Creatine Use Spreads to High School Athletes

From the WebMD Archives

Dec. 27, 2000 -- High school athletes and their parents may believe that because it's available in almost any health food store, it's okay to use the dietary supplement creatine. In fact, researchers from the Mayo Clinic found that almost 1 in 10 high school athletes are using this strength-enhancing substance. However, experts say that not enough is known about creatine's long-term health effects to label the supplement as safe.

Creatine is produced naturally when the body breaks down meat into energy that is released into muscles. The liver also makes creatine.

"The theory is that if we stuff the bodies with creatine, then we'll be stronger and quicker athletes," says Gary Werhonig, MS, assistant director of the Human Performance Laboratory at Colorado State University. "It's for short bursts of energy that last maybe 20 seconds. It's been shown it does work."

Though most athletes who have been surveyed about their creatine use believe that it enhances their athletic performance, controversy surrounds the practice of using the supplement to gain an edge on the playing field.

Although no long-term studies have been done, Werhonig tells WebMD that a few studies have indicated that there may be some health risks associated with creatine use. For example, muscles store creatine, but the kidneys remove it when too much is present. Many doctors and other sports medicine experts worry that taking the supplement for long periods of time could overwork the kidneys and damage them.

Because of these concerns, Werhonig says, it could be dangerous to take creatine or any supplement that has unknown effects. This is especially true for children and adolescents, who are still developing.

Thus, the results of the first formal survey of creatine use among a select population of high school athletes, published in the latest issue of the journal Mayo Clinic Proceedings, may be worrisome.

The study authors surveyed 328 male and female athletes, aged 14-18, from five schools in and around Rochester, Minn. They found that 8% of the students said they had used, or were still using, creatine.

This rate of high school creatine use compares with previous studies reporting that 32% of college athletes used the substance, as did 25-75% of professional football players and about 45% of a group of Norwegian weightlifters aged 17-31.

One of the most significant problems the researchers identified was that neither the scientific community nor the youngsters themselves have enough information about creatine's use or effects. They discovered that most high school creatine users get their information from friends and then purchase the substance in health food stores.

The authors also point out that that creatine, as a supplement, isn't regulated by the FDA, which may pose another problem. Substances sold as creatine may actually contain very little of the supplement or -- worse yet -- may contain other ingredients that could have their own ill effects.

According to the authors, the FDA and the National Collegiate Athletic Association (NCAA) have both expressed concern about creatine's effects because of reports of muscle cramping, strains, dehydration, stomach problems, nausea, and seizures in those who use it. But no studies have been done on these side effects either. Experts say it would be difficult to assess such health problems because creatine supplementation is relatively new.

Brian Robinson, MS, ATC/L, head athletic trainer for Glenbrook South High School in Glenview, Ill., says that he believes creatine use among high school athletes is less prevalent than it was about three years ago. But many students are still willing to try it, he says.

"We seem to live in a quick-fix society, and high school kids are looking for anything that will make them bigger, faster, stronger," Robinson tells WebMD. One of the reasons the teenagers are curious about creatine is the college athletes come home and talk about how big and strong they're getting and that they are taking the supplement. So the high schoolers think it's the creatine, but they don't realize that the football player is in heavy training and in the weight room three times a week."

The Mayo Clinic study showed that 85% of the high school respondents bought creatine in health food stores. Other studies had previously reported that college athletes generally obtained it directly from their training room. The NCAA has now passed a rule restricting this practice.

In his area, Robinson says the athletic trainers and coaches all advise both parents and students against taking any dietary supplements. He believes that increasing the knowledge that students and parents have about the substances has decreased usage.

"The easiest way for kids to convince the parents to let them take it is to tell them that the coaches say they should," he says. "But all the coaches here are on the same page: We discourage its use."

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