Average Dose – 20-25 g. per day for 5- 7 days then 2-25 grams per day thereafter.

Cost – $5 – Sixty dollars per month based on dose and source.

Projected Mechanism of Action- Consuming the above amount results in fifteen to 30 percent growth in total creatine. Amplified creatine pool outcomes in bigger ATP synthesis. Note- twenty to 30 percent of persons do not respond to creatine supplementation.
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Effects on Performance – No improvements in aerobic ability. Positive outcomes are just seen in high intensity, intermittent physical activities. More than 25 studies have been executed, with the great mass showing increase in muscle strength, energy, and sprint performance of five – 15%. Improvements in ability are most likely due to a combination of better metabolic efficiency and improved quality of training.

Adverse Effects- There are no long term ( greater than one year) studies present. Recent studies have not demonstrated any adverse effects other than weight gain and lack of fluids with short term use (under four weeks) in young fit athletes. Anecdotal information include rash, muscle cramping, dyspnea, vomiting, fatigue, anxiety, diarrhea, migraine, myopathy, seizures, polymyositis and atrial fibrillation. No long term studies have been executed.
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Amount of Use – NCAA survey indicates greater than thirty % of college athletes consume it. A players survey estimates 60 percent of MLB players use creatine.

Legal Issues – Non-prescription. Not FDA approved. Not banned by International Olympic Group or any other athletic organization. American College of Sports Medicine has no position papers on creatine but calls for additional research.

Conclusion:
Based on available literature, creatine seems to improve sports performance by unique mechanisms in specific situations. The most profound factor is most likely enhanced strength training which leads to increased strength and power. Based on this information alone, many athletes will choose to take this agent in spite of the risks involved. As a doctor, the best approach in dealing with athletes is not to be judgmental, but insted be a source of reliable information, and let the athlete make their own decision.

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