Creatine; Friend or Foe?, By: Hugo Riveria

This week a report came from Paris originated by the French Agency of Medical Security for Food (AFSSA) indicating that there is a "potential carcinogenic risk" for creatine users "particularly in the long term". In addition, the report indicated the following:

1-Long term effects of creatine have not being sufficiently studied.
2-Potential risks associated with taking creatine are "currently insufficiently evaluated".
3-The product was of little benefit to athletes hoping to improve their performance.
4-Its use may promote digestive, muscular and cardiovascular problems.
5-Widespread claims concerning gains in strength and speed from taking creatine supplements were unfounded.
6-Increased muscle bulk resulting from the use of creatine supplements was largely due to water retention.
7-According to Jean-Louis Berta, a food safety expert at AFSSA, its use "involves a risk disproportionate to its effectiveness".

For the past six months I have been working on a Research and Development of Networks Technologies position (my schooling is in Engineering) where I basically have to constantly research on the behavior of new technologies and report results to standards meetings. In this position I have really developed my analytical and observation skills. I have also learned that because an "expert" from company X makes a statement about Y technology, instead of blindly accepting the statement as a fact you need to raise the following questions:

1-How did the expert arrived to those conclusions?
2-What were the test parameters and conditions involved?
3-Are the test conditions typical of real life scenarios, are they worst-case low probability scenarios, or are they scenarios that are just unrealistic?
4-Are the test results repeatable?
5-Is the expert making the statements biased?

Because I spend a great deal of time in such environment I can tell you that there are alot of claims in the world that are unfounded. Now, going back to the creatine issue, lets look at the statements made by the AFSSA one more time. Now I would like you to ask yourself the same questions that I just posted. The article from where I got the information just basically reported on the same seven points that I have on this article. Such points are really conclusions arrived as to the effects of creatine on the body. However, note that no effort was made to indicate how such conclusions were arrived at.

English Translation: "Report on the evaluation of risks presented by the use of creatine to the consumer and of the veracity of allegations relative to sports performance or the augmentation of muscle mass".

Not happy with the fact that the rest of the report was missing, I did a search on the site on creatine and got nothing back. So for the time being I guess that there is no way to see how the AFSSA got to such conclusions up until they post the complete report.

However, there are a few comments that I would like to make on their conclusions:

Regarding Long Term Effects
Yes, I think we know that long-term effects of creatine have not being sufficiently studied. However, every single study that has being performed on creatine's short term effects fail to show any potentially fatal side effects. Common side effects seen in these studies are the usual gastric upset initially caused by the compound (an effect that in my experience goes away as soon as the body gets used to it). In addition, there are no know mechanisms in the body that would lead researchers to believe that the results of a long term study will yield different results.

Note: Allow me to play Devil's advocate for a second and say that there are many drugs out there being sold with little knowledge of their long-term effects. Worst yet, some have being widely distributed with good research indicating very dangerous side effects (i.e. Phen/Fen).

Regarding Creatine's Effectiveness
As far as effectiveness there are scientific studies out there that date as far back as 75 years ago (refer to The Journal of Biological Chemistry 67 (1926): 29-41) that reported on creatine's ability to promote weight gain and improve nitrogen balance. In 1981, an article published in the New England Journal of Medicine by Dr. I. Sipila, shows creatine's effectiveness for improving strength and bodyweight. In addition, unofficial studies conducted by me on myself and other test subjects clearly indicate a performance, bodyweight and strength increase (I'll elaborate on next week's article).

Besides, if you look closely at the claims made by the AFSSA you'll see a small contradiction. On one hand they tell you that creatine does not work for performance or strength gains. On the other hand they tell you that it increases muscle bulk through water retention. First of all, what is so wrong with an increase of muscle mass due to water retention? One thing is extra cellular water retention and another thing is intra-cellular (inside the cell) water retention. Intra-cellular water retention such as the one caused by creatine, is a good thing as this will enlarge the cell from the inside something that results in a muscle voluminizing effect (a full looking and pumped up muscle) and also aids in strength gain. In addition, according to studies conducted in animal cells (refer to studies by D. Haussinger: "The Role of Cellullar Hydration in the Regulation of Cell Function", Biochem.J.313 (1996):697-710 and "Nutritional State and the Swelling-Induced Inhibition of Liver Proteolysis in Perfused Rat Liver", Nutr.J.126 (1996):395) a super hydrated cell may trigger protein synthesis and minimize catabolism. In addition, this enhanced state of the cell may also improve glycogen synthesis.

I guess I am not really bothered by claims of ineffectiveness as if you look in the Physician's Desk Reference and look for steroids you'll find that supposedly these drugs have not being proven to promote strength gains or augmentation of muscle mass. So if a claim as silly as this one makes it to the Physician's Desk Reference, the existence of a silly claim reporting on creatine's supposed ineffectiveness is to be expected.

Conclusion
I am not here to conclude beyond the shadow of a doubt that creatine is 110% safe. While all studies that I have read (in addition to the fact that I have been using creatine for years now with no adverse side effect) seem to indicate that the compound has no problems, perhaps twenty years from now somebody may find that in certain people creatine may cause some type of malady. In my opinion this is very unlikely but as a researcher myself I know that such possibility can never be discounted.

However, having said that, what I really want you to remember from this article is to always be critical and objective about claims. If you choose to use or not use creatine do so under the basis of the conclusions that you draw after having analyzed all the information that you have been exposed to on the subject objectively. The fact that the information comes from a name that may have a BS, MS or PhD attached at the end does not mean that such information is always accurate.