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Creatine Supplementation: A Comparison of Loading and Maintenance Protocols on Creatine Uptake by Human Skeletal Muscle

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David Preen
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Brian Dawson
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Carmel Goodman
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John Beilby
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Simon Ching
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The purposes of this investigation were first to determine the impact of 3 different creatine (Cr) loading procedures on skeletal muscle total Cr (TCr) accumulation and, second, to evaluate the effectiveness of 2 maintenance regimes on retaining intramuscular TCr stores, in the 6 weeks following a 5-day Cr loading program (20 g · day−1). Eighteen physically active male subjects were divided into 3 equal groups and administered either: (a) Cr (4 X 5 g · day−1 X 5 days), (b) Glucose+Cr (1 g · kg−1 of body mass twice per day), or (c) Cr in conjunction with 60 min of daily muscular (repeated-sprint) exercise. Following the 5-day loading period, subjects were reassigned to 3 maintenance groups and ingested either 0 g · day−1, 2 g · day−1 or 5 g · day−1 of Cr for a period of 6 weeks. Muscle biopsy samples (vastus lateralis) were taken pre- and post-loading as well as post-maintenance and analyzed for skeletal muscle ATP, phosphocreatine (PCr), Cr, and TCr concentrations. Twenty-four hour urine samples were collected for each of the loading days and last 2 maintenance days, and used to determine whole body Cr retention. Post-loading TCr stores were significantly (p < .05) increased in all treatment conditions. The Glucose+Cr condition produced a greater elevation (p < .05) in TCr concentrations (25%) than the Cr Only (16%) or Exercise+Cr (18%) groups. Following the maintenance period, muscle TCr stores were still similar to post-loading values for both the 2 g · day−1 and 5 g · day−1 conditions. Intramuscular TCr values for the 0 g · day−1 condition were significantly lower than the other conditions after the 6-week period. Although not significantly different from pre-loading concentrations, muscle TCr for the 0 g · day−1 group had not fully returned to baseline levels at 6 weeks post-loading. The data suggests that Glucose+Cr (but with a much smaller glucose intake than currently accepted) is potentially the most effective means of elevating TCr accumulation in human skeletal muscle. Furthermore, after 5 days of Cr loading, elevated muscle TCr concentrations can be maintained by the ingestion of small daily Cr doses (2-5 g) for a period of 6 weeks and that TCr concentrations may take longer than currently accepted to return to baseline values after such a Cr loading regime.

D. Preen, B. Dawson, and C. Goodman are with the Department of Human Movement and Exercise Science at The University of Western Australia, Crawley, W.A., Australia, 6009. J. Beilby and S. Ching are with The Western Australian Centre for Pathology and Medical Research, QEII Medical Centre, Nedlands, W.A., Australia, 6009.

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