Teen Use of Muscle Booster Creatine Sparks Concern

Kids who want to grow strong these days sometimes turn to creatine.

The strength training supplement, popular among pro and college athletes, has filtered down to the high school set. This unsettles adults, who doubt the young athletes understand what creatine does and don’t know how many teens are involved.

“We do not know,” said researcher Charles Yesalis of Pennsylvania State University. “I can speculate. I think a lot. I think it’s down to the junior high level.”

Creatine is found almost entirely in skeletal muscle, where it helps fuel the energy bursts needed for explosive contractions such as those in weight training.

Athletes take creatine supplements to give their muscles as much creatine as their cells can handle, expecting to gain extra energy, train longer and harder--and bulk up. And many studies have indicated that creatine works. Athletes who take it get stronger and bigger, although some of the increased size may be the result of water retention.

Training with steroids produces greater strength gains, but the male hormone supplements are illegal for use as a training aid, not to mention potentially dangerous. Risks range from baldness to heart disease.

But Creatine is widely available and legal. The Food and Drug Administration lists it as a food supplement and allows it to be sold with no more restrictions than those on vitamins. Teen athletes can buy it at their local health food store--possibly their local supermarket.

Yesalis, who studies athletes’ quests for better bodies through chemistry, would like government agencies such as the Centers for Disease Control and Prevention to add questions on substances such as creatine to their health habits surveys.

One new study is in the current issue of the Mayo Clinic Proceedings. Researchers had 182 male and 146 female Minnesota students ages 14 to 18 complete an anonymous questionnaire when they appeared for physical exams required in sports.

Twenty-seven athletes, including one female, said they had used creatine, and 14 said they were using it at the time of the survey.

“It’s our impression that at least in terms of the Midwest, our athletes are reflective of the general population,” said Dr. Jay Smith, who co-wrote the article with fellow Mayo physician Diane L. Dahm.

The study found 74% of the young creatine users relied on friends for information about the supplement. That’s worrisome to Smith, who says teens ought to go to adults who can give them more reliable information.

Teens should not use creatine, Smith said. “The safest thing is not to take it,” he said. Although short-term side effects are relatively mild, including cramping and diarrhea, long-term effects are not known because the substance has not been followed long enough, he said.

“Speaking as a parent, I don’t think we should get our kids in the habit,” Yesalis said. “When taken as directed, nothing there scares me. However, if there is one thing I have learned in 22 years, there is a group that lives by the adage that if one works, 10 will work great.”

The National Federation of State High School Assns., governing high school sports, says high school officials, including coaches, should not condone supplement use.

But researcher Richard Kreider of the University of Memphis says the risks of creatine, even in high schoolers, are vastly overstated. Research has not found the stuff to be dangerous, and drinking lots of water can control cramping, he said.

Creatine may help smaller athletes get stronger, play better and avoid injury in games against bigger opponents, Kreider said. Plus, making creatine off-limits puts it in the same class as more dangerous substances, he said, and teens may then say, “I’m going to take the hard stuff that I’m also not allowed to take.”