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The effects of creatine supplementation on thermoregulation and physical (cognitive) performance: a review and future prospects

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Abstract

Creatine (Cr) is produced endogenously in the liver or obtained exogenously from foods, such as meat and fish. In the human body, 95 % of Cr is located in the cytoplasm of skeletal muscle either in a phosphorylated (PCr) or free form (Cr). PCr is essential for the immediate rephosphorylation of adenosine diphosphate to adenosine triphosphate. PCr is rapidly degraded at the onset of maximal exercise at a rate that results in muscle PCr reservoirs being substantially depleted. A well-established strategy followed to increase muscle total Cr content is to increase exogenous intake by supplementation with chemically pure synthetic Cr. Most Cr supplementation regimens typically follow a well-established loading protocol of 20 g day−1 of Cr for approximately 5–7 days, followed by a maintenance dose at between 2 and 5 g day−1 for the duration of interest, although more recent studies tend to utilize a 0.3-g kg−1 day−1 supplementation regimen. Some studies have also investigated long-term supplementation of up to 1 year. Uptake of Cr is enhanced when taken together with carbohydrate and protein and/or while undertaking exercise. Cr supplementation has been shown to augment muscle total Cr content and enhance anaerobic performance; however, there is also some evidence of indirect benefits to aerobic endurance exercise through enhanced thermoregulation. While there is an abundance of data supporting the ergogenic effects of Cr supplementation in a variety of different applications, some individuals do not respond, the efficacy of which is dependent on a number of factors, such as dose, age, muscle fiber type, and diet, although further work in this field is warranted. Cr is increasingly being used in the management of some clinical conditions to enhance muscle mass and strength. The application of Cr in studies of health and disease has widened recently with encouraging results in studies involving sleep deprivation and cognitive performance.

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Abbreviations

AGAT:

l-arginine:glycine aminotranferase

ADP:

Adenosine diphosphate

ATP:

Adenosine triphosphate

BW:

Body weight (kg)

CK:

Creatine kinase

COPD:

Chronic obstructive pulmonary disease

Cr:

Creatine

CrT:

Total creatine

CreaT−/y :

Cr transporter (SLC6A8) knock-out mice

FFM:

Fat free mass (kg)

GAMT:

Guanidinoacetate methytransferase

ICW:

Intracellular water (L)

IMP:

Inosine monophosphate

HR:

Heart rate (bt min−1)

HRmax :

Maximal heart rate (bt min−1)

LBM:

Lean body mass

miRNA:

MicroRNA

PCr:

Phosphocreatine

RE:

Running economy

RNA:

Ribonucleic acid

RM:

Repetition maximum

RPE:

Rate of perceived exertion

TBW:

Total body water (L)

T core :

Core body temperature (°C)

T re :

Rectal temperature (°C)

T skin :

Skin temperature (°C)

f-TRP:

Free tryptophan

\({\dot{\text{V}}\text{O}}_{2}\) :

Oxygen uptake (ml min−1; ml kg−1 min−1)

\({\dot{\text{V}}\text{O}}_{2\hbox{max} }\) :

Maximal oxygen uptake (ml min−1; ml kg−1 min−1)

\({\dot{\text{V}}\text{O}}_{{2{\text{peak}}}}\) :

Peak oxygen uptake (ml min−1; ml kg−1 min−1)

WRmax :

Maximal work rate (W)

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Authors and Affiliations

  1. Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End, London, E1 4NS, UK

    R. Twycross-Lewis

  2. Applied Science, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Bay Campus, Fabian Way, Swansea, SA1 8EN, UK

    L. P. Kilduff

  3. FIMS Reference Collaborating Centre of Sports Medicine for Anti-Doping Research, University of Brighton, 30 Carlisle Road, Eastbourne, BN20 7SN, UK

    G. Wang & Y. P. Pitsiladis

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  1. R. Twycross-Lewis
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  2. L. P. Kilduff
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  3. G. Wang
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  4. Y. P. Pitsiladis
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Correspondence to Y. P. Pitsiladis.

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Twycross-Lewis, R., Kilduff, L.P., Wang, G. et al. The effects of creatine supplementation on thermoregulation and physical (cognitive) performance: a review and future prospects. Amino Acids 48, 1843–1855 (2016). https://doi.org/10.1007/s00726-016-2237-9

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