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Popular Ergogenic Drugs and Supplements in Young Athletes
Ryan Calfee and Paul Fadale
Pediatrics 2006;117;577-589
"Effects
Creatine supplementation does appear to have athletic
benefits. However, nearly 30% of athletes do not see
benefits with creatine use, thereby falling into a category
of “nonresponders” who are theorized to have already
maximal phosphocreatine stores.[9] Most common, performance
effects are seen in increasing strength and
outcomes in short-duration, anaerobic events. Studies
do not show improved endurance performance as expected
given that prolonged muscle activity depends on
aerobic glycolysis.[84] In a well-controlled setting, Volek et
al[85] performed a double-blinded study that examined 12
weeks of creatine use including standard loading and
maintenance phases in recreational weightlifters. In
those athletes who were taking creatine, significant increases
in fat-free body mass; bench press maximal lift;
peak power production in sets of repeated jump squats;
and biopsied type I, IIA, and IIAB muscle fibers were
demonstrated.
Adverse Effects
Athletes who take creatine commonly experience early
weight gain of 1.6 to 2.4 kg, which can be detrimental in
purely speed-based events. It is also common for athletes
to report minor gastrointestinal discomfort and muscle
cramps, although these generally do not curb use.[4] There
have been 2 case reports of renal function compromise.
One was an athlete who had previously diagnosed focal
segmental glomerulosclerosis and experienced a transient
50% loss of glomerular filtration rate, and 1 previously
healthy athlete reported transient interstitial nephritis.
86,87 However, at least 1 study of self-reported use
over several years did not show adverse renal effects.[88]
Three highly publicized deaths have occurred in college
wrestlers who were known to take creatine, although
official autopsy results indicated that dehydration and
weight loss were at fault, not creatine.[81] Additional questions
remain, as there are no data to judge the effects of
supplementation on the other tissues that store creatine
(heart and brain), the effects of chronic use, or the
effects of creatine use in minors."
4. Cogeni J, Miller S. Supplements and drugs used to enhance
athletic performance. Pediatr Clin North Am. 2002;49:435–461
9. McDevitt ER. Ergogenic drugs in sports. In: DeLee J, Drez D,
eds. Orthopaedic Sports Medicine: Principles and Practice. 2nd ed.
Philadelphia, PA: WB Saunders; 2003:471–483
81. PDR Health. Creatine. Available at:
www.pdrhealth.com/
drugif o/nmdrugprofiles/nutsupdrugs/cre0086.shtml. Accessed
January 20, 2006
84. Engelhardt M, Neuman G, Berbalk A, Reuter I. Creatine
supplementation in endurance sports. Med Sci Sports Exerc.
1998;30:1123–1129
85. 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:
1147–1156
88. Poortmans JR, Francaux M. Long-term oral creatine supplementation
does not impair renal function in healthy athletes.
Med Sci Sports Exerc. 1999;31:1108–1110