Creatine --- What Not to Mix
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April 10, 2013
By A. Turner, Featured Columnist and S. Callahan, Health Editor

Creatine has exploded in popularity over the past decades among
athletes in almost all sports, at almost all levels. Coaches and trainers in
The National Strength and Conditioning Association reported in 2000
that 86% of their athletes use creatine.  Another study  in 2000
reported that 41% of all Division I athletes have used creatine.  No
figures are available yet for the number of pro athletes who use
creatine but if the college numbers are any indication --- and given the
even greater pressure to perform at the pro level --- then pro athletes
are using creatine in overwhelming numbers.

Creatine is legal at the pro and collegiate level. But given the spreading
acceptance of creatine as an almost universal supplement, what do we
know about the dangers of creatine use?  What medications should you
not mix with creatine? Are there foods or drinks that you can’t safely
mix with creatine?

What Is Creatine?

Creatine is a chemical that is in all of our skeletal muscle tissues, as well
as in the brain, heart, retina, and testes.  Our livers, kidneys, and
pancreases synthesize between one to two grams of creatine every
day  and we also get creatine from fish and meats.  In fact, if you eat
meat amnd fish, you probably get about 1 to 2 grams of creatine a day.

Creatine has also been used against congestive heart failure,
depression, diseases of the muscles and nerves, and high cholesterol,
though the largest supplemental use is for building muscle and
improving exercise performance.

Currently, three forms of creatine are available in the United States:
creatine monohydrate, creatine phosphate and creatine citrate.

Does creatine work and what are the risks?   Unfortunately creatine is
not magical, and probably won't give you the life of a professional
athlete.  However, this substance could be a way to help you improve
your athletic performance.  The effectiveness of creatine for improving
athletic performance seems to depend upon who's taking it.  The
chemical does not seem to improve performance in aerobic exercises
(any rhythmic activity affecting large muscle groups for a long period
of time, such as running or biking),  in the elderly, nor, curiously, do
studies show much improvement in the performance of highly trained
athletes.  Some people have better luck creatine "loading," that is,
taking 20 grams a day for five days, more so than with continuous use.

Creatine has helped a lot of people with the conditions mentioned
above, but it isn't perfect.  The substance can be dangerous if taken in
the wrong way, leading to conditions as serious as kidney damage or
even stroke.  

Here are the common drinks and medications you should never mix
with creatine, based on our review of medical studies.

Medications and Drinks That You Shouldn't Mix with Creatine

1.  Don’t Mix Creatine with Caffeine

Creatine and caffeine don’t mix, according to new research studies.  If
you're a sports buff and trying to get buffer, you have probably done
your research on ergogenic aids.  If you are new to the term
"ergogenic," the word refers to substances, practices, or anything else
that can enhance an individual's use of energy.  These aids can range
from special stretching exercises, to well-designed shoes, and, of
course, can come in pills or powders.   

Two of the most popular dietary ergogenic aids are caffeine and
creatine.  Both caffeine and creatine are easy to access, easy to use,
and oftentimes quite effective.  

However, some experts, including those at St. Luke's Emergency
Services in Texas,  warn that combining these two boosters could
increase your risk for dehydration -- which is not a good way to
improve your athletic performance (see below).  Additionally, a review
from Ontario finds that mixing creatine with caffeine can do more harm
than help if you don't know what you're doing.

In 2010, M. Tarnopolsky with the Department of Pediatrics and
Medicine at McMaster University in Ontario, Canada,  reviewed the
effectiveness of both caffeine and creatine as ergogenic aids in sport.  
Data showed that while both creatine and caffeine can function as
erogogenic aids, "they do so in a sport-specific context," and that
"there is no rationale for their simultaneous use in sport."  

Hear that? There is no justification at all for using both creatine and
caffeine together.

And the news gets worse.  Furthermore, numbers suggest that "higher
doses of caffeine can be toxic" and that there is "no rationale for
creatine doses in excess of recommendations, and some athletes can
get stomach upset, especially at higher creatine doses."

Bottom line is that if you want to pump up your performance as fast as
possible, washing down a double dose of creatine with a triple
espresso is not the way to go. Creatine mixed with caffeine can be toxic.

Don't Take Creatine with NSAIDs

Taking creatine with NSAIDs can cause kidney damage. Common
NSAIDs  --- non-steroidal inflammatory drugs --- include ibuprofen
(Advil) and aspirin.  NSAIDs are  often prescribed for arthritis, sports
injuries, general pain, to reduce fevers, and to prevent blood from
clotting.  While these drugs have helped out a lot of people in a lot of
ways, there are some risks with taking NSAIDs.  If you are pregnant,
have high blood pressure, a history of kidney or liver disease, or are
taking any other drugs or supplements  -- including creatine -- you are
advised to tell your physician before beginning the use of the drug.  

In 2011, a large team of specialists from various institutions in
California, Georgia, and other states, including Laura Plantinga with the
Department of Epidemiology at the Rollins School of Public Health in
Atlanta,  set out to "characterize patterns" between chronic kidney
disease and the use of NSAIDs.  Using data from over 12,000 adults,
they found that while 2.5% of people who did not have kidney disease
currently used NSAIDs every day for 30 days or longer, twice that
many people (5%) with "moderate to severe" chronic kidney disease
reported the same use of NSAIDs.  Furthermore, over 66% of those
with moderate to severe kidney disease had used NSAIDs for one year
or longer at some point.

Some of us take an Ibuprofen without thinking twice for that pesky
headache. But, if you're also  taking  creatine, you may want to
reconsider some of your NSAIDs habits.

Creatine in a Supplemental Cocktail Part II --- Possible Kidney

Continue reading   page 1   
page 2

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