Creatine in Skeletal Muscle Physiology

The topic of creatine supplementation has received considerable attention for more than two decades, and it is likely to get even more attention, given that creatine plays such an essential role in skeletal muscle physiology. Creatine is an endogenous guanidine compound, which is synthesized starting from three amino acids (methionine, glycine, and arginine), able to influence muscle biochemical processes involved in energy production and recovery from exercise. In several experimental conditions the potential of creatine supplementation on anaerobic and aerobic performance has been extensively established. Other evidence suggests that creatine may exert beneficial effects to increase muscle hypertrophy and to reduce muscle damage by regulating various mechanisms, such as muscle fiber gene expression, inflammatory response, oxidative stress, calcium homeostasis, and satellite cell activity. The goal of this chapter is to examine the results of existing studies on creatine supplementation and its role on skeletal muscle physiology in healthy humans.