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by direct injection of cells, such cell-based therapies must be administered systemically Previous We have designed a custom build systematic setup ( Fig. action at this particular magnetic field and performed experiments in microvascular .. mation on MENR was also confirmed by magnetic force microscopy (MFM).

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The muscle hypertrophy effects of Cr seem to be linked to the activity of exercise training, as Cr supplementation without training does not seem to lead to increases in SC activity 61 or muscle-fiber area. In conclusion, Cr monohydrate affects the cellular processes involved with muscle-fiber growth in response to exercise. By accelerating the adaptation of SC to resistance training, Cr can result in increased muscle hypertrophy and possibly, increased muscular strength.

Most information about Cr is obtained through word of mouth, sales associates, or the popular press; and may not be entirely accurate. Misunderstandings and anecdotes, both positive and negative, of Cr are plentiful. The idea that Cr induces significant water retention, cramping, and may even cause heat intolerance is one common anecdote that has failed to be substantiated in a number of studies.

Also, the musclebuilding effects of Cr are commonly thought to be a fallacy, and the increase in weight after Cr supplementation is attributed only to increased fluid retention. Because of these common rumors surrounding Cr usage, many individuals may be cautious of supplementing with Cr and might convince others to avoid this supplement all together.

However, certain athletes, particularly those who regularly participate in activities or sports involving high-intensity, short-duration movements e. For a sports nutritionist to provide accurate information of Cr to athletes of all ability levels, and dispel the plethora of myths surrounding Cr supplementation, they must understand first the fundamental basics of Cr metabolism. The information provided in this chapter can provide sports nutritionists with the proper tools to educate athletes who come to them with questions and interests about Cr monohydrate supplementation.

Also, with accurate information supported by research provided in this chapter, the athlete would be able to make an informed decision regarding their usage or nonusage of Cr. Recent research has supported the safety and efficacy of Cr supplementation for improving exercise performance in various populations.

There is also a better understanding of the mechanisms responsible for these positive performance outcomes. It would be fair to state that Cr supplementation represents one of the most studied dietary supplements, and in particular one repeatedly shown to have ergogenic effects. This does not mean that all athletes will benefit significantly from Cr supplementation only that, in controlled studies subjects supplemented with Cr often outperform and experience improved adaptations to resistance training compared with placebo controls.

Side Bar No. Although this perspective may prove true in the case of many supplements, it does a Overview of Cr Metabolism 19 serious disservice to Cr, which is undoubtedly the most researched supplement in history. Numerous studies have verified Cr's short-term safety. Although the long-term effects of Cr supplementation have not yet been explored, given that athletes have been utilizing the supplement for almost a decade without noteworthy incident, there appears to be little cause for concern in this regard. The fact that Cr is a naturally occurring substance in our body and the foods we eat further validates this perspective.

Neither the National Collegiate Athletic Association nor the International Olympic Committee-both very strict organizations when it comes to regulating supplement useprohibits Cr supplementation. The principal benefits of Cr supplementation to athletes include increases in strength, speed, and muscle mass-effects that occur secondary to the athlete's ability to train longer and at a higher intensity and recover quicker because of enhanced cellular energy provisions.

More recently, Cr has shown promise in improving general health.

There is research to support a role for Cr supplementation in the treatment of muscular dystrophy and Lou Gehrig's disease. Cr supplementation decreases the level of homocysteine-a contributing factor to cardiovascular disease-in the blood, and the supplement might also possess anti-inflammatory and antioxidant properties. Cr is best taken postexercise with carbohydrates, and contrary to popular belief, it is unnecessary to "load" Cr.

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A smaller daily dose g over several weeks is equally effective in increasing muscle-Cr stores with a decreased likelihood of gastrointestinal problems the most common side effect as stated by Eric Cressey, M. The enhancement of Cr accumulation in muscle when combined with the simple carbohydrate glucose is thought to be a result of carbohydrate-mediated insulin release.

Insulin has been shown to stimulate muscle-Cr transport through the membrane transport protein, CreaT. However, the investigations that suggest large doses of carbohydrate are required to enhance Cr uptake have used very-high doses of carbohydrate. For athletes and recreational exercisers looking to enhance their performance with Cr, taking such a high dose of pure glucose may not be advisable or even palatable.

It also might compromise health and body composition. Other researchers have shown that lower doses of carbohydrate taken with Cr, such as 1 g of both carbohydrate and Cr per kg bodyweight taken twice per day can also improve Cr uptake, relative to taking Cr alone. However, this is still a large dose of carbohydrate g and may not be desirable or economical for any person to ingest. As an alternative, people may still enhance their Cr stores by eliminating the large carbohydrate and Cr dose required in the loading phase, but waiting longer for the ergogenic effects to be noticed.

Therefore, if one wishes to enhance their muscle-Cr stores without consuming a large dose of carbohydrate, they could supplement slowly, avoiding the loading phase, and consume a small dose of carbohydrate to slightly increase insulin and enhance Cr uptake. Chanutin A, Guy LP. The fate of creatine when administered to man.

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Summary of how to study for and then take the CISSN exam

Clin Chim Acta ; Influence of folic acid and vitamin B 12 on formation of creatine in vitro and in vivo. Nature ; The synthesis of choline and creatine in rats under various dietary conditions. Urine C-peptide and creatinine Jaffe method excretion in healthy young adults on varied diets: sustained effects of varied carbohydrate, protein, and meat content. Am J Clin Nutr ; Absorption of creatine supplied as a drink, in meat or in solid form. J Sports Sci ; Long-term creatine intake is beneficial to muscle performance during resistance training.

J Appl Physiol; The effect of oral creatine supplementation on the lOOO-m performance of competitive rowers. Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci Lond ; Overview of Cr Metabolism 21 Creatine supplementation in health and disease.

Effects of chronic creatine ingestion in vivo: down-regulation of the expression of creatine transporter isoforrns in skeletal muscle. Mol Cell Biochem ; Extracellular creatine regulates creatine transport in rat and human muscle cells.


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Creatine and the creatine transporter: a review. Mol Cell Biochem I; Skeletal muscle metabolism during short duration high-intensity exercise: influence of creatine supplementation. Acta Physiol Scand ]; Creatine ingestion favorably affects performance and muscle metabolism during maximal exercise in humans. Am J Physiol ; :EE Phosphorus nuclear magnetic resonance offast- and slow-twitch muscle. Am J Physiol ; CC Mammalian skeletal muscle fibers distinguished by contents of phosphocreatine, ATP, and Pi.

Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. Muscle creatine loading in men. J Appl Physiol ; Maughan RJ. Creatine supplementation and exercise performance. Effect of creatine supplementation and a lacto-ovo-vegetarian diet on muscle creatine concentration.

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Factors influencing creatine loading into human skeletal muscle. Exerc Sport Sci Rev ; Virgili F. Maiani G. Zahoor ZH. Ciarapica D.

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Raguzzini A. Ferro-Luzzi A. Relationship between fat-free mass and urinary excretion of creatinine and 3-methylhistidine in adult humans.

Contribution of phosphocreatine and aerobic metabolism to energy supply during repeated sprint exercise. Effect of oral creatine supplementation on skeletal muscle phosphocreatine resynthesis. Am J Physiol EE Shortening of muscle relaxation time after creatine loading. Katch, Victor L.

Essentials of Creatine in Sports and Health PDF

Sports and Exercise Nutrition. Lippincott, Williams, and Wilkins, Baltimore, Transport of energy in muscle: the phosphorylcreatine shuttle. Science ; Ogut O. Brozovich FY.


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Creatine phosphate consumption and the actomyosin crossbridge cycle in cardiac muscles. Circ Res ; A simple analysis of the "phosphocreatine shuttle". Am J Physiol; CC Effect of creatine on aerobic and anaerobic metabolism in skeletal muscle in swimmers.

Br I Sports Med ; Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc ; Carbohydrate ingestion augments creatine retention during creatine feeding in humans. Acta Physiol Scand ; Protein- and carbohydrate-induced augmentation of whole body creatine retention in humans.

Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle. Role of submaximal exercise in promoting creatine and glycogen accumulation in human skeletal muscle. I Appl Physiol; Ann Neuro; , author reply , Human skeletal muscle creatine transporter mRNA and protein expression in healthy, young males and females. Effects of acute creatine monohydrate supplementation on leucine kinetics and mixed-muscle protein synthesis.

Clinical pharmacology of the dietary supplement creatine monohydrate. Pharmacol Rev ; The effects of creatine supplementation on exercise-induced muscle damage. J Strength Cond Res ; Francaux M, Poortmans IR.