Creatine as a therapeutic strategy for myopathies

Area of Science:

• Muscle physiology and biochemistry
• Neuromuscular disorders
• Nutritional supplementation

Background:

• Myopathies encompass genetic and acquired skeletal muscle disorders causing weakness and exercise intolerance.
• Creatine supplementation theoretically offers benefits like enhanced muscle mass, strength, endurance, and antioxidant effects.

Purpose of the Study:

• To evaluate the efficacy and safety of creatine supplementation in various myopathy patient populations.
• To compare creatine's effects across different types of myopathies, considering potential mechanisms of action and limitations.

Main Methods:

• Review of existing studies on creatine monohydrate supplementation in patients with muscular dystrophy, myotonic dystrophy, McArdle's disease, MELAS syndrome, and CPEO.
• Analysis of reported outcomes including muscle strength, fat-free mass, exercise capacity, and adverse events.

Main Results:

• Muscular dystrophy patients showed increased strength and fat-free mass with creatine supplementation.
• Myotonic dystrophy patients exhibited inconsistent responses, potentially due to creatine transport issues.
• McArdle's disease patients demonstrated modest benefits at lower doses, with higher doses possibly causing cramping. MELAS syndrome patients showed some exercise capacity improvement, while CPEO patients had less robust effects.

Conclusions:

• Creatine supplementation offers potential benefits for certain myopathies, but efficacy varies significantly based on the specific condition and dosage.
• The risk of side effects from creatine supplementation is minimal compared to conventional treatments like corticosteroids.
• Further research may be needed to optimize creatine dosing and delivery for different myopathies, addressing issues like creatine uptake.