Tuesday, August 16, 2011

SuppVersity Supplement Scrutiny: Athletic Edge Nutrition Creatine RT - More Than Yet Another Marketing Gag?

Image 1: Creatine RT by Athletic
Edge Nutrition
; cutting edge or
overpriced creatine monohydrate?
Read the whole analysis!
After posting last week's issue of "Ask Dr. Andro", in which I dessicated the "improvements" in BSN's "new" N.O.-Xplode 2.0 Advanced Strength, several readers asked me to do similar write-ups on a regular basis. Since I do not want to turn the SuppVersity into a pillory for the "revolutionary new" products supplement companies are introducing to an almost (over-)saturated market on a weekly basis, the new column "SuppVersity Supplement Scrutiny" will only deal with products that either hold some promise, are in fact revolutionary or at least new, or are marketed (and this includes the hilarious pimping that is going on on various bulletin boards all over the Internet, lately) as tried and proven must-haves for each and every trainee, dieter or health conscious individual.

A Tale of Thousand-and-One Creatines: Creatine RT - Athletic Edge Nutrition's

Table 1: One of the few things we know about the new
creatines is that you get less creatine per gram than
with the original monohydrate (CM) (Jäger. 2011)
I do not know if you are familiar with the movie Groundhog Day with Bill Murray, who finds himself repeating the same day over and over again!? Somehow I feel I am sharing the same fate, when I look at new product releases from time to time and find yet another "new" creatine product that is marketed as the novel ne plus ultra of muscle building, performance enhancing dietary supplement... and guess what!? It happened again, just a few minutes ago:
"Introducing Creatine RT- The World's First and Only Clinically Supported Creatine and Russian Tarragon Extract Combination. NO CARBS/SUGAR NEEDED."
Well, in these days of "carbophobia" (the pathological fear of carbohydrate consumption) "no carbs/sugar needed" certainly sounds good, doesn't it!? But wait, did we ever really need sugar to derive the benefits from creatine? No. We did not. Actually it would not have needed Steenge's 2000 study (Steenge. 2000), but just sanity and reason to understand that the carbohydrate fattening (pun intended) that was common practice when the first carb + creatine combos hit the supplement market would probably make you gain more weight, namely water and fat weight, but would not increase creatine retention beyond what a simple protein shake that is rich in insulin-triggering BCAAs and a large banana (~40-50g carbs) can do just as well. After all, it's no the carbs but the insulin response they provoke that drives the creatine from your blood into the muscles and I am positively surprised that this is exactly, where Athletic Edges' new patented creatine formula comes into play.
Image 2: Jäger et al. also hold the patent
on the co-administration of RT + CM.
(Google Patents)
As a scientist I fully understand the need to patent new ideas in order to make a living on what one is doing. Nevertheless, I thought it prudent to let you know that the only study (Jäger. 2008) which directly investigated the effect of co-administering Artemisia dracunculus (russian terragon) and creatine monohydrate on cellular creatine uptake has been conducted by Ralf Jäger, Martin Purpura and Ivo Pischel from Phytolab - the same German scientists who hold patent #US 2011/0123654 A1 (cf. image 2) for respective products.
To get the insulin without the carbs - and even without potentially unwanted calories from protein - the Athletic Edge (AE) supplement designers licensed an idea from Ralf Jäger, Martin Purpura and Ivo Pischel, three German scientists, who found that 1g of an extract from the perennial herb tarragon, lat. Artemisia dracunculus (something they could have found in their grandmothers' kitchen cabinet), significantly reduced plasma creatine levels 60 min after administration of 60mg/kg creatine monohydrate in eleven healthy subjects (Jäger. 2008). If one assumes that this reduction in plasma creatine levels is the result of cellular creatine uptake and not renal creatine clearance, this does sound promising. Nevertheless, we would initially have to know what the effect of the 'competition', i.e. a plain creatine + carbohydrate formula would be, in order to assess how effective "the World's First and Only Clinically Supported Creatine and Russian Tarragon Extract Combination" really is.

Carbohydrates, Protein and Tarragon: Which one drives the most creatine into your muscles?

According to the data, Greenwood et al. published in the Official Journal of the American Society of Exercise Physiologists in May 2003 (Greenwood. 2003) the number AE's Creatine RT has to beat would be a +32.1% increase in creatine retention over the first 3 days of supplementation with 5g creatine + 16g glucose. This is a pretty high value, compared to the +4% and +10% in whole body creatine retention measured in the aforementioned study by Steenge et al. for the "low"-CHO (50g) and the high CHO (100g), as well as the CHO + PRO (50g carbs + 50g protein) groups, respectively. But in the end we cannot really rely on these values for our comparison, anyway, because Jäger et al. did not even measure the amount of creatine that actually made it into the muscle of their subjects (or at least they did not cite the respective value).
Figure 1: Plasma creatine concentration in µmol/l at 0-120min after administration of 60mg/kg creatine monohydrate + placebo or tarragon extract; small graph: relative differences in serum concentration at 0, 30, 60, 90 and 120 min (data adapted from Jäger. 2008)
In the study the scientists presented at the Fifth International Society of Sports Nutrition (ISSN) Conference and Expo in 2008 Jäger et al. measured only the plasma creatine concentrations and assume that the lower creatine levels 60min after co-administration of creatine monohydrate with the Russian tarragon extract are the result of increased muscular creatine absorbtion. While it would certainly have been appropriate to measure renal creatine and creatinine clearance, the data from Steenge, et al. shows that at the 60min mark, plasma creatine concentrations were in fact the lowest for the CHO + PRO and the HIGH CHO groups, which eventually retained the greatest amount of creatine (as measured by urinary creatine and creatinine clearance).
Figure 2: Plasma creatine concentration in µmol/l at 0-120min after administration of 60mg/kg creatine monohydrate + 5g (placebo) or 96g of carbohydrate; small graph: relative differences in serum concentration at 0, 30, 60, 90 and 120 min (data adapted from Steenge. 2000)
Support for the hypothesis that the "missing" (compared to placebo) serum creatine did not simply leave the body of the subjects, but was actually "driven" into the cells by the insulin-mimicking effect of the tarragon extract, comes from studies by Wang (2011; 2008), Kheterpal (2010), Ribnicky (2006) and Korkmaz (2002) who report profound, insulin-like effects of tarragon extracts on glucose clearance. If we follow Jäger's train of thought and conclude that this effect would be "comparable to that of glucose and protein", it is a reasonable assumption that Creatine RT actually works.
Is Russian Tarragon an insulin-mimetic at all? Incited by a very insigthful comment by Learner (s. below), I dug again into the non-creatine-related studies on Russian Terragon (TR) and found that Jaeger's assumption that TR would drive creatine into the muscle just like insulin, i.e. via mimicking insulin's action - is not directly supported by the existing literature. Rather, RT appears to increase insulin sensitivity or in the words of Ribnickey et al. (Ribnickey. 2005), it "increase in the effectiveness of the insulin" at the cellular level. Most importantly, however, it does so only in diabetic rodents. These results are corroborated by human a study Learner mentions (Bloomer. 2011), in which, interestingly Ivo Pischel, one of the patent holders was a co-author, and which found only very "slight" increments in glucose clearance, as well as a "slight" reduction in insulin after adminstration of 6mg/kg RT + 75g of dextroe over control. This raises the question of we just do not understand the mechanism by which RT influences creatine uptake or whether it actually does not to this at all (cf. comment in red box below).
In order to evaluate the magnitude of its effect we still have to compare the plasma creatine concentrations, respectively their clearance rates of the Jäger and Steenge studies (cf. fig. 1 vs. fig. 2). At first sight, it seems that the tarragon extract from the Jäger study would easily outperform 96g of carbohydrates, when it comes to creatine clearance.
Note! In case of the terragon extract, we only assume that the disappearance of creatine from the blood of the subjects equals muscular uptake, a respective study, which would have to measure urinary creatine clearance (this is what Steenge et al. did) has not been conducted or at least not published, yet.
A minor, yet significant difference in the composition of the placebo does yet disqualify this impression. While Jäger et al. apparently used a non-carbohydrate placebo, the "placebo" used in the study by Steenge et al. contained at least 5g of fast acting carbs - in view of the +32.1% increase in creatine retention Greenwood et al. reported in their study with only 16g of simple carbs, it is thus questionable if the small but significant insulin spike from the 5g of simple sugars in the placebo of the Steenge study did not already increase muscular creatine uptake by about 10% (linear model) or even 19% (logarithmic model) over a placebo that is devoid of carbs. If we assume a linear model (relatively unlikely) the +22% mean increase in creatine clearance (?=creatine retention) from the Russian tarragon extract would indicate that, at a dosage of 1g, Russian terragon is 10x as potent as the same amount of carbohydrates in driving creatine into the muscle. If we assume the (more natural) logarithmic model, it would still about 5x as potent.

Conclusion - additional studies needed

While the aforementioned scientifically based speculations (I do not want to call them "hypotheses" based on the limited amount of data) would indicate that Creatine RT does work and would spare you all those unnecessary carbs. There are still two major caveats:
  1. The assumption that creatine clearance equals or is at least a reliable indicator of muscular creatine uptake still has to be proven for Russian terragon (RT could just as well increase creatine turnover and urinary creatine clearance, although this is pretty unlikely ;-)
  2. Who says that you have to take large amounts of carbohydrates for creatine to do its magic? I've seen enough studies that showed real world results without large boluses of carbs (even the 16g of carbs in the Greenwood study were superior to the tarragon extract), not to mention the saturation effect you will eventually see, when your muscle creatine stores are topped off regardless of whether you achieved that in say 1 week by using carbs and or tarragon or within 2-3 weeks by sticking to creatine + normal nutrition, alone.
A pros pos real world results, until Athletic Edge Nutrition does not present a study that shows exactly those real world results in terms of muscle or performance gains, the claim that their product was "clinically supported" has little meaning.