A bodybuilder who appeared to be in good health and had no prior tobacco use or history of major medical problems suffered from an ischemic stroke. Prior to the stoke, the bodybuilder took one supplement (dose 2 capsules) containing MaHuang extract (20 mg ephedra alkaloids), 200 mg caffeine, 100 mg L-carnitine, and 200 μg chromium. A second supplement contained 6000 mg creatine monohydrate, 1000 mg taurine,100 mg inosine, and 5 mg coenzyme Q10 per scoop. Additionally, 40–60 mg ephedra alkaloids, 400–600 mg caffeine, and 6000 mg creatine monohydrate were taken daily for 6 weeks prior to having a stroke. (20)
Creatine monohydrate and androgens:
A randomized controlled cross-over study was designed to test the resting concentrations of selected androgens (dihydrotestosterone [DHT] and testosterone [T]) after 3 weeks of creatine supplementation in college-aged male rugby players. The total supplementation period was 21 days. A 7-day loading phase with creatine (25 g/day creatine with 25 g/day glucose) or placebo (50 g/day glucose). Followed by 14 days of maintenance (5 g/day creatine with 25 g/day glucose or 30 g/day glucose placebo). Testosterone levels did not change substantially for either the placebo or the creatine phase at any time point. However, DHT levels increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (p<0.001). The ratio of DHT:T also increased by 36% after 7 days of creatine supplementation and remained elevated by 22% after the maintenance dose (p<0.01). These findings suggest that creatine supplementation increased the rate of conversion of testosterone to DHT. In the medical literature DHT has been associated with hair loss, benign prostate hypertrophy (BPH) and prostate cancer. (16)