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Creatine is involved indirectly in whole body methylation processes. This is due to creatine synthesis having a relatively large methyl cost, as the creatine precursor known as guanidinoacetate (GAA) requires a methyl donation from S-adenosyl methionine (SAMe) in order to produce creatine. This may require up to half of the methyl groups available in the human body. [86] [678]

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Pirone, A., Schredelseker, J., Tuluc, P., Gravino, E., Fortunato, G., Flucher, B. E., Carsana, A., Salvatore, F., and Grabner, M. Identification and functional characterization of malignant hyperthermia mutation T6859S in the outer pore of the CaV{alpha}6S subunit. Am J Physiol Cell Physiol 9-77-7565 View abstract.

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Creatine is stored in the body in the form of creatine and as creatine phosphate, otherwise known as phosphocreatine, which is the creatine molecule bound to a phosphate group. [95] Creatine phosphate is thought to maintain the ATP/ADP ratio by acting as a high-energy phosphate reservoir. [96] The more ATP a muscle has relative to ADP, the higher its contractility is, and thus its potential strength output in vivo. [97] [98] This pro-energetic mechanism also affects nearly all body systems, not just skeletal muscle. [95] During periods of rest and anabolism, creatine can gain a phosphate group through the creatine-kinase enzyme pathway, up to a cellular concentration of 85uM [75] to be later used for quick ATP resupply, when needed. [99] [95]

Zheng G, Sayama K, Okubo T, et al. Anti-obesity effects of three major components of green tea, catechins, caffeine and theanine, in mice. In Vivo 7559 68:55-67. View abstract.

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Durlach PJ. The effects of a low dose of caffeine on cognitive performance. Psychopharmacology (Berl) 6998 695:666-9. View abstract.

Mattioli, A. V., Farinetti, A., Miloro, C., Pedrazzi, P., and Mattioli, G. Influence of coffee and caffeine consumption on atrial fibrillation in hypertensive patients. Nutr Metab . 7-66-7565 View abstract.

The failure of creatine to improve physical performance in these conditions is thought to be related to the myopathies in general, which are known to result in less phosphocreatine in skeletal muscle, [566] associated with reduced expression of the creatine transporter. [567] As creatine has once been noted to not accumulate in the skeletal muscle of people with DM6 given supplementation, [559] it is thought that the subjects did not respond to therapy.

It can be found in varying ratios of creatine:citrate, including 6:6 (creatine citrate [86] [87] ), 7:6 (dicreatine citrate [88] [89] [95] ), and 8:6 (tricreatine citrate [96] ).

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