MND - FAQ on Creatine and ALS

FAQ on Creatine and ALS

Creatine, an over-the-counter supplement popular as a muscle builder among athletes, works twice as well in diseased mice as the only approved prescription drug available for treating Lou Gehrig's disease, researchers report.

The research studied mice with a genetic mutation that normally leads to the same type of motor neuron destruction as is seen in amyotrophic lateral sclerosis, which is also called Lou Gehrig's disease or ALS. The study found that animals given a diet high in creatine had the same amount of healthy muscle-controlling nerve cells as mice in the control group.

The study,done by researchers at Harvard Medical School and Cornell University Medical College in Manhattan, was reported Friday in the science journal Nature Medicine.

Sold widely in health food stores, creatine is a natural body substance involved in the cellular transport of energy in the body, scientists say. The animal models of Lou Gehrig's disease involve a genetic mutation in mitochondrial genes that regulates the energy of cells, and it is believed that similar defects in humans with the disease.

The animals on the creatine supplements showed complete protection up to four months,when the disease would normally have begun to take hold, said Dr. Flint Beal, chairman of neurology at Cornell. And the creatine worked twice as well as Riluzole, the only federally approved drug for Lou Gehrig's disease.

About 30,000 Americans have the muscle-robbing disease that another baseball legend, former pitcher Jim "Catfish" Hunter, recently contracted. The disease is marked by the death of motor neurons, which paralyses people. It doesn't affect the mind.

While Beal says the creatine "looks better than anything else we've ever tested in ALS," he says that it will be important to study it quickly in patients to help determine efficacy in humans and proper dosage.

The problem, he and others agree, is that the substance is readily available and Riluzole, the FDA-approved ALS drug, provides only modest improvement in some patients. Riluzole, made by Rhone-poulenc pharmaceuticals, extends life by a few months but does not prevent the death of motor neurons.

Normally, people with ALS die within four years of diagnosis.

"If I had ALS, I would take it," Beal said. But he didn't want to make recommendations before we do clinical trials to prove it has efficacy,"

Dr. Leon Charash, a pediatric neurologist in New York who is chairman of the Muscular Dystrophy Association's medical advisory committee, agreed that many Lou Gehrig's disease patients will probably try creatine. "I would find it hard for anyone who can buy extra months of life not to try it. Its appeal would be irresistible." He agrees that human studies should be done.

The study was funded by the National Institutes of Health, the Muscular Dystrophy Association and the ALS Association

Creatine Background

What it is, naturally

An amino acid (a protein) that is produced in tiny doses by the liver, kidneys and pancreas and stored in the muscles. In food, it is found in meat and fish.

What it is, synthetically

A simple heated brew of water and the salts cyanamide and sarcosine.

How it works, technically

creatine helps muscles replenish adenosine triphosphate (ATp), the fuel for muscle contraction. Since muscles recuperate more quickly from exercise with creatine supplementation, athletes can train longer, more frequently (with less rest) and at higher intensity.

What it does, practically

Think of creatine as carbo-loading for power athletes. It helps weightlifters add extra weight and extra reps. Note: It is not anabolic -- that is, capable of building muscle by itself; the extra exercise does that. In other words, creatine will not build muscles for couch potatoes.

What you need

USRDA is 2 grams per day. Athletes in training take up to 10 grams per day. A typical starter's program for active athletes is a one-week creatine "loading" phase of 20 grams per day followed by a maintenance program of five grams per day.

Sources and numbers

One gram of creatine is normally found in a pound of fish or red meat. It would take 10 to 20 steaks a day to give many athletes their standard creatine dose. A pound of creatine equals the amount of protein in 100 pounds of red meat.

What it costs

$50 to $60 for a four-pound can of powder that will normally last for one month.

How to take it

Twice a day, dissolve one scoop (43 grams) into a glass of energy drink, water or juice. Use it with a lot of fluid; creatine's a diuretic, meaning that drinking it can lead to dehydration. Caffeine blocks creatine. Bodybuilders hoping to optimize their creatine intake should not drink coffee.

Risks and side effects

1) Megadosing. If you take 10 times the recommended dose, as does Baltimore's Brady Anderson, a spokesman for a creatine manufacturer, the kidneys can become stressed from eliminating the excess. Derek Bell, a Houston Astros outfielder, was twice hospitalized last year for severe kidney ailments which he openly blames on creatine.

2) Common side effects include stomach cramping, diarrhea and dehydration, although drinking a great deal of water appears to mitigate these problems.

3) Other complications include muscle cramping, tears, pulls and seizures.

4) Impure doses. products coming in from China and other foreign countries have been found to be cut with baking soda and laced with rat hairs.

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