Furthermore, because creatine can help restore ATP levels, increasing energy, it can lead to reduced amounts of heart muscle stress. More energy in your life will result in less pain, stress, and boost morale in everyday life which has a significant role in improving heart health. The increased capacity to exercise is also crucial in maintaining and improving heart health.
Despite creatine not interfering with UV(A) irradiation acting upon a cell or the production of oxidation due to it, creatine appears to prevent the functional consequences (such as mitochondrial DNA damage) due to preventing an ATP depletion in the cell, which would normally precede a reduction in mitochondrial membrane potential and mutagenesis, but this effect is prevented for as long as creatine stores are sufficient.[446] Creatine has also been noted to near-fully protect mitochondrial DNA from hydroxyl radicals and oxidative damage, although there was no protective effect for nuclear DNA, due to it being less sensitive to hydroxyl radicals.[447]
In humans, studies that investigate links between serotonin and creatine supplementation find that 21 trained males, given creatine via 22.8g creatine monohydrate (20g creatine equivalent) with 35g glucose, relative to a placebo of 160g glucose, was found to reduce the perception of fatigue in hot endurance training, possibly secondary to serotonergic modulation, specifically attentuating the increase of serotonin seen with exercise (normally seen to hinder exercise capacity in the heat[233]) while possibly increasing dopaminergic activity (conversely seen to benefit activity in the heat[234]).[155]
A 2001 study at the University of Texas found that lifters who drank a shake containing amino acids and carbohydrates before working out increased their protein synthesis more than lifters who drank the same shake after exercising. The shake contained 6 grams of essential amino acids — the muscle-building blocks of protein — and 35 grams of carbohydrates.
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Young adult athletes who reported creatine usage for over two years prior to the study (retrospective design) were not significantly different than controls.[501] Elsewhere, in a similar cohort of athletes reporting creatine usage for up to four years, failed to note significant differences in liver enzymes, although a nonsignificant reduction in LDH was noted.[502]
The major controversies regarding creatine are its side effects and the best form to use. Nearly all side effects attributed to creatine, such as muscle cramps, kidney disease and gastrointestinal disturbances, haven't proved significant under controlled scientific scrutiny. Although various claims are made for a variety of creatine supplements, creatine monohydrate, which is 99 percent absorbed, is the best form to use.
These effects are secondary to creatine being a source of phosphate groups and acting as an energy reserve. The longer a cell has energy, the longer it can preserve the integrity of the cell membrane by preserving integrity of the Na+/K+-ATPase and Ca2+-ATPase enzymes.[241][235][236] Preserving ATP allows creatine to act via a nongenomic response (not requiring the nuclear DNA to transcribe anything), and appears to work secondary to MAPK and PI3K pathways.[226]
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