Continued from page 1

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

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

When creatine is part of a muscle-building cocktail, the results can be
fatal.  Studies have found that some cocktails could increase the risk for
stroke (see above), and another study, conducted by experts at the
Mayo Clinic, finds that creatine in other supplement combinations could
lead to kidney problems.

In 2006, Dr. Vesna Garovic with the Division of Nephrology and
Hypertension at Mayo Clinic College of Medicine in Rochester,
Minnesota,  and other specialists in the same state, reported on a 24
year old male with "acute renal failure and proteinura [wherein the
urine has an abnormal amount of protein]  while taking creatine and
multiple other supplements for bodybuilding purposes."  This patient
recovered after he stopped taking the supplements.  The team advises
that because other case studies have shown a connection between
creatine and renal dysfunction, warnings should be included to advise
consumers of this possible side effect.

Note that in the study above the patient did not take creatine in a pill
with lots of other ingredients: he took creatine, and lots of other
ingredients.  Any time you're thinking about combining one supplement
with others, consider seeking professional guidance before swallowing.

Creatine in a Supplemental Cocktail Can Cause Stroke

Creatine has helped many athletes build muscle and improve
performance.  However, some athletes use products that contain
creatine along with a whole lot of other stuff.  Researchers at Groton
found that some of these creatine-containing products may not be
adequately tested before they reach the market, and that these drug
cocktails could be associated with stroke.

In 2012, C. Young with the Naval Undersea Medical Institute in Groton,
Connecticut, along with a team of other experts,  encountered a 26
year old male seeking treatment with a "severe headache" and having
suffered a type of "hemorrhagic stroke."  

The team discovered that the patient had recently consumed a "weight-
lifting supplement called Jack3d," whose active ingredients include
caffeine, creatine monohydrate, schizandrol A, and several other

Some of these other chemicals were seen in other reports suggesting
that they may "predispose to stroke and hemorrhage," and there was a
"paucity of data" regarding Schizandrol A, an herb used in eastern
medicine.  Furthermore, the investigating team found that the product
had "no readily apparent disclaimer or warning," and that it is sold as a
nutritional supplement that renders it "not subject to same FDA
regulation and scrutiny that a pharmaceutical receives."  

If you want to take creatine to help improve your athletic performance,
be wary of supplements with a long list of ingredients in addition to

Creatine Can Cause Heart Arrhythmias  Especially If Mixed with
Stimulants or Alcohol

Some people can't eat walnuts, some can't digest dairy, and some
people are hypersensitive to creatine.  The bad part is, you probably
don't know until you try.

In 2005, Ryan Kammer with the Department of Pharmacy at Moses H.
Cone Memorial Hospital in Greensboro, North Carolina,  reported on a
30 year old male who came to the emergency room with irregular heart
rhythms, also known as  "atrial fibrillation with rapid ventricular
response." The doc explains that atrial fibrillation is "rare" in young
patients without structural heart disease, and that thyroid disorders,
the use of stimulants, or acute alcohol intoxication are generally among
the causes.  

It was soon revealed that the patient used creatine monohydrate,
which has been previously linked to "the development of arrhythmia."  
The patient was admitted to the hospital and treated intravenously with
drugs to control his heart rhythm.  Dr. Kammer advises that patients be
questioned not only about drug therapy histories, but about their use
of herbal products and dietary supplement upon intake.

If you want to take creatine but are worried about a negative reaction,
consider starting the supplement at a low dose.  

6. Creatine Plus Surgery: A Fast Track to Rhabdomyolysis?

Rhabdomyolysis is not part of that song they sing in Mary Poppins
(supercalifrag…) -- no matter how ward we wish it were.  
Rhabdomyolysis is the breakdown of muscle fibers and the consequent
release of those fibers (myoglobin) into the bloodstream.  
Unfortunately, myoglobin does not get along well with the kidney, and
its unwanted presence can cause kidney damage.  You may be
experiencing kidney damage from this condition if you have abnormal
urine color, general weakness, fatigue, or muscle tenderness.  
Rhabdomyolysis could occur from any condition that damages skeletal
muscles, such as injuries, heatstroke, seizures, severe exertion, genetic
muscle diseases, or even the use of certain drugs.   Indeed, research
from the University of Pennsylvania finds that even creatine could play
a role in the development of rhabdomyolysis -- especially if taken prior
to a surgical procedure.  

In 2006, a group of specialists including N.P. Sheth with the
Department of Orthopedic Surgery at the University of Pennsylvania
School of Medicine in Philadelphia,  investigated the cause of a college
football player and weight-lifter who "unexpectedly developed
rhabdomyolysis [and]acute renal failure following arthroscopic knee
surgery."  They discovered that the patient took 10 grams of creatine
every day for the six weeks leading up to his surgery, and suggest that
"the patient's use of creatine increased the risk of skeletal muscle injury
due to ischemia [a decrease in the blood supply] from intra-operative
tourniquet application."

If you take creatine and have an upcoming surgery, be sure to let your
surgeon, nurses, and physicians know about the supplement: your
skeletal muscles may thank you later.

Don’t Mix Creatine with  Diuretics

If you're taking creatine to improve your athletic performance, you
probably want to...improve your performance.  However, if you
combined your creatine with diuretics you may be doing just the

In 2003, researchers from Pennsylvania State University and New York
University proclaimed that "diuretic use is significantly associated with
dehydration diagnosis."   And who cares if we're dehydrated -- can't
we just drink water later?  Research from Chicago insists that
dehydration in athletes is not to be taken lightly, as it can decrease our
lower and upper body power.

In 2008, Leon Jones with the Athletics Department at Chicago State
University , along with a team of specialists, examined how dehydration
affected seven subjects.  They found that when athletes were
dehydrated their "fatigue severity" increased 70%, and that the mean
power was decreased 7.17% in the upper body and 19.2% in the
lower.  The report concludes "dehydration of 2.9% body mass
decreases the ability to generate upper and lower body anaerobic

We wouldn't eat a salad with a candy bar, would we?  Okay, maybe we
would.  However, knowing that dehydration could counteract some of
the improvement you're seeking with creatine could be a good reason
to stay away from diuretics.

Contaminated Creatine: Watch out for Liquid Forms.

Creatine supplements come in many forms: pills, powder, food, and
even in something as basic as water.  While it's always nice to have
options, it seems there have been some glitches in some manufacturers'
attempts to stabilize creatine in liquid for long periods of time.  
According to a study published about a liquid creatine product in
Australia, liquid creatine could become "contaminated," and throw
health workers for a loop when consumers of the product present at
the hospital.

In 2010, a team of specialists at the Royal Brisbane and Women's
Hospital in Australia, including the hematologist Kathryn Jackson,  
encountered a 20 year old male with supposed "elevation of creatinine
after consuming a creatine water supplement."  

The patient was admitted to the hospital for "apparent acute renal
dysfunction," though intensive testing revealed no "significant
abnormalities to account for the apparent renal impairment."

The team eventually determined that the high creatinine in the patient
was not due to kidney damage, but to creatinine contamination in liquid
creatine drinks.  When the patient stopped using the supplement, the
team saw "rapid normalization of creatinine level."

The above case study emphasizes the importance of telling your
healthcare provider about
all supplements that you take, even if you
are questioned only about "medications."  Substances like creatine
could influence any testing that you have done, and hinder your
doctor's ability to diagnose your condition.

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