A RANDOMIZED, CONTROLLED TRIAL OF CREATINE MONOHYDRATE IN PATIENTS WITH MITOCHONDRIAL CYTOPATHIES

Fatigue in patients with mitochondrial cytopathies is associated with decreased basal and postactivity muscle phosphocreatine (PCr). Creatin e monohydrate supplementation has been shown to increase muscle PCr an d high-intensity power output in healthy subjects. We studied the effe cts of creatine monohydrate administration (5 g PO b.i.d. x 14 days -- > 2 g PO b.i.d, x 7 days) in 9 mitochondrial cytopathy patients using a randomized, crossover design. Measurements included: activities of d aily living (visual analog scale); ischemic isometric handgrip strengt h (1 min); basal and postischemic exercise lactate; evoked and volunta ry contraction strength oi the dorsiflexors; nonischemic, isometric, d orsiflexion torque (NIDFT, 2 min); and aerobic cycle ergometry with pr e-and post-lactate measurements. Creatine treatment resulted in signif icantly (P < 0.05) increased handgrip strength, NIDFT, and postexercis e lactate, with no changes in the other measured variables. We conclud ed that creatine monohydrate increased the strength of high-intensity anaerobic and aerobic type activities in patients with mitochondrial c ytopathies but had no apparent effects upon lower intensity aerobic ac tivities. (C) 1997 John Wiley & Sons, Inc.