TweetCreatine - Beyond the Confusion


Creatine - Beyond the Confusion

If you haven't heard of creatine before this, you've been living under a damn large rock. Since creatine was first introduced in the early 90s, it has been the "poster boy" for the athletic community, and it's not going away anytime soon. Creatine has been in the news, on the cover of almost every health magazine imaginable and even on TV. Ask strength coaches and trainers to name the best supplement for increasing size and strength, and they will cite creatine. Despite the hype, many are confused as to what it does, how it works, its safety, and why they should use it. Take partial or inaccurate information, add some half-baked, misrepresented statements that get plastered in the news, and you have people scratching their heads. One guy asked me, "Is that steroid, creatine, any good?" Creatine, of course, is not a steroid. I could fill a book about creatine's effects, but I prefer to present this product to you in an understandable manner. Most people know creatine only as a supplement that athletes use, but as you will see later in this article, there are numerous other uses for this breakthrough product.

Creatine - What is is?

Creatine, also known as methyl guanidine-acetic acid [NH2 - C(NH) - NCH2(COOH) - CH3], is an amino acid used by the body to provide energy. Phosphocreatine and free creatine, which are stored in the body, make up what is known as your total creatine pool.(5) Those who increase their total creatine pool are able to increase available energy. Scientists discovered in 1932 that the body retained some ingested creatine,(5) but it was not until the early 1990s that creatine began to gain recognition with the athletic community.

Creatine helps volumize muscle (makes muscles larger), increases strength and power, provides energy to the muscles and buffers lactic acid. Oh yeah - creatine may also prevent mental fatigue, help with genital herpes, lower the risk of coronary heart or cerebrovascular disease, and has been linked with a decreased risk in some neurodegenerative diseases, such as Alzheimer's. Yes, those are a lot of claims, and yes, creatine fulfills all of them.

Creatine is a naturally occurring substance in our bodies; the average person stores over 100 grams of it. Ninety-five percent of creatine is stored in the skeletal muscles, with the other five percent in the brain, heart and testes. (Sorry guys, it won't make your boys bigger.)(5) Creatine is formed when our kidneys, liver and pancreas convert three amino acids - Arginine, Glycine and Methionine - into creatine. We can get additional (albeit miniscule amounts) of creatine from our diets through such foods as red meat and salmon. Since you would need to eat almost 18 steaks to get 20 grams of creatine, the more effective way to increase its presence is to use a high quality commercial supplement.


Strength & Power

When you consume creatine, it combines with phosphate in your body to create phosphocreatine, which in turn is stored in your muscle cells, waiting to be called upon for energy. When your muscles are exposed to short but intense exercise (0-30 seconds), you call upon your alactic system (otherwise known as phosphogen, or ATP-PC system) to complete the work. When you expose your muscles to this short, intense exercise, your muscles require a chemical energy called ATP (Adenosine Triphosphate), the quickest and best source of energy for your muscles.(6) Unfortunately, ATP is in very short supply in your muscles.(7) When you run out of ATP, you run out of gas. This is where creatine comes in. When your body uses ATP for energy, it creates a by-product called ADP (Adenosine Diphosphate), which is useless to our body. Fortunately, the phosphocreatine stored in your muscles allows your body to convert the ADP back into ATP and be used for energy.(6) (7) So, to make a long story short, by increasing the amount of creatine you consume, you increase the amount of phosphocreatine in your muscles, which elevates the amount of ATP you have available for muscular energy. The increased level of ATP, in turn, allows you to increase your workload and sustain it over a longer period of time. (6) (8) Essentially, creatine helps you either lift heavier weight, complete more reps, or both. This elevated work capacity results in an increased ability to develop lean muscle tissue. Because creatine offers an increased capacity for short bursts of energy, athletes in football, hockey, baseball, sprinting, bodybuilding, basketball, or any other sport that requires quick but substantial bursts of energy, benefit from this supplement. As virtually every sport (except maybe lawn bowling) requires athletes to have high levels of strength and muscularity, creatine becomes a viable supplement. I recommend making creatine part of your supplement routine throughout the year. At the very least, use it during the off season, when building strength is a priority.

There you have it. If you want to grow up big and strong eat your Wheaties AND take your creatine!


Pump Up The Volume!

Creatine attracts water, so as your muscles absorb and store creatine, it brings additional water with it. This process super-saturates the muscle tissue with water and creatine, thus enlarging the actual muscle tissue. This super-saturation results in your muscles having that "just trained feeling" all day long. Many refer to this as the "perpetual pump" from creatine. Larger muscles in a matter of days: Can you believe some people refer to this phenomenon as a "side effect" of creatine? Indeed, many people take creatine for this "side effect" alone! When you first start to take this supplement, it is common to gain a few pounds of muscle. Typical gains are three to five pounds, up to ten being possible, all in a week to ten days - thanks to this super-saturation. The additional weight gain in your muscles is good news, because every extra pound of functional muscle means you will burn additional calories…even while you are resting.

Make no mistake. Even though some of the weight increase is water in your muscles, it still acts as functional muscle. Some creatine opponents have gone on record stating that it just causes your muscles to retain water and is of no real value. Let's put things in perspective. Your muscles are already about 70 percent water without creatine. So is that seventy percent of your muscle useless to begin with? I don't think so. If you suck the water out of your muscles, you are left with a wrinkly little corpse. But the question remains, are the gains you receive only muscular water retention, or are they actually lean muscle? According to a study done on a bunch of little piggies at Texas A & M University, the gain is lean muscle.(9) Before they were slaughtered, some pigs were fed 25g of creatine for five days, while the other little piggies got none. The pigs that were fed creatine gained almost five pounds more than the ones that did not receive creatine. When cooked, the muscle-bound little pigs that fed creatine showed less meat loss than the pigs not fed creatine. Bacon, anyone? So what can we learn from our squealy little friends (besides how much fun rolling around naked in mud is, of course)? From this study, one can conclude that while creatine results in inter-muscular water retention, it may also increase lean muscle. In yet another Belgium study, 25 healthy males were placed on a 42-day controlled strength-training program. Eight were fed creatine, ten a placebo, and seven formed a control group. The body mass of the creatine group went up two kilograms, while the other two groups showed no increase. The researchers concluded that "the relative volumes of the body water compartments remained constant and therefore the gain in body mass cannot be attributed to water retention, but probably to dry matter growth accompanied with a normal water volume." (10)

Pssst! - Got any Acid?

Lactic acid. I guarantee for those of you who don't know what lactic acid is, you have felt it before. The easiest way to describe lactic acid is the unbelievable burning you get in your muscle when completing a task over a longer period of time. Still not sure? Stand up and raise and lower yourself on your toes (calf raise). Do this exercise as fast as you can over and over until it feels like somebody is injecting boiling water into your calf muscles...that's lactic acid. When performing tasks longer in duration you call upon the lactic system (also called the glycolytic system) for energy. Performing this type of task increases the amount of lactate (hydrogen ions) in the muscle. When lactate levels become too high, the pH of the cells drops to the point where you can not achieve muscle contraction.(2) As stored phosphocreatine is broken down it combines with ADP (Adenosine Diphosphate) and hydrogen ions to replenish ATP (adenosine triphosphate). This reaction decreases the pH in the cells, thereby buffering the burning sensation known as lactic acid. (2) I think you would agree that a product that could help prevent this pain would of significant value. Furthermore, by buffering lactic acid, you are essentially increasing work capacity by prolonging the point of physical failure.

To Load or Not to Load...That is the Question?

The common practice for taking creatine is to "load" creatine for five to seven days, then continue to take a "maintenance" amount indefinitely. For example, most supplement manufacturers recommend 20 grams of creatine be taken in five-gram servings for five to seven days followed by five grams per day after that. The idea is that by taking a larger amount of creatine, you can super-saturate the muscle and increase the total creatine pool. Then all you need is a maintenance serving to keep an elevated level of creatine in the muscle. Loading creatine with 20 grams and maintaining with five grams is the most common recommended protocol and the one that has been deemed safe through longer-term studies. (11) (12)

Another option for gittin' loaded was presented by Dr. Eric Serrano. Rather than making a "blanket recommendation," Dr. Serrano bases his method on the body weight of the individual taking the creatine:

Creatine Loading By Weight Week 1 .35g of creatine per kg of bodyweight

Week 2-4 .15g of creatine per kg of bodyweight

Week 5 Off

Week 6 .35g of creatine per kg of bodyweight

Week 7 .15g of creatine per kg of bodyweight

Week 8-10 Off

Repeat


Although I have no scientific evidence to prove Dr. Serrano's system is better, I believe that using body weight and cycling creatine is more beneficial than the standard 20g-load/5g maintenance protocol. Obviously, a 250-pound muscle-head requires more creatine than a 105-pound bikini model. Another reason I prefer Dr. Serrano's system is that you cycle off and re-load creatine periodically. I can only speak from experience when I say that cycling creatine works better than a simple maintenance of 5g per day. Every time I cycled off, then re-loaded, I noticed an accelerated improvement in performance.

Some people say that loading creatine is just another way for supplement companies to eat out of your wallet. However, studies have shown that supplementing with 3g of creatine for 14 and 30 days provide less muscular retention of creatine than 20g for only five days. (5) (13)

The bottom line is, don't be ashamed to get loaded now and again.


Use Your Head:

Getting knocked in the melon is never fun, trust me; I have had my share of crushing blows to the head. Every year 1.5 million people in the United States experience a traumatic brain injury (TBI) as a result of motor vehicle accidents, violence (mostly angry girlfriends…just kidding!), falls, and sports-related activities. (17) Out of the 1.5 million brain injuries, a staggering 300,000 injuries are a result of sports or physical activity. Furthermore, 50,000 people will die and 80,000 people will experience long term disabilities as a result of TBI. (18) Athletes are more likely to receive TBI from sports such as, football, hockey, boxing and other contact sports (i.e. Jell-O-wrestling). However, you are less likely to experience TBI while lawn bowling. The most common TBI experienced in sports is a concussion, resulting from your brain bouncing around inside your skull. Initial symptoms of concussion include headache, dizziness, and nausea. Postponed symptoms of concussion, which may occur several days after the initial incident, include headache, ringing in the ears, memory problems, lightheadedness, and irritability.

In a study conducted at Sanders-Brown Center on Aging, researchers looked at the possibility that creatine may assist in the protection of brain tissue after TBI. Creatine was fed to rats for four weeks prior to researchers cracking them on their little noggins, inducing TBI. The result of creatine supplementation was that brain damage was reduced by 50% when compared to rats fed a regular diet. Researchers concluded that creatine has the ability to protect against TBI by maintaining proper ATP (Adenosine Triphosphate) in the brain cells. (19)

With 300,000 TBI per year resulting from sports or physical activity, athletes may greatly reduce their risk of long term brain damage from regular supplementation of creatine. Athletes such as, boxers, football players, and hockey players all repeatedly put themselves in the direct path of a concussion. Reducing the brain damage of these concussions by 50% may have profound effects, including: extending careers and allowing athletes lead a "normal" life (i.e. No drooling, chronic shaking, or memory loss) after having their head smacked around. If you are currently involved in sports that put you at risk of TBI, I strongly recommend supplementing your diet with a high quality creatine supplement. Although creatine can reduce long term brain damage from TBI if somebody dares you to put your head through a wall, trust me, you are going to the hospital, creatine or no creatine.

Brain Drain:

There is no doubt that creatine is good for building bigger, stronger muscles. However, it's apparently equally as good for one of your most important organs as well. Yeah, I know that organ's important too, but I'm talking about your brain. In a study at the University of Tokyo researchers found that eight grams of creatine a day over five days reduced mental fatigue.(7) Maybe that's why all of those superstar college athletes get such good grades. Then again, maybe it's not.

Did you say Herpes?

What can you say about herpes? It's kind of like one of those girls that are fun to pick up and party with until she moves in with you, becomes a disgusting living nightmare, and never, ever leaves...ever. If you were in this situation and someone told you how to keep the little "lady" under control, I think you would want to hear about it, wouldn't you? Apparently creatine can help inhibit the replication of herpes simplex 1 and 2 (HVS-1, HVS-2), and may reduce morbidity and mortality of those who suffer from HVS-2. A practitioner at Camp Pendleton Marine Base who was treating several cases of herpes noticed that several of his patients failed to return for periodic acyclovir therapy. After inquiring, it was revealed that these patients had all commenced supplemental creatine after their last outbreak and had experienced no further outbreaks. (8) Apparently cyclocreatine, a synthetic compound structurally and functionally homogolous to creatine, has the ability to inhibit HVS-1 and HVS-2. Because creatine and cyclocreatine have shown neuroprotective and cancer-retardant effects in rodents, the speculation exists that creatine shares the anti-viral ability of cyclocreatine. (8)

In the United States approximately 45 million individuals (about one in five people over age 12) are infected with HVS-2.20 Furthermore, there will be up to 1 million new HVS-2 infections transmitted each year.(21) With 45 million people in the United States suffering form herpes I believe that anything that can prevent these unfortunate people from future outbreaks should be looked at very seriously.

If only you could prevent your mother-in-law from coming back by giving her a little creatine...

Choosing the Right Creatine!

Purchasing commercial creatine involves three basic choices:



100% pure creatine monohydrate - It's a white powder (not unlike baking soda) that is basically tasteless and odorless. You can mix it in water, juice, protein shake, etc. Do not, however, mix creatine with a citrus drink. The combination of creatine and a citrus drink may result in some breakdown of the product, converting creatine into creatinine, which is useless to your body.


Creatine and sugar (premixed) - What's the deal with mixing creatine with sugar? A 1996 study showed that ingesting a carbohydrate solution with creatine promoted a 60 percent greater increase in total creatine concentrations in the muscle, compared with taking creatine alone.(14) Sixty percent is a big difference. However, the subjects who took the creatine and carbohydrates were pounding back 93g of carbs four times per day for five days. 93g of carbohydrates is an additional 1,488 calories per day, or 7,440 calories for the five-day experiment. Any way you look at it, that is a good way to get fat. So, if you are going to follow the protocol of this study and suck back four sugar shakes per day for five days, that's where I would leave it. In other words, if you are not concerned about how big your gut gets in a week's time, and you want to load creatine, this is a proven method. After the loading period is over, if you wanted to continue with this type of drink, I would reserve the 93g of sugary goodness for your post-workout meal only. Post-workout is when your muscles are begging for sugar like a crack addict looking for a fix. If one were to critically compare this study to commercial creatine premixes, most supplement manufacturers would fall short on the amount of sugar in one serving. Does this make a difference? It's a good question with no clear answers. The sugar increases insulin, which transports creatine into the muscles. Do you need that much sugar to get the same response? I'll share with you what I consider a much better alternative later in this section. For now, suffice it to say I have tried many premixed creatine drinks and can say with a great degree of certainty that they do work better than creatine alone. Like I said, though, if you want to follow this protocol, reserve this drink reserved for a post-workout shake, and you won't have to worry about bustin' your gut.


Creatine and insulin mimicking agents
- Agents that mimic insulin, such as Alpha-lipoic acid, have an effect similar to sugar on your body. When you consume high levels of simple sugars, your insulin goes through the roof. The insulin is responsible for getting nutrients (i.e. creatine) to the muscles. So these products theoretically punch up your insulin without the 93g of gut-busting sugar. The concept is fantastic, and I believe they work. A 1998 study confirmed that "insulin can enhance muscle creatine accumulation in humans, but only when present at physiologically high or supraphysiological concentrations."(15) What this means is high insulin levels need to exist to enhance creatine's effects. Using insulin mimickers instead of sugar is an area moving to the forefront of "making creatine better."

So the choice is yours. If you want my opinion (I'm going to give it to you even if you don't), I would load with a creatine product that has insulin-mimicking agents and maintain with a creatine/protein/carbohydrate drink post-workout. Why? As I said earlier, I will share a better alternative with you. In another recent study researchers showed that consuming a drink containing protein (50g) and carbohydrates (47g) had an equal effect on creatine absorption and retention as a drink containing 96g of carbohydrates alone. (16) So you get the same results with half the sugar and additional protein when your muscles need it. As far as buying premixed creatine sugar drinks, I would save some money and pick up a kilo of 100 percent pure creatine and mix it with something like Gatorade and Whey protein powder. It's simple and it works. That said, your choices may be different based on whether your priorities involve fat loss, muscle gain, etc. With the above information, you should have no trouble putting together an optimal plan.

Creatine Scare Tactics:

Scare tactics, I love to hate them. In January 2001 some very unfounded headlines splashed across newspapers, newsmagazines, and television. They read "creatine, a dietary supplement used by many athletes to increase bulk, could lead to cancer" (Reuters, January 24, 2001). What I find funny how the press gets a hold of a catchy little story about a popular sports supplement and cancer and considers it front page news. However, you don't hear about the fact that it can help Alzheimer's patients. Anyway, the story was based on a study by the French Agency of Medical Security for Food (AFSSA). The study made three points:

The study made three points:

Creatine could be involved in the formation of carcinogenic nitrosamines, under conditions of high concentrations of sugars and amino acids.
- According to the U.S. Council for Responsible Nutrition "These conditions do not apply to oral intake of creatine, and thus allegations of lack of safety for oral creatine cannot be based on this issue."


Creatine could be involved in the formation of carcinogenic agents known as heterocyclic amines from creatine during the charbroiling of meat.
- The Council of Responsible Nutrition responded by saying "The possibility is supported by a large body of scientific data, but is not relevant to oral creatine supplementation...Allegations of lack of safety for oral creatine cannot be based on this issue."


Creatine itself might be a carcinogenic. - This is interesting, because the quacks (I mean scientists) cited absolutely zero studies of any way, shape, or form to substantiate this claim. Nothing, zero, ziltch, zippo. In other words they made it up. If you haven't caught on yet, CREATINE IS NOT A CARCINOGENIC. The Council for Responsible Nutrition summed it up by saying "The recent press reports on creatine safety were wrong and misleading. The AFSSA report that prompted this negative publicity does not contain any scientific evidence to support a contention that oral creatine might cause cancer."


The bottom line is that creatine has never been proven in any way to cause cancer. But let me ask you this: how many newspapers, newsmagazines, and television news broadcasts ran the facts about creatine? Hmmm? What can I say, scare tactics must make good news.

Safety & Side Effects:

There are surprisingly few side effects with creatine. If you take too much, it may cause an upset stomach, or you may blow a hole in the back of your new track pants. Taking too much creatine may also result in a little extra quality time with your toilet. If you notice an upset stomach, reduce the quantity you are taking and slowly introduce higher levels. Some people have reported cramping while taking creatine. Preventing cramping is simple: Drink more water. You can't blame creatine for people's ignorance. Read the label. If it says drink more water, then drink more water.

Creatine is considered a very safe supplement, even under the scrutiny of some longer-term studies. Studies have shown that athletes who took creatine did not experience a greater incidence of injuries, dehydration, cramping, musculoskeletal injuries or gastrointestinal disturbances.(17) Nor did subjects taking creatine experience additional renal stress.(18) That about wraps up the side effects for creatine. When it comes to creatine and safety, don't pinch your pennies by purchasing the lowest priced product. As with any supplement, impurities can be an issue. That is why I recommend purchasing creatine from a reputable supplement company. My personal preference is a product that uses Creapure creatine. Creapure is the trademark name for creatine monohydrate, produced by SKW Trostberg AG, a chemical and natural products manufacturing company. SKW Trostberg AG is also the patent processing holder and leading manufacturer of creatine products in the world. All material is certified for its top quality and purity. According to present analytical methods, Creapure is also guaranteed to be free of impurities and by-products, including creatinine, cicyandiamide and dihydrotriazine. Companies such as EAS, Prolab, Labrada, and Muscletech all put out high quality creatine supplements.

Conclusion!

As I said earlier, I could go on and on about creatine. I could tell you about how it's equally useful for women as men.(13) I could tell you about the potential benefits for neurodegenerative diseases such as Alzeihmer's and Lou Gehric's disease.(14) (15) I could also tell you how creatine could potentially be beneficial to attenuate age-related muscle atrophy and strength loss. (15) Creatine may also lower the risk of coronary heart disease or cerebrovascular disease.(16) However, I didn't set out to write a book, just a "short" article. Furthermore, most people who are reading this article are more interested in how creatine is going to make them a stronger, faster, more muscular sex machine (I mean athlete). I hope that this article was able to answer some, most, or all of your questions regarding creatine. In reality, however, I have just scratched the surface regarding this incredible supplement. As I said at the beginning of this article, for obvious reasons, creatine "isn't going away any time soon". I think it's plain to see that I am a big proponent of creatine, and it's a supplement that I confidently recommend. If you are a serious athlete, or even a weekend warrior, it is safe to say that creatine will improve your performance. It will make you stronger, bigger, more powerful, and hey, it just might clear up those herpes that you have been squawking about.
For those of you who contend that creatine is only good for bloated muscles, I hope you get used to losing...and that rash.

As with any supplement you should always consult with your doctor prior to consuming.
My Top Creatine Pics

100% pure creatine monohydrate
Prolab Creatine
Prolab 100% Creatine Monohydrate is the most advanced nutritional supplement available for athletes. Research shows an increase in muscle peak torque production (force of contraction), muscle strength, and endurance with oral Creatine Monohydrate usage. This may be a result of Creatine Monohydrate's ability to better maintain ATP levels. Creatine Monohydrate users also experienced a decrease in levels of plasma ammonia. Prolab Nutrition invites you to try the Creatine Monohydrate that is unsurpassed in purity, quality and potency; Prolab Nutrition's 100% pure Creatine Monohydrate. Each teaspoon provides 5 grams of pure creatine monohydrate.



Creatine and sugar (premixed)
Muscle Tech Cell-Tech
In a recent clinical study, Cell-Tech was put head to head against creatine monohydrate. When the results were tabulated, CELL-Tech users gained 880% more lean muscle mass than subjects using creatine monohydrate. Cell-Tech's incredible mass-building formula combines 10 grams of pure creatine monohydrate with exactly 75 grams of pharmaceutical grade dextrose and 200mg of the powerful insulin-potentiating nutrient alpha lipoic acid. Cell Tech also contains other key nutrients which act synergistically to enhance the uptake of creatine into muscle cells, which leads to dramatic increases in size, strength, and power. Bodybuilders using Cell Tech are experiencing incredible gains. Some users have gained as much as 10 pounds in as little as 7 days! If you would like to make gains like this and dramatically transform your physique, you need to try Cell Tech for yourself.




Creatine and Branch Chain Amino Acids (Sugar Free)
MHP TRAC

Description:
Trac (creatine) 400 grams from MHP.

What are the benefits of TRAC?



No Sugar
Improves Creatine Transport
Increases Energy Levels
Improves Absorption and Bioavailability
Cell regulation and DNA repair
Anti-Oxidant and immune system support
Sustained nutrient delivery
Stimulation of dopamine, adrenaline, and norepinephrine
Increased blood flow
BetaGen is a combination of maintenance doses of HMB and creatine monohydrate, plus it includes the cell-volumizing amino acids glutamine and taurine. Included in each serving of BetaGen is two grams of Phosphagen and one gram of HMB.

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References:
1 Balsom, P.D., Soderlund, K. & Ekblom, B. (1994) Creatine in Humans with Special Reference to Creatine Supplementation, Sports Medicine, Vol. 18, 4, pp.268-280.
2 McArdle, W.D., Katch, F.I. & Katch, V.L. (1991) Exercise Physiology: Energy, Nutrition & Human Performance, (3rd ed), pp. 102-103, 123, 428, Lea & Febiger: Malvern, Pennsylvania
3 Maughan, R.J. (1995) Creatine supplementation and exercise performance. International Journal of Sport Nutrition, Vol. 5, 2, pp. 94-101.
4 Wilmore, J.H. & Costill, D.L. (1994) Physiology of Sport & Exercise, pp. 97-98, 114 & 117. Human Kinetics:Champaign, Illinois.
5 Maddock R.J., Binder B.S., Carr S.N., Mckeith F.K., Berg E.P, Savell J.W. Department of Animal Sciences, Texas A & M University.
6 Francaux M, Poortmans J.R., Effects of training and creatine supplement on muscle strength and body mass. Eur J Appl Physiol Occup Physiol 1999 Jul;80(2):165-168
7 Watanabe A, Kato N, Kato T. Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation. Neurosci Res 2002 Apr;42(4):279-85 Department of Neuropsychiatry, Faculty of Medicine, University of Tokyo.
8 Ness S.R., McCarty M.F., Does supplemental creatine prevent herpes recurrences? Med Hypotheses 2001 Sep;57(3):310-2. Pantox Laboratories, San Diego, California.
9 Nuttall, F. (1994) Creatine Supplementation, Athletics Coach, Vol. 28, 3, pp. 12-13.
10 Green A.L., Hultman E, Macdonald I.A, Sewell D.A., Greenhaff P.L. Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. Am J Physiol 1996 Nov;271(5 pt 1):E821-6.
11 Steenge G.R., et al., Protein and carbohydrate-induced augmentation of whole body creatine retention in humans," J Appl Physiol 2000 Sept., 89 (3): 1165-1171.
12 Steenge G.R., Lambourne J, Casey A, Macdonald I.A., Greenhaff P.L. Stimulatory effect of insulin on creatine accumulation in human skeletal muscle. Am J Physiol 1998 Dec;275(6 pt 1):E974-9.
13 Tarnopolsky M.A., MacLennan D.P., Creatine monohydrate supplementation enhances high-intensity exercise performance in males and females. Int J Sport Nutr Exerc Metab 2000 Dec;10(4):452-63.
14 Wyss M, Schulze A, Health implications of creatine: can oral creatine supplementation protect against neurological and atherosclerotic disease? Neuroscience 2002;112(2):243-60
15 Tarnopolsky M.A., Potential benefits of creatine monohydrate supplementation in the elderly. Curr Opin Clin Nutr Metab Care 2000 Nov;3(6):497-502
16 Wyss M, Schulze A., Health implications of creatine: can oral creatine supplementation protect against neurological and atherosclerotic disease? Neuroscience 2002;112(2):243-60
17 Sosin D.M., Sniezek J.E., Thurman D.J.. Incidence of mild and moderate brain injury in the united states, 1991. Brain Inj 1996 Jan;10(1):47-54.
18 Centers for Disease Control. "Traumatic Brain Injury in the United States: A Report to Congress." www: Centers for Disease Control, (January 16, 2001) https://www.cdc.gov/ncipc/pub-res/tbicongress.htm
19 Sullivan P.G., Geiger J.D., Mattson M.P., Scheff S.W. Dietary supplement creatine protects against traumatic brain injury. Ann Neurol 2000 Nov;48(5):723-9
20 Fleming DT, et al. Herpes Simplex Virus type 2 in the United States, 1976 to 1994. NEJM 1997;337:1105-11.
21American Social Health Association. Sexually Transmitted Diseases in America: How Many Cases and at What Cost? Menlo Park, CA: Kaiser Family Foundation, 1998.

TweetGood read! One thing i learned is to make sure you get the micronized. It is like a powder and dissolves easily in beverages. The other settles and is gritty.