Thread by @BrandonLuuMD

Creatine doesn’t just build muscle—it PRESERVES it during injury or immobility 💪

Here’s how👇 🧵1/10

This study used a 29-day single-blind, placebo-controlled, crossover design to test creatine's impact on muscle immobilization in a cast. Participants alternated arm immobilization with placebo or creatine (20 grams per day). Measurements of lean tissue mass, strength, and endurance were taken at baseline, post-cast, and study end /2

It is well known that muscle mass declines rapidly during immobilization. For example, elbow extensor muscle mass has been reported to decrease by 20-32% when immobilized for 6-8 weeks /3

One of the most striking findings of this study was the rate of elbow flexor STRENGTH in just 7 DAYS in the control group. Elbow flexor strength was reduced by 20% in the control group, and less than 5% in the CREATINE GROUP /4

Elbow flexor/extension endurance (Max reps at 60% 1RM) was SIGNIFICANTLY PRESERVED in the CREATINE group. There was up to 40% REDUCTION in the control group after just 1 week /5

Preservation of elbow extensor strength was similarly much improved in the creatine group relative to placebo /6

Lean tissue mass stayed the same (if not slightly improved) in the creatine group while reduced in the placebo group /7

Some important things to keep in mind for this study: All subjects were creatine naive for at least 12 weeks before the study and were not performing resistance-type exercise — so these results should be interpreted with caution in those who already use creatine/perform resistance exercise. It would be interesting to see a study for those with ongoing creatine use who do resistance exercise to see if results are similar. This is also just one study with a limited sample size. As always, people should also check with their health care team before trying a new supplement /8

The mechanism of muscle preservation is unclear but the authors suggest it may be from up-regulaation of transcription factors related in protein synthesis or elevated intracellular osmolarity /9

This is an interesting study I found when injured a few years ago that identifies CREATINE supplementation as a potential way to PRESERVE muscle mass during periods of immobilization. Deriving protocols from this could and exploring the mechanisms with further studies could have significant benefit as we know muscle mass RAPIDLY declines during periods of immobilization /10