In sports circles, it's known as "the power powder." It's a popular
muscle builder that many college athletes and even some pros believe
is the secret to their success. Now, it's trickled down to the
high school level -- with many an aspiring jock "power loading"
the crystalline substance before every big game.
thinking illegal street drugs -- guess again. The item in question
is the nutritional supplement creatine, a "natural" product that
increases athletic performance, much like anabolic steroids without
the documented risks.
But just because
creatine is sold in health food stores, don't believe it's problem-free.
While some health experts say there's not enough evidence to call
for a ban of its use, creatine is a supplement we know relatively
little about -- and therein may lie the danger.
medical standpoint, there remains confounding literature that
both supports and refutes negative side effects of creatine supplements
-- including the possibility of liver and kidney damage," says
Dr. Robert Gotlin, the director of the Orthopedic and Sports Rehabilitation
Program at Beth Israel Medical Center in New York City. "We just
don't know what long-term use will do."
he cautions, "it's not safe until it's proven safe, and it should
not be used, particularly by young athletes."
it they are. According to the Mayo Clinic Sports Medicine Center
in Rochester, Minn., an anonymous survey of 300 teen athletes
revealed that 8 percent are using creatine, often knowing little
about it. The results, say the study's authors, are probably indicative
of the national trend.
"We have no
reason to believe the group of kids we surveyed is any different
from any group of teen athletes around the nation. So the figures
are probably pretty accurate in terms of depicting not only use,
but the lack of knowledge about it by those who use it," says
Dr. Jay Smith, a sports medicine physician at the Mayo Clinic,
and one of several doctors who oversaw the study.
not hard to figure how the creatine craze landed on the steps
of America's high schools. A 1997 survey of National Collegiate
Athletic Association (NCAA) athletes found almost one-third were
using creatine supplements, while estimates for use by pro athletes,
particularly football players, have run as high as 75 percent.
All this despite the fact that creatine and other over-the-counter
supplements, although legal, have been banned by the National
Football League, the NCAA and the International Olympic Committee
is an amino acid that's produced by the liver, and is also available
via high-protein foods like red meat and poultry. It increases
the production and availability of ATP, adenosine triphosphate,
the fuel the body uses for quick bursts of energy -- the kind
required in football, wrestling and power lifting, for example.
appears to enable athletes to maintain a high training volume,
so they can recover more quickly from the high-power activity
and go again, which is why it is believed to improve performance,"
reports Ellen Coleman, a registered dietitian who counsels athletes
at the Sports Clinic in Riverside, Calif.
adds bulk to muscles -- almost immediately, increasing their size
usually within seven days.
But the benefits
are not without risk. Muscles that bulk too quickly are more subject
to injury, Gotlin notes. And weight gain and gastrointestinal
upset are frequently cited short-term side effects of creatine
use, along with dehydration and a potentially dangerous imbalance
of electrolytes, the minerals the body needs to regulate heart
sweat a great deal, their natural potential for dehydration is
greater than normal, and those risks increase with creatine use,
which holds water in the muscles and pulls it away from the rest
of the body," Coleman says.
There is also
at least some suspected risk of long-term damage to the liver,
and particularly the kidneys, which help filter excess creatine
from the body.
are more anecdotal reports, not necessarily well-designed follow-up
studies. So the unanswered question is, if you are taking this
stuff in greater amounts than what is made by the body naturally,
and it's excreted, what, if anything, is it doing to your kidneys?"
effects of creatine use, particularly in young athletes, prompted
the American College of Sports Medicine to convene a special roundtable
of experts to examine data on the supplement's effectiveness.
Their conclusion, recently published in the journal Medicine
and Science in Sports and Exercise, stated:
that creatine is a naturally occurring compound does not make
supplementation safe, as numerous compounds are good, even essential
in moderation, but detrimental in excess. Further, the lack of
adverse effects does not equal safety since unending research
must be performed to eliminate the possibility of all theoretical
we may not have much in the way of proven evidence against creatine
use -- in fact one five-year study found no problems with regular
use at all -- at least some experts believe that what we still
don't know about creatine could harm us.
what we know now, I would not recommend it," Gotlin says.
believe the best plan is simply to "approach with caution."
"If we know
the kids are going to be taking it anyway, it's better that we
at least be there to counsel them on the correct way to use the
supplement, and in the correct amounts, and in that way, help
reduce the likelihood of at least some potential problems," says
"We don't encourage use. But if the kids say they really want
to take it, we tell them what we know and what we don't know and,
with the parents involved, let them make their own decision. Because,
right now, we don't have any grounds to come out strongly against
If your teen
athlete insists on using creatine, it's imperative that you and
your child talk to his or her doctor first.