Creatina: MedlinePlus suplementos

T ¿Qué es?
P La creatina es una sustancia química que se encuentra presente en forma natural en el cuerpo, principalmente en los músculos. El cuerpo la produce y también se puede obtener de algunos alimentos. Los pescados y las carnes son buenas fuentes de creatina. La creatina también se puede hacer en el laboratorio.
P La creatina se usa más comúnmente para mejorar el rendimiento físico y para aumentar la masa muscular en los atletas y los adultos mayores. Hay algunas pruebas científicas, que apoyan el uso de la creatina para mejorar el rendimiento deportivo de la gente joven y sana en los breves momentos de actividad de alta intensidad como el sprinting. Pero al parecer los adultos mayores no obtienen ningún beneficio. La creatina no parece mejorar la fuerza o composición corporal en las personas mayores de 60 años.
P El amplio uso de la creatina entre los atletas profesionales y aficionados ha sido reconocido por atletas muy conocidos como Mark McGuire, Sammy Sosa y John Elway. Después de que se demostró que las soluciones de carbohidratos aumentan aún más los niveles de creatina en los músculos, las bebidas deportivas con creatina se han hecho muy populares.
P El uso de la creatina está permitido por el Comité Olímpico Internacional, la Asociación Nacional de Atletismo Colegial (NCAA) y por los deportes profesionales. Sin embargo, la NCAA no permite dar a los estudiantes de los colegios y universidades creatina comprada con fondos escolares. Está permitido para los estudiantes comprar creatina por su cuenta y la NCAA no tiene planes para prohibir la creatina a menos que la evidencia médica demuestre que es dañina. Con los métodos actuales de análisis, no es posible detectar el uso de suplementos de creatina.
P Además de mejorar el rendimiento deportivo, la creatina se utiliza para la insuficiencia cardiaca congestiva (CHF), la depresión, el trastorno bipolar, la enfermedad de Parkinson, las enfermedades de los músculos y los nervios, un trastorno ocular llamado atrofia girata y para el colesterol alto. También se usa para retardar el empeoramiento de la esclerosis amiotrófica lateral (ALS, la enfermedad de Lou Gehrig), la artritis reumática, la enfermedad de McArdle y para muchas distrofias musculares.
P Los americanos usan más de 4 millones de kilos de creatina al año.

T ¿Qué tan efectivo es?
P Natural Medicines Comprehensive Database (La Base Exhaustiva de Datos de Medicamentos Naturales) clasifica la eficacia, basada en evidencia científica, de acuerdo a la siguiente escala: Eficaz, Probablemente Eficaz, Posiblemente Eficaz, Posiblemente Ineficaz, Probablemente Ineficaz, Ineficaz, e Insuficiente Evidencia para Hacer una Determinación.
P La clasificación de la eficacia para este producto es la siguiente:
t Posiblemente eficaz para...
- Rendimiento deportivo. Muchos factores parecen afectar la eficacia de la creatina, incluyendo el estado físico y la edad de la persona que la utiliza, el tipo de deporte y la dosis. La creatina no parece mejorar el rendimiento durante los ejercicios aeróbicos o beneficiar a las personas de más edad. Además, la creatina no parece aumentar la resistencia o mejorar el rendimiento en los atletas altamente entrenados. Sin embargo, hay cierta evidencia de que una “dosis de carga” de creatina, usando 20 gramos diarios por 5 días, puede ser más eficaz que el uso continuo de ella. Pero recuerde, todavía hay cierta inseguridad acerca de quién puede beneficiar del uso de la creatina y con qué dosis. Hasta el momento, los estudios han incluido un pequeño número de personas (todos han involucrado menos de 72 participantes) y no es posible sacar conclusiones de números tan pequeños.
- Síndromes causados por problemas para metabolizar la creatina. Los problemas para metabolizar la creatina pueden causar disminución de los niveles de creatina en el cerebro, lo que ocasiona retraso mental, convulsiones, autismo y trastornos motrices. La ingesta diaria de creatina durante un máximo de 3 años aumenta los niveles de creatina en el cerebro y disminuye los trastornos motrices y las convulsiones, pero tiene poco efecto sobre la capacidad mental en niños y adultos jóvenes con un síndrome de carencia de creatina llamada déficit de guanidinoacetato metiltransferasa. Sin embargo, la ingesta de creatina durante un máximo de 8 años parece mejorar la atención, el lenguaje y el rendimiento académico en niños con déficit de guanidinoacetato metiltransferasa llamado deficiencia de arginina-glicina amidinotransferasa (AGAT). La ingesta de creatina no parece mejorar los niveles de creatina en el cerebro, los trastornos motrices o la capacidad mental en niños con deficiencia del transportador de creatina.
t Posiblemente ineficaz para...
- La esclerosis amiotrófica lateral (ELA, enfermedad de Lou Gehrig). La ingesta de creatina no parece disminuir la progresión de la enfermedad o mejorar las chances de supervivencia en las personas con ALS.
t Insuficiente evidencia para hacer una determinación para...
- Envejecimiento de la piel. La investigación preliminar muestra que la aplicación diaria de una crema con creatina, guaraná y glicerol en la cara durante seis semanas disminuye las arrugas y la flacidez en la piel de la cara. Otra investigación sugiere que una crema que contiene creatina y ácido fólico disminuye las arrugas y mejora la piel dañada por el sol.
- Enfermedad pulmonar (enfermedad pulmonar obstructiva crónica [EPOC, COPD]). Es inconsistente la investigación sobre los efectos de la creatina en personas con enfermedad obstructiva crónica (EPOC). Cierta investigación sugiere que la ingesta diaria de creatina no mejora la función pulmonar. Sin embargo, otra investigación sugiere que la ingesta de creatina podría mejorar la función pulmonar o la capacidad de ejercitación física.
- Insuficiencia cardiaca. La ingesta diaria de creatina durante 5-10 días parece mejorar la fuerza y resistencia muscular, pero no los síntomas de la cardiopatia.
- Depresión. La investigación preliminar sugiere que la ingesta diaria de creatina durante 8 semanas mejora los efectos del antidepresivo escitalopram en mujeres con trastorno depresivo severo.
- Diabetes. La investigación preliminar muestra que la ingesta de creatina durante 5 días disminuye los niveles de azúcar en la sangre después de comer en personas con diabetes recientemente diagnosticada. Sin embargo, se desconocen los efectos de la ingesta de creatina durante más de 5 años en personas con diabetes.
- Pérdida de la visión (Atrofia girada de la coroides y la retina). La investigación muestra que la carencia de creatina, que ha estado asociada con esta forma de pérdida de visión, puede ser corregida con suplementos. La ingesta diaria de creatina durante un año parece disminuir la lesión ocular y la pérdida de visión.
- Daño nervioso hereditario (neuropatía sensitivo-motora hereditaria). La investigación preliminar en personas con daño nervioso hereditario, como la enfermedad de Charcot-Marie-Tooth, sugiere que la ingesta diaria de creatina entre las semanas 1-12 no tiene efecto sobre la fuerza y la resistencia muscular.
- Una enfermedad hereditaria llamada enfermedad de Huntington. La investigación preliminar sugiere que la ingesta diaria de creatina durante un año no mejora la fuerza muscular, la coordinación o lo síntomas en personas con la enfermedad de Huntington.
- Trastorno muscular llamado enfermedad de McArdle. Cierta investigación preliminar sugiere que la ingesta diaria de creatina mejora la función muscular en ciertas personas con la enfermedad de McArdle. No obstante, la ingesta de dosis más altas de creatina parece empeorar el dolor muscular.
- Enfermedades musculares y neurológicas llamadas miopatías mitocondriales. Cierta investigación sugiere que la ingesta de creatina no mejora la función muscular o la calidad de vida en personas con miopatías mitocondriales. Sin embargo, la creatina podría mejorar ciertas mediciones de la fuerza muscular.
- Esclerosis múltiple. La investigación preliminar sugiere que la ingesta diaria de creatina durante 5 días no mejora la capacidad física en personas con esclerosis múltiple.
- Pérdida de tejido muscular. La ingesta diaria de creatina no parece aumentar la masa o fuerza muscular en personas con pérdida muscular por VIH. Sin embargo, la ingesta de creatina parece ayudar a mantener la masa muscular y a disminuir la pérdida de fuerza muscular asociada con el uso del yeso.
- Calambres musculares. La investigación preliminar muestra que la ingesta de creatina antes de tratamientos de hemodiálisis parece disminuir los calambres abdominales.
- Distrofia muscular. No es consistente la investigación preliminar sobre el uso de la creatina en personas con distrofia muscular. Cierta evidencia muestra que la fuerza y fatiga muscular parece mejorar después de la ingesta diaria de creatina durante las semanas 8-16. Sin embargo, otra investigación sugiere que la creatina no brinda ningún beneficio en personas con distrofia muscular.
- Problemas respiratorios durante el sueño en recién nacidos. La investigación preliminar muestra que administración de creatina en bebés prematuros no mejora los problemas respiratorios mientras duermen.
- Artrosis. La investigación preliminar sugiere que la ingesta diaria de creatina junto con ejercicios de fortalecimiento mejora la función física en mujeres menopaúsicas con artrosis de rodilla.
- Enfermedad de Parkinson. La investigación preliminar sugiere que la ingesta diaria de creatina disminuye el rápido avance de la enfermedad de Parkinson. Sin embargo, en personas con enfermedad de Parkinson avanzada, la ingesta de creatina no brinda ningún beneficio.
- Un trastorno del sistema nervioso llamado síndrome de Rett. La investigación preliminar sugiere que la ingesta diaria de creatina durante 6 meses puede mejorar levemente los síntomas en mujeres con el síndrome de Rett.
- Artritis reumatoide. La investigación preliminar muestra que la ingesta diaria de creatina mejora la fuerza muscular, pero no el funcionamiento físico en personas con artritis reumatoide.
- Esquizofrenia. La investigación preliminar muestra que la ingesta diaria de creatina durante dos meses no mejora los síntomas o la función mental en personas con esquizofrenia.
- Lesión en la médula espinal. La investigación preliminar muestra que la ingesta diaria de creatina durante 7 días mejora la capacidad física al mejorar la función pulmonar en personas con lesión de la médula espinal. Sin embargo, otra investigación muestra que la creatina no mejora la función muscular de la muñeca o la mano.
- Pérdida muscular en la columna vertebral. La investigación preliminar sugiere que la ingesta de creatina en niños con pérdida muscular en la columna vertebral no presenta ningún beneficio.
- Recuperación de la cirugía. La investigación preliminar muestra que la ingesta diaria de creatina no acelera la recuperación de la fuerza muscular después de una cirugía.
- Traumatismo. La investigación preliminar sugiere que la ingesta diaria de creatina disminuye la amnesia, la cefalea, los mareos y la fatiga en niños después de una lesión cerebral traumática.
- Colesterol alto.
- Trastorno bipolar.
- Otras afecciones.
P Se necesita más evidencia para poder aprobar a la creatina para estos usos.

T ¿Cómo funciona?
P La creatina está involucrada en la generación de la energía que necesitan los músculos para su funcionamiento.
P Al parecer, los vegetarianos y las personas que tienen niveles más bajos de creatina, obtienen un mayor beneficio cuando empiezan a tomar suplementos de creatina que las personas que empiezan con un nivel más alto de creatina. Los músculos esqueléticos solo pueden almacenar una determinada cantidad de creatina; añadiendo más no eleva más los niveles.. Este “punto de saturación” generalmente se alcanza dentro de los primeros días de tomar una “dosis de carga.”

T ¿Hay preocupación por la seguridad de su uso?
P La creatina es PROBABLEMENTE SEGURA cuando se lo ingiere de manera apropiada durante un máximo de 5 años.
P La creatina es POSIBLEMENTE NO SEGURA cuando se toma por vía oral en dosis altas. Hay cierta preocupación de que podría dañar los riñones, el hígado o el funcionamiento del corazón. Sin embargo, la conexión entre las dosis altas y estos efectos negativos no se ha comprobado. La creatina también podría causar dolor de estómago, náuseas, diarrea y calambres abdominales.
P La creatina obliga a los músculos a extraer agua del resto del cuerpo. Asegúrese de beber más agua que lo normal para compensar por ello. Además, si está tomando creatina no haga ejercicio cuando hace calor. Puede producir deshidratación.
P Muchas de las personas que usan creatina suben de peso. Esto se debe a que la creatina produce retención de agua por los músculos y no a la formación de músculos.
P Hay cierta preocupación de que la combinación de creatina con cafeína y la hierba efedra (también conocida como Ma Huang) podría aumentar las probabilidades de sufrir serios efectos secundarios tal como un derrame cerebral.
P Hay cierta preocupación de que la creatina podría producir latidos irregulares en algunas personas. Pero se necesita más información para saber si la creatina puede producir este problema.
P Hay cierta preocupación de que, en algunas personas, la creatina podría producir un trastorno a la piel llamado dermatitis purpúrica pigmentada Pero se necesita más información para saber si la creatina puede causar este problema.
t Advertencias y precauciones especiales:
P Embarazo y lactancia: No se tiene suficiente información sobre el uso de la creatina durante el embarazo y la lactancia. Sea precavida y evite su uso.
P Enfermedad renal o diabetes: No use la creatina si tiene enfermedad a los riñones o una enfermedad como la diabetes que aumenta sus posibilidades de desarrollar enfermedad renal. Hay cierta preocupación de que la creatina podría empeorar su enfermedad a los riñones.

T ¿Existen interacciones con medicamentos?
P Moderadas
P Tenga cuidado con esta combinación
P Medicamentos que pueden dañar los riñones (Fármacos nefrotóxicos)
P El tomar dosis altas de creatina podría causar daño a los riñones. Algunos medicamentos también podrían causar daño a los riñones. El tomar creatina con otros medicamentos que pueden causar daño a los riñones podría aumentar las posibilidades de daño renal.
P Algunos de estos medicamentos que pueden causar daño a los riñones incluyen ciclosporina (Neoral, Sandimmune); aminoglicósidos incluyendo amikacina (Amikin), gentamicina (Garamycin, Gentak, otros), tobramicina (Nebcin, otros); medicamentos antiinflamatorios no esteroidales (AINEs) incluyendo el ibuprofeno (Advil, Motriz, Nuprin, otros), indometacino (Indocin), naproxeno (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene) y numerosos otros.

T ¿Existen interacciones con hierbas y suplementos?
P Cafeína
P Hay cierta preocupación de que la combinación de cafeína, efedra y creatina podría aumentar el riesgo de efectos secundarios graves. Hay un informe de un atleta que sufrió un derrame cerebral después de consumir, diariamente y durante 6 semanas, 6 gramos de monohidrato de creatina, 400-600 mg de cafeína, 40-60 mg de efedra y una variedad de otros suplementos. La cafeína podría también disminuir los efectos beneficiosos de la creatina en el rendimiento atlético.

T ¿Existen interacciones con alimentos?
P Carbohidratos
P La combinación de carbohidratos con creatina puede aumentar más los niveles de creatina en los músculos que la creatina sola. Si a 5 gramos de creatina se le agregan 93 gramos de carbohidratos simples y se toma esta combinación 4 veces al día por 5 días se aumentan los niveles de creatina en los músculos en un 60% más que cuando se toma la creatina sola.

T ¿Qué dosis se utiliza?
P La siguiente dosis se ha estudiado en investigaciones científicas:
P POR VÍA ORAL:
- Para mejorar el rendimiento físico, se han probado varias dosis y regimenes diferentes:
- Se usa una dosis de carga de 20 gramos de creatina (o 0.3 gramos por kg) al día por 5 días y luego se sigue con una dosis de mantenimiento de 2 o más gramos (0.03 gramos por kg) diarios. A pesar de que 5 días de dosis de carga es lo típico también se ha usado una dosis de carga por solo 2 días.
- También se ha usado una dosis de carga de 9 gramos por 6 días. Algunas fuentes sugieren que, en vez de dar dosis de carga por tantos días, se pueden obtener resultados similares si se dan 3 gramos al día por 28 días.
P Mientras se usan suplementos de creatina, la ingesta de agua deber se de 64 onzas por día.
- Para la insuficiencia cardiaca: 20 gramos al día por 5-10 días.
- Para la enfermedad de Parkinson:
- 10 gramos al día.
- También se ha usado una dosis de carga de 20 gramos/día por 6 días seguida de 2 gramos/día por 6 meses y luego 4 gramos diarios por 18 meses.
- Para mejorar el entrenamiento de resistencia en las personas con la enfermedad de Parkinson: Se usa una dosis de 20 gramos/día por 5 días, seguido de 5 gramos/día.
- Para la atrofia girata: 1.5 gramos por día.
- Para las distrofias musculares: se han usado 10 gramos por día por los adultos y 5 gramos por día por los niños.
- Para la enfermedad de McArdle: 150 mg/kg diarios por 5 días y luego se continua con 60 mg/kg/día.

T Otros nombres
P Cr, Créatine, Créatine Anhydre, Creatine Anhydrous, Creatine Citrate, Créatine Citrate, Creatine Ethyl Ester, Créatine Ethyl Ester, Creatine Ethyl Ester HCl, Créatine Ethyl Ester HCl, Créatine Kré Alkaline, Creatine Malate, Créatine Malate, Creatine Monohydrate, Créatine Monohydrate, Créatine Monohydratée, Creatine Pyroglutamate, Créatine Pyroglutamate, Creatine Pyruvate, Créatine Pyruvate, Dicreatine Malate, Dicréatine Malate, Di-Creatine Malate, Éthyle Ester de Créatine, Glycine, N-(aminoiminométhyl)-N-Méthyl, Kre-Alkalyn Pyruvate, Malate de Tricréatine, N-amidinosarcosine, N-(aminoiminomethyl)-N Methyl Glycine, Phosphocreatine, Phosphocréatine, Tricreatine HCA, Tricréatine HCA, Tricreatine Malate, Tricréatine Malate.

T Metodología
P Para saber más sobre cómo este artículo fue escrito, refiérase a la metodología de la Base exhaustiva de datos de medicamentos naturales.

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- Ayoama, R., Hiruma, E., and Sasaki, H. Effects of creatine loading on muscular strength and endurance of female softball players. J Sports Med Phys Fitness 2003;43:481-487. View abstract.
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