Re: Creatine and Side Effects

[Guest guest]

I have never ever heard something like that! Creatine causes injury? Where is

the scientific proof for that? I have been taking creatine for over 10 years now

and I have never had any side effects (besides the fact that I weight 117 kg).

Same goes for my clients. The injuries mentioned in the other replies are

connected to poor training or generally structural problems. If I train an

athlete and he/she has an injury I would question my training, because a good

training program prevents injury. I would never blame creatine or

intergalactical x-rays or other things that are not connected to injury just to

excuse for my lack of knowledge regarding training. In Germany we also use

Creatine for pregnant women to decrease the risk of a brain damage of the child

during the birth phase. If it is safe for pregnant women how could it be unsafe

for athletes? Plus if it is allowed in Germany it must be safe because here even

50mg of Zinc are not allowed to be sold in pharmacies. We have very strict laws

concerning supplements and also vitamins and minerals.

Kind Regards

Knebel

Wuppertal, Germany

[Guest guest]

I am unaware of any negative side effects from using

creatine. My position is result of 14 yrs of athletes

using creatine, including thousands of college

athletes. I have long considered creatine a vastly

superior alternative to steroids. The only side effect

I am aware of is you get bigger when creatine is used

with a good muscle hypertrophy training and proper

nutritional support.

Coach

Ubermensch Sports

San Diego Ca.

--- carruthersjam wrote:

>

>

> <<<This is very disappointing. I have been

> advocating the use of

> creatine by prep school athletes for many years.

> With steroids

> epidemic in the high schools I see creatine as a

> viable and very safe

> alternative. It is the most studied supplement in

> history and while I

> do not consider myself an authority I do have an

> extensive nutrition

> background and the only side effect directly

> attributable to creatine

> I'm aware of is, you get bigger. The purpose of

> going to school is to

> learn, yet some of the people who give out homework

> often aren't

> willing do do their own.>>>

>

> ***A potential negative side effect of creatine

> supplementation, that I recall reading about some

> time ago, is that it increases the anterior

> compartment pressure of the lower leg.

>

> Carruthers

> Wakefield, UK

[Guest guest]

Could this also present itself as making one's " heels " hurt in the morning?

Thanks,

Brett

Draper, UT

Schaefer wrote:

>The problem is actually posterior compartment syndrome. Posterior

>compartment is the gastrocnemius and the soleus and that's the big muscles

>attaching to the Achilles tendon, thus a very painful push on the middle

>compartment. (Anterior is usually more a matter of hypertrophy of the

>tibialis anterior and your classic " shin splint " is the start of that one.)

>My recollection is that it started with cyclists, but I have seen 2 cases

>now in my own MT practice, one a shw male master powerlifter. His case was

>so severe he could barely walk four blocks before his calves would tie up.

>It struck bilaterally about three weeks after he started using creatine.

>Only going off creatine abated the problem.

>

>By the way, his doctors were baffled and well, suggested he " stop trying to

>walk for cardio " .... There was absolutely nothing wrong with him but taking

>creatine.

><good stuff snipped>

>

[Guest guest]

Sorry, but that conclusion sounds like rather questionable deductive reasoning.

Coach

Ubermensch Sports

San Diego, Ca.

-------------

Brett wrote:

<<<Could this also present itself as making one's " heels " hurt in the

morning?>>>

------------

Schaefer wrote:

>The problem is actually posterior compartment syndrome. Posterior

>compartment is the gastrocnemius and the soleus and that's the big muscles

>attaching to the Achilles tendon, thus a very painful push on the middle

>compartment. (Anterior is usually more a matter of hypertrophy of the

>tibialis anterior and your classic " shin splint " is the start of that one.)

>My recollection is that it started with cyclists, but I have seen 2 cases

>now in my own MT practice, one a shw male master powerlifter. His case was

>so severe he could barely walk four blocks before his calves would tie up.

>It struck bilaterally about three weeks after he started using creatine.

>Only going off creatine abated the problem.

>

>By the way, his doctors were baffled and well, suggested he " stop trying to

>walk for cardio " .... There was absolutely nothing wrong with him but taking

>creatine.

><good stuff snipped>

[Guest guest]

Coach ,

Conclusion? Questionable deductive reasoning? I just asked a question...no

conclusions here.

I have no idea on how compartment syndrome presents.

My heels used to hurt in the morning but do not hurt in the morning anymore, and

the only thing that has changed is that I stopped using creatine just over a

year ago, after using it nearly continuously for 8 years (love the stuff).

I was curious and so I asked the question. I would like to begin using creatine

again after a 50 mile backpacking trip at the end of the month, so this caught

my attention.

I was graciously informed offlist that compartment syndrome usually presents as

excruciating pain in the calf area (my words).

:-)

Best regards,

Brett

Draper, UT

________________________________

From: Supertraining on behalf of W.G.

Sent: Wed 7/5/2006 2:22 PM

To: Supertraining

Subject: Re: Creatine and Side Effects

Sorry, but that conclusion sounds like rather questionable deductive reasoning.

Coach

Ubermensch Sports

San Diego, Ca.

-------------

Brett wrote:

<<<Could this also present itself as making one's " heels " hurt in the

morning?>>>

------------

Schaefer wrote:

>The problem is actually posterior compartment syndrome. Posterior

>compartment is the gastrocnemius and the soleus and that's the big muscles

>attaching to the Achilles tendon, thus a very painful push on the middle

>compartment. (Anterior is usually more a matter of hypertrophy of the

>tibialis anterior and your classic " shin splint " is the start of that one.)

>My recollection is that it started with cyclists, but I have seen 2 cases

>now in my own MT practice, one a shw male master powerlifter. His case was

>so severe he could barely walk four blocks before his calves would tie up.

>It struck bilaterally about three weeks after he started using creatine.

>Only going off creatine abated the problem.

>

>By the way, his doctors were baffled and well, suggested he " stop trying to

>walk for cardio " .... There was absolutely nothing wrong with him but taking

>creatine.

><good stuff snipped>

[Guest guest]

>

> I am unaware of any negative side effects from using

> creatine. My position is result of 14 yrs of athletes

> using creatine, including thousands of college

> athletes. I have long considered creatine a vastly

> superior alternative to steroids. The only side effect

> I am aware of is you get bigger when creatine is used

> with a good muscle hypertrophy training and proper

> nutritional support.

Below are a number of studies that may be of interest:

Elevated Anterior Compartment Pressure in the Leg After Creatine

Supplementation: A Controlled Case Report.

J Athl Train. 2001 Mar;36(1):85-88.

Potteiger JA, Randall JC, Schroeder C, Magee LM, Hulver MW.

OBJECTIVE: To report abnormal changes in lower leg anterior

compartment pressure in 1 subject who consumed creatine as a dietary

supplement. BACKGROUND: The subject received creatine at a dosage of

0.3 g.kg body mass(-1).d(-1) for 6 days, followed by 0.03 g.kg body

mass(-1).d(-1) for 28 days. Thereafter, the subject consumed no

supplement for 21 days. Compartment pressure was measured pre-

exercise and for 15 minutes postexercise after a treadmill run for 20

minutes at 80% of VO(2) max before supplementation and after 6 and 34

days of supplementation.

DIFFERENTIAL DIAGNOSIS: Normally, resting anterior compartment

pressure is less than 15 mm Hg, whereas postexercise pressure is

below 30 to 35 mm Hg. Creatine supplementation for 6 days

dramatically increased pressure at rest (31 mm Hg) and at 1 minute

(67 mm Hg), 5 minutes (35 mm Hg), 10 minutes (28 mm Hg), and 15

minutes (26 mm Hg) postexercise. Pressure remained high at rest (35

mm Hg) and at 1 minute (109 mm Hg), 5 minutes (90 mm Hg), 10 minutes

(87 mm Hg), and 15 minutes (69 mm Hg) postexercise after 34 days of

supplementation.

TREATMENT: The subject stopped taking creatine for 21 days.

Compartment pressure was measured at rest and after exercise after 7

and 21 days with no supplementation. Anterior compartment pressure

decreased after cessation of creatine supplementation. However,

pressures were elevated at 7 days postsupplementation at rest (26 mm

Hg) and at 1 minute (112 mm Hg), 5 minutes (58 mm Hg), 10 minutes (40

mm Hg), and 15 minutes (30 mm Hg) postexercise. Pressures at 21 days

postsupplementation remained high at rest (24 mm Hg) and at 1 minute

(64 mm Hg), 5 minutes (42 mm Hg), 10 minutes (27 mm Hg), and 15

minutes (27 mm Hg) postexercise. CONCLUSION: These data indicate that

creatine supplementation can substantially increase anterior

compartment pressure in the leg.

Individuals suffering from increased compartment pressures are

expected to complain of lower extremity aching, cramping, or burning

pain and sometimes tightness over the affected compartment.17

Symptoms resembling these complaints were noted by the subject after

6 and 34 days of supplementation. Subjective complaints of tightness

and pain in the region of the anterior compartment during exercise

were noted and continued for approximately 15 to 20 minutes after

exercise ended. Consequently, despite the positive performance

benefits that may result from creatine supplementation, the risk of

abnormally elevating the pressures of the anterior compartment may

contraindicate supplementation in some individuals.

It is important that medical personnel be aware of this side effect

associated with creatine supplementation.

Knowledge of this adverse effect is important in diagnosing those

individuals more susceptible to lower leg injury and should enable

the identification of potentially preventable adverse medical

conditions. Stretching, cross-training, slow exercise progression,

and avoiding ballistic movements may minimize the exacerbation of

present symptoms, and modification of training programs should

decrease the possible occurrence of debilitating conditions.

Additional study of the effects of creatine supplementation on muscle

blood flow, muscle function, and nerve conduction in the anterior

compartment of the lower leg should be performed.

---------------

Changes in Lower Leg Anterior Compartment Pressure Before, During,

and After Creatine Supplementation.

J Athl Train. 2002 Jun;37(2):157-163.

Potteiger JA, Carper MJ, Randall JC, Magee LJ, sen DJ, Hulver MW.

OBJECTIVE: To determine if 35 days of creatine supplementation (Cr)

followed by 28 days of no supplementation altered lower leg anterior

compartment pressure (ACP) at rest and after exercise. DESIGN AND

SETTING: Subjects were divided into 2 treatment groups: (1) high dose

(0.3 g Cr.kg body mass(-1).d(-1) for 7 days followed by 0.03 g Cr.kg

body mass(-1).d(-1) for 28 days), or (2) low dose (0.03 g Cr.kg body

mass(-1).d(-1) for 35 days). After 35 days, supplementation was

terminated, and no Cr was ingested for 28 days. SUBJECTS: Sixteen

physically active, healthy, college-aged males (O(2)max = 47.6 +/-

5.1 mL.kg(-1).min(-1)). MEASUREMENTS: At baseline, 7 days and 35 days

of supplementation, and 28 days postsupplementation, ACP was measured

preexercise and immediately, 1, 5, 10, and 15 minutes postexercise

after a treadmill run at 80% O(2)max.

RESULTS: For ACP, there was no significant group-by-time interaction,

but there was a significant time effect for group when the data were

combined. ACP was significantly increased at preexercise, immediately

postexercise, and 1, 5, and 10 minutes from baseline to 7 days. ACP

remained significantly elevated from baseline at 35 days immediately

postexercise and 1 minute postexercise. After 28 days of no

supplementation, ACP began to return to presupplementation levels,

with only the 1-minute postexercise measurement significantly

elevated from baseline.

CONCLUSIONS: Creatine supplementation increased ACP at rest and after

exercise, and ACP began to return to normal after 28 days of no

supplementation.

---------------

The effects of creatine dietary supplementation on anterior

compartment pressure in the lower leg during rest and following

exercise.

Clin J Sport Med. 2001 Apr;11(2):87-95.

Schroeder C, Potteiger J, Randall J, sen D, Magee L, Benedict S,

Hulver M.

OBJECTIVE: To examine the effects of creatine supplementation on

anterior compartment pressure of the lower leg at rest and following

exercise. DESIGN: 14 college-age males received creatine or placebo

supplementation for 34 days. At baseline, anterior compartment

pressure was measured preexercise, immediately postexercise, and 1,

5, and 15 minutes postexercise after a level treadmill run for 20

minutes at 80% of maximal aerobic power.

INTERVENTION: Following baseline testing, subjects began a 6-day

creatine or placebo loading phase at a dosage of 0.3 g x kg body mass

(-1) x d(-1). This was followed by a 28-day maintenance phase at a

dosage of 0.03 g x kg body mass(-1) x d(-1). Subjects and

investigators were blinded as to treatment administration. Subjects

continued to exercise during the supplementation period. After 6 days

and 34 days of supplementation. anterior compartment pressure was

measured at rest and following exercise.

RESULTS: Creatine supplementation for 6 days significantly increased

compartment pressure compared with the placebo group at rest (76%),

immediately post- (150%), 1 minute post- (125%), 5 minute post-

(106%), and 15 minute postexercise (77%). Anterior compartment

pressures continued to remain significantly higher for the creatine

group compared with the placebo group at rest (72%), immediately post-

(125%) and 1 minute postexercise (180%) after 34 days of creatine

supplementation. CONCLUSIONS: These data indicate that creatine

supplementation abnormally increases anterior compartment pressure in

the lower leg at rest and following 20 minutes of level running at

80% of maximal aerobic power.

-------------

Carruthers

Wakefield, UK

[Guest guest]

Dear ,

I write nutrition, health, and performance columns for several US fitness

magazines. I use a " People Magazine " format (short vignettes summarizing and

commenting on articles in the literature). I have followed the literature on

creatine monohydrate very carefully. Also, I have spent time at professional

meetings with researchers from Nottingham and Baylor Univ, who do much of the

research on this topic.

Except for the studies on anterior compartment pressure, no studies have

reported any significant side effects. Even those studies didn't show an

increased

incidence of anterior compartment syndrome. The case isn't closed on creatine

and side effects, but the supplement appears safe and shouldn't be banned on

those grounds.

I am a masters level discus thrower (US champion, former world champion) and

have used creatine. I had some muscle cramping problems, but this has not been

replicated in the literature.

Tom Fahey

Dr. Fahey

Exercise Physiology Lab, Dept of Kinesiology

Track and Field Team

California State University, Chico

Chico, CA 95929-0330

[Guest guest]

It would be possible to conclude from reading Mr. 's several adamant

postings that he has some reason other than intellectual for defending

creatine heavily here. Does Mr. sell creatine to his athletes? No

offense, but if you are receiving a sponsorship, or selling creatine, or

hold significant investment in a supplement company or endorsements, this

might inhibit any response people have to you regarding creatine? It is

also possible your athletes will be less informative to you, or perhaps they

had some subtle problem that you dismissed as unimportant.... it sounds as

though if someone had a similar experience to Brett's, you might dismiss

their concerns...and that would be a way one could go 15 years without

hearing anyone give you a significant side effect?

Sometimes people buy a product and then quietly put it aside in a closet...

unless you are monitoring your athletes 24/7, it's possible they had some

side effects and quietly quit using the creatine.....and if you display an

attitude to them that says " creatine is great, there are no side effects,

and you will ALL use it " they may be less than honest to you.

Brett is not a newbie athlete and if he can say his training, diet and other

factors have not changed, and that the problem in his bilateral heels is

possibly due to creatine, he should not be told it's " extremely remote " .

I would say if he goes off the creatine, finds this abates in short order

and does not return, again, without altering training or diet and other

factors, then it may be the creatine. Were the symptoms to return again

after starting creatine again, after a good clear out period, then he would

be wise to NOT use creatine.

I would say Mr. 's clear prejudice in favor of creatine usage by ALL

his athletes may have kept some from telling him of their symptoms or other

concerns, as it is clear he believes it should be used by all.

I do not agree that " creatine is too far valuable an ergogenic aide " to be

used without concern. I have seen some have digestive problems that started

when using the creatine and stopped when they quit using it. That was a

reason for them to quit, right there. I didn't have digestive problems on

it myself, but when someone I was coaching told me they were having them, I

listened, they quit the creatine and the problems went away. Just because

one's personal experience with something is great does not mean it should be

used by ALL. Or that it will benefit ALL.

The gal I talked to who gained about TEN Pounds in about a week on creatine

also won't be taking it, that's hardly proof that " creatine is too valuable

an ergogenic aide " . When she went off it, the ten pounds came off. When

there is no other change of diet or activity to account for such odd

effects, would you as a coach dismiss this?

I am SURE that the athlete I had here with severe bilateral calf problem

here WAS creatine as he was not using anything other than whey protein, and

he had no prescriptions, no pre-existing health problem other than

nearsightedness, and had not changed his diet or his workouts. He also was

an athlete of long experience too, no newbie athlete, and very careful about

where he bought his creatine too as he is a drug tested champion. The fact

that the problem went away after stopping creatine too was convincing. I

don't think he thinks creatine is a good idea after that.... and I think he

would tell you so in no uncertain terms! The pain he was in was NO JOKE.

Would i say creatine is bad for ALL based on this? no. But I would not join

Mr. in advising ALL to universally use creatine either!

Therefore, I agree with Brett it may be his heel problems are creatine

related and he could in a reasonably fashion go off the creatine, clear it

out, see if the symptoms continue, if he keeps all other things steady

state, and then go on again and see if this returns. I do not think

creatine the ONLY cause of heel or calf problems, no lol. But in this

instance it's possible as this was the only apparent change he made.

Belief that some substance is universally good is a blind spot.

The Phantom

aka Schaefer, CMT, CSCS, competing powerlifter

Denver, Colorado, USA

it was written:

> My concern is the reasoning behind the conclusion.

> Problems with your calves (pain) may be attributable

> to a variety of factors. The possibility that the

> cause is creatine seems extremely remote, so I wanted

> to be sure all possibilities were considered. Make

> sense? Creatine is far too valuable an ergogenic aide

> to be dismissed without powerful evidence it's use is

> contraindicated. Thus far, in 15 years, I've had

> thousands of athletes of all ages use it without any

> problems, that I'm aware of.

>

> Coach

> Ubermensch Sports

> San Diego Ca.

>

>

>

> --- Brett wrote:

>

>> Coach ,

>>

>> Conclusion? Questionable deductive reasoning? I

>> just asked a question...no conclusions here.

>>

>> I have no idea on how compartment syndrome presents.

>>

>> My heels used to hurt in the morning but do not hurt

>> in the morning anymore, and the only thing that has

>> changed is that I stopped using creatine just over a

>> year ago, after using it nearly continuously for 8

>> years (love the stuff).

>>

>> I was curious and so I asked the question. I would

>> like to begin using creatine again after a 50 mile

>> backpacking trip at the end of the month, so this

>> caught my attention.

>>

>> I was graciously informed offlist that compartment

>> syndrome usually presents as excruciating pain in

>> the calf area (my words).

>>

>> :-)

>>

>> Best regards,

>> Brett

>> Draper, UT

[Guest guest]

Santayana said that " Experience is the only true

fact. "

My experience goes back to 1991 when I and some of my

athletes began using creatine, which is now the most

studied supplement known to man. When Colgan reported

creatine to be a " bogus ergogenic aide " in his book

Optimum Sports Nutrition, I corrected him after

reviewing the proofs. His research was studies done

with basketball players. Wrong energy system.

In the 90's I was a principal in a small supplement

company called Natures Advantage. We provided a number

of Div. I colleges and universities, such as San Diego

State and UCLA, with creatine. As a strength coach and

NSCA member I was available to the strength coach for

consultation should any of the thousands of athletes

using our creatine all over the country manifest any

problem, of any kind. Not once did anyone ever call me

with problems of any kind.

I confrontated the strength coach for the Padres

several years ago when he claimed in the local paper

that his players were getting pulls, cramps, strains

and PMS from using creatine. He admitted he was

covering his ass because he knew his athletes were

using steroids.

Steroids have been a problem in prep schools for

decades and are now pandemic in prep schools. I take a

pragmatic approach. I consider it infinetly preferable

that prep school athletes use creatine under proper

supervision than juicing on their own.

I am a consultant to a supplement company, Global

Health Trax and they are looking into bringing the

latest advance in creatine to market, very much at my

urging.

Coach

Ubermensch Sports

San Diego Ca.

[Guest guest]

" Would i say creatine is bad for ALL based on this?

no. But I would not join

Mr. in advising ALL to universally use

creatine either! "

****

This comment doesn't make sense. If it is the case

that a very small part of the athlete population

manifests problems that may actually be directly

attributable to creatine, how do you propose to

determine who those folks are, if they don't try it?

I might also remind you that you have not addressed

the issue of the quality of the product.

Instead you have made an unsupported sweeping

generalization based on a few people's experience.

The last athlete I had with heel problems got new

shoes, problem solved. Far too many as yet unexplained

variables to blame this on creatine. I consider your

position hypothetical and a sketchy hypothesis at

that. One example: Dosage? How much and for how long?

One of my distinctive competences as a coach is my

holistic approach. I require total compliance. I

control diet, training, rest, etc. Even with this

level of program control, I would find it difficult to

determine the exact source of the problem without a

thorough and systematic review of everything the

athlete does and uses. It would be great if you could

assay the creatine product he was using, for a start.

And please be aware that my first operating principle

is:

" First, do no harm. "

Coach

Ubermensch Sports

San Diego