For creatine, promising uses for muscle disease sufferers.

the aged, or patients otherwise suffering from muscle disease and disuse, may be able to benefit from creatine, a nitrogen-containing compound made in the body and found in meat and fish. It is known to combine with phosphorus to form high-energy phosphates, important in living cells for storing and using energy. Creatine has been observed for some time for its possible performance-enhancing ability. With chronic supplementation and strength training, creatine may increase protein synthesis and decrease protein breakdown. However, there is some dissenting opinion, particularly among high school coaches, regarding its use.

It seems that not everyone responds to creatine supplementation in the same way. If the inconsistencies in the existing literature can be resolved, the potential for creatine as a treatment for muscle weakness beyond the athletic realm would be of great benefit.

The Exercise Nutrition Research laboratory at the University of Western Ontario has assembled a useful review of the current data, and attempted to explain some of its inconsistencies. They posit that small sample sizes are one answer to the great variability in response to creatine loading. And because of the invasive nature of muscle biopsy, many researchers have failed to obtain subjects' creatine levels prior to studying them.

Brief, intense, repetitive exercise seems to benefit most from creatine loading. Endurance activities are generally unaffected, and certainly not in the way they can be from carbohydrate-loading. There is also an optimal rest/recovery period for exercise with creatine use that needs to be illuminated. Additionally, there have been anecdotal reports of increased muscle strain and exertional compartment syndrome in the leg with creatine use.

The scientists in Canada call for additional data collection to resolve these issues, but remain confident that based on the published information to date, creatine has an ability to enhance muscle function in elderly patients or others who have lost significant muscle strength and function.

(Can. J. Appl. Physiol., 2002, Vol. 27, No. 6, pp. 663-680)