The FDA does not regulate creatine and other such supplements. No published investigation has been conducted on creatine to determine what impurities might be present in creatine supplements, and what com their long-term effects might be. Creatine monohydrate is a popular new supplement that serves as an energy reserve in muscle cells. Muscular contraction is powered by the breakdown of ATP(adenosine triphosphate) to ADP(adenosine diphosphate). When all the ATP is broken down, creatine phosphate in the muscle donates a phosphate group to ADP, and further energy reactions can occur. Creatine monohydrate is a precursor to creatine phosphate. By supplementing with CM, CP levels in muscle apparently are maximized, and more muscular work can occur, since there are greater energy reserves to use. Creatine also helps with resistance training by bloating the muscle with creatine rich fluid. This allows for greater leverage and requires the muscle to move less and lift more weight. While this may seem kind of trivial, some researchers today think that one of the stimulating factors of steroid use is water retention. Anabolic steroids may actually work in part because of cellular fluid retention in the muscles. The swelling action and the related stretching of the cells may in and of itself cause a reaction which stimulates the muscle cells to grow. So in some respects creatine might be as good as steroids. The good: Many people report increasing their lean muscle mass between 6 and 10 lbs while using CM, though gains seem to stop after that point. CM is nontoxic, even in large amounts. The bad: Some people report symptoms including headaches, clenched teeth, and the sound of blood rushing in their ears while using CM. Creatines effects on blood pressure are an open question. Since it has the effect of fluid retention in muscle, it might increase blood pressure in the same way high sodium levels do, but this has not been established or refuted. Also, it is expensive. Other side effects Short-term(less than 2 weeks) exercise studies have not reported any adverse events associated with creatine supplementation. There have been no long-term studies done to evaluate the safety of prolonged administration. This is unfortunate because more and more athletes are taking creatine supplements for longer periods. There is potential for direct toxicity on renal tubules where urine is formed, and for acceleration of kidney stone formation. A while back, a baseball player for the Houston Astros was determined to have suffered from dehydration, kidney stones, and transient kidney damage as the result of creatine supplementation. Additionally, the recent deaths of 3 collegiate wrestlers are being investigated to determine what role creatine supplementation may have played. Creatine creates a byproduct called creatinine, which may show up on medical tests. Creatinine is usually a sign of kidney problems, but it is harmless as a side effect of creatine supplements. In other words, this is a false positive result. But ppl have known to have problems with insurance medical tests as the insurance companies dont believe this a would not give insurance You can do the following to avoid creatinine showing up in tests * Always make certain that you are drinking plenty of water. This is especially important to help the kidneys deal with the abundance of nutrients that bodybuilders seek to keep in their blood. * Consider dropping supplements such as creatine monohydrate about a week before taking a blood test for insurance or a physical. The creatine that is normally present in human muscle may come from two potential sources; dietary(animal flesh) and/or internally manufactured. The liver and kidneys easily make what is not present in the diet from a few amino acids(glycine, arginine and methionine). A 70kg adult has about 120g of creatine in the muscles, and the daily turnover is roughly 2g. About half of this is replaced by the diet while the other half is synthesized endogenously. The exogenous intake of creatine appears to exert negative feedback on the endogenous production of creatine(i.e., more creatine present in the diet means less production by the body). Creatine is eliminated from the body by the kidneys either as creatine, or as creatinine, which is formed from the metabolism of creatine. Things to keep in mind Proper usage Of course, first read the label and any additional leaflets that come with your brand of creatine monohydrate. Usually, the use of creatine is split into a loading and maintenance phase. During the loading phase, large quantities of creatine monohydrate are taken. Because the creatine only slowly disappears from the body, a maintenance phase in which less creatine is taken will still provide the body with adequate levels of creatine. For suggested duration of the phases and quantities see below. It is recommended to drink lots of water while on the creatine. Most users recommend a loading phase when first starting with CM. For 5 to 7 days, take a teaspoon(approx. 5 grams) 5 times per day. After that go on maintenance at 5 grams twice per day. Note: it is discouraged to use caffeine while on creatine; while creatine makes your muscles hold water, caffeine will do the opposite, thereby reducing the effects of the creatine intake. Don’t mix creatine with citrus juice. Orange, grapefruit, cranberry, in fact, most fruit juices have been most recently found to neutralize the activity of creatine monohydrate. The reason is the waste product creatinine develops. A lot of you put creatine on your tongue and drink it down with grapefruit juice. If you have taken creatine this way in the past, stop it now! You are not getting creatine, you’re getting waste product. Do mix creatine monohydrate with warm water-in a glass. This is the only way to ensure you’re getting the full benefits of creatine in its dry form. Creatine does not have to dissolve to be effective. Do be sure to drink a full eight ounce glass of good water 8 times a day. Creatine pulls water from other parts of the body to perform its work in cell volumization of the muscle. This is what makes the muscle larger and firmer. Replenish your H2O! Recommendations: Bodyweight Phase 1(loading) Phase 2(maintenance) days 1-4 days 5 and on 65-74kg 10g per day 3g per day 143-163lbs (2x5g per day) 75-84kg 15g per day 4g per day 165-185lbs (2x7.5g per day) 85-95kg 20g per day 5g per day 187-209lbs (2x10 per day) NSTC mentioned above is an abbreviation for Nutrition and Soft Tissue Center.] The bottom line is that no one can confidently state that prolonged creatine supplementation is safe, and its use would best supervised until more data can be compiled. Prolonged administration is, in essence, an uncontrolled toxicity study and one that might yield harmful results. Is it worth the risk? Remember. it’s your body! Unless you perform a blood test and discover your creatine levels are naturally too low, then you shouldn’t take more of it. Too much of a good thing always turns out badly in the end.