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Creatine Monohydrate

Uses

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
Athletic Performance and Non-Weight Bearing Endurance Exercise
15 to 20 grams daily for five or six days
Taking this supplement for five or six days may improve performance of high-intensity, short-duration exercise (like sprinting) or sports with alternating low- and high-intensity efforts.

Creatine (creatine monohydrate) is used in muscle tissue for the production of phosphocreatine, a factor in the formation of ATP, the source of energy for muscle contraction and many other functions in the body.3 , 4 Creatine supplementation increases phosphocreatine levels in muscle, especially when accompanied by exercise or carbohydrate intake.5 , 6 It may also increase exercise-related gains in lean body mass, though it is unclear how much of these gains represents added muscle tissue and how much is simply water retention.7

Over 40 double-blind or controlled studies have found creatine supplementation (typically 136 mg per pound of body weight per day or 15 to 25 grams per day for five or six days) improves performance of either single or repetitive bouts of short-duration, high-intensity exercise lasting under 30 seconds each.8 , 9 , 10 , 11 , 12 , 13 , 14 Examples of this type of exercise include weightlifting; sprinting by runners, cyclists, or swimmers; and many types of athletic training regimens for speed and power. About 15 studies did not report enhancement by creatine of this type of performance. These have been criticized for their small size and other research design problems, but it is possible that some people, especially elite athletes, are less likely to benefit greatly from creatine supplementation.15

Fewer studies have investigated whether creatine supplementation benefits continuous high- intensity exercise lasting 30 seconds or longer. Five controlled studies have found creatine beneficial for this type of exercise,16 but one study found no benefit on performance of a military obstacle course run.17 Most studies of endurance performance have found no advantage of creatine supplementation, except perhaps for non-weight bearing exercise such as cycling. 18 , 19 , 20

Long-term use of creatine supplementation is typically done using smaller daily amounts (2 to 5 grams per day) after an initial loading period of several days with 20 grams per day. Very little research has been done to investigate the exercise performance effects of long-term creatine supplementation. One study reported that long-term creatine supplementation improved sprint performance.21 Four controlled long-term trials using untrained women,22 trained men,23 or untrained older adults found that creatine improved gains made in strength and lean body mass from weight-training programs.24 , 25 However, two controlled trials found no advantage of long-term creatine supplementation in weight-training football players.26 , 27

Creatine supplementation appears to increase body weight and lean body mass or fat-free mass, but these measurements do not distinguish between muscle growth and increased water content of muscle.28 , 29 A few double-blind studies using more specific muscle measurements have been done and found that combining creatine supplementation with strength training over several weeks does produce greater increases in muscle size compared with strength training alone.30 , 31 , 32

2 Stars
Athletic Performance and High-Intensity, Short Duration Exercise or Sports with Alternating Low- and High-Intensity Efforts
15 to 20 grams a day for five or six days
Supplementing with creatine may improve performance of non-weight bearing endurance exercises such as cycling.

Creatine (creatine monohydrate) is used in muscle tissue for the production of phosphocreatine, a factor in the formation of ATP, the source of energy for muscle contraction and many other functions in the body.33 , 34 Creatine supplementation increases phosphocreatine levels in muscle, especially when accompanied by exercise or carbohydrate intake.35 , 36 It may also increase exercise-related gains in lean body mass, though it is unclear how much of these gains represents added muscle tissue and how much is simply water retention.37

Over 40 double-blind or controlled studies have found creatine supplementation (typically 136 mg per pound of body weight per day or 15 to 25 grams per day for five or six days) improves performance of either single or repetitive bouts of short-duration, high-intensity exercise lasting under 30 seconds each.38 , 39 , 40 , 41 , 42 , 43 , 44 Examples of this type of exercise include weightlifting; sprinting by runners, cyclists, or swimmers; and many types of athletic training regimens for speed and power. About 15 studies did not report enhancement by creatine of this type of performance. These have been criticized for their small size and other research design problems, but it is possible that some people, especially elite athletes, are less likely to benefit greatly from creatine supplementation.45

Fewer studies have investigated whether creatine supplementation benefits continuous high- intensity exercise lasting 30 seconds or longer. Five controlled studies have found creatine beneficial for this type of exercise,46 but one study found no benefit on performance of a military obstacle course run.47 Most studies of endurance performance have found no advantage of creatine supplementation, except perhaps for non-weight bearing exercise such as cycling. 48 , 49 , 50

Long-term use of creatine supplementation is typically done using smaller daily amounts (2 to 5 grams per day) after an initial loading period of several days with 20 grams per day. Very little research has been done to investigate the exercise performance effects of long-term creatine supplementation. One study reported that long-term creatine supplementation improved sprint performance.51 Four controlled long-term trials using untrained women,52 trained men,53 or untrained older adults found that creatine improved gains made in strength and lean body mass from weight-training programs.54 , 55 However, two controlled trials found no advantage of long-term creatine supplementation in weight-training football players.56 , 57

Creatine supplementation appears to increase body weight and lean body mass or fat-free mass, but these measurements do not distinguish between muscle growth and increased water content of muscle.58 , 59 A few double-blind studies using more specific muscle measurements have been done and found that combining creatine supplementation with strength training over several weeks does produce greater increases in muscle size compared with strength training alone.60 , 61 , 62

2 Stars
Chronic Obstructive Pulmonary Disease
5 grams three times a day for two weeks, and then 5 grams once daily
Creatine has been shown to increase muscle strength, muscle endurance, and overall health status.

In a double-blind study, people with COPD received creatine or a placebo for 12 weeks. After the first 2 weeks of supplementation, all participants underwent an outpatient pulmonary rehabilitation program. Compared with the placebo, creatine significantly increased muscle strength, muscle endurance, and overall health status, but not exercise capacity.63 The amount of creatine used in this study was 5 grams three times a day for 2 weeks, and then 5 grams once a day for 10 weeks.

1 Star
High Cholesterol
Refer to label instructions
One trial found that supplementing with creatine significantly lowered serum total cholesterol and triglycerides in people with high cholesterol.
A double-blind trial found that 20 grams per day of creatine taken for five days, followed by ten grams per day for 51 days, significantly lowered serum total cholesterol and triglycerides, but did not change either LDL or HDL cholesterol, in both men and women.64 However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program.65 Creatine supplementation in this negative trial was lower—only 5 grams per day were taken for the last 11 weeks of the study.
1 Star
High Triglycerides
Refer to label instructions
One trial found that supplementing with significantly lowered serum total triglycerides in both men and women.

A double-blind trial found that a supplement of 5 grams of creatine plus 1 gram of glucose taken four times per day for five days followed by twice a day for 51 days significantly lowered serum total triglycerides in both men and women.66However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program.67 Creatine supplementation in this negative trial was lower—only five grams per day was taken for the last 11 weeks of the study.

How It Works

How to Use It

Two methods are used for supplementing with creatine. In the loading method, 20 grams of creatine per day (in four divided amounts mixed well in warm liquid) are taken for five to six days.68 Muscle creatine levels increase rapidly, which is beneficial if a short-term rise in force is needed, such as during a weight-lifting competition, football game, or sprinting. To maintain muscle creatine levels after this loading period, 2–10 grams per day may be effective.69 , 70

In another method, 3 grams of creatine monohydrate per day are taken over an extended training period of at least four weeks, during which muscle creatine levels rise more slowly, eventually reaching levels similar to those achieved with the loading method.71 However, no trials testing exercise performance changes have been done using this method. Taking creatine with sugar appears to maximize muscle uptake.72 , 73

Caffeine intake should not be excessive, as large amounts may counteract the benefits of creatine supplementation.74

Where to Find It

Creatine is produced naturally in the human liver, pancreas, and kidneys. It is concentrated primarily in muscle tissues, including the heart. Animal proteins, including fish, are the main source of the 1–2 grams per day of dietary creatine most people consume. Supplements in the form of creatine monohydrate are well absorbed and tolerated by the stomach.

Possible Deficiencies

People involved in intense physical activity, especially those limiting their intake of red meat, may have low muscle stores of creatine. Several muscle diseases, as well as rheumatoid arthritis, and chronic circulatory and respiratory diseases, are associated with lowered creatine levels.75

Interactions

Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known supplement or food interactions with this supplement.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • Atorvastatin
    In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.76
  • Lovastatin
    In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.77
  • Pitavastatin
    In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.78
  • Pravastatin
    In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.79
  • Rosuvastatin
    In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.80
  • Simvastatin
    In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.81

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Little is known about long-term side effects of creatine, but no consistent toxicity has been reported in studies of creatine supplementation. In a study of side effects of creatine, diarrhea was the most commonly reported adverse effect of creatine supplementation, followed by muscle cramping.82 Some reports showed that kidney, liver, and blood functions were not affected by short-term higher amounts83 , 84 or long-term lower amounts 85 , 86 of creatine supplementation in healthy young adults. In a small study of people taking 5–30 grams per day, no change in kidney function appeared after up to five years of supplementation.87 However, interstitial nephritis, a serious kidney condition, developed in an otherwise healthy young man, supplementing with 20 grams of creatine per day.88 Improvement in kidney function followed avoidance of creatine. Details of this case strongly suggest that creatine supplementation triggered this case of kidney disease. Creatine supplementation may also be dangerous for people with existing kidney disease. In one report, a patient with nephrotic syndrome (a kidney disorder) developed glomerulosclerosis (another serious kidney condition) while taking creatine. when the creatine was discontinued, the glomerulosclerosis resolved.89

Muscle cramping after creatine supplementation has been anecdotally reported in three studies.90 , 91 , 92

References

1. Greenhaff PL, Bodin K, Soderlund K, et al. Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis. Am J Physiol 1994;266:E725-30.

2. Greenhaff PL. Creatine and its application as an ergogenic aid. Int J Sport Nutr 1995;5:94-101.

3. Greenhaff PL, Bodin K, Soderlund K, et al. Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis. Am J Physiol 1994;266:E725–30.

4. Greenhaff PL. Creatine and its application as an ergogenic aid. Int J Sport Nutr 1995;5:94–101.

5. Harris RC, Soderlund K, Hultman E. Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci 1992;83:367–74.

6. Green AL, Simpson EJ, Littlewood JJ, et al. Carbohydrate ingestion augments creatine retention during creatine feeding in humans. Acta Physiol Scand 1996;158:195–202.

7. Kreider RB, Ferreira M, Wilson M, et al. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc 1998;30:73–82.

8. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

9. Watsford ML, Murphy AJ, Spinks WL, Walshe AD. Creatine supplementation and its effect on musculotendinous stiffness and performance. J Strength Cond Res 2003;17:26–33.

10. van Loon LJ, Oosterlaar AM, Hartgens F. Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci (Lond) 2003;104:153–62.

11. Warber JP, Tharion WJ, Patton JF, et al. The effect of creatine monohydrate supplementation on obstacle course and multiple bench press performance. J Strength Cond Res 2002;16:500–8.

12. Ziegenfuss TN, Rogers M, Lowery L, et al. Effect of creatine loading on anaerobic performance and skeletal muscle volume in NCAA Division I athletes. Nutrition 2002;18:397–402.

13. Cottrell GT, Coast JR, Herb RA. Effect of recovery interval on multiple-bout sprint cycling performance after acute creatine supplementation. J Strength Cond Res 2002;16:109–16.

14. Izquierdo M, Ibanez J, Gonzalez-Badillo JJ, Gorostiaga EM. Effects of creatine supplementation on muscle power, endurance, and sprint performance. Med Sci Sports Exerc 2002;34:332–43.

15. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

16. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

17. Warber JP, Tharion WJ, Patton JF, et al. The effect of creatine monohydrate supplementation on obstacle course and multiple bench press performance. J Strength Cond Res 2002;16:500–8.

18. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

19. Van Loon LJ, Oosterlaar AM, Hartgens F. Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci (Lond) 2003;104:153–62.

20. Izquierdo M, Ibanez J, Gonzalez-Badillo JJ, Gorostiaga EM. Effects of creatine supplementation on muscle power, endurance, and sprint performance. Med Sci Sports Exerc 2002;34:332–43.

21. Van Loon LJ, Oosterlaar AM, Hartgens F. Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci (Lond) 2003;104:153–62.

22. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997;83:2055–63.

23. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc 2000;32:654–8.

24. Brose A, Parise G, Tarnopolsky MA. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. J Gerontol A Biol Sci Med Sci 2003;58:11–9.

25. Chrusch MJ, Chilibeck PD, Chad KE Creatine supplementation combined with resistance training in older men. Med Sci Sports Exerc 2001;33:2111–7.

26. Stout JR, Eckerson J, Noonan D, et al. The effects of a supplement designed to augment creatine uptake on exercise performance and fat-free mass in football players. Med Sci Sports Exerc 1997;29:S251 [abstract].

27. Wilder N, Gilders R, Hagerman F, Deivert RG. The effects of a 10-week, periodized, off-season resistance-training program and creatine supplementation among collegiate football players. J Strength Cond Res 2002;16:343–52.

28. Kreider RB, Ferreira M, Wilson M, et al. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc 1998;30:73–82.

29. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

30. Volek JS, Duncan ND, Mazzetti SA, et al. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc 1999;31:1147–56.

31. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc 2000;32:654–8.

32. Willoughby DS, Rosene J. Effects of oral creatine and resistance training on myosin heavy chain expression. Med Sci Sports Exerc 2001;33:1674–81.

33. Greenhaff PL, Bodin K, Soderlund K, et al. Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis. Am J Physiol 1994;266:E725–30.

34. Greenhaff PL. Creatine and its application as an ergogenic aid. Int J Sport Nutr 1995;5:94–101.

35. Harris RC, Soderlund K, Hultman E. Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci 1992;83:367–74.

36. Green AL, Simpson EJ, Littlewood JJ, et al. Carbohydrate ingestion augments creatine retention during creatine feeding in humans. Acta Physiol Scand 1996;158:195–202.

37. Kreider RB, Ferreira M, Wilson M, et al. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc 1998;30:73–82.

38. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

39. Watsford ML, Murphy AJ, Spinks WL, Walshe AD. Creatine supplementation and its effect on musculotendinous stiffness and performance. J Strength Cond Res 2003;17:26–33.

40. van Loon LJ, Oosterlaar AM, Hartgens F. Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci (Lond) 2003;104:153–62.

41. Warber JP, Tharion WJ, Patton JF, et al. The effect of creatine monohydrate supplementation on obstacle course and multiple bench press performance. J Strength Cond Res 2002;16:500–8.

42. Ziegenfuss TN, Rogers M, Lowery L, et al. Effect of creatine loading on anaerobic performance and skeletal muscle volume in NCAA Division I athletes. Nutrition 2002;18:397–402.

43. Cottrell GT, Coast JR, Herb RA. Effect of recovery interval on multiple-bout sprint cycling performance after acute creatine supplementation. J Strength Cond Res 2002;16:109–16.

44. Izquierdo M, Ibanez J, Gonzalez-Badillo JJ, Gorostiaga EM. Effects of creatine supplementation on muscle power, endurance, and sprint performance. Med Sci Sports Exerc 2002;34:332–43.

45. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

46. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

47. Warber JP, Tharion WJ, Patton JF, et al. The effect of creatine monohydrate supplementation on obstacle course and multiple bench press performance. J Strength Cond Res 2002;16:500–8.

48. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

49. Van Loon LJ, Oosterlaar AM, Hartgens F. Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci (Lond) 2003;104:153–62.

50. Izquierdo M, Ibanez J, Gonzalez-Badillo JJ, Gorostiaga EM. Effects of creatine supplementation on muscle power, endurance, and sprint performance. Med Sci Sports Exerc 2002;34:332–43.

51. Van Loon LJ, Oosterlaar AM, Hartgens F. Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans. Clin Sci (Lond) 2003;104:153–62.

52. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997;83:2055–63.

53. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc 2000;32:654–8.

54. Brose A, Parise G, Tarnopolsky MA. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. J Gerontol A Biol Sci Med Sci 2003;58:11–9.

55. Chrusch MJ, Chilibeck PD, Chad KE Creatine supplementation combined with resistance training in older men. Med Sci Sports Exerc 2001;33:2111–7.

56. Stout JR, Eckerson J, Noonan D, et al. The effects of a supplement designed to augment creatine uptake on exercise performance and fat-free mass in football players. Med Sci Sports Exerc 1997;29:S251 [abstract].

57. Wilder N, Gilders R, Hagerman F, Deivert RG. The effects of a 10-week, periodized, off-season resistance-training program and creatine supplementation among collegiate football players. J Strength Cond Res 2002;16:343–52.

58. Kreider RB, Ferreira M, Wilson M, et al. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc 1998;30:73–82.

59. Mesa JL, Ruiz JR, Gonzalez-Gross MM, et al. Oral creatine supplementation and skeletal muscle metabolism in physical exercise. Sports Med 2002;32:903–44 [review].

60. Volek JS, Duncan ND, Mazzetti SA, et al. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc 1999;31:1147–56.

61. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc 2000;32:654–8.

62. Willoughby DS, Rosene J. Effects of oral creatine and resistance training on myosin heavy chain expression. Med Sci Sports Exerc 2001;33:1674–81.

63. Fuld JP, Kilduff LP, Neder JA, et al. Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary disease. Thorax2005;60:531–7.

64. Earnest CP, Almada AL, Mitchell TL. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin Sci 1996;91:113–8.

65. Volek JS, Duncan ND, Mazzetti SA, et al. No effect of heavy resistance training and creatine supplementation on blood lipids. Int J Sport Nutr Exerc Metab 2000;10:144–56.

66. Earnest CP, Almada AL, Mitchell TL. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin Sci 1996;91:113–8.

67. Volek JS, Duncan ND, Mazzetti SA, et al. No effect of heavy resistance training and creatine supplementation on blood lipids. Int J Sport Nutr Exerc Metab 2000;10:144–56.

68. Greenhaff PL. The nutritional biochemistry of creatine. J Nutr Biochem 1997;8:610–8.

69. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997;83:2055–63.

70. Becque MD, Lochmann JD, Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc 2000;32:654–8.

71. Hultman E, Soderlund K, Timmons J, et al. Muscle creatine loading in man. J Appl Physiol 1996;81:232–7.

72. Green AL, Hultman E, Macdonald IA, et al. Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in man. Am J Physiol 1996;271:E821–6.

73. Feldman EB. Creatine: a dietary supplement and ergogenic aid. Nutr Rev 1999;57:45–50.

74. Vandenberghe K, Gills N, Van Leemputte M, et al. Caffeine counteracts the ergogenic action of muscle creatine loading. J Appl Physiol 1996;80:452–7.

75. Silber ML. Scientific facts behind creatine monohydrate as a sports nutrition supplement. J Sports Med Phys Fitness 1999;39:179–88 [review].

76. Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690–2.

77. Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690–2.

78. Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690–2.

79. Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690–2.

80. Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690–2.

81. Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690–2.

82. Juhn MS, O’Kane JW, Vinci DM. Oral creatine supplementation in male collegiate athletes: a survey of dosing habits and side effects. J Am Diet Assoc 1999;99:593–5.

83. Sewell DA, Robinson TM, Casey A, et al. The effect of acute dietary creatine supplementation upon indices of renal, hepatic and haematological function in human subjects. Proc Nutr Soc 1998;57:17A.

84. Poortmans JR, Auquier H. Renaut V, et al. Effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol Occup Physiol 1997;76:566–7.

85. Earnest C, Almada A, Mitchell T. Influence of chronic creatine supplementation on hepatorenal function. FASEB J 1996;10:4588.

86. Almada A, Mitchell T, Earnest C. Impact of chronic creatine supplementation on serum enzyme concentrations. FASEB J 1996;10:4567.

87. Poortmans JR, Francaux M. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc 1999;31:1108–10.

88. Koshy KM, Griswold E, Schneeberger EE. Interstitial nephritis in a patient taking creatine. N Engl J Med 1999;340:814–5 [letter].

89. Pritchard NR, Kaira PA. Renal dysfunction accompanying oral creatine supplements. Lancet 1998;351:1252–3 [letter].

90. Hultman E, Soderlund K, Timmons J, et al. Muscle creatine loading in man. J Appl Physiol 1996;81:232–7.

91. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training. J Appl Physiol 1997;83:2055–63.

92. Juhn MS, Tarnopolsky M. Potential side effects of oral creatine supplementation: a critical review. Clin J Sport Med 1998;8:298–304 [published erratum appears in Clin J Sport Med 1999;9:62].

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