It did not take long for young athletes to start looking for other products to give them an "edge." They tried several substances, such as bee pollen carnitine, and chromium, without success. Soon a new product - creatine - appeared in gyms and high school locker rooms. Touted as the "safe steroid," the use of creatine supplements was promoted as a powerful energy source for muscles.

To understand why some believe creatine works, a short course in biochemistry is needed. Energy is burned during exercise and sport activities. The primary source of the muscle’s energy during exercise and sporting events is a compound called adenosine triphosphate, or ATP. Creatine helps regenerate the ATP our bodies use to power muscle contractions during activity bursts.

Creatine is an amino acid naturally made in the liver and pancreas, stored in the muscle, and naturally found in milk, meat, and fish. The daily requirement of creatine is about two grams. The theory by some trainers and coaches is that if by saturating muscles with creatine athletes will increase the muscle's creatine stores. Athletes will then be able to regenerate ATP faster and have more energy and less exhaustion. According to a study in July's Journal of the American Dietetic Association, weight lifters who took supplementary creatine could do more powerful jump squats and more bench-press repetitions because their ATP was replenished faster.

Word quickly spread that creatine was safe and effective since it seemed to increased muscle strength and accelerated the muscle’s recovery time between bouts of intense exercise. Therefore, creatine may work by allowing athletes to work out harder. Creatine does nothing by itself without exercise.

Once the use of creatine became more widespread, doctors and trainers began seeing side effects. The most common reason young athletes stop using the product is severe diarrhea and gastric distress. Many athletes became predisposed to cramping and dehydration (even those promoting creatine supplements encourage hydration). More scientific studies were done that showed positive effects in the exercise laboratory, but no positive effects with athletes in competition. Respected members of the sports medicine community have reported muscle tears in athletes on creatine. Furthermore, taking over five grams per day of creatine was associated with kidney and liver inflammation.

Since studies on creatine loading are less than a decade old, it is still unknown what long term effects the extra creatine will have. Some researchers fear that, with the amount of extra creatine ingested through supplements, the body might stop producing it. Furthermore, supplements like creatine are not regulated by the Food and Drug Administration. Therefore, what is on the label may have nothing to do what is inside the package.

"I do not recommend creatine supplementation for anyone under the age of sixteen," commented St. Petersburg orthopaedic surgeon Michael J. Smith, M.D. "Unfortunately, the only way we will find out if there are any negative effects of creatine is its long term use. We might find out the hard way that it is dangerous," added Dr. Smith. Should parents find out that their older teenager is using the supplement, Dr. Smith recommends that they take no more than five grams per day. The concern many pediatricians have is the thinking of many student athletes that "if a little is good, more is better." Therefore, there is a danger that adolescents using creatine might take much more than the recommended dose on the label.