Creatine FAQ
Q.
What are some of the side effects?
A. Nausea, stomach upset, dizziness or
weakness, loose stools, diarrhea, and weight
gain are the most common, and generally
occur with dosages greater than 5 grams a
day. Muscle cramping is also commonly
reported. Sprains and strains can occur when
individuals over enthusiastically and
rapidly increase their workout regimen
before their tendons and ligaments are
adapted to the increase in muscle size.
Long-term consequences of daily creatine
ingestion, especially in high dosages, are
currently not known. There is a strong
possibility that excess creatine can put
stress on the kidneys and liver. Therefore,
we strongly discourage the regular, high
dose use of creatine. Individuals with
kidney diseases should not use creatine.
Q. You mention that creatine helps retain
fluid thereby having some effect on
increased muscle mass. What if one were to
stop taking creatine, will the volume
gradually decrease as weight training
continued? Or if weight training didn't
continue, will the muscle mass decrease
significantly?
A. There will be a decline in muscle mass if
creatine is stopped, but the decline will be
much slower if weight training is continued.
Q. I am a competitive cyclist and just
started using creatine. I am following your
recommended dosage (every other day with one
week off per month and one month off every
three). After the month off, do I have to
repeat the loading phase?
A. It depends how quickly you want to regain
the muscle mass. If you don't mind it coming
back a little slower, you don't have to
repeat the loading phase.
Q. Can you supply me with any info on
creatine citrate regarding benefits or
disadvantages that citrate bound creatine
may have compared to the monohydrate form?
A. I am not aware of studies with the
citrate form in comparison to the
monohydrate.
Q. Are there side effects from creatine use?
A. High doses can lead to nausea, stomach
upset, loose stools and dizziness. If you
overtrain, you can get muscle cramping or
strained ligaments and tendons. High dosages
for prolonged periods may stress the
kidneys, particularly in those with a
tendency for kidney disease. We have
anecdotal reports of possible stress on the
liver, leading to elevated liver enzymes,
but we still aren't sure that creatine was
the cause. We always recommend users take
breaks from use.
Q. Looking to gain approximately 10 pounds
by taking creatine and working out. Will
this work and what is the dosage I should
take??
A. Creatine can increase muscle mass and
weight, particularly in combination with
weight training. Three to five grams a day
for one month is satisfactory for most
people.
Q. I have been weight training for the last
couple of months. I find it helps stabilize
my blood pressure. I am thinking about
trying creatine, but am worried that it
might effect my blood pressure.
A. There is no indication at this time that
short term (such as one or two months) use
of creatine has much of an influence on
blood pressure. The use of creatine should
by cycled, that is, people should not use it
continuosly without taking breaks.
Q. What can you tell me about using
Glutamine at the same time as Creatine, as
sport supplements? They both have claims of
benefits for athletes. Glutamine has claims
of other benefits as well. Can you take
both? Should you only try one for a period
of time and then try the other for a period
of time?
A. I am not aware of long term studies that
have combined creatine and glutamine. It is
always wise to try one supplement at a time
to see how well it works with your body by
itself and to learn the benefits and side
effects. I have many friends who are body
builders, and some clain glutamine helps
them. So, you may try them individually, and
then in combination.
Q. For the past 3 months, I've been on the
atkins diet, and I've lost 25 pounds. I like
the diet, but I want to start building
muscle mass. If I go to a normal diet,
exercise, and take creatine, will I gain all
the weight back? Also, if I chose to stay on
the diet, will the carb restriction
interfere with the creatine efficiency?
A. Adding creatine will increase muscle
mass, even if you are carb restricted. The
weight you gain on creatine will be due to
muscles and not fat. The amount of weight
you gain on creatine will depend on how much
you use and how much training you do.
Q. I am 25 years old and am 3 and a half
years out from a Kidney Transplant. I am
also an avid bodybuilder. I have had
absolutely no complications in the nearly 4
years following my operation and my health
has never been better. I know that creatine
is not recommended for people with kidney
disease but in my case how harmful could
creatine be?
A. Science still does not have a full
understanding of creatine supplementation
and its relation to kidneys. I would
recommend for the time being to not take
creatine because in your case of a kidney
transplant, it's not worth taking a risk,
even if this risk is minimal.
Q. I have been bodybuilding since i was 17
years old. I have used almost every product
on the market today, including taking
steroids. I will turn 49 years old in
august. To this day i still train very hard,
and work out 4 times a week. When creatine
came out i started using it. I used creatine
for 3 months when i went in to do some lab
work my blood pressure shot up to 140 over
110. My doctor asked me how i felt and i
told him i have never felt better. My doctor
told me to stop using the creatine, and see
if my blood pressure would come down. I made
gains on the creatine that was unbelievable.
It took almost two and half months for my
pressure to come down. If i can't use the
creatine, do you believe i could use a
growth hormone, or one of the andro
products?
A. It's difficult to say whether creatine
was responsible for the increase in blood
pressure but we'll have to assume this until
proven otherwise. I do not recommend human
growth hormone or andro at this time. You
don't mention how much creatine you were
using, but it's quite possible you would not
have side effects if you used a small
amount, such as 3 mg a day with two days off
per week and one week off per month.
Q. I have been taking creatine for 2 weeks
and working out. So far I have put on about
9 pounds, but I don't know which is
attributed to the creatine and which is to
the myoplex protein shake that I take twice
a day. Anyway I was wondering when I should
cycle off, I loaded for 5 days (about 20g a
day) and my maintenance has been 5g per day
after that. Also how long should I cycle off
for?
A. In my book All About Creatine, I give
recommendations on cycling creatine, and
mention that there are many ways to do it.
There is always a balance between
maintaining muscle mass by continuing the
creatine versus potential unknown risks of
taking creatine continuously. Each adult
needs to make up their mind on how much they
wish to take. I prefer the maximum dose of
creatine on a long-term basis to not exceed
3 mg every other day.
Q. You frequently mention that no long term
studies are available concerning creatine
use. However, are there any studies
currently in effect to track it's long term
consequences? or, are we all just waiting to
see what happens to people years from now? I
believe it's safe if used intelligently, but
never hear of any studies taking place.
A. There are currently ongoing studies that
will test creatine use for one year, but it
is unlikely we will see studies that
evaluate creatine use for several years.
It's too expensive to do these multi-year
studies.
Q. Please tell me what is a high dose. I
currently take 5 grams of creatine on a
daily basis and on days that I work out I
take 10 grams. Surely this cannot be too
much. BTW, I have seen very good results
through creatine use.
A. My preference is for people not to use
more than 3 gm every other day if they are
planning to take it for very extended
periods. Other doctors may have a higher
dosage limit but I tend to be cautious since
we don't yet know enough about long term
creatine use.
Q. I am a 28 year old female recreational
body builder. I have seen many good results,
but continue to struggle to get my ideal
legs. I am thinking about taking creatine.
If I were to get pregnant while on creatine,
would this harm the fetus? Is there any long
term hormonal effects to a woman after
discontinuing use of creatine? What is your
opinion of creatine monohydrate or creatine
citrate?
A. Creatine has not been tested during
pregnancy therefore it is difficult to say
whether it would have an effect on the
fetus. It is best to avoid most supplements
while trying to get pregnant just to be on
the safe side. There doesn't appear to be
any longterm hormonal effects to a woman
after discontinuing creatine use. Creatine
monohydrate is the best studied form of
creatine tested, but other forms may also
work just as well.
Q. I just purchased some creatine for the
first time and began taking it for muscle
gain. I know I should increase my water
consumption while taking it. How much extra
water should I drink to support the action
of each 5mg of creatine?
Also, I just began taking an epehdra-caffeine-aspirin
supplement for fat reduction. I know the
creatine and caffeine work against each
other. Is that only because of the diuretic
action of the caffeine, or is there also a
chemical interaction between them? If its
only due to caffeine's diuretic effect can I
just increase my water intake even more to
offset it? If so, how much water do I need
to drink to offset the diuretic effects of
each 200 mg of caffeine? If there is a
chemical interaction, how long should I wait
after the consumption of one of them before
I take the other?
A. Eight to twelve ounces of extra water per
5 grams of creatine should be fine. At least
one study has shown that caffeine when taken
at the same time as creatine, may interfere
with creatine's muscle building benefits.
It's not clear how the interaction occurs so
it's difficult to say whether drinking more
water offsets the interaction. Spacing the
caffeine and creatine a minimum of six hours
apart should be adequate. I'm not a big fan
of ephedra/caffeine pills and don't think
they are healthy supplements to take since
can cause increased heart rate and blood
pressure.
Q. If muscle mass is slowly decreased after
the use of creatine if weight training is
continued, then what is the point of
creatine if you are back where you started
before you started using the supplement?
A. Good question. Creatine can be used at
the start of an exercise program to motivate
working out and overcoming the initial
inertia that so often accompanies those who
are just starting an exercise program. The
motivation is due to the gains in muscle
mass that come much quicker while on
creatine. Many people don't stop using
creatine completely but take 3 gm two to
four times a week which seems to be enough
to maintain the gain in muscle mass.
Q. I have read Your book about creatine and
I would like to ask you some more questions.
Creatine helps the muscles to get bigger.
One thing that happens when you take
creatine is a volume increase due to the act
that more intracellular is retained by the
muscle cells. My question is about the heart
muscle; does it get bigger too like the
other muscles?
The other question is about the
psychological influences of creatine. Could
creatine affect conditions like anxiety,
nervouseness, or other psychological
conditions? Are there people who should not
take this supplement?
A. I have also wondered whether creatine
influences the size of the heart but I have
not come across any studies evaluating heart
size after creatine supplementation. I will
post any findings if they are done.
Creatine does not seem to have any
significant effect on mental function. I do
not recommend those with kidney or liver
disease to take creatine, or those with
gastrointestinal problems.
Q. Is creatine monohydrate allowed in the
olympics or other competitions where they
check for drugs. Since it is a naturaly
produced in all humans is there a rule to
how much is legal?
A. Creatine is not an illegal substance for
use in the Olympics or in competitions.
Perhaps some competitors did use creatine in
the Olympics with potential benefits.
Q. I am interested in purchasing creatine to
gain some weight and help me to build up my
physique down the gym. I am 5.11 and weigh
10 stone so although I am not underweight I
could still put on a couple of stone and
still be within the healthy weight range for
my height. My question is because creatine
is quite a remarkable product what can stop
users from putting on too much weight when
using the product. How can users control
their weight through use of creatine to
achieve their ideal weight.
A. It's very easy. If you notice too much
muscle and weight gain, just reduce your
creatine intake and your muscle mass and
weight will be reduced in a few days.
Written by
Ray
Sahelian, M.D.
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