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Response from Mr. Vergel

Here is the only placebo controlled study done using creatine supplementation (Jarrow brand) in HIV combined with exercise versus exercise alone. 33 Patients (16 creatine, 17 placebo) began with a loading dose of 20 g/day (divided among four doses) or an equivalent number of placebo capsules for 5 days, followed by maintenance dosing of 4.8 g/day (in two 2.4 g doses) or placebo. Maintenance dosing was interrupted briefly for additional 5-day loading cycles at the beginning of weeks 7 and 13.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2646129
There was a small increase in creatinine of 0.2 mg/dl after 12 weeks, which may not be a problem for most within normal ranges.
The authors specified that 80% of patient were taking nucleoside analogs, but they did not say how many were taking Truvada or Viread. I emailed Dr Mulligan to ask her. I presume many were taking Viread since the study was done after that drug got approved.
They found that creatine and/or exercise increased strength and lean body mass, but creatine did not add any additional strength compared to the exercise only group. I find that hard to believe since I have seen great results myself. But probably the strength benefits of creatine plateau after a few weeks. Also, the sample size was small (16 and 17 people in each arm)and the positive differences in strength due to creatine were not significant for this small group (larger sample size or a longer period of time may detect statistically significant changes). Blood levels of creatinine were slightly increased, so just have your doctor check your kidney function every two months while you take the supplement. Of course, I would not worry as much when taking the 5 gram a day maintenance dose. What worries me a little is the loading phase of 20 grams a day for 5 days.
Lean body mass increased significantly with creatine compared to exercise alone. I was also surprised that creatine actually decreased insulin levels better than exercise alone. Increased insulin is a metabolic problem we see . Also, fat under the skin did not decrease in either arm, which puts to rest the fear that exercise may increase lipoatrophy.
Nelson
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