Performance-enhancing drugs: Know the risks #7

Creatine

What is it?

Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs. Supplements are available over-the-counter as powders or pills.

The most popular supplement among athletes is probably creatine monohydrate. Creatine is a naturally occurring compound produced by your body that helps your muscles release energy.

Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power. Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. There's no evidence, however, that creatine enhances performance in aerobic or endurance sports.

Your liver produces about 2 grams of creatine each day. You also get creatine from the meat in your diet. Creatine is stored in your muscles, and levels are relatively easily maintained. Because your kidneys remove excess creatine, the value of supplements to someone who already has adequate muscle creatine content is questionable, basically you are manufacturing expensive urine.

Risks

Supplements are considered food and not drugs by the Australian Therapeutic Goods Administration (TGA). This means supplement manufacturers are not required to conform to the same standards as drug manufacturers do. In some cases, supplements have been found to be contaminated with other substances, which have inadvertently led to a positive test for performance-enhancing drugs.

Possible side effects of creatine that can decrease athletic performance include:

• Stomach cramps
• Muscle cramps
• Nausea
• Diarrhea
• Weight gain

Weight gain is sought after by athletes who want to increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention than an increase in muscle mass. Water is drawn into your muscle tissue, away from other parts of your body. This puts you at risk of dehydration.  High-dose creatine use may potentially damage your kidneys and liver.

It appears safe for adults to use creatine at the doses recommended by manufacturers. But there are no studies investigating the long-term benefits and risks of creatine supplementation.  

In the absence of substantial scientific testing and clinical trials to back up the purported benefits of using Creatine, my recommendation is: don’t.

Our next instalment, the final in this series, looks at Stimulants.