More study needed on creatine use among athletes, Mayo Clinic reports

December 11, 2000

ROCHESTER, MINN. -- Based on their recently completed survey of high school athletes, Mayo Clinic doctors are recommending a large-scale study on the use and long-term effects of creatine, a supplement used by athletes who believe it enhances athletic performance. The survey of high school athletes completed at the Mayo Clinic Sports Medicine Center showed that users of creatine usually rely on friends for their information about the supplement and most either aren't aware of the dosages they take, or take more than the recommended amounts. The Mayo Clinic authors used anonymous surveys returned by male and female high school athletes during the August 1999 pre-participation examinations to determine the level of use and knowledge about creatine. Of the 328 students surveyed (182 males and 146 females), 27 athletes (26 male, 1 female) or 8.2 percent, reported creatine use. Most of the users were high school football players, who received their information about it from friends. And most of them reported they did not know how much creatine they were taking or reported taking amounts that were more than the recommended doses.

The article "Creatine Use Among a Select Population of High School Athletes," appears in the December issue of Mayo Clinic Proceedings, and is among the first to look at the use of creatine among users in the 14 to 18 year-old age group.

Creatine users in this population reported relatively minor side effects, such as: diarrhea, cramps and loss of appetite. Multiple studies have failed to document performance enhancement with creatine supplementation, the authors report. Both the Food and Drug Administration (FDA) and the National Collegiate Athletic

Conference (NCAA) have expressed concern about creatine supplementation practices. Anecdotal reports of muscle cramping, strains, dehydration, gastrointestinal distress, nausea and seizures have emerged, but long-term prospective population-based studies are lacking. Creatine use has generally outpaced scientific study and athletes at all levels may feel that it is a "safe" alternative to anabolic steroids. A 1997 survey of NCAA athletes found almost one-third reporting the use of creatine, while the use of creatine by American professional football players has been estimated from 25 to 75 percent.

"Given the uncertainties regarding effects and side effects of creatine supplementation in the high school population, healthcare professionals should strive to become unbiased sources of information for athletes regarding the use of creatine," the authors write. The authors also stressed that further study of larger groups of high school athletes is warranted.
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Mayo Clinic Proceedings is a peer-reviewed and indexed general internal medicine journal, published for 75 years by Mayo Foundation, with a circulation of 120,000 nationally and internationally.

Mayo Clinic

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