Key points about creatine monohydrate for Duchenne muscular dystrophy (DMD)
- creatine is a naturally occurring compound that can improve the function of muscles
- studies have shown that creatine can improve strength and performance in tamariki (children) with DMD, although the effect on long-term outcomes is unclear
- creatine is safe and not associated with any known side-effects
What is creatine?
Creatine is a naturally occurring compound involved in making energy in cells in the body, particularly in the brain and muscle. It is made in the liver and kidneys, as well as being in food.
In healthy people, taking creatine monohydrate supplements increases muscle strength.
What recent studies have shown about creatine monohydrate
Duchenne muscular dystrophy (DMD) affects 1 in 5000 boys.
Many medicines have been tried in DMD. Corticosteroids such as prednisolone are the only proven effective medicine in DMD.
Recent studies of the dietary supplement creatine monohydrate in boys with DMD have shown increased muscle strength in the short and medium term. Creatine monohydrate supplements may also have other effects including better energy use within muscle cells and decreased muscle breakdown. These benefits were seen without any significant side-effects. So there is good evidence for the safe and effective use of creatine monohydrate in boys with DMD.
Benefits of creatine
Studies show that tamariki with DMD taking creatine maintain strength longer and do better in activities like walking and climbing stairs. It’s also been shown that parents notice an overall improvement in their children’s strength. These benefits are present while tamariki are taking the supplement, but the long-term benefits of this treatment are not yet known.
Risks of creatine
No side-effects have been identified in boys with DMD who take creatine monohydrate as a dietary supplement. Healthy people who take creatine monohydrate, and those who take creatine monohydrate for other reasons, also do not report side-effects.
When to start creatine
The best time to start a creatine monohydrate supplement in boys with DMD is not known. But, because there are no known side-effects, it’s reasonable for you and your doctor to consider it from the time of diagnosis.
Where to buy creatine
Creatine comes in several different forms. The following are the forms used for treating DMD.
Creatine monohydrate
You can buy this from pharmacists or stores selling dietary supplements. You can also buy it online.
Kre-Alkalyn
This ‘buffered creatine’ (made to have a high pH) comes in a capsule form, which is easier to take for some people. It is not the form of creatine which has been studied in people with muscle disorders. But it has been shown to have the same effect as creatine monohydrate in athletes and body builders. You can buy it online.
It is best to buy creatine from New Zealand suppliers. They have to meet local medicine standards.
Calculating the creatine dose
Your doctor can help you work out the right dose for your child.
Child's name:
Date:
Weight:
Your child’s current dose is ___________________ grams
So your child should have ___________________ teaspoons each day
How to give creatine to your child
Creatine monohydrate is a powder. You can mix it into drinks.
Follow these steps when giving creatine to your child.
Add the correct dose of creatine to 50 to 100mls of milk or juice.
Mix well.
Drink immediately.
Creatine powder does not dissolve very well, so you need to keep mixing it to make sure that the white powder is not left at the bottom of the glass.
The best time of day to take creatine is in the morning, before school.
Tips for using creatine
Do
Do mix well!
Do drink immediately after mixing.
Do take daily.
Do buy creatine monohydrate or Kre-Alkalyn instead of other forms (such as creatine esters).
Don’t
Don’t buy from suppliers outside New Zealand.
Don’t buy in pre-mixed powders containing other supplements.
Acknowledgements
This content has been developed and approved by the New Zealand Paediatric Neurology Clinical Network.
