[This is a guest blog by Earl Wilcox. Earl is a graduate from the Kinesiology program at the University of North Carolina at Greensboro. Earl currently possesses his CSCS from the NSCA and is an Applied Sports Science Intern at Athletic Lab.]

Creatine1Creatine is one of the top supplements of choice for increasing athletic performance. According to the University of Maryland Medical Center, Americans spend around 14 million dollars a year on creatine supplementation. The main draw to supplementing with creatine is that it can help promote greater changes in muscle mass, body composition and strength gains when combined with the proper training regimen. However, supplementation may not just be for elite level athletes and those who are trying to look good come beach season. There are now studies that show creatine supplementation may in fact help in the treatment of Parkinson’s disease as well as help prevent sarcopenia and traumatic brain injuries.

Before we get into how creatine can help prevent these particular issues, I believe it is important to explain what creatine is and how it works. First of all, creatine is a naturally occurring substrate in the body and can be found in most animal-based proteins. It is used during the resynthesis of ATP. Think of ATP as the currency the body uses to perform any task; if you spend too much of it, you become unable to perform said task. The body has three different ways to produce ATP, one of which uses creatine. The phosphocreatine system.  The phosphocreatine system can produce a vast amount of ATP, however it is limited to producing energy for up to 6-10 seconds. The phosphocreatine system would be like driving a Ferrari in a cross country trip, you could drive fast, but you would be stopping for gas a lot more than if you drove a Prius. This is where creatine supplementation helps. It  gives individuals a greater store of creatine, which supplies the phosphocreatine system with more fuel to burn. This allows for greater performance during high intensity exercise, since it enhances the ability of a person to complete more repetitions and recover faster in between sets. In fact, one study has shown that creatine supplementation and concurrent resistance training resulted in an 8% greater increase in strength and a 12% increase in muscular endurance over just resistance training alone (Rawson and Persky, 2007).

Parkinson’s Disease (PD) progressively attacks the nervous system, causing issues that mostly affect movement. It commonly will start with tremors in the hand and will grow progressively worse from there. While there is no cure for PD, the symptoms can be mitigated through medication and exercise. However, because PD causes limited muscular performance, it can expedite the onset of sarcopenia or age-related muscle atrophy (Hass et al.,2007). Creatine supplementation can help enhance the value of resistance training for people with PD and/or sarcopenia, because it can increase both the muscle and brain ability to store creatine. These increased stores aid in the production of ATP, help act as a pH buffer during high intensity exercise, and most importantly, improve the ability to tolerate the training stimulus leading to greater volume and intensity of training (Hass et al.,2007). This last point cannot be emphasized enough, since if the training can more easily be tolerated, then the patient is more likely to do it, which is the most important part because the training will help mitigate the rate at which these diseases will cause deterioration of the nervous system and muscle fibers. To illustrate how creatine combined with resistance training provides greater effects over just resistance training alone, a study was done using creatine and a placebo. After the supplementation and training protocols were completed, the creatine supplementation group had on average a 10% greater increase in strength versus the placebo group, which did see strength gains, just not as much (Hass et al.,2007). One other important note is that the protocol  (a 20/g per day loading dose for 7 days, followed by a 3-5 g per day maintenance dose) did not have any side effects or decrease efficacy of medication.

cardiacFinally, creatine may be able to help prevent traumatic brain injuries in sports, which is a matter of increasing concern. While we currently don’t have all the answers, we are starting to gain a greater understanding of these injuries. First, it is important to recognize that the brain requires a lot of energy to operate, even during exercise. In the picture below, you can see the percentage of blood flow to various organs of the body both at rest and during heavy exercise. While the percentage of total percentage of cardiac output decreases to the brain, the absolute total amount of blood received by the brain does not. This is vital because while most organs tend to have a decreased role during exercise, the brain does not and still requires the same if not a little more blood flow in order to maintain its function. When someone suffers a brain injury, it is normally the loss of blood flow to the area that causes the most issues because without blood the brain’s energy production become compromised (Turner et al., 2015). Creatine can aid in protecting the brain by allowing for it to create energy without a reliance on oxygen to produce energy, due to the phosphocreatine systems ability to create ATP without oxygen. One study tested this by artificially altering the oxygen content of the air subjects would breath to create hypoxia, which is a decreased level of oxygen reaching the tissues. The subjects were then put through cognitive tests to see how this state would affect mental function. The group that supplemented with creatine saw an increase in creatine stores within the brain as well as better scores during cognitive tests when compared to those who took a placebo (Turner et al., 2015).

These various studies show that while creatine is not the magic bullet for any one particular issue it can be combined with other treatments or preventative measures to maximize their effectiveness. This in turn is how supplements are used most effectively.

References:

  • Rawson, E; Persky, A. Mechanisms of muscular adaptations to creatine supplementation. International SportMed Journal. 8, 2, 43-53 11p, June 2007.
  • Hass, C; Collins, M; Juncos, J. Resistance training with creatine monohydrate improves upper-body strength in patients with Parkinson disease: a randomized trial. Neurorehabilitation & Neural Repair. Thousand Oaks, California, 21, 2, 107-115 9p, Mar. 2007
  • Turner, C. E., Byblow, W. D., & Gant, N. (2015). Creatine supplementation enhances corticomotor excitability and cognitive performance during oxygen deprivation. The Journal Of Neuroscience, 35(4), 1773-1780.