Topic: News: Creatine- Marvel or Menace?

[Chris Ⓐ LeRoux]

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Creatine: Marvel or Menace?
Professors and Doctors Disagree about the Risks of a Popular Dietary Supplement
By Alan Gustafson

When John Fleener looks back on the all-league and all-state honors he won playing three sports at Kennedy High School, he gives an assist to creatine.

Fleener, a 2004 graduate from the Mount Angel school, said he didn't know anything about the purported muscle-building supplement until his older brother Jeremy urged him to bulk up.

At that time, Jeremy Fleener was a salesman for Highland Laboratories, a dietary-supplement manufacturer in Mount Angel, about 20 miles east of Salem.

"The summer before my senior year, he said I should start taking creatine and whey protein because I needed to gain some muscle," John Fleener said.

Creatine is a popular supplement among high school athletes, particularly football players. They think it helps them get bigger and stronger.

Doctors who specialize in sports medicine warn that research is lacking into creatine's effects on children. Neither safety nor effectiveness in children has been scientifically proved, they said.

As it stands, "there's essentially no research into these supplements, what they do for kids or how they harm kids," said Dr. Linn Goldberg of the Oregon Health & Science University.

Goldberg developed nationally recognized education programs aimed at steering high school athletes away from steroids and sports-related dietary supplements.

Creatine, like all dietary supplements sold in the United States, is exempt from strict oversight by the U.S. Food and Drug Administration.

Federal law allows thousands of products, including sports supplements and herbal remedies, to be sold without being proved safe or effective.

Goldberg's advice to teen athletes tempted to use creatine: "I recommend not using it. No. 1, we don't know about the purity; you can't be sure what you're taking. And it's never been studied in kids under the age of 18."

His advice is echoed by many doctors, medical groups and athletics groups.

Frank Uryasz, the president of the Kansas City, Mo.-based National Center for Drug Free Sport, operates www.drugfreesport.com, which urges young athletes to stay clear of creatine and other supplements.

"The American Academy of Pediatrics has a very clear position statement that no one under the age of 18 should be taking creatine," he said. "There's no evidence that it's safe."

But some researchers disagree.

Professor Richard Kreider, the director of the Exercise and Sport Nutrition Laboratory at Baylor University, thinks creatine gets a bum rap from the medical profession.

"Because it's a very popular supplement, it gets lumped in with steroids and andro and all these other supplements that people are against," he said.

"You even see Blue Cross Blue Shield talking about the dangers of creatine. I think that's unfortunate. More than 1,000 studies have been done on creatine. If there's something hazardous to it, we would have seen it by now."

Several years ago, Kreider said, his study of college football players showed no harmful effects from creatine.

As for high-schoolers, "There's really no reason why somebody that's 16 or 17 years of age can't take creatine. There are no studies showing it's adverse to kids," Kreider said.

What is Creatine?

Creatine is an amino-acid compound found naturally in the human body, mainly in muscles. It binds with body chemicals to create adenosine triosphate (ATP), which fuels intense exercise.

Half of the creatine in humans comes from eating foods such as hamburger, steak and fish. The other half is naturally produced in the liver, kidneys and pancreas.

Creatine use by athletes gained worldwide attention in 1992, when British sprinter Linford Christie praised it after he won the 100-meter race at the Barcelona Olympic Games.

By the mid-1990s, creatine products were being sold in U.S. drugstores. In 1998, St. Louis Cardinals star Mark McGwire reportedly used creatine and androstenedione, a now-banned substance similar to anabolic steroids that is designed to boost testosterone, during his record-breaking home-run drive.

Today, creatine ranks as a top-selling sports supplement, according to the Nutrition Business Journal, a firm that provides research and consulting for the supplements industry. Creatine sales total almost $200 million per year, or nearly 10 percent of the $2 billion annually spent on sports-related supplements in the United States.

Creatine is sold in powder, pill, liquid and chewable-wafer form. Locally, prices range from $77.99 for an 8-pound container of fruit-punch-flavored Creatine Burst powder to $19.99 for 40 orange-flavored chewable wafers.

Does creatine produce performance-enhancing benefits?

Research suggests that creatine increases energy during bursts of intense exercise, such as sprinting and weightlifting.

"Much like a carbohydrate-loading effect, you get extra stored energy for sprints and recovery," Kreider said. "This allows you to perform at a higher intensity and recover faster."

As Kreider sees it, creatine is effective and safe for young athletes, as long as they follow certain ground rules:

"We put a lot of caveats on it," he said. "They need to be heavily engaged in training. They need to be eating a good diet. Their parents need to know what it is, and they need to know the pros and cons.

"The athletes need to be supervised so they take the right amount. If they follow all that, there's no reason in my view for serious adolescent athletes to stay away from it. There's no data to say it's not safe."

But research points to side effects and other concerns. Among them:

* It doesn't work for everyone. For instance, people who have naturally high amounts of creatine in their muscles won't experience any energy-boosting effect from extra amounts.

* Young athletes often exceed recommended doses, which can overload the kidneys.

* Weight gain may occur, but the extra bulk may come from retained water, not increased muscle mass. Quit taking creatine and the extra water weight may soon vanish.

* Dehydration and muscle cramps can afflict some users. Drinking plenty of fluids is the best way to avert such problems.

As Goldberg tells it, inadequate scientific information about creatine's long-term effects on children and doubts about product quality outweigh marginal benefits.

"Not all the studies show that it's effective at all," he said. "It's a transporter of high energy, so it increases your ability to recover from very strenuous exertion. It does not do anything for endurance. In fact, there's some evidence that it (decreases) endurance."

The same or better results can be achieved with a healthy diet and good conditioning, Goldberg said.

Area Coaches Respond

The Statesman Journal asked strength and conditioning coaches at all six Salem-Keizer School District high schools to estimate rates of creatine use by football players. Answers ranged from less than 1 percent at South Salem to 2 percent to 5 percent at Sprague to 20 percent at West Salem.

West Salem's 20 percent mark reflects a downward trend, said head football coach Shawn Stanley, who doubles as strength and conditioning coach.

"It seems like (creatine) has lost some of its momentum," Stanley wrote in response to a list of questions the newspaper submitted to him and other local coaches.

Salem-Keizer coaches generally said they don't encourage athletes to use creatine. Some try to discourage it; others take a neutral stance, dispensing information to curious athletes.

"I refer them to several scientific-based studies that I keep on file as well as remind them to not listen to the companies that are trying to sell the product," Stanley wrote. "I always remind them that without proper nutrition, no supplement is the answer."

West Salem football player Mike Baker, a senior linebacker and running back, said he likes Stanley's approach.

"He told us at the beginning of the year that if we had questions about (supplements), that he'd help us find the information we need," Baker said.

"When we do our weight program during the summer, we discuss creatine, whey protein and other stuff to gain weight. He told us he didn't have a biased opinion either way. He said if you had questions, he would talk to you in private."

Diverging from Stanley's estimate, Baker estimated that only a handful of West Salem football players have taken creatine, mostly during the offseason.

"Maybe five players have used it," he said, "but they are not doing it during the season."

Rick Lacey, the head strength and conditioning coach at South Salem, also takes a nonjudgmental stance on creatine.

"Do we encourage kids to go out and buy that stuff? No, but kids are looking for a training edge. We try to do our job to educate them about the positive and negative effects, and how it should be used if a person chose to use it."

South Salem senior Sean Monroe, who in the spring posted the state's best season mark in the triple jump, said he considered using creatine to boost his year-round training regimen. He decided against it after researching the pros and cons on the Internet.

Creatine use is a type of cheating, Monroe said, "because all the athletes who really work hard to get where they are can't compete with these people who take supplements."

"I want to be the best out there, but I just decided to go the hard route and work my butt off," he said.

Fleener's Experience

John Fleener said that before taking creatine, he visited Highland Laboratories, where a chemist told him how to take daily doses of powdery creatine, mixed into orange juice or milk. At the urging of his older brother, he also took another protein supplement.

"He said it would make me bigger, and they would kind of complement each other if I took both," he said. "That's pretty much what the chemist told me, too."

As for any discussion about safety, Fleener said the chemist told him, "A lot of people are kind of leery about it because it hasn't really been around that long, so they don't know about any long-term effects."

Fleener had no qualms. "I wasn't too worried. I just wasn't completely sure how it was going to work," he said.

As Fleener tells it, doses of creatine, coupled with diligent weight training, transformed his lanky 6-foot-3 frame the summer before his senior year.

"I took it all summer and I gained about 15 pounds of muscle; I went from 180 to 195," he said. "I definitely noticed that I got bigger, my muscles got bigger, and I was more defined."

His younger brother, Charlie Fleener, reports similar results.

This summer, he said, he put on 15 pounds of muscle by lifting weights and taking creatine during a five-week stretch.

The 18-year-old senior, who plays football and baseball at Kennedy, said he stopped using creatine when school started in September.

"I got lazy," he said.

Planning to pack on 15 more pounds by the time baseball season rolls around in the spring, Charlie Fleener said he plans to resume his creatine intake soon.

NCAA Restrictions

Creatine isn't a new concern on the sports scene. In 1998, the Statesman Journal reported extensively on the pros and cons of creatine use by high school athletes.

Since then, the National Collegiate Athletic Association has prohibited member schools from supplying athletes with creatine.

"The NCAA is really down on all supplements," said Dr. Thad Stanford, a Salem orthopedist and the leader of the sports medicine committee of the Oregon School Activities Association.

But no safeguards protect high school athletes, he said.

A 2005 bill that originated with the OSAA called for barring Oregon school employees and volunteers from "promoting, suggesting or supplying performance-enhancing supplements to students."

It failed to clear the Legislature.

Stanford said teens and their parents need to be better informed about unproven, potentially harmful supplements.

"They need to know that unlike pharmaceuticals, these supplements aren't scrutinized by any independent agency," he said. "So they come on the market without any controls."

The FDA's 2004 clampdown on sales of ephedra, an herbal supplement marketed to athletes and dieters, highlighted concerns about unregulated dietary supplements.

Ephedra was banned only after it was linked to dozens of deaths, including the 2001 heatstroke death of Minnesota Vikings offensive lineman Korey Stringer and the 2003 death of Baltimore Orioles pitcher and Medford native Steve Bechler, who collapsed and died during spring training.

Anabolic steroids and ephedra were classified as supplements before their dangers became known, Stanford said.

"We suspect that there are others that may be dangerous, too," he said.

So far, no scientific evidence has linked creatine to fatalities or serious health problems; some doctors say there hasn't been enough time to draw long-term conclusions.

Reported short-term side effects in creatine users include cramps, diarrhea, nausea and headaches.

In addition, doctors say, taking excessive amounts of creatine can overload the kidneys. Goldberg recalled a college athlete who came to OHSU for advice after he was sickened by a creatine binge. He got well after curtailing creatine.

Asked what advice he would give to young athletes about creatine, Stanford said: "Don't use it. If you want to bulk up, get back on the weights and eat good food. There are ways to bulk up that don't include medications or supplements."

Defending the Product

John Fleener shelved his college plans when he received no athletic-scholarship offers. He went to work, landing a $12-per-hour-job at Traeger Industries.

This fall, he started taking classes at Chemeketa Community College in Salem. Now 20, he still likes to work out and stay in good shape. Although he no longer uses creatine, he sees no need for young athletes to shun the supplement.

"If you ask one person, they'll tell you that it's bad for you. If you ask another, they'll tell you it's great," he said. "It's kind of one of those things where you have to make a decision for yourself. Me personally: I think it's good."

Charlie Fleener also endorses creatine.

"I think as long as you use it right, it's fine. You get bigger, stronger; you're able to do more (weight-lifting) reps because there's less recovery time."

Jeremy Fleener no longer works for Highland Laboratories. But he still sounds like a salesman when he talks about high school athletes gaining an edge by taking creatine and other supplements.

"Once you're past 16 years old, I don't think there should be an issue about taking that stuff," he said. "I mean, it's natural. It's not like you're injecting yourself with steroids."

Candy Scott, the chief executive officer for Highland Laboratories, told the Statesman Journal that the company plans to drop creatine from its line of 250 dietary-supplement products.

"We are almost out of creatine and we will be discontinuing that," she said.

Highland's product line includes standard vitamins and minerals as well as diet aids touted as "body slimmers" and athletic supplements that include "Super Muscle Gain," called a steroid-free anabolic weight-gain formula in the company's catalog.

Scott said it made business sense to drop creatine from the company's product line.

"There are so many other companies out there that specialize in that and do big volumes and offer just the newest, greatest, hottest thing," she said. "We're not big in that area at all. That's not our niche."

Asked whether she thought high school athletes should take creatine, Scott said: "Creatine has been on the market for quite a while, and there hasn't been a lot of actual factual data as far as it being harmful. But I feel that anyone that's still growing really shouldn't be taking a product that we don't have enough long-term information on.

"I have to look at it this way: If my son were 16, would I allow him to take that product? No."

[Chris Ⓐ LeRoux]

Link

Creatine Primer

Basic information

Creatine is a natural compound produced by humans. Your liver produces about 2 grams of creatine per day. You also can get creatine from meat and fish in your diet.

Athletic role

Creatine helps muscles produce and circulate adenosine triosphate, or ATP, which is used during bursts of athletic activity such as weightlifting, sprinting and jumping.

Sports-related use of creatine supplements began several decades ago in the Soviet Union. It gained worldwide attention in 1992 when Olympic champions Linford Christie (100 meters) and Sally Gunnell (400 meters) credited creatine with helping them train harder.

Teen Use

High school athletes who use creatine think that it helps them train longer, recover quicker and increase strength. In Oregon, no surveys have been done to determine how many high school athletes use creatine. Creatine use among male prep athletes has been pegged from as much as 10 percent in Iowa to 17 percent in Wisconsin.

Legalities

It's a legal over-the-counter dietary supplement, widely available in stores and on the Internet.

Supplies

Creatine supplements are sold in powder, pill, liquid and wafer form. Locally, prices range from $77.99 for an 8-pound container to $19.99 for chewable wafers.

Methods

The regimen usually starts with a five-day loading phase during which 20 grams is taken per day in 5-gram doses. The dosage drops to 3 to 5 grams per day in a single dose during the ensuing maintenance phase. This cycle is usually repeated once a month.

Side Effects

Creatine can cause stomach cramps, muscle cramps, nausea, vomiting and diarrhea, especially when taken immediately before intense exercise in hot weather.

Medical Concerns

Teen athletes who lack supervision may exceed the recommended doses, which can overload their kidneys.

Long-term effects of creatine use are unknown.

Like all dietary supplements, creatine isn't regulated by the Food and Drug Administration, meaning consumers can't be sure about the purity and quality of products they buy. Studies have found some creatine products contained ingredients not listed on labels.

Bottom Line

Many doctors and sports governing officials advise young athletes not to use creatine.

[Eamonn Flanagan]

You know, articles like these really are a shame. Of all the countless supplements that are available over the counter creatine is one of the very few that has been empirically proven to a) work and to b) be safe in recommended doses.

There is some truth in this article that no studies have been conducted investigating the safety of children taking creatine, but many well controlled research studies have proven it to be a safe supplement for adults. I would agree with their assessment that children should wait until they are adults to take it, but I agree with this statement from a sociological standpoint rather than an issue of health and safety.

In the published research, the only documented side effect of creatine supplementation is an increase in body mass caused by increased water retention within the muscle. There have been many anecdotal claims that creatine users are more likely to suffer from heat related cramping and renal dysfunction. However, empirical evidence does not support these claims and has shown that creatine supplementation over prolonged periods, within recommended dosages, is a safe practice and does not increase incidences of cramping nor renal dysfunction.


GREENWOOD M., R.B. KREIDER, L. GREENWOOD, and A. BYARS. Cramping and injury incidence in collegiate football players are reduced by creatine supplementation. J. Athl. Train. 38:216 - 219. 2003.

GREENWOOD M., R.B. KREIDER, L. GREENWOOD, D. WILLOUGHBY and A. BYARS. The effects of creatine supplementation on cramping and injury occurrence during college baseball training and competition. J. Ex. Physiol. Online. 6:16 - 23. 2003b.

GREENWOOD, M., R. B. KREIDER, C. MELTON, C. RASMUSSEN, S. LANCASTER, E. CANTLER, P. MILNOR and A. ALMADA. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol. Cell. Biochem. 244:83 – 88. 2003c.

KREIDER, R.B., C. MELTON, C.J. RASMUSSEN, M. GREENWOOD, S. LANCASTER, E.C. CANTLER, P. MILNOR, and A.L. ALMADA. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol. Cell Biochem. 244:95 - 104. 2003.

SCHILLING, B.K., M. H. STONE, A. UTTER, J.T. KEARNEY, M. JOHNSON, R. COGLIANESE, L. SMITH, H. S. O’BRYANT, A. C. FRY, M. STARKS, R. KEITH, and M. E. STONE. Creatine supplementation and health variables: a retrospective study. Med. Sci. Sports Exerc. 33:183 - 188. 2001.

WATSON, G., D.J. CASA, K.A. FIALA, A. HILE, M.W. ROTI, J.C HEALEY, L.E. ARMSTRONG and C.M. MARESH. Creatine use and exercise heat tolerance in dehydrated men. J. Athl. Train. 41:18 – 29. 2006.

[Eamonn Flanagan]

Link

Creatine Primer


Teen Use

High school athletes who use creatine think that it helps them train longer, recover quicker and increase strength. In Oregon, no surveys have been done to determine how many high school athletes use creatine. Creatine use among male prep athletes has been pegged from as much as 10 percent in Iowa to 17 percent in Wisconsin.

They think this because it does help them train longer, recover quicker and increase strength. These are not fallacious claims.


Legalities

It's a legal over-the-counter dietary supplement, widely available in stores and on the Internet.


Because it has been proven to be safe and effective


Side Effects

Creatine can cause stomach cramps, muscle cramps, nausea, vomiting and diarrhea, especially when taken immediately before intense exercise in hot weather.

False. There is no scientific evidence to support these claims. These are anecdotal reports that have been thoroughly tested, and rebutted. Check out any of the references I have listed above, or if anybody would like me to I can attach them to a post.

Medical Concerns

Teen athletes who lack supervision may exceed the recommended doses, which can overload their kidneys.

True. But the same could be said for multi-vitamins, aspirin, paracetemol, tylenol and any number of useful products. Of coure exceeding recommended dosages can cause harm! Screw it, I betting if you eat enough apples that will have some negative side effects too!

Long-term effects of creatine use are unknown.

Not true.

Like all dietary supplements, creatine isn't regulated by the Food and Drug Administration, meaning consumers can't be sure about the purity and quality of products they buy.

This is true. That is why it is important for athletes to source their product from a reliable brand such as optimum nutrition or champion nutrition who have had their processing plants and processes approved by the FDA.


Bottom Line

Many doctors and sports governing officials advise young athletes not to use creatine.

Many doctors are very poorly informed. Realistically we cannot expect our doctors to stay up date on every piece of research to come out on sports supplements, nutrition, pharmacuticals etc. It is impossible.

Again, I do agree that young athletes should not take creatine but the reasons listed for this in these articles are fallacious. And it is a safe and effective supplement for adults.

[Chris Ⓐ LeRoux]

Eamonn,

I would never advise minors to use creatine because I think it sets the wrong mindset- a dependence on pills, powders, and special concoctions instead of hard, smart training with lots of sleep and a good diet. Still, I will disagree with a couple points you made.

#1) It's a legal over-the-counter dietary supplement, widely available in stores and on the Internet.

Because it has been proven to be safe and effective

I disagree with this statement you made. Creatine is not legal and over the counter because it is proven safe, whether it is safe or not. It is legal because the supplement industry is unregulated, which you stated in other parts of your post. The research done on it does indicate it appears safe, but what about usage over a twenty year period or with juveniles? There are no studies on those issues and likely will not be.

#2) I wouldn't trust ANY supplement company to maintain the purity of any substance they sell. They are unregulated and are out to make a buck or two, not perform a noble service to athletes. The statistics show that a very high percentage of supplements are contaminated with ingredients not listed on the label. This happens for two reasons. One is that they often make different supplements in the same vats and another is that it is often in their interest to spike their supplements with ingredients which will increase the ergogenic effect and thus increase sales. Often, it is a shell game with the companies spiking and removing said ingredients to fit their marketing and sales figures.

Bottom line, I agree with the doctors, personally. Kids should stay away from it and the rest of the supplement industry. The statistics say they will likely consume things of which they have no guarantee of purity and things which they don't even know or intend to consume. And, finally, in my opinion, sports simply are not about who takes the best powders, pills, and concoctions. I believe it is the wrong mindset for the spirit of sport and for achieving peak performance in the long run.

Just my two cents. Here is a link to information about tainted supplements: http://weightliftingexchange.com/smf/index.php?topic=2436.0

[Eamonn Flanagan]

Eamonn,

I would never advise minors to use creatine because I think it sets the wrong mindset- a dependence on pills, powders, and special concoctions instead of hard, smart training with lots of sleep and a good diet.

I agree with you. I would not recommend creatine to minors either but like I said and as you have stated here, this is for sociological reasons not safety reasons. So while agree with the original article that this supplement should not be for kids, I disagree with the way they present the information regarding safety. It is misleading and largely untrue.

Similarly, I would only recommend a creatine supplement to an adult as just that: a "supplement". It should only be used as a supplementary aid to smart training, good recovery and good nutrition. While creatine does work, it is no miracle worker.



I disagree with this statement you made. Creatine is not legal and over the counter because it is proven safe, whether it is safe or not.

You are right. the two facts are not causative. But the fact remains that the supplement is safe and effective.

#2) I wouldn't trust ANY supplement company to maintain the purity of any substance they sell. They are unregulated and are out to make a buck or two, not perform a noble service to athletes. The statistics show that a very high percentage of supplements are contaminated with ingredients not listed on the label.

I dont really think there are definitive reliable statistics on this. I do agree that some companies could be unscrupulous in their actions but I dont think this is as big an issue as you are making out. The single research study that is present in the thread you referenced did not test a wide array of supplements. They only tested "pro-hormone" supplements, which I would never recommend to anyone. In fact, I wouldnt even purchase a creatine or whey protein product from a company who produces pro-hormones. So that should eliminate the "cross contamination" issue you raised.

In my opinion, sports simply are not about who takes the best powders, pills, and concoctions. I believe it is the wrong mindset for the spirit of sport and for achieving peak performance in the long run.

I agree with you. But we are not taking about steroids here, we are talking about nutritional supplements. I would be interested on what your opinion on endurance runners drinking glucose containing drinks prior to or during competition? Or weightlifters drinking a strong cup of coffee prior to competition?

Just my two cents. Here is a link to information about tainted supplements: http://weightliftingexchange.com/smf/index.php?topic=2436.0

Thanks for the link. I do have to strongly disagree with the statement in this thread you made:

" If they work, they contain banned supplements. "

Many supplements categorically do work and do not contain banned substances. I have conducted experiments in the lab myself with creatine which was tested for purity and observed an ergongenic effect. Countless peer-reviewed, published research studies have also done this. The same could be said for caffeine use, glucose supplements etc.

I should point out that considering you are an active weightlifter exposed to drug testing regularly I do completely understand your stance and caution relating to the possibility of contaminated supplements. While I do not think the problem is as great as you think, I can definitely appreciate the need for caution or avoidance.

[Chris Ⓐ LeRoux]

Eamonn,

I think caffeine and glucose drinks fall more in line with normal dietary questions. I do agree the research done so far indicates creatine is safe, but, the research hasn't looked at long term consumption or consumption by juveniles. We can not assume it is absolutely safe in either case, though it might be. I used creatine for a little while several years ago. I noticed nothing except the expense. I am familiar with the research on the matter as well. Dr. Richard Kreider, quoted in this article, was my undergraduate exercise science professor, by the way.

In my opinion, "significant"  benefits in a controlled study of the order that creatine has demonstrated does not equal any significant performance gains 'on the field.' I don't think there is a single creatine study, for instance, that demonstrates a significant gain in the snatch or clean and jerk 1RM. I believe it is the wrong mindset, especially for juveniles, to look to powders, pills, and other concoctions rather than their training regiment, diet, sleeping pattern, etc. I also believe massage is far more effective for $ spent than any legal (for Olympic drug testing) supplement. And, massage is expensive. Plane tickets to meets, to training camps, shoes, singlets, training clothes, food, etc, are all expensive. I think all are far more important than creatine and other such substances. Rather than spend money on creatine, I would advise an athlete to take a trip and travel to another club for a change in environment for a short camp or take a massage or two every week, etc. So, I think such supplements are a waste of money, establish the wrong mindset, could be contaminated causing failed drug tests, could cause health damage, and could lead a kid to think the answers to getting better lie in the powders, pills, and such rather than inside them. This could be true, but I don't think so unless one crosses over in to banned substances. So, its not that I have moral issues with someone who chooses to use creatine. I just think its the wrong path, for many reasons.