Hearing that "creatine supplementation doesn't increase muscle Cr-P content" gets old.  It does.

PubMed Results
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1. Int J Sport Nutr Exerc Metab. 2004 Oct;14(5):517-31.
Skeletal muscle total creatine content and creatine transporter gene expression in vegetarians prior to and following creatine supplementation.

Watt KK, Garnham AP, Snow RJ.
School of Health Sciences, Deakin University, Burwood, Australia.


This study examined the effect of vegetarianism on skeletal muscle total creatine (TCr) content and creatine transporter (CreaT) gene expression, prior to and during 5 d of Cr supplementation (CrS). In a double-blind, crossover design, 7 vegetarians (VEG) and nonvegetarians (NVEG) were assigned Cr or placebo supplements for 5 d and after 5 wk, received the alternative treatment. Muscle sampling occurred before, and after 1 and 5 d of treatment ingestion. Basal muscle TCr content was lower (P < 0.05) in VEG compared with NVEG. Muscle TCr increased (P < 0.05) throughout the Cr trial in both groups but was greater (P < 0.05) in VEG compared with NVEG, at days 1 and 5. CreaT gene expression was not different between VEG and NVEG. The results indicate that VEG have a lower muscle TCr content and an increased capacity to load Cr into muscle following CrS. Muscle CreaT gene expression does not appear to be affected by vegetarianism.

PMID: 15673098 [PubMed — indexed for MEDLINE]
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2. Int J Sport Nutr Exerc Metab. 2003 Mar;13(1):97-111.
Creatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle.

Preen D, Dawson B, Goodman C, Beilby J, Ching S.
Department of Human Movement and Exercise Science at The University of Western Australia, Crawley, W.A., Australia, 6009.


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 x day(-1). Eighteen physically active male subjects were divided into 3 equal groups and administered either: (a) Cr (4 x 5 g x day(-1) x 5 days), (b) Glucose+Cr (1 g x (-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 x day(-1), 2 g. day(-1) or 5 g x 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 x day(-1) and 5 g x day(-1) conditions. Intramuscular TCr values for the 0 g x 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 x 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.

PMID: 12660409 [PubMed — indexed for MEDLINE]
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3. Acta Physiol Scand. 2002 Jan;174(1):57-65.
Differential response of muscle phosphocreatine to creatine supplementation in young and old subjects.

Rawson ES, Clarkson PM, Price TB, Miles MP.
Department of Exercise Science, University of Massachusetts Medical School, 229 Shaw Building, Amherst, MA 01655, USA.


This study compared the effects of short-term creatine supplementation on muscle phosphocreatine, blood and urine creatine levels, and urine creatinine levels in elderly and young subjects. Eight young (24 +/- 1.4 years) and seven old (70 +/- 2.9 years) men ingested creatine (20 g day-1) for 5 days. Baseline muscle phosphocreatine measurements were taken pre- and post-supplementation using nuclear magnetic resonance spectroscopy (NMR). On the first day of supplementation subjects had blood samples taken immediately before and hourly for 5 h following ingestion of 5 g of creatine, and a pharmacokinetic analysis of plasma creatine levels was conducted. Twenty-four hour urine collections were conducted for 2 days prior to the supplementation period and for 5 days during supplementation. Old subjects had significantly higher baseline plasma creatine levels than young subjects (68.5 +/- 12.5 vs. 34.9 +/- 4.7 micromol L-1; P < 0.02). There were no significant differences between groups in plasma creatine pharmacokinetic parameters (i.e. area under the curve, elimination rate constant, absorption rate constant, time to maximum concentration, and maximum concentration) following the 5 g oral creatine bolus. Urine creatine, assessed pre and on 5 days of supplementation, increased (P < 0.001), with no difference between groups. Urine creatinine did not change as a result of creatine supplementation. Young subjects showed a significantly greater increase in muscle phosphocreatine compared with old subjects, and post-supplementation muscle phosphocreatine levels were greater in young subjects (young 27.6 +/- 0.5; old 25.7 +/- 0.8 mmol kg-1 ww) (P=0.02). There were no differences in blood or urine creatine between groups in response to supplementation, but old subjects had a relatively small increase (young 35% vs. old 7%) in muscle phosphocreatine after supplementation.

PMID: 11851597 [PubMed — indexed for MEDLINE]
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4. Int J Sports Med. 2000 Feb;21(2):139-45.
Effect of exogenous creatine supplementation on muscle PCr metabolism.

Francaux M, Demeure R, Goudemant JF, Poortmans JR.
Institut d'Education Physique et de Réadaptation, Université Catholique de Louvain, Louvain-la-Neuve, Belgium. [email protected]


31P NMR was used to assess the influence of two weeks creatine supplementation (21g x d(-1)) on resting muscle PCr concentration, on the rate of PCr repletion (R(depl)), and on the half-time of PCr repletion (t 1/2). Body mass (BM) and volume of body water compartments were also estimated by impedance spectroscopy. Fourteen healthy male subjects (20.8+/-1.9 y) participated in this double-blind study. PCr was measured using a surface coil placed under the calf muscle, at rest and during two exercise bout the duration of which was 1 min. They were interspaced by a recovery of 10 min. The exercises comprised of 50 plantar flexions-extensions against weights corresponding to 40% and 70% of maximal voluntary contraction (MVC), respectively. Creatine supplementation increased resting muscle PCr content by approximately 20% (P= 0.002). R(depl) was also increased by approximately 15% (P< 0.001) and approximately 10% (P = 0.026) during 40% and 70% MVC exercises, respectively. No change was observed in R(repl) and t1/2. BM and body water compartments were not influenced. These results indicate that during a standardized exercise more ATP is synthesized by the CK reaction when the pre-exercise level in PCr is higher, giving some support to the positive effects recorded on muscle performance.

PMID: 10727076 [PubMed — indexed for MEDLINE]
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5. Clin Sci (Lond). 1992 Sep;83(3):367-74.
Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation.

Harris RC, Söderlund K, Hultman E.
Department of Clinical Chemistry II, Karolinska Institute, Huddinge University Hospital, Sweden.


1. The present study was undertaken to test whether creatine given as a supplement to normal subjects was absorbed, and if continued resulted in an increase in the total creatine pool in muscle. An additional effect of exercise upon uptake into muscle was also investigated. 2. Low doses (1g of creatine monohydrate or less in water) produced only a modest rise in the plasma creatine concentration, whereas 5g resulted in a mean peak after 1h of 795 (SD 104) mumol/l in three subjects weighing 76-87 kg. Repeated dosing with 5g every 2h sustained the plasma concentration at around 1000 mumol/l. A single 5g dose corresponds to the creatine content of 1.1 kg of fresh, uncooked steak. 3. Supplementation with 5g of creatine monohydrate, four or six times a day for 2 or more days resulted in a significant increase in the total creatine content of the quadriceps femoris muscle measured in 17 subjects. This was greatest in subjects with a low initial total creatine content and the effect was to raise the content in these subjects closer to the upper limit of the normal range. In some the increase was as much as 50%. 4. Uptake into muscle was greatest during the first 2 days of supplementation accounting for 32% of the dose administered in three subjects receiving 6 x 5g of creatine monohydrate/day. In these subjects renal excretion was 40, 61 and 68% of the creatine dose over the first 3 days. Approximately 20% or more of the creatine taken up was measured as phosphocreatine. No changes were apparent in the muscle ATP content.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1327657 [PubMed — indexed for MEDLINE]
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