Q:

What are the negative side effects of Creatine short/long term and when taking more than the prescribed dosage?

Is Creatine regulated by the FDA and if not is there a stamp/seal on certain brands that lets consumers know it is 'safe' to buy?

Are there 'safe' substitutes to Creatine e.g. Whey Protein?

 

A:

Creatine is taken by people mainly to improve short-term anaerobic exercise performance and to increase muscle bulk. There is some evidence that using creatine can improve recovery from brief, high-intensity exercise such as sprinting in younger people. Creatine increases muscle bulk because it holds water in muscle cells when its concentration in those cells is increased.

Creatine is usually taken initially in a “loading dose” of 20 grams daily for 5 days, and then a maintenance dose is taken daily of 2 grams per day. High water intake while using creatine is important. Once the loading dose has been taken, it does not make any sense to take more than the maintenance dose, because the muscles can hold only so much creatine, and extra just gets flushed from the body.

Creatine seems reasonably safe. No relationship between high doses and adverse effects, except adverse effects on the pocketbook, have been identified. There is ongoing concern that creatine use may exacerbate underlying kidney disease, but there is no hard evidence about this. There has been some anecdotal report of an increased incidence of muscle and tendon injury in people using creatine; this would likely relate to changes in the mechanical properties of those tissues, and their interactions, caused by changes in muscle bulk with creatine.

Creatine is not regulated by the FDA. It is marketed as a “food” or “nutritional supplement.” As such, there is no guarantee as to actual content of the container, or the presence of other chemicals or impurities in the product. There is no reliable stamp or seal on creatine that communicates safety to consumers, although I am sure that many brands of creatine have some very impressive seals and testimonials on the container.

In terms of “substitutes” creatine is pretty much unique in its physiology and action. “Whey protein” is not a substitute for creatine, but is used to increase protein intake in people who want to do so. In most normal people this is unnecessary: athletic activity does not increase the demand of the body for protein significantly above the recommended 1-2 grams per kilogram of body weight per day. Extra protein can put a bit of a strain on the renal excretory mechanism and make underlying renal disease more problematic.

In summary, the best nutritional supplement program is a well-balanced, varied and tasty diet coupled with a sensible exercise program.

~The Doc