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Creatine: A New Look at an Old Friend

by Dan Moore

There are probably very few muscle enthusiasts who have not either used Creatine or at the least contemplated using Creatine. There are more myths and hype surrounding Creatine use than a leopard has spots and unfortunately all these myths further only confuse most new trainees entering the weightlifting/body building enthusiast ring who may find Creatine advantageous.

Recently many studies have come out that have reputed Creatineís effectiveness, especially concerning any anabolic potential it may have (1,2). Now the results of those studies do show that Creatine itself may not be directly causal to inducing myofibrillar or sarcoplasmic changes but a more recent paper shows us another side of the story, so let's take a look.

Creatine supplementation augments the increase in satellite cell and
myonuclei number in human skeletal muscle induced by strength training.

J Physiol. 2006 Jun 1;573(Pt 2):525-34. Epub 2006 Mar 31.
Olsen S, Aagaard P, Kadi F, Tufekovic G, Verney J, Olesen JL, Suetta C, Kjaer M.

The present study investigated the influence of creatine and protein supplementation on satellite cell frequency and number of myonuclei in human skeletal muscle during 16 weeks of heavy-resistance training. In a double-blinded design 32 healthy, male subjects (19-26 years) were assigned to strength training (STR) while receiving a timed intake of creatine (STR-CRE) (n=9), protein (STR-PRO) (n=8) or placebo (STR-CON) (n=8), or serving as a non-training control group (CON) (n=7). Supplementation was given daily (STR-CRE: 6-24 g creatine monohydrate, STR-PRO: 20 g protein, STR-CON: placebo). Furthermore, timed protein/placebo intake were administered at all training sessions. Muscle biopsies were obtained at week 0, 4, 8 (week 8 not CON) and 16 of resistance training (3 days per week). Satellite cells were identified by immunohistochemistry. Muscle mean fibre (MFA) area was determined after histochemical analysis. All training regimes were found to increase the proportion of satellite cells, but significantly greater enhancements were observed with creatine supplementation at week 4 (compared to STR-CON) and at week 8 (compared to STR-PRO and STR-CON) (P<0.01-0.05). At week 16, satellite cell number was no longer elevated in STR-CRE, while it remained elevated in STR-PRO and STR-CON. Furthermore, creatine supplementation resulted in an increased number of myonuclei per fibre and increases of 14-17% in MFA at week 4, 8 and 16 (P<0.01). In contrast, STR-PRO showed increase in MFA only in the later (16 week, +8%) and STR-CON only in the early (week 4, +14%) phases of training, respectively (P<0.05). In STR-CRE a positive relationship was found between the percentage increases in MFA and myonuclei from baseline to week 16, respectively (r=0.67, P<0.05). No changes were observed in the control group (CON). In conclusion, the present study demonstrates for the first time that creatine supplementation in combination with strength training amplifies the training-induced increase in satellite cell number and myonuclei concentration in human skeletal muscle fibres, thereby allowing an enhanced muscle fibre growth in response to strength training.

Looking at Table 4 below itís apparent that Creatine still holds up as probably one of the few supplements that have panned out to be beneficial to anyone trying to gain lean mass. Even though itís mode of action as an anabolic aid has been called into question numerous times we can see that supplementation may have further value than protein and carbohydrates alone.

Creatine Muscle Satellite Cell Study

So in the end how important is this study and what are the implications?

To assess this we need to re-address the impact of sarcoplasmic domain size. In previous unsupplemented studies strength training has lead to 19 to 44% increases in satellite cell number (3). In this study substantially larger gains in the relative number of SC were observed when strength training was combined with protein supplementation (+61% at wk 4) and even more when supplemented with creatine (+84% and +99% at wks 4 and 8, respectively). Indicating an increased contribution from the newly donated nuclei to mRNA transcription, leading to elevated rates of myofibrillar protein synthesis (see my earlier article on Rep Ranges in this issue).

Also in this study the response seen was accompanied by an increase in maximum isometric muscle strength (MVC). Although this change of strength could be accounted for by increases in neural efficiency itís generally accepted that the changes in neural efficiency occur predominantly in the earlier weeks of training while hypertrophy is mainly the cause of increased MVC passed the ďlearning curveĒ(4). Since in this study the MFA increased at weeks 4, 8, and 16 itís unlikely that the increase in MVC was not related to the increase in MFA and hence larger force generation capacity accompanying hypertrophy.

Dan Moore


  1. Louis, M., Poortmans, J. R., Francaux, M., Berre, J., Boisseau, N., Brassine, E., Cuthbertson, D. J., Smith, K., Babraj, J. A., Waddell, T., & Rennie, M. J. (2003a). No effect of creatine supplementation on human myofibrillar and sarcoplasmic protein synthesis after resistance exercise. Am J Physiol Endocrinol Metab 285, E1089-94.
  2. Louis, M., Poortmans, J. R., Francaux, M., Hultman, E., Berre, J., Boisseau, N., Young, V. R., Smith, K., Meier-Augenstein, W., Babraj, J. A., Waddell, T., & Rennie, M. J. (2003b). Creatine supplementation has no effect on human muscle protein turnover at rest in the postabsorptive or fed states. Am J Physiol Endocrinol Metab 284, E764-E770.
  3. Kadi, F., Schjerling, P., Andersen, L. L., Charifi, N., Madsen, J. L., Christensen, L. R., & Andersen, J. L.(2004b). The effects of heavy resistance training and detraining on satellite cells in human skeletal muscles. J Physiol 558, 1005-1012.
  4. Aagaard, P., Simonsen, E. B., Andersen, J. L., Magnusson, P. & Dyhre-Poulsen, P. (2002). Increased rate of force development and neural drive of human skeletal muscle following resistance training. J Appl Physiol 93, 1318-1326.

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