A friend of mine (bodybuilder) suggested I started taking 1000mg of vit C in the morning and another 1000 mg of Vit C after working out in the evening.
I tried his suggestion and noticed an IMMEDIATE and dramatic improvement in recovery.
Have you guys ever experienced this? I experienced greatly reduced DOMS and reduced fatigue overall.
I was quite frankly amazed.
Cheers
chris
yes I completely agree with you. About 5 weeks ago I started taking 3000mg/day and noticed a good difference. I ran out for a couple weeks and noticed recovery was not as good without it.
I also take vita c. I take 2000 mg 2x a day. I cant tell if it has helped my recovery since my workouts are always changing, however when I am sick I bump it up to 10 grams per day and it lessens the symtoms or puts the cold off a few days. But when I stop taking that high a dose the cold has caught back up with me.
Just my experiences.
There is no doubt about C’s big improvement in recovery for me.
regardless of performance improvement or not it has been proven that a person who gets 500mg of vit c per day will live about 5 years longer than someone who doesn’t.
Thats a hell of a lot!
Do you (or anyone else) find they get gassy when they take Vit C in high doses?
Not if I take it in doses of 2 grams 4-5 x a day. Yes if you take 5 grams at once you may get diherea. SO THEY SAY 
Best to slowly build up the dosage.
Linus Pauling stated that you should increase until you have gastric “distress” (diarrhea) & then cut back a bit. For those who don’t know, Linus was probably the biggest proponent of vitc & studied it extensively.
Vit c was what brought me out of a bad bout with chronic fatigue syndrome. Anytime I am in a particularly hard training phase, I increase the c. During injury recovery, it is increased again to help w/ the flushing/healing. I have been as high as 10g/day over many doses.
If you increase, be careful when it is time to decrease as it increases iron absorb. & if you decrease too fast you will run the risk of low iron (I went from running 15X150m to not being able to jog 2 laps when I dropped it too fast… took 3 weeks to level things off)
Did you dudes see what Dr. Lonnie Lowry wrote recently on vit C…Check dis out!!!
"Enter the other antioxidant big boy, vitamin C. As another vitamin with a history of low-toxicity and a correspondingly high “tolerable upper limit” of 2000mg per day, there’s nothing wrong with supplementing a gram or two every day, right? Heck, it’s even water-soluble and therefore more easily excreted.
Unfortunately, there’s more to it. Vitamin C supplementation (500mg for six weeks) has been shown to actually induce pro-oxidant effects in healthy humans, as measured by DNA damage. (31) Very high doses (500mg/kg) in rats cause superoxide radical generation, induce P450 liver enzymes (particularly risky to even moderate drinkers) and, again, DNA damage. (29, 31)
In fact, this DNA fragmentation thing is mentioned quite a bit in academic publications. (29, 31, 26, 32, 33) A dose of 12.5mg per kilogram of body weight, when given with NAC, has even been shown to worsen eccentric muscle damage. (11) Then there’s that new study showing a dose-dependent worsening of osteoarthritis in animals — as can also occur in veteran weight lifters — complete with a recommendation not to exceed the current 90mg RDA. (24
Vitamin C may also be involved in creating and preserving (not protecting against) cancerous cells, (10, 25) thickening arteries at 500mg, (25) and worsening iron overload, particularly in persons with this common genetic disorder — not good for oxidative stress. (11, 13, 14, 15, 18) " I take a lot of vitamin C no wonder I am such a weak DNA deformed midget!! :eek:
Can you post the list of references, as I would like to look more closely at population that these findings are based on. Remember elite athletes are different animals than John and Mary from next door! So it’s always important to look at the population before any conclusions are drawn,
Thanks
This is why I love a lot of the european research on teams…Junkerpt showed that 1 gram was ABSORBED fully with elite distance runners, yet I still see university research showing that 2 x 8 reps on a leg extension failed to improve vertical jumps. No wonder Doctors tell parents not to have little timothy lift! I have seen some lame research and that is why I read the entire article and not just the summary or piggyback research from other writers.
Abstracts and summaries can be very mislead as they print the findings and in turn sending people in to a panic. They either run to the closest health shop or emptying the medicine cabinets. 
Dudes I did not say I believed the research I pop a lot of vitamin C!!! I just need an excuse to why I am so ugly and weak, I though in my eplanation I could use this article !!! Here is the full article, references at the end, it is from t-nation in case you cared???
"Evil Antioxidants?
The whole story about antioxidants and your health
by Dr. Lonnie Lowery
Are Antioxidants (Gasp!) Dangerous?
Although it could make me roughly as popular as boiled-over microwave oatmeal, I think it’s time I bring some emerging research to light. Yes, perhaps it’s time we take a more cautious look at antioxidant supplements and decide whether they’re really all they’re cracked up to be.
A growing number of new studies are slowly getting many professionals to revise their opinions on the stuff. Do you take vitamin E, C or an antioxidant blend? Do you have strong opinions regarding your current dose? If so, read on.
Mounting Questions
First, and perhaps the straw that broke squatter’s back, is the large American Heart Association analysis (2) of several studies. This was more than just a single research study with a small number of subjects. Whether you consider it overblown by the media or not (actually, I do), seeing an overall increase in death in those subjects taking 400 IU or more of vitamin E daily should nonetheless be enough to get your attention. Do we need this much when the RDA is just 30IU (15mg) for adult men?
And what about co-ingestion with other anti-thrombotic (clot-reducing) supplements like ginkgo, fish oils and NSAIDS such as aspirin or ibuprofen? And let’s not even get into the addition of hypertensive agents like ephedra. Would these combinations increase the risk of a cerebrovascular accident (“blown hose”) under a 400-pound squat attempt? Is a 400 or 800 IU daily capsule (181-354mg synthetic vitamin E) now considered harmful despite the “official” upper limit of 1000 mg per day? What are the alternatives?
Enter the other antioxidant big boy, vitamin C. As another vitamin with a history of low-toxicity and a correspondingly high “tolerable upper limit” of 2000mg per day, there’s nothing wrong with supplementing a gram or two every day, right? Heck, it’s even water-soluble and therefore more easily excreted.
Unfortunately, there’s more to it. Vitamin C supplementation (500mg for six weeks) has been shown to actually induce pro-oxidant effects in healthy humans, as measured by DNA damage. (31) Very high doses (500mg/kg) in rats cause superoxide radical generation, induce P450 liver enzymes (particularly risky to even moderate drinkers) and, again, DNA damage. (29, 31)
In fact, this DNA fragmentation thing is mentioned quite a bit in academic publications. (29, 31, 26, 32, 33) A dose of 12.5mg per kilogram of body weight, when given with NAC, has even been shown to worsen eccentric muscle damage. (11) Then there’s that new study showing a dose-dependent worsening of osteoarthritis in animals — as can also occur in veteran weight lifters — complete with a recommendation not to exceed the current 90mg RDA. (24)
Vitamin C may also be involved in creating and preserving (not protecting against) cancerous cells, (10, 25) thickening arteries at 500mg, (25) and worsening iron overload, particularly in persons with this common genetic disorder — not good for oxidative stress. (11, 13, 14, 15, 18)
We also need to consider, however controversial, rebound scurvy symptoms like bloody gums that occur when tablets aren’t at arm’s length, and at least some conclusions that the common cold argument has been “overstated.” (20)
This isn’t looking like a one-sided positive consensus in the scientific literature anymore, is it? Hey, don’t shoot the messenger. Recent findings are important, yes, but let’s also remember that they don’t yet constitute unanimous condemnation among all healthcare authorities. We can’t be content with selective citations, either pro or con. There’s just too much out there on both sides to ignore. At the very least, we should stay abreast of new research, both positive and negative. (Yes, there’s a ton of positive research out there too, even in this article’s references, but we already know a lot about that.)
So, based on what’s now available, should we instead be turning to “newer” antioxidants like pine bark, carnosine, green tea and grape seed extracts? (Check out some interesting references below!) If our old standbys, E and C, are “bad,” what now?
Because of the above findings and still others, the American Heart Association, the same group who actually broke the mold surrounding dietary supplements and started suggesting fish oil capsules for certain individuals (1), came forward this past August with an advisory not to take antioxidant supplements. (3) Ugh! But what about the decades of earlier data? Are all those studies that showed benefits and low toxicity now wrong?
Good point. But like it or not, it appears that the AHA isn’t satisfied with the existing positive evidence. The new recommendation is plain: avoid antioxidant supplements. If you’re getting hot under your defensive collar by now, have no fear. I don’t disagree with you.
Does It Apply to Us?
First, heart patients, like those who populated November’s rather scary vitamin E review, are not bodybuilders. Hence, the research may not be especially applicable. Not only are most of us free of their multitude of cardiovascular medications, we also have our training stress and recovery to consider!
Nor are we guinea pigs (at least not in a literal sense) or a group of cells floating in a dish. We’re mostly healthy adult males. Is there anything out there directly pertinent to us? As one positive example, a new study focusing on “our” population did recently find lower systolic blood pressure after 12 weeks on large daily amounts of antioxidants (1000mg vitamin C, 800mg vitamin E, 10mg folate). (36) That’s cool. But we’re even more than just “healthy adult males.” We are highly active athletes.
You’re right in thinking that even a brief bout of exercise can significantly kick-up oxidative stress. And this is to say nothing of eccentric muscle damage and reperfusion injury (obstructed and re-opened blood flow) that’s possible during weight training. (26) As a positive example here, 400mg vitamin C supplemented for three weeks prior and one week post-exercise was indeed shown to reduce eccentric force losses. (22) Hence, we definitely shouldn’t write-off all doses of antioxidants just yet.
So What Can We Do?
As mentioned, we athletes aren’t generally heart patients and aren’t even “normal” by sedentary standards. We have an increased need to protect against oxidation (elevated metabolic rate during and post-exercise), tissue damage (eccentric contractions or “negatives”) and arguably even fish oil intake (possible pro-oxidative effects despite many benefits).
So what can we do if not take ongoing large doses of antioxidant supplements? Well, for one, those who are concerned can tone down their supplement doses and even use them cyclically. Dose and duration of intake are huge factors in determining whether these compounds are anti- or paradoxically pro-oxidant in nature!
We can also increasingly go to the natural source, whole foods. Obviously many foods contain antioxidant vitamins, minerals and phytochemicals (often in inimitable combinations). Imagine then, how quickly the vitamin C (not E, so much) would mount-up considering a mere 250mg tablet and a diet rich in fruits and vegetables!
So, let’s look at a few foods that are extremely fast to prep and eat, and are convenient and portable:
• Green tea, black tea, even a little medium roast coffee!
• Plums! (A bag of dried plums [i.e. prunes] is handy as a car snack.)
• Citrus! Oranges (even “Mandarin” style in their own juice), lemons and limes.*
• Grapes (anthocyanins, reveratrol, etc.)
• Berries! (more anthocyanins/ polyphenols)
• Red bell pepper (a big time vitamin C source!)
• Tomatoes, carrots, pumpkin (carotenoids can decline in the body under stress)
• Olive oil! (phenolics)
• Even functional foods like orange juice with added E and C
Here’s an irresistible whole food quote from Sánchez-Moreno and colleagues:
"In fact, in the present study, consumption of 250 mg vitamin C, contained in two glasses of orange juice (500 mL), significantly increased plasma vitamin C from a range of 30—50 to a range of 60—90 ?mol/L in just three hours. The increased concentration was maintained as long as the subjects were drinking the orange juice, which suggests that this is an efficient means of increasing vitamin C concentrations in the body.
“In other studies, blood concentrations of vitamin C were manipulated through the use of high vitamin C intake in the form of tablets (2000 mg), and vitamin C concentrations reached 116 ?mol/L two hours after ingestion and 95 ?mol/L after taking 500 mg, which suggests that high-dose supplements might not be the most efficient way of increasing the body’s pool of vitamin C.”
This is by no means a complete listing. If you’re into scanning large amounts of new scientific material and can interpret inferential statistics, I’d love to hear your suggestions and conclusions on the antioxidant supplement vs. food topic!
When digging through hardcore literature on Medline or other databases, however, we need to be careful regarding the methodology of whole food studies. Since the assays used to assess total antioxidant capacity of common fruits and veggies differ, you’ll find different conclusions among studies as to which are “best.” The obvious recommendation is to eat as large a variety as possible.
The Cyclical Use Theory
Regarding supplements, let’s examine the cyclical use theory. Just like the natural cycles surrounding seasonal foods, we might consider supplemental antioxidant support only during periods of accelerated training stress. I’m not referring to periodizing low-rep negative training with higher-rep functional training, but rather I’m considering those times of the year that you’re specifically gearing up for an event.
Even non-competitors often gear up for early summer with added cardio and even stimulants (fat burners.) A boosted metabolic rate, however attractive for fat loss, does jack-up oxidative stress. Hard training can outstrip the body’s endogenous (internal) up-regulation of antioxidant enzymes, too. (26) And I’d be remiss not to at least mention that 1,500mg of vitamin C could potentially reduce overtraining effects. You see, this dose can even lower cortisol levels. (30) But considering this fairly whopping amount, there are probably better ways to do it, like meditation (38) and coffee reduction, if excessive.
So, in addition to a daily multi-vitamin/multi-mineral (many now have 150-200% vitamins E and C anyway), here are some err-on-the-side-of-caution supplemental suggestions during ramped-up training times:
Low dose E (200 IU daily) or the lowest dose of tocotrienols you can find. If necessary, take a half-tablet.
Vitamin C (250mg once or maximally twice daily, AM and PM)*
A simple one-shot approach would be Protegra or related off-brands (a moderate-dose mix of antioxidant vitamins and minerals) on alternating training weeks.**
Pine bark (pycnogenol), grape seed extract (proanthocyanidin) and miscellaneous antioxidant-related compounds like MSM and SAMe: limit intake to a half-dose or weekends-only intake until more research arrives.
** Now here’s a practical quote: “…the well-known reversibility of the inductive phenomenon responsible for O2.- over-generation, suggests that human risk following typical vitamin C supplementation may be easily controlled by providing a discontinuous supply (e.g. alternate weeks).” (29)
Cutting Edge vs. Recklessly Overdone
Does all the seemingly conflicting research presented in this article frustrate you? Welcome to nutrition. It’s a world where consensus forms slowly and we have to think for ourselves based on as much scientific evidence (not emotional conviction) as we can scrounge.
Thank God for the Think Tank! Without a constant flow of new data and discussion, we might get excited enough to sailor’s dive into things, head-first and prematurely, only to ruefully come around to more moderate decisions later. Our purpose here was just to reveal that there’s indeed a darker side to all the cool antioxidant research we usually hear. Maybe it’ll even help you make decisions a little more slowly in the future.
We can walk a balance between cutting edge and recklessly overdone. The concept is as old school as one can imagine. Aristotle’s 2300 year-old “moderation in all things” is as true of supplements as it is of whole foods. Mild recovery enhancement isn’t worth blowing a hose under the squat bar or needlessly damaging your DNA or ending up with early arthritis. I sincerely doubt these things will actually happen to you, but any sane person at least performs a risk-to-benefit analysis.
They say the passions of youth become the regrets of maturity, so just decide how close you’re willing to cut it. With a balanced research perspective (pro and con), it’s time to determine how you will gain some benefits without the repercussions of overdoing it.
About the Author
Dr. Lonnie Lowery holds graduate degrees in exercise physiology and nutrition, has competed successfully in regional bodybuilding events, and is a regular contributor to T-Nation.com. Also, get information on his book chapter/dietary supplement review at lifestyleschanges.com, or email him at Lonman7@hotmail.com for his bodybuilding audio CD, Experiments vs. Experience.
References and Related Reading
AHA Scientific Statement: Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease, #71-0241 Circulation. 2002;106: 2747-2757.
AHA.org Meeting Report: High doses of vitamin E supplements do more harm than good. www.americanheart.org/presenter.jhtml?identifier=3026060. Nov 10, 2004; accessed Dec. 12, 2004.
AHA.org Scientific Advisory: Get antioxidants from food, not supplements, says American Heart Association. www.americanheart.org/presenter.jhtml?identifier=3023709. Aug3, 2004; accessed Dec. 12, 2004.
Ambrogini P, et al. Effects of proanthocyanidin on normal and reinnervated rat muscle. Boll Soc Ital Biol Sper. 1995 Jul-Aug;71(7-8):227-34.
Arcangeli, P. Pycnogenol in chronic venous insufficiency. Fitoterapia. 2000 Jun;71(3):236-44.
Bagchi, D., et al. Molecular mechanisms of cardioprotection by a novel grape seed proanthocyanidin extract. Mutat Res. 2003 Feb-Mar;523-524:87-97.
Boldyrev, A., et al. Protection of neuronal cells against reactive oxygen species by carnosine and related compounds. Comp Biochem Physiol B Biochem Mol Biol. 2004 Jan;137(1):81-8.
Bolyrev, A., et al. Carnosine, the protective, anti-aging peptide. Biosci Rep. 1999 Dec;19(6):581-7.
Buetler, T., et al. Green tea extract decreases muscle necrosis in mdx mice and protects against reactive oxygen species. Am J Clin Nutr. 2002 Apr;75(4):749-53.
Cerutti, P. Science. 1985 227:375-381.
Childs, A., et al. Supplementation with vitamin C and N-acetyl-cysteine increases oxidative stress in humans after an acute muscle injury induced by eccentric exercise. Free Radic Biol Med. 2001 Sep 15;31(6):745-53.
Cho, K., et al. Inhibition mechanisms of bioflavonoids extracted from the bark of Pinus maritima on the expression of proinflammatory cytokines. Ann N Y Acad Sci. 2001 Apr;928:141-56.
Custer, E., et al. Population norms for serum ferritin. J Lab Clin Med 1995, 126(1): 88-94.
Dantas, W. Hereditary hemochromatosis. Rev Gastroenterol Peru 2001, 21(1): 42-55.
Deugnier, Y., et al. Gender-specific phenotypic Expression and screening strategies in C282Y-linked haemochromatosis: a study of 9396 French people. Br J Haematol 2002, 118(4): 1170-1178.
Dupin AM, Stvolinskii SL. Changes in carnosine levels in muscles working in different regimens of stimulation. Biokhimiia. 1986 Jan;51(1):160-4.
Dutka TL, Lamb GD. Effect of carnosine on excitation-contraction coupling in mechanically-skinned rat skeletal muscle. J Muscle Res Cell Motil. 2004;25(3):203-13.
Fleming, D., et al. dietary factors associated with the risk of high iron stores in the elderly Framingham heart study cohort. Am J Clin Nutr 2002, 76(6): 1375-1384.
Hasegawa, J. Inhibition of lipogenesis by pycnogenol. Phytother Res. 2000 Sep;14(6):472-3.
Hemilia, H. Vitamin C supplementation and the common cold—was Linus Pauling right or wrong? Int J Vitam Nutr Res. 1997;67(5):329-35.
Imai, K. and Nakachi, K. Cross sectional study of effects of drinking green tea on cardiovascular and liver diseases. BMJ 1995, 310(6981): 693-696.
Jakeman P, Maxwell S. Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise. Eur J Appl Physiol Occup Physiol. 1993;67(5):426-30.
Johnston, C., et al. Orange juice ingestion and supplemental vitamin C are equally effective at reducing plasma lipid peroxidation in healthy adult women. J Am Coll Nutr. 2003 Dec;22(6):519-23.
Kraus, V., et al. Ascorbic acid increases the severity of spontaneous knee osteoarthritis in a guinea pig model. Arthritis Rheum. 2004 Jun;50(6):1822-31.
Leslie, M. Vitamin C: How much do you really need? http://my.webmd.com/content/article/12/1668_50385. Jun 19, 2000; accessed Dec. 10, 2004.
Lowery, L., et al. Antioxidants Supplements and Exercise. In: Sports Supplements (Antonio and Stout, Eds.). 2001; Lippincott, Williams and Wilkins: Philadelphia, PA: 260-278.
Nagai, K. [The inhibition of inflammation by the promotion of spontaneous healing with L-carnosine (author’s transl)]. Langenbecks Arch Chir. 1980;351(1):39-49.
Natella, F., et al. Grape seed proanthocyanidins prevent plasma postprandial oxidative stress in humans. J Agric Food Chem. 2002 Dec 18;50(26):7720-5.
Paolini, M., et al. The nature of pro-oxidant activity of vitamin C. Life Sci, 1999 64(23): PL273-278.
Peters, E., et al. Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running. Int J Sports Med. 2001 Oct;22(7):537-43.
Podmore, D., et al. Nature. 1998 392: 559.
Puntarulo, S. and Cederbaum, A. Free Rad Biol Med. 1998 24: 1324-1330.
Sakagami, H. and Satoh, K. Anticancer Res. 1997 17:3513-3520.
Sánchez-Moreno, C., et al. Effect of orange juice intake on vitamin C concentrations and biomarkers of antioxidant status in humans. Am J Clin Nutr. 2003 Sep;78(3):454-60.
Sano, A., et al. Procyanidin B1 is detected in human serum after intake of proanthocyanidin-rich grape seed extract. Biosci Biotechnol Biochem. 2003 May;67(5):1140-3.
Schutte, A., et al. Cardiovascular effects of oral Supplementation of vitamin C, E and folic acid in young healthy males. Int J Vitam Nutr Res. 2004 Jul;74(4):285-93.
Stuerenburg HJ, Kunze K. Concentrations of free carnosine (a putative membrane-protective antioxidant) in human muscle biopsies and rat muscles. Arch Gerontol Geriatr. 1999 Sep;29(2):107-13.
Sudsuang, R., et al. Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time. Physiol Behav. 1991 Sep;50(3):543-8.
Virgili, F. Ferulic acid excretion as a marker of consumption of a French maritime pine (Pinus maritima) bark extract. Free Radic Biol Med. 2000 Apr 15;28(8):1249-56.
Wander RC, Du SH. Oxidation of plasma proteins is not increased after supplementation with eicosapentaenoic and docosahexaenoic acids. Am J Clin Nutr. 2000 Sep;72(3):731-7.
A few months ago David W indicated Vit C in relatively high dosages (5g before sleep) as used by weightlifters for diuretic purposes.
After experimenting for a while I have to say this protocol (implemented in an “impact” fashion for a week or so, then reverted to a more tolerable 2g per day “basic” supplementation) did work very well - for aforementioned purposes- with a few female athletes of different ages.
On the other hand, some doctors warned me about possible interferences of the excessive dosages of Vit C with nervous processes. I wasn’t able to get any further clarification nor I found any valuable resource in this regard.
Anyone ?
to an earlier question; if one takes a lot of Vit C in effervescent form, possible gastic distress…wind, bloating etc could result from the high level of sodium bicabonate (baking soda) being ingested
You can’t repost an entire article on the site without t-nation or lowery’s permission. Provide a link instead. That’s all we need is a t-nation/cf.com war
ASCORBIC ACID "v’ CITRIC ACID ‘v’ WHOLE FOOD’s.
When somebody takes vit c in ascorbic acid form (Most common with tablets) they are robbing their body of other nutrients according to many nutritionalists. Now, seeing as I’m a bit tired, can anyone fill me in as to what sort of vitamin C the t-nation report was going on about? Is it vit C in general or the ascorbic acid version,( which by robbing from the body of other vits/minerals that has an indirect adverse effect on nerve problems and not protecting against cancers etc?).
Research or not. I severely doubt that taking 1000Mg in cycles is going to hurt you in any way, especially if you don’t take in much Vit C to begin with!
LMFAO
Too much of anything is not good for you bc the body has to urinate or dispose of any excess in foods/supplements/water that it does not use! Hell even too much water is bad for you (fluoride)!
I only take 1000mg 3-4 times daily when I am about to get sick or do get sick. However, it seems that since Vit C is used for recovery purposes I will now cycle it in for weeks 2 and 3 of my 4 week mesocycle. I only choose to cycle the Vit C instead of taking it all the time bc I do take it in tablet form; however, if one takes this amount naturally through food then I wouldn’t be concerned with this subject at all.
Besides athletes usually need at least twice whatever sedentary individuals need anyways!
Talk to Charles Poloquin? Did I read somewhere he is a fan of his athletes using off-the-scale amounts of VitC. I am waiting for the CP Vitamin C product line…!
here is another article on vit. C, sorry for posting it on here but I could not find the link where I got it from yesterday when I copied it to my personal files!!!
CREATINE AND KIDNEY DAMAGE?
Will G Hopkins PhD, Physiology and Physical Education, University of Otago, Dunedin 9001, New Zealand. Email: will.hopkins=AT=otago.ac.nz. Sportscience 4(1), sportsci.org/jour/0001/inbrief.html#creatine, 2000 (476 words)
Creatine supplementation for a week or so probably enhances performance of repeated sprints by a few percent in some sports, and continued supplementation combined with training appears to have a more substantial anabolic effect on strength. Creatine supplements work by increasing the amount of creatine in muscle, where it helps you perform short, high-intensity activities. You have to take a lot of creatine to get any extra into muscle, and most of what you take ends up in your urine. That’s why there’s some concern that creatine supplementation could damage kidneys. To get rid of the extra creatine, you have to make more urine–about 25% more each day, according to a recent study of long-term users by Poortmans and Francaux (1999). Does that produce some sort of strain on the kidneys that might eventually lead to kidney disease?
Poortmans and Francaux couldn’t find any indication of failing kidneys in nine athletes who had been taking creatine for up to five years, but is nine subjects enough to declare creatine kidney-friendly? Kuehl and coworkers didn’t think so, in a letter to the editor in the January issue of Medicine and Science in Sports and Exercise. They had other criticisms that didn’t stand up to close scrutiny, but in his reply Jacque Poortmans acknowledged that “larger studies should be implemented”. Richard Kreider and his coworkers are doing their best to remedy that problem: there is no evidence of serious side effects in their many recent studies, or in the abstracts of several studies to be presented at this year’s annual meeting of the American College of Sports Medicine.
But… the letters to the editor of Med Sci Sports referred to two case studies of inflamed kidneys apparently resulting from creatine supplementation. In one case an existing kidney condition flared up when the athlete started taking creatine; in the other case the athlete developed serious inflammation of the kidneys. Are these cases the tip of an iceberg? Probably not: it’s likely that only one athlete in many thousand will suffer from kidney problems when taking creatine supplements. The risk is very low, but it is certainly not zero. And the risk is almost certainly much higher for someone who already has a kidney condition.
Poortmans JR, Francaux M (1999). Long-term oral creatine supplementation does not impair renal function in healthy athletes. Medicine and Science in Sports and Exercise 31, 1108-1110
Kuehl K, Goldberg L, Elliot D. (2000). Re: long-term oral creatine supplementation does not impair renal function in healthy athletes. Medicine and Science in Sports and Exercise 32, 248
Poortmans JR (2000). Response. Medicine and Science in Sports and Exercise 32, 248-249
For recent reviews of creatine on the Web, see Incledon (2000) and Kreider (1999). For a large collection of recent abstracts of research by Kreider et al., all showing no harmful side effects from creatine supplementation, click here.
LIABILITY FOR SIDE EFFECTS
Will G Hopkins PhD, Physiology and Physical Education, University of Otago, Dunedin 9001, New Zealand. Email: will.hopkins=AT=otago.ac.nz. Sportscience 4(1), sportsci.org/jour/0001/inbrief.html#liability, 2000 (420 words)
The possibility that vitamin C and creatine can be harmful raises the question of liability. It seems reasonable to me that the label on the supplements–or indeed on any product or service–should give a realistic warning of possible side effects. I also believe that such a warning should protect the manufacturer or supplier from litigation, unless it can be shown that there was deliberate or careless underestimation of the risk or failure to update the risk in the light of new data. I floated these ideas on the Sportscience list, using the risk of kidney damage with creatine as an example. I received many valuable replies, which the senders subsequently gave me permission to publish. Click here to view. Here is a summary of the opinions in the replies, not all of which I agree with:Studies to date have not eliminated the possibility of a low but real risk of side effects with use of creatine.
An informative label would still not protect the manufacturer, and would even harm the manufacturer.
It is unrealistic to expect to see such labels on everyday items.
It is difficult to link rare side effects to the use of a supplement.
There are industry standards for safety warnings.
Researchers should be liable for promoting use of ergogenic aids that have harmful side effects.
Creatine could in principle promote growth of tumors.
Over-the-counter products should be used at your own risk.
You can’t make sensible estimates of low risk.
There is no evidence of harmful side effects with creatine.
After reading these replies, I am confident that the consumer and the manufacturer would be well served by a statutory warning of side effects. It should be possible to estimate the maximum odds of rare side effects to an accuracy of an order of magnitude, on the basis of clinical trials and case studies. Most estimates of the risk of long-term effects would be high, reflecting the lack of data from long-term studies.
See below for the sort of warning I believe we need. I did not consult any industry standards for this example, so please regard it only as a concept. I have based the example on risks from use of an imaginary amino-acid supplement, glucamine dihydrate. I have included risk of injury or death from an everyday activity, to help consumers interpret the risks. I have also included the website of an imaginary government agency that would control risk assessment.
Statutory Warning of Side Effects for: Glucamine Dihydrate
Use this product at your own risk. This warning protects the manufacturer and any agent from litigation for any harmful side effects.
Serious inflammation of kidneys: known odds are 1:10,000 after one month of use; odds are 1:10 for anyone with an existing kidney problem.
All other harmful side effects: none confirmed by 04/31/00; odds are at most 1:1000 after one month of use, 1:100 after one year of use, and 1:10 after 10 years of use.
For comparison, odds are 1:1000 for serious injury or death from one year of average car use in the US.
Visit http://ConsumerRisk.org for updates of risk of side effects.