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A large body of literature has clearly documented that creatine supplementation increases muscle stores of creatine and enhances high intensity exercise performance.
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Yet another study by Brazilian researchers recently confirmed these positive effects of creatine supplementation, but they addressed another important question related to betaine supplementation.  Betaine is involved in the biosynthesis of creatine in the liver, and therefore may represent an alternative way to increase muscle creatine stores and performance. Indeed, there are a couple reports of betaine supplementation improving strength and power production but the mechanisms remain unclear. These researchers had subjects supplement with creatine, betaine, creatine + betaine of placebo. After 10 days muscle phosphocreatine levels and performance were increased only in the groups taking creatine but not in the betaine only or placebo groups.  Thus betaine does not appear to be an effective approach for increasing creatine stores. This was expected since increasing synthesis in the liver would not be predicted to increase plasma levels high enough to cause significant accumulation in muscle tissue. It remains unclear how betaine improved performance in other studies.  Betaine is a nitrogen containing compound and methyl derivative. Its role as a potential ergogenic aid has been only been looked at in a few studies, but that research has revealed some interesting findings. Betaine's principle role is an osmolyte whereby it protects cells during periods of dehydration by increasing the water content of cells. Betaine may also play a role in choline metabolism and other methyl donating reactions which impact metabolism.  Bottom line...betaine and creatine supplementation work through different mechanisms and betaine appears to produce less consistent improvements in performance.

. Del Favero S, Roschel H, Artioli G, Ugrinowitsch C, Tricoli V, Costa A, Barroso R, Negrelli AL, Otaduy MC, da Costa Leite C, Lancha-Junior AH, Gualano B. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids. 2011 Jul 9.