An Unusual Lung Disease Treatment
October 27, 2005—Supplementing with creatine monohydrate—a naturally occurring energy source for muscles—may help build muscle mass and improve overall health in people with chronic obstructive pulmonary disease (COPD), reports the journal Thorax (2005;60:531–7).
COPD refers to a group of conditions including emphysema, chronic bronchitis, and sometimes asthma. Cigarette smoking is the most common cause, but certain genetic disorders and exposure to environmental pollutants or inhaled chemicals may predispose people to the disease. As it progresses, COPD causes permanent damage to the structure of the lungs, limiting airflow and making breathing more difficult. The use of accessory muscles—those that aren’t normally used for breathing—to aid in breathing may create a “barrel chest” appearance in people afflicted with COPD. Other symptoms can include cough, shortness of breath, wheezing, chest tightness, and mucus that is coughed up from the lungs (sputum production). People with COPD are also more prone to serious lung infections than are healthy people.
About 30 to 70% of people with COPD suffer from malnutrition. The use of accessory muscles for breathing greatly increases the need for calories, but, unfortunately, many people with COPD have a diminished appetite. Along with changes in nutritional needs, a lack of exercise, loss of adequate oxygen supply to the muscles, inflammation, aging, and certain medications may contribute to a state of severe weight loss called “pulmonary cachexia syndrome.” This syndrome ultimately causes a loss of muscle mass and is associated with increased mortality in people with COPD. Growth hormone, anabolic steroids, appetite stimulants, and various nutritional supplements have been investigated to address this problem. Although these treatments may lead to weight gain, muscle strength does not appear to improve.
Creatine has been shown to improve muscle performance in healthy people as well as in those with heart failure, muscle loss from disuse, and certain other muscle diseases. The new study was undertaken to determine if creatine might also be useful for treating the muscle loss associated with COPD. The trial included 38 people with moderate to severe COPD. The participants received either 15 grams of creatine per day for two weeks, followed by a maintenance dose of 5 grams per day for ten weeks or placebo. During the maintenance phase, the participants in both groups engaged in a pulmonary rehabilitation program, which met two times per week for one hour. The rehabilitation program included exercises to increase strength, endurance, and mobility, as well as education and behavioral interventions pertinent to treatment. Indexes of lung function, body composition (measures of body fat and muscle mass), upper and lower body strength and endurance, exercise capacity (as measured on a treadmill and stationary bicycle), and overall health status were measured to determine the response to treatment.
After the first two weeks of the study, lower body strength and endurance, and upper body endurance were significantly greater in the creatine-supplemented group than in the placebo group. Body weight was also significantly greater in the creatine group, largely due to a gain in muscle mass. With the addition of the rehabilitation program, the creatine group continued to make even greater improvements in muscle function and lean body mass gain than did the rehabilitation-only (placebo) group. A significant improvement in overall quality of life was also seen in the creatine group. There were no significant changes in exercise capacity in either group. The creatine supplement was well tolerated, with no reports of side effects.
This study provides compelling evidence that creatine may help build lean body mass, possibly reducing the mortality associated with a loss of muscle tissue in people with COPD.
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Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI. Dr. Beauchamp practices as a birth doula and lectures on topics including whole-foods nutrition, detoxification, and women’s health.
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