Creatine and the heart

[Guest guest]

With all of the discussion around creatine on the list, understanding that

creatine helps in the retention of water in muscle and, the heart being a

muscle, has there been any studies pro or con about this? Does the heart

muscle retain water as the result of creatine at all?

Carson Wood.

Westbrook ME USA.

[Guest guest]

Carson,

Good question. I read somewhere some time ago, (been using creatine

since '91) that creatine was good for the heart. Will try to find the

source. A very worthwhile area of research.

W.G.

Ubermensch Sports Consultancy

San Diego CA

>

> With all of the discussion around creatine on the list,

understanding that

> creatine helps in the retention of water in muscle and, the heart

being a

> muscle, has there been any studies pro or con about this? Does the

heart

> muscle retain water as the result of creatine at all?

>

> Carson Wood.

> Westbrook ME USA.

>

[Guest guest]

Carson,

Good question. I read somewhere some time ago, (been using creatine

since '91) that creatine was good for the heart. Will try to find the

source. A very worthwhile area of research.

W.G.

Ubermensch Sports Consultancy

San Diego CA

>

> With all of the discussion around creatine on the list,

understanding that

> creatine helps in the retention of water in muscle and, the heart

being a

> muscle, has there been any studies pro or con about this? Does the

heart

> muscle retain water as the result of creatine at all?

>

> Carson Wood.

> Westbrook ME USA.

>

[Guest guest]

--- Carson Wood wrote:

> With all of the discussion around creatine on the

> list, understanding that

> creatine helps in the retention of water in muscle

> and, the heart being a

> muscle, has there been any studies pro or con about

> this? Does the heart

> muscle retain water as the result of creatine at

> all?

>

> Carson Wood.

> Westbrook ME USA.

The following may be helpful for to the present

discussion:

Ralph Giarnella MD

Southington Ct USA

***********************************

Creatine and Other Supplements

Pediatric Clinics of North America - Volume 54, Issue

4 (August 2007)  -  Copyright © 2007 W. B. Saunders

Company

 Lattavo, DOa, & #8727;

 Kopperud, MDb,c

D. , MD, MPH, FAAPc,d

Creatine has been studied and found to have no

clinically significant effect on blood pressure [58],

[59], liver enzymes [51], [52], [53], [62], [63],

electrolytes [52], glucose [52], uric acid [53],

hematologic parameters [52], [53], [59], [62], or

muscle enzymes [52], [59], [62]. Some studies

indicated a modest favorable effect on lipid

parameters of uncertain clinical significance [52],

[53].

There have been anecdotal reports of muscle cramps and

stiffness, musculotendinous injury, dehydration, and

heat illness, but the research to date indicates that

creatine does not increase the incidence of these

effects [4], [43], [51], [52], [53], [54]. The

incidence of musculoskeletal injuries and heat illness

actually may be decreased by creatine [54]; however,

there is evidence that creatine may increase muscle

compartmental pressures in the leg [58].

Several case reports of more serious adverse effects

are found in the literature. These include:

• New onset of lone atrial fibrillation during the

creatine loading phase [66]

• Interstitial nephritis and focal tubular injury in

a previously healthy 20-year-old man taking creatine,

20 g/d, for 4 weeks, which resolved with

discontinuation of creatine [67].

• Worsening renal function (elevated serum creatinine

and decline in glomerular filtration rate) after

initiating a standard-dose regimen of creatine in a

25-year-old man who had focal segmental

glomerulosclerosis and frequently relapsing

steroid-responsive nephrotic syndrome, taking a

therapeutic dose of cyclosporine. His renal function

normalized 1 month after stopping creatine [68].

• Rhabdomyolysis and acute renal failure following

arthroscopic anterior cruciate ligament reconstruction

in a 21-year-old, previously healthy college football

player who had been taking creatine preoperatively, up

to 10 g/d for 6 weeks, with full recovery [69].

• Acute quadriceps compartment syndrome and

rhabdomyolysis in a 24-year-old male bodybuilder

taking creatine, 25 g/d, and no other supplements or

anabolic steroids, after a lower extremity resistance

training session. He underwent fasciotomy, had a

complicated postoperative course, and at 6 months, his

quadriceps strength was just 60% of his baseline

strength. The investigators stated that creatine may

have predisposed him to compartment syndrome by

increasing water content in the muscle cells, and,

thus, increasing baseline compartment pressures, a

hypothesis that has some scientific support [55],

[58].

[41]  Haussinger D., Roth E., Lang F., et al: 

Cellular hydration state: an important determination

of protein catabolism in health and disease.

 Lancet 341. 1330-1332.1993;  Abstract

[42]  Kreider R.:  Creatine supplementation: analysis

of ergogenic value, medical safety, and concerns.

 Journal of Exercise Physiology Online 1. (1):

1998;Available at:Available

at: http://faculty.css.edu/tboone2/asep/jan3.htm 

[43]  Bemben M.G., Lamont H.S.:  Creatine

supplementation and exercise performance: recent

findings.  Sports Med 35. (2): 107-125.2005;  Abstract

[44]  Derave W., Eijinde B.O., Hespel P.:  Creatine

supplementation in health and disease: what is the

evidence for long term efficacy?.  Mol Cell

Biochem 244. 49-55.2003;  Abstract

[45]  Hespel P., Maughan R.J., Greenhaff P.L.: 

Dietary supplements for football.  J Sports

Sci 24. (7): 749-761.2006;  Abstract

[46]  Ciocca M.:  Medication and supplement use by

athletes.  Clin Sports Med 24. 719-738.2005;  Full

Text

[47]  Lemon P.W.:  Dietary creatine supplementation

and exercise performance: why inconsistent results?.

 Can J Appl Physiol 27. (6): 663-680.2002;  Abstract

[48]  Grindstaff P.D., Kreider R., Bishop R., et al: 

Effects of creatine supplementation on repetitive

sprint performance and body composition in competitive

swimmers.  Int J Sport Nutr 7. 330-346.1997;  Abstract

[49]  Theodorou A.S., Havenetidis K., Zanker C.L.: 

Effects of acute creatine loading with or without

carbohydrate on repeated bouts of maximal swimming in

high-performance swimmers.  J Strength Cond

Res 19. (2): 265-269.2005; 

[50]  Ostojic S.M.:  Creatine supplementation in young

soccer players.  Int J Sport Nutr Exerc

Metab 14. 95-103.2004;  Abstract

[51]  Shao A., Hathcock J.N.:  Risk assessment for

creatine monohydrate.  Regul Toxicol

Pharmacol 45. (3): 242-251.2006;  Abstract

[52]  Kreider R.B., Melton C., Rasmussen C.J., et al: 

Long-term creatine supplementation does not

significantly affect clinical markers of health in

athletes.  Mol Cell Biochem 244. (1–2): 95-104.2003; 

Abstract

[53]  Schilling B.K., Stone M.H., Utter A., et al: 

Creatine supplementation and health variables: a

retrospective study.  Med Sci Sports Exerc 33. (2):

183-188.2001;  Abstract

[54]  Greenwood M., Kreider R.B., Melton C., et al: 

Creatine supplementation during college football

training does not increase the incidence of cramping

or injury.  Mol Cell Biochem 244. (1–2): 83-88.2003; 

Abstract

[55]  S.J.:  Acute quadriceps compartment

syndrome and rhabdomyolysis in a weight lifter using

high-dose creatine supplementation.  J Am Board Fam

Pract 13. (2): 134-137.2000;  Citation

[56]    PDR Health. Creatine. Available at:

http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/cre_0086.shtml.

Accessed December 30, 2006. 

[57]  DesJardins M.:  Supplement use in the adolescent

athlete.  Curr Sports Med Rep 1. 369-373.2002; 

[58]  Bizzarini E., De Angelis L.:  Is the use of oral

creatine supplementation safe?.  J Sports Med Phys

Fitness 44. (4): 411-416.2004;  Abstract

[59]  Mihic S., Mac J.R., McKenzie S., et al: 

Acute creatine loading increases fat-free mass, but

does not affect blood pressure, plasma creatinine, or

CK activity in men and women.  Med Sci Sports

Exerc 32. (2): 291-296.2000;  Abstract

[60]  Groeneveld G.J., Beijer C., Veldink J.H., et

al:  Few adverse effects of long-term creatine

supplementation in a placebo-controlled trial.  Int J

Sports Med 26. (4): 307-313.2005;  Abstract

[61]  Pline K.A.,  C.L.:  The effect of creatine

intake on renal function.  Ann Pharmacother 39. (6):

1093-1096.2005;  Abstract

[62]  T.M., Sewell D.A., Casey A., et al: 

Dietary creatine supplementation does not affect some

haematological indices, or indices of muscle damage

and hepatic and renal function.  Br J Sports

Med 34. 284-288.2000;  Abstract

[63]  Mayhew D.L., Mayhew J.L., Ware J.S.:  Effects of

long-term creatine supplementation on liver and kidney

functions in American college football players.  Int J

Sport Nutr Exerc Metab 12. (4): 453-460.2002; 

Abstract

[64]  Poortmans J.R., Francaux M.:  Long-term oral

creatine supplementation does not impair renal

function in healthy athletes.  Med Sci Sports

Exerc 31. (8): 1108-1110.1999;  Abstract

[65]  Yoshizumi W.M., Tsourounis C.:  Effects of

creatine supplementation on renal function.  J Herb

Pharmacother 4. (1): 1-7.2004; 

[66]  Kammer R.T.:  Lone atrial fibrillation

associated with creatine monohydrate supplementation.

 Pharmacotherapy 25. (5): 762-764.2005;  Abstract

[67]  Koshy K.M., Griswold E., Schneeberger E.E.: 

Interstitial nephritis in a patient taking creatine.

 N Engl J Med 340. (10): 814-815.1999;  Citation

[68]  Pritchard N.R., Kalra P.A.:  Renal dysfunction

accompanying oral creatine supplements.

 Lancet 351. (9111): 1252-1253.1998;  Citation

[69]  Sheth N.P., Sennett B., Berns J.S.: 

Rhabdomyolysis and acute renal failure following

arthroscopic knee surgery in a college football player

taking creatine supplements.  Clin Nephrol 65. (2):

134-137.2006;  Abstract

[Guest guest]

--- Carson Wood wrote:

> With all of the discussion around creatine on the

> list, understanding that

> creatine helps in the retention of water in muscle

> and, the heart being a

> muscle, has there been any studies pro or con about

> this? Does the heart

> muscle retain water as the result of creatine at

> all?

>

> Carson Wood.

> Westbrook ME USA.

The following may be helpful for to the present

discussion:

Ralph Giarnella MD

Southington Ct USA

***********************************

Creatine and Other Supplements

Pediatric Clinics of North America - Volume 54, Issue

4 (August 2007)  -  Copyright © 2007 W. B. Saunders

Company

 Lattavo, DOa, & #8727;

 Kopperud, MDb,c

D. , MD, MPH, FAAPc,d

Creatine has been studied and found to have no

clinically significant effect on blood pressure [58],

[59], liver enzymes [51], [52], [53], [62], [63],

electrolytes [52], glucose [52], uric acid [53],

hematologic parameters [52], [53], [59], [62], or

muscle enzymes [52], [59], [62]. Some studies

indicated a modest favorable effect on lipid

parameters of uncertain clinical significance [52],

[53].

There have been anecdotal reports of muscle cramps and

stiffness, musculotendinous injury, dehydration, and

heat illness, but the research to date indicates that

creatine does not increase the incidence of these

effects [4], [43], [51], [52], [53], [54]. The

incidence of musculoskeletal injuries and heat illness

actually may be decreased by creatine [54]; however,

there is evidence that creatine may increase muscle

compartmental pressures in the leg [58].

Several case reports of more serious adverse effects

are found in the literature. These include:

• New onset of lone atrial fibrillation during the

creatine loading phase [66]

• Interstitial nephritis and focal tubular injury in

a previously healthy 20-year-old man taking creatine,

20 g/d, for 4 weeks, which resolved with

discontinuation of creatine [67].

• Worsening renal function (elevated serum creatinine

and decline in glomerular filtration rate) after

initiating a standard-dose regimen of creatine in a

25-year-old man who had focal segmental

glomerulosclerosis and frequently relapsing

steroid-responsive nephrotic syndrome, taking a

therapeutic dose of cyclosporine. His renal function

normalized 1 month after stopping creatine [68].

• Rhabdomyolysis and acute renal failure following

arthroscopic anterior cruciate ligament reconstruction

in a 21-year-old, previously healthy college football

player who had been taking creatine preoperatively, up

to 10 g/d for 6 weeks, with full recovery [69].

• Acute quadriceps compartment syndrome and

rhabdomyolysis in a 24-year-old male bodybuilder

taking creatine, 25 g/d, and no other supplements or

anabolic steroids, after a lower extremity resistance

training session. He underwent fasciotomy, had a

complicated postoperative course, and at 6 months, his

quadriceps strength was just 60% of his baseline

strength. The investigators stated that creatine may

have predisposed him to compartment syndrome by

increasing water content in the muscle cells, and,

thus, increasing baseline compartment pressures, a

hypothesis that has some scientific support [55],

[58].

[41]  Haussinger D., Roth E., Lang F., et al: 

Cellular hydration state: an important determination

of protein catabolism in health and disease.

 Lancet 341. 1330-1332.1993;  Abstract

[42]  Kreider R.:  Creatine supplementation: analysis

of ergogenic value, medical safety, and concerns.

 Journal of Exercise Physiology Online 1. (1):

1998;Available at:Available

at: http://faculty.css.edu/tboone2/asep/jan3.htm 

[43]  Bemben M.G., Lamont H.S.:  Creatine

supplementation and exercise performance: recent

findings.  Sports Med 35. (2): 107-125.2005;  Abstract

[44]  Derave W., Eijinde B.O., Hespel P.:  Creatine

supplementation in health and disease: what is the

evidence for long term efficacy?.  Mol Cell

Biochem 244. 49-55.2003;  Abstract

[45]  Hespel P., Maughan R.J., Greenhaff P.L.: 

Dietary supplements for football.  J Sports

Sci 24. (7): 749-761.2006;  Abstract

[46]  Ciocca M.:  Medication and supplement use by

athletes.  Clin Sports Med 24. 719-738.2005;  Full

Text

[47]  Lemon P.W.:  Dietary creatine supplementation

and exercise performance: why inconsistent results?.

 Can J Appl Physiol 27. (6): 663-680.2002;  Abstract

[48]  Grindstaff P.D., Kreider R., Bishop R., et al: 

Effects of creatine supplementation on repetitive

sprint performance and body composition in competitive

swimmers.  Int J Sport Nutr 7. 330-346.1997;  Abstract

[49]  Theodorou A.S., Havenetidis K., Zanker C.L.: 

Effects of acute creatine loading with or without

carbohydrate on repeated bouts of maximal swimming in

high-performance swimmers.  J Strength Cond

Res 19. (2): 265-269.2005; 

[50]  Ostojic S.M.:  Creatine supplementation in young

soccer players.  Int J Sport Nutr Exerc

Metab 14. 95-103.2004;  Abstract

[51]  Shao A., Hathcock J.N.:  Risk assessment for

creatine monohydrate.  Regul Toxicol

Pharmacol 45. (3): 242-251.2006;  Abstract

[52]  Kreider R.B., Melton C., Rasmussen C.J., et al: 

Long-term creatine supplementation does not

significantly affect clinical markers of health in

athletes.  Mol Cell Biochem 244. (1–2): 95-104.2003; 

Abstract

[53]  Schilling B.K., Stone M.H., Utter A., et al: 

Creatine supplementation and health variables: a

retrospective study.  Med Sci Sports Exerc 33. (2):

183-188.2001;  Abstract

[54]  Greenwood M., Kreider R.B., Melton C., et al: 

Creatine supplementation during college football

training does not increase the incidence of cramping

or injury.  Mol Cell Biochem 244. (1–2): 83-88.2003; 

Abstract

[55]  S.J.:  Acute quadriceps compartment

syndrome and rhabdomyolysis in a weight lifter using

high-dose creatine supplementation.  J Am Board Fam

Pract 13. (2): 134-137.2000;  Citation

[56]    PDR Health. Creatine. Available at:

http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/cre_0086.shtml.

Accessed December 30, 2006. 

[57]  DesJardins M.:  Supplement use in the adolescent

athlete.  Curr Sports Med Rep 1. 369-373.2002; 

[58]  Bizzarini E., De Angelis L.:  Is the use of oral

creatine supplementation safe?.  J Sports Med Phys

Fitness 44. (4): 411-416.2004;  Abstract

[59]  Mihic S., Mac J.R., McKenzie S., et al: 

Acute creatine loading increases fat-free mass, but

does not affect blood pressure, plasma creatinine, or

CK activity in men and women.  Med Sci Sports

Exerc 32. (2): 291-296.2000;  Abstract

[60]  Groeneveld G.J., Beijer C., Veldink J.H., et

al:  Few adverse effects of long-term creatine

supplementation in a placebo-controlled trial.  Int J

Sports Med 26. (4): 307-313.2005;  Abstract

[61]  Pline K.A.,  C.L.:  The effect of creatine

intake on renal function.  Ann Pharmacother 39. (6):

1093-1096.2005;  Abstract

[62]  T.M., Sewell D.A., Casey A., et al: 

Dietary creatine supplementation does not affect some

haematological indices, or indices of muscle damage

and hepatic and renal function.  Br J Sports

Med 34. 284-288.2000;  Abstract

[63]  Mayhew D.L., Mayhew J.L., Ware J.S.:  Effects of

long-term creatine supplementation on liver and kidney

functions in American college football players.  Int J

Sport Nutr Exerc Metab 12. (4): 453-460.2002; 

Abstract

[64]  Poortmans J.R., Francaux M.:  Long-term oral

creatine supplementation does not impair renal

function in healthy athletes.  Med Sci Sports

Exerc 31. (8): 1108-1110.1999;  Abstract

[65]  Yoshizumi W.M., Tsourounis C.:  Effects of

creatine supplementation on renal function.  J Herb

Pharmacother 4. (1): 1-7.2004; 

[66]  Kammer R.T.:  Lone atrial fibrillation

associated with creatine monohydrate supplementation.

 Pharmacotherapy 25. (5): 762-764.2005;  Abstract

[67]  Koshy K.M., Griswold E., Schneeberger E.E.: 

Interstitial nephritis in a patient taking creatine.

 N Engl J Med 340. (10): 814-815.1999;  Citation

[68]  Pritchard N.R., Kalra P.A.:  Renal dysfunction

accompanying oral creatine supplements.

 Lancet 351. (9111): 1252-1253.1998;  Citation

[69]  Sheth N.P., Sennett B., Berns J.S.: 

Rhabdomyolysis and acute renal failure following

arthroscopic knee surgery in a college football player

taking creatine supplements.  Clin Nephrol 65. (2):

134-137.2006;  Abstract

[Guest guest]

Apparently there are no studies concerning the heart.

Read below.

Ralph Giarnella MD

Southington Ct USA

****************

Creatine and Other Supplements

Pediatric Clinics of North America - Volume 54, Issue

4 (August 2007)  -  Copyright © 2007 W. B. Saunders

Company

Creatine and Other Supplements

 Lattavo, DOa, & #8727;

 Kopperud, MDb,c

D. , MD, MPH, FAAPc,d

Creatine's effects on other creatine-containing

tissues, such as the brain, cardiac muscle, and

testes, are unknown [4].

[4]  Tokish J.M., Kocher M.S., Hawkins R.J.: 

Ergogenic aids: a review of basic science,

performance, side effects, and status in sports.  Am J

Sports Med 32. (6): 1543-1553.2004;  Abstract