. And what's a good way to determine how much you really need? If you're under 120 pounds, three grams should suffice. If you're 120 to 200 pounds, 5 grams should suffice. And if you're above 200 pounds, 7. 5 to 10 grams should suffice. One thing I would make note of though is make sure that whatever supplement you choose is CGMP certified. And these are basically regulations and guidelines set by the FDA to ensure quality, potency, purity, and certain QA and QC systems to be put in place by supplement manufacturers. Creatine loading has been around for a long time. Basically, it's where you take 20 to 25 grams split into 4 to 5 doses for several days, usually about a week. The idea is that it will quickly saturate your muscles with creatine, particularly if you haven't started it. My personal take on it is it's really not necessary, and some of the side effects of it, like dehydration, upset stomach, and muscle cramps, are things that I've seen in patients who've done it, despite my recommendation not to. Just like any other supplement, you want to consult with your physician before taking it. One thing that you may notice on lab values is that your creatinine may rise. Creatinine is a byproduct of creatine and it's a commonly used marker in determining kidney function. Now the data has suggested that rise is fairly harmless, but again, something to talk over with your physician. Expanding on this, most of the data has suggested that long term creatine use is safe for patients with healthy kidneys, and there's been some research that's actually looked at creatine usage in individuals who have mild to moderate decrease in kidney function and noted that creatine is safe. I think more and more physicians are learning more about it, but I do suspect if they don't work out regularly or have an athletic background, their knowledge might be limited. So hopefully the information I present in this video can be of use to you.