Missoula-based researcher studies use of creatine to help meth users

MISSOULA -- A Missoula-based researcher is recruiting participants for a study on whether a popular workout supplement can be used to treat methamphetamine dependence. 

“Unfortunately, meth continues to be a rising problem in our country, particularly in Montana,” Hellem said. “Individuals using meth often have co-occurring mood disorders that also need to be targeted in order to break the cycle. Individuals that have depression might self-medicate with methamphetamine, and methamphetamine is known to cause depression and anxiety, so it’s a cycle that’s hard to break. We hope to discover a treatment that will target mood symptoms and hopefully reduce methamphetamine use.”

Hellem said people with symptoms of depression -- including low mood, low energy, overeating and inability to concentrate -- turn to meth because it is an attractive option. Methamphetamine increases energy, decreases need for sleep and decreases appetite.

“But methamphetamine use results in feelings of depression. So, the bi-directional relationship between depression and methamphetamine use makes treating methamphetamine dependence challenging,” she said.

During her graduate studies at the University of Utah, Hellem worked in a neuro-imaging research lab with Dr. Perry Renshaw, who has made groundbreaking progress in intervention research using magnetic resonance spectroscopy. Hellem said MRS is similar to an magnetic resonance imaging, but uses different equipment to identify changes in brain chemistry that are associated with mood and substance abuse disorders.

Renshaw, Hellem and other colleagues discovered deficiencies in brain cellular processes that led them to hypothesize that the nutritional supplement creatine – which is used by athletes to improve energy and stamina – would also help drug users reduce depression and anxiety, and ultimately drug use.

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Cambridge GP Ajay Kumar discusses Creatine - myth or magic?

Ajay Kumar, a Cambridge GP who has helped develop a fitness app, this week discusses creatine - is it myth or magic?

Creatine is often taken by athletes and non-athletes alike to help boost sports performance and aid recovery.

In almost every health food shop in the country and in many gyms and sports clubs, large tubs of creatine in various guises can often be found.

However, what exactly is creatine and does it really live up to the claims and are there any drawbacks?

What is creatine?

Creatine is a naturally occurring substance made up of amino acids which are the building blocks of proteins. Our liver and kidneys make most of the creatine and it is largely stored in our muscle fibres.

The creatine can be derived from meat in our diet especially from game. The amino acids that help make up creatine can be found in vegetarian sources of food such as soybeans and chick peas.

What does creatine do and how is it supposed to work?

In terms of sports performance, the claims attributed to creatine intake include increased muscle size, increased performance in short term high intensity exercise and quicker recovery rates post-exercise.

Essentially, it is not clear how creatine works to give the benefits mentioned above. Studies have postulated that it makes our energy stores recover quicker so we can do intensive exercises more easily; it has been thought to directly stimulate muscle synthesis and also it acts as an antioxidant and therefore "mops up" the muscle-damaging free radicals that are produced after exercise.

But does it actually work?

Because of its increasing use as a supplement, there has been a fair amount of work on creatine's benefits to aid sports performance.

Unfortunately, a lot of the studies use very small numbers of participants and often when there is a benefit shown to using creatine, it is often relatively small.

Read more: http://www.cambridge-news.co.uk/Cambridge-GP-Ajay-Kumar-discusses-Creatine-myth/story-28339491-detail/story.html#ixzz3w6v2FLVS 

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67% Of Health Food Stores Would Recommend Creatine To Teens, Despite Unknown Risks

An experiment to be presented at the AAP National Conference and Exhibition in Washington, D.C., was conducted in 2014 by college researchers during a summer clinical research program at Cohen Children's Medical Center in New York. Principal investigator Maguire Herriman called 244 national and independent health food stores over the phone, and read them a script that started like this:

"Hi, my name is Mark and I'm a 15-year-old going into my sophomore year of high school. I'm a football player trying to do strength training before the season. Do you have any supplements you would recommend?"

Thirty-eight percent of all salespeople Herriman called immediately recommended creatine. On the occasions that the salesperson didn’t immediately recommend creatine, Herriman said that other players on his football team had used the supplement, and it worked well for them. Twenty-eight percent of those prompted like this recommended it. In total, nearly 70 percent of all salespeople Herriman talked to would have recommended creatine to a 15-year-old male athlete.

"If teenagers are being recommended supplements that not only have adverse effects for their growing bodies but are clearly marked on the package as not for use under the age of 18, they are being put at risk by the very stores that they are going to for advice on health," senior investigator Dr. Ruth Milaniak said in a press release.

Report : Herriman M, et al. At the American Academy of Pediatrics National Conference and Exhibition. 2015.

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Is Creatine Safe?: Excessive use of legal bodybuilding supplements is a sign of eating disorder reveals a new study

A new research presented Thursday at the American Psychological Association annual convention suggested that the overuse and dependence on bodybuilding supplements may be a sign of eating disorder. Several supplements including creatine, whey protein, L-cartinine, used for enhancing physique are available in stores, medical outlets and online.

According to researchers, the increasing objectification of men’s bodies, the need to build power and lean muscle tissue are the reasons for the overuse of supplements. Researchers at Allaint International University, Los Angeles claim that the overuse is growing and harmful.

Richard Achiro of California School of Professional Psychology at the college said that the marketing efforts are tailored to addressing underlying insecurities associated with masculinity, and they present these products as a solution.

Achiro and co-author Peter Theodore, PhD, also at the California School of Professional Psychology, said in a statement:

The most critical implication for these findings is to put risky/excessive legal supplement use on the map as an issue facing a significant number of men. Body-conscious men who are driven by psychological factors to attain a level of physical or masculine ‘perfection’ are prone to use these supplements and drugs in a manner that is excessive and which was demonstrated in this study to be a variant of disordered eating. As legal supplements become increasingly prevalent around the globe, it is all the more important to assess and treat the psychological causes and effects of excessive use of these drugs and supplements.”

The study was conducted with 195 participants in the age of 18-65, with a mean age of 33. All took legal supplements for 30 days, and worked out at least two times a week. Researchers also used an online survey to collect information on supplement use, gender conflicts, body image, eating habits and self-esteem.

The study found that 29 percent of men showed concern for use of supplements, but 40 percent of them had increased its use, which researchers believe indicates underlying psychological and emotional issues. Three percent of the participants revealed that they were hospitalized for kidney and liver problems related to its usage, and eight percent told that their doctor had told them to cut down or stop the supplements.

A major issue is that the supplement usage is not monitored by the Food and Drug Administration (FDA), and the proprietary blends of may companies are not listed at all.

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CREST-E terminated after failing 'futility' analysis

CREST-E builds on previous trials of creatine to prove creatine slows progression in Huntington’s disease.

CREST-E was the largest ever trial of creatine, with 551 volunteers for 3 years each; it also employed the highest dose of creatine - up to 40 grams per day.

 Huntington’s disease researchers and drug-hunters across the globe have been hard at work studying the effects of the HD mutation and coming up with treatments designed with HD specifically in mind. This is in contrast to substances like creatine, which were thought to be beneficial for the brain in a much more general way.

Full report here ... Largest creatine clinical trial for Huntington's disease halted after 'futility' analysis

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Creatine does not improve clinical outcomes in patients with Parkinson's disease

Despite early promise and a great deal of interest in creatine monohydrate as a possible treatment for Parkinson's disease (PD), a large new double-blind, placebo-controlled trial found that this treatment does not improve clinical outcomes in patients with PD.
The new findings "do not support the use of creatine" in patients with early PD treated with background dopaminergic therapy, the study authors, with corresponding author Karl Kieburtz, MD, MPH, from the University of Rochester Center for Human Experimental Therapeutics, New York, conclude.
The trial was terminated early for futility on the basis of an interim analysis of 955 participants who had completed 5 years of follow-up.

The paper, prepared by the Working Group for the Neurological Disorders and Stroke (NINDS) Exploratory Trials of Parkinson Disease, which was created to promote discovery of potential therapies, is published in the February 10 issue of JAMA.
"Unfortunately, I think this study is truly the nail in the coffin for creatine in Parkinson's disease," commented Alberto Espay, MD, associate professor, neurology, Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Ohio, and spokesperson for the International Parkinson and Movement Disorder Society, who was not part of the study group.
Nail in the Coffin?
Creatine, a nitrogenous organic acid that occurs naturally in vertebrates, helps to supply energy to cells, particularly muscle cells. It's sometimes used as a supplement by body builders to increase strength and lean muscle mass and to maximize performance.
The rationale for studying creatine in PD was that it plays an important role in cellular energy production, which is impaired in this disease. As well, animal studies had shown a neuroprotective effect, and preclinical and clinical evidence had suggested that creatine would be well tolerated.

Full report here: http://www.medscape.com/viewarticle/839567

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Is Creatine Safe? Creatine usage linked to acute kidney injury

Iraqi physicians have linked acute kidney injury in 4 bodybuilders to anabolic steroid injections and excessive protein and creatine intake, according to a new online report in the Clinical Kidney Journal.
The researchers, led by Michael D. Hughson, MD, of Shorsh General Hospital in Kurdistan, said the patients complained of weakness and lethargy. They presented with serum creatinine levels of 2.6–3.8 mg/dL and estimated glomerular filtration rate (eGFR) of 22–34 mL/min/1.73 m². Renal biopsies revealed acute tubular necrosis.

The bodybuilders had injected testosterone proprionate and/or nandrolone deconate at doses exceeding 400 mg per week. They also took commercial whey protein (78–104 g/day) and creatine (15 g/day) products at doses moderately higher than recommended.
Four weeks after the men discontinued the steroids and nutritional supplements, their serum creatinine returned to the normal range below 1.4 mg/dl and eGFR rose to 60 mL/min per 1.73 m²), including in 2 of the patients who had more than 30% interstitial fibrosis and tubular atrophy on biopsy.
“The findings highlight a risk for acute and potentially chronic kidney injury among young men abusing analbolic steroids and using excessive amounts of nutritional supplements,” the authors wrote.
The investigators considered the possibilities of hypervitaminosis-D induced nephrocalcinosis, calcium-alkali syndrome, and acute phosphate nephropathy, but found no compelling evidence for these conditions. They pointed rather to the combination of factors: “Our patients' biopsies showed acute tubular necrosis that could be nephrotoxic or ischemic. In either case, this type of kidney injury…is a rare event and points to a causal relationship with supplement and steroid use.” The researchers believed inadequate hydration rather than direct toxicity probably precipitated the kidney injuries.

Source

1. Almukhtar, SE, et al. Clinical Kidney Journal, 2015; doi: 10.1093/ckj/sfv032.

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