Creatine is often taken by athletes as a supplement for those wishing to gain muscle mass (bodybuilding). There are a number of forms but the most common are creatine monohydrate - creatine complexed with a molecule of water, and Creatine ethyl ester (CEE). A number of methods for ingestion exist - as a powder mixed into a drink, or as a capsule or caplet. Once ingested, creatine is highly bioavailable, whether it is ingested as the crystalline monohydrate form, the free form in solution, or even in meat. Creatine salts will become the free form when dissolved in aqueous solution. Conventional wisdom recommends the consumption of creatine with high glycemic index carbohydrates, though research indicates that the use of high GI carbs in combination with protein is also beneficial.[5]
There is scientific evidence that taking creatine supplements can marginally increase athletic performance in high-intensity anaerobic repetitive cycling sprints, but studies in swimmers and runners have been less than promising, most likely because these activities are sustained at a given intensity and thus do not allow for significant intra-exercise synthesis of additional creatine phosphate molecules. Ingesting creatine can increase the level of phosphocreatine in the muscles up to 20%. It must be noted creatine has no significant effect on aerobic endurance, though it will increase power during short sessions of high-intensity aerobic exercise.[6][7]
Since body mass gains of about 1 kg can occur in a week’s time, many studies suggest that the gain is simply due to greater water retention inside the muscle cells. However, studies into the long-term effect of creatine supplementation suggest that body mass gains cannot be explained by increases in intracellular water alone.[8] In the longer term, the increase in total body water is reported to be proportional to the weight gains, which means that the percentage of total body water is not significantly changed. The magnitude of the weight gains during training over a period of several weeks argue against the water-retention theory.
Also, research has shown that creatine increases the activity of satellite cells, which make muscle hypertrophy possible. Creatine supplementation appears to increase the number of myonuclei that satellite cells will ‘donate’ to damaged muscle fibers, which increases the potential for growth of those fibers. This increase in myonuclei probably stems from creatine’s ability to increase levels of the myogenic transcription factor MRF4.[9][10].
In another study, researchers concluded that changes in substrate oxidation may influence the inhibition of fat mass loss associated with creatine after weight training when they discovered that fat mass did not change significantly with creatine but decreased after the placebo trial in a 12-week study on ten active men. The study also showed that 1-RM bench press and total body mass increased after creatine, but not after placebo.[11] The underlying effect of Creatine on body composition if there is indeed one has yet to be determined, as another study with a similar timeframe suggests no effect on body composition, but had less overall emphasis on metabolic effects. [12]
Creatine use is not considered doping and is not banned by the majority of sport-governing bodies. However, in the United States, the NCAA recently ruled that colleges could not provide creatine supplements to their players, though the players are still allowed to obtain and use creatine independently.
Creatine ethyl ester
Main article: Creatine ethyl ester
CEE is a form of commercially available creatine touted to have higher absorption rates and a longer serum half-life than regular creatine monohydrate by several supplement companies. No peer-reviewed studies have emerged on creatine ethyl ester to conclusively prove these claims, however, a study presented at the 4th International Society of Sports Nutrition (ISSN) annual meeting demonstrated that the addition of the ethyl group to creatine actually reduces acid stability and accelerates its breakdown to creatinine. The researchers concluded that creatine ethyl-ester is inferior to creatine monohydrate as a source of creatine.[13]
As a supplement, the compound was developed, patented and licensed through UNeMed, the technology transfer entity of the University of Nebraska Medical Center.[14]