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Creatine: Safety and Side Effects

Posted Aug 24 2008 1:49pm
PAUL MONIZ: I'm Paul Moniz. Thanks for joining us. There is no question about it. Americans are obsessed with dietary supplements. As many as 1 in 3 Americans takes one every day, and 7 in 10 admit to using them from time to time. With more than $6 billion a year in sales at stake, companies that manufacture these supplements are constantly hawking their products promising more energy, a leaner body, increased mental alertness and even better sexual performance. The problem is that the FDA does not regulate these products. What the companies generally don't want you to know is that the supplements can be dangerous and at times deadly.

Here to assess the effects and risks are two nutritionists. We have Doug Kalman who is a registered dietitian and a Director of Clinical Research at Peak Wellness, which is a private health center in Greenwich, CT. Thanks Doug for being here.

PAUL MONIZ: We also have Heidi Skolnik, who is the team nutritionist for the New York Mets and the Giants, and also the owner of Nutrition Condition, a private company.

What about using creatine? There seems to be an explosion of people, especially men, using creatine to get better workouts, reduce fat. Is it safe?

DOUG KALMAN, MS, RD, CDN: Well, creatine appears to be safe for the general population or anyone that does not have kidney disease. However, you have to be aware that what creatine does is that it increases the retention or shifts fluid in the body. It also works by increasing protein synthesis in the body.

If you just take creatine and do nothing, you're going to have extra creatine in your body and still not look any better. But if you take creatine and you're involved in weight training and resistance exercise, you can get stronger and you're going to gain weight. Now you do not necessarily gain Arnold Schwarzeneggar type muscles, but you gain a combination of water weight and some new muscle.

PAUL MONIZ: So do you lose fat, or do you essentially gain muscle, but don't necessarily lose fat.

DOUG KALMAN, MS, RD, CDN: It could be either of those two. That's really dependent upon everything else you're doing in your life. But creatine in and of itself does not help with fat loss. There are no real good studies that says that creatine reduces fat. There are good studies that show that creatine with weight lifting can increase fat free mass or muscle.

HEIDI SKOLNIK, MS, CDN, FACSM: One of the things you want to be careful of with creatine, and again, when I work with the athletes that are taking it, one of the things I advise them is to get real with your lifestyle. So if you're taking creatine, which as Doug was talking about causes a shift in your fluid, you can become dehydrated, if you're not staying well hydrated. Staying well hydrates is an issue for most athletes to begin with. So if you're going to take creatine, you have to be careful to stay hydrated, and then realize, are you drinking alcohol, which dehydrates you? Are you drinking a lot of caffeine products, which dehydrates you? Are you taking any other over-the-counter sorts of things like any other caffeine-based products that can also dehydrate you.

Then you're setting yourself up for risk of soft tissue damage, muscle tears and pulls that can really injure you and keep you out. In the case of the athletes that I work with, it could be career ending. So then does the benefit outweigh the risk?

Creatine is shown to be effective. There have been well over 100 studies that have shown that it is effective with a very low risk. There are really limited side effects.

PAUL MONIZ: Except for digestive effects, which can be serious for some people who take it.

HEIDI SKOLNIK, MS, CDN, FACSM: Perhaps. But that's never actually been in any of the studies. That's interesting. I think that has more to do with a hydration issue than anything else. It's hard to say for sure because it's more from the field and not in the studies.

PAUL MONIZ: That's some good advice. I appreciate your time. Doug Kalman, than you for being here, and Heidi Skolnik for your time as well.

I'm Paul Moniz. Thanks for joining us. Remember these products are not regulated by the FDA, but as our guests mentioned if you talk to your doctor and other health professionals, you should be able to come to some reasonable determination about how they should used.

Thanks for joining us.

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