Nephrectomized rats may have significantly reduced creatine synthesis rates[509] via impairment of methylation (the GAMT enzyme)[510] although creatine reuptake from the urine seems unimpaired.[511] Supplemental creatine in a rat model of 2/3rds nephrectomy (2% creatine in the diet) does not appear to negatively influence kidney function as assessed by the serum biomarkers of cystatin C and urinary protein or creatinine clearance rates.[512] Elsewhere, 2% creatine in the diet in rats for two weeks again failed to show negative effects on kidney function, but showed benefit in reducing homocysteine in late-stage uremic rats.[312] While there is not much human evidence for the rat nephrectomy model, a lone case study in a man with a single kidney failed to find an impairing effect of creatine (20g daily for five days and 5g for another month) in conjunction with a high protein diet.[513]
1. Train each muscle group twice per week. To maximize muscle growth, plan to train every major muscle group at least twice per week. According to a 2016 Sports Medicine review, even if you don't work that muscle any harder or longer, by simply dividing your chest, leg or back workout into two days, you'll spur more muscle growth. While the jury is still out on whether training each muscle group three days per week is better than two at spurring hypertrophy, it is likely better suited toward experienced lifters than beginners, Matheny says.
^ Haykowsky MJ, Liang Y, Pechter D, Jones LW, McAlister FA, Clark AM (June 2007). "A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients: the benefit depends on the type of training performed". Journal of the American College of Cardiology. 49 (24): 2329–36. doi:10.1016/j.jacc.2007.02.055. PMID 17572248.
In the United States, the manufacturers of dietary supplements do not need to provide the Food and Drug Administration with evidence of product safety prior to marketing.[8] As a result, the incidence of products adulterated with illegal ingredients has continued to rise.[8] In 2013, one-third of the supplements tested were adulterated with unlisted steroids.[9] More recently, the prevalence of designer steroids with unknown safety and pharmacological effects has increased.[10][11]
That means it takes time for supplements aimed at joint treatment to work. So plan not to feel anything for about two months after you start using glucosamine. After that, pain control with the supplement is comparable to what happens with drug use, according to various studies. The typical doses are 1,200 milligrams daily of glucosamine and 800 of chondroitin, which can be doubled initially.
When combined with an appropriate exercise program, dietary supplementation with β-hydroxy β-methylbutyrate (HMB) has been shown to dose-dependently augment gains in muscle hypertrophy (i.e., the size of a muscle),[38][39] muscle strength,[38][40][41] and lean body mass,[38][40][41] reduce exercise-induced skeletal muscle damage,[note 1][38][39][41] and expedite recovery from high-intensity exercise.[38][42] HMB is believed to produce these effects by increasing muscle protein synthesis and decreasing muscle protein breakdown by various mechanisms, including activation of the mechanistic target of rapamycin (mTOR) and inhibition of the proteasome in skeletal muscles.[40][43]

The basic principles of weight training are essentially identical to those of strength training, and involve a manipulation of the number of repetitions (reps), sets, tempo, exercise types, and weight moved to cause desired increases in strength, endurance, and size. The specific combinations of reps, sets, exercises, and weights depends on the aims of the individual performing the exercise.


A double-blind study provided 20 g/day of creatine monohydrate for 5 days to qualified sprinters and jumpers who performed 45 seconds of continuous jumping and 60 seconds of continuous treadmill running. Supplementation enhanced performance in the jumping test by 7% for the first 15 seconds and 12% for the next 15 seconds, but there was no difference for the final 15 seconds. There was a 13% improvement in the time of intensive running to exhaustion [12].

It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
In regard to practical interventions, concurrent glycogen loading has been noted to increase creatine stores by 37-46% regardless of whether the tissue was exercised prior to loading phase.[176] It is important to note, however, that creatine levels in response to the creatine loading protocol were compared in one glycogen-depleted leg to the contralateral control leg, which was not exercised.[176] This does not rule out a possible systemic exercise-driven increase in creatine uptake, and the increase in creatine noted above[176] was larger than typically seen with a loading protocol (usually in the 20-25% range). Consistent with an exercise-effect, others have reported that exercise itself increases creatine uptake into muscle, reporting 68% greater creatine uptake in an exercised limb, relative to 14% without exercise.[153]
Children: Creatine is POSSIBLY SAFE in children when taken by mouth appropriately. Creatine 3-5 grams daily for 2-6 months has been taken safely in children 5-18 years of age. Creatine 2 grams daily for 6 months has been taken safely in children 2-5 years of age. Additionally, creatine 0.1-0.4 grams/kg daily for up to 6 months has been taken safely in both infants and children.
In the 1970s, bodybuilding had major publicity thanks to the appearance of Arnold Schwarzenegger, Franco Columbu, Lou Ferrigno, and others in the 1977 docudrama Pumping Iron. By this time, the IFBB dominated the competitive bodybuilding landscape and the Amateur Athletic Union (AAU) took a back seat. The National Physique Committee (NPC) was formed in 1981 by Jim Manion,[7] who had just stepped down as chairman of the AAU Physique Committee. The NPC has gone on to become the most successful bodybuilding organization in America and is the amateur division of the IFBB. The late 1980s and early 1990s saw the decline of AAU-sponsored bodybuilding contests. In 1999, the AAU voted to discontinue its bodybuilding events.
For several years, research studies have shown that adolescents concerned with both athletics and appearance are taking performance-enhancing supplements. A study by the American Academy of Pediatrics of middle-school and high-school students ages 10 to 18 years found creatine use in all grades 6 through 12. About 5.6% of the study participants and 44% of high-school senior athletes admitted taking creatine.
Extracellular creatine (creatine outside of a cell) appears to influence creatine uptake into a cell. It seems that prolonged and excessive levels of creatine actually suppress uptake (a form of negative regulation to prevent excessive influx).[180] In vitro studies in rat muscle cells have shown that including 1mM creatine into cell culture medium substantially reduces creatine uptake into cells. The inhibitory effect was partially negated by protein synthesis inhibitors, suggesting that high levels of creatine induce the expression of a protein that suppresses creatine transporter activity.[180] Similar findings were reported in a later study in cultured mouse myoblasts, which noted a 2.4-fold increase in intracellular creatine levels in the presence of the protein synthesis inhibitor cyclohexamide.[174]
In a later study, it was found that biologically relevant concentrations (10-30mM) of creatine bind synthetic membranes with lipid compositions mimicking the inner mitochondrial membrane or plasma membrane in a concentration-dependent manner. This also conferred a degree of protection, increasing membrane stability in response to challenge from a number of destabilizing agents. Phosphocreatine was more effective than creatine in this context, although both were able to bind and stabilize membranes.[119]
In 1990, professional wrestling promoter Vince McMahon announced that he was forming a new bodybuilding organization named the World Bodybuilding Federation (WBF). McMahon wanted to bring WWF-style showmanship and bigger prize money to the sport of bodybuilding. A number of IFBB stars were recruited but the roster was never very large and featured the same athletes competing; the most notable winner and first WBF champion was Gary Strydom. McMahon formally dissolved the WBF in July 1992. Reasons for this reportedly included lack of income from the pay-per-view broadcasts of the contests, slow sales of the WBF's magazine Bodybuilding Lifestyles (later WBF Magazine), and the expense of paying multiple six-figure contracts while producing two TV shows and a monthly magazine.
In 1990, professional wrestling promoter Vince McMahon announced that he was forming a new bodybuilding organization named the World Bodybuilding Federation (WBF). McMahon wanted to bring WWF-style showmanship and bigger prize money to the sport of bodybuilding. A number of IFBB stars were recruited but the roster was never very large and featured the same athletes competing; the most notable winner and first WBF champion was Gary Strydom. McMahon formally dissolved the WBF in July 1992. Reasons for this reportedly included lack of income from the pay-per-view broadcasts of the contests, slow sales of the WBF's magazine Bodybuilding Lifestyles (later WBF Magazine), and the expense of paying multiple six-figure contracts while producing two TV shows and a monthly magazine.
Kornblum, C., Schroder, R., Muller, K., Vorgerd, M., Eggers, J., Bogdanow, M., Papassotiropoulos, A., Fabian, K., Klockgether, T., and Zange, J. Creatine has no beneficial effect on skeletal muscle energy metabolism in patients with single mitochondrial DNA deletions: a placebo-controlled, double-blind 31P-MRS crossover study. Eur J Neurol 2005;12(4):300-309. View abstract.
The majority of studies have used nothing but a loading period and the duration, overall, was about a week. This is partially because one study that noted benefit with a loading period failed to note benefit with prolonged supplementation.[156] Lowballing supplementation at 2g a day in high active swimmers does not appear to be sufficient to alter any function in skeletal muscle.[383]

Collectively the above investigations indicate that creatine supplementation can be an effective strategy to maintain total creatine pool during a rehabilitation period after injury as well as to attenuate muscle damage induced by a prolonged endurance training session. In addition, it seems that creatine can act as an effective antioxidant agent after more intense resistance training sessions.
Cornelissen VA, Defoor JG, Stevens A, Schepers D, Hespel P, Decramer M, Mortelmans L, Dobbels F, Vanhaecke J, Fagard RH, Vanhees L. Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. Clin Rehabil. 2010;24:988–999. doi: 10.1177/0269215510367995. [PubMed] [CrossRef]

Recommended Dose: 3-6 grams before or during exercise. A ratio of two parts leucine to one part each of isoleucine and valine appears to be most beneficial. As Krissy Kendall, PhD, explains in "The Top 7 Supplements to Boost Endurance Performance," BCAAs can be just as effective for endurance athletes like runners, rowers, and cyclists as they can be for lifters and bodybuilders.
Though weight training can stimulate the cardiovascular system, many exercise physiologists, based on their observation of maximal oxygen uptake, argue that aerobics training is a better cardiovascular stimulus. Central catheter monitoring during resistance training reveals increased cardiac output, suggesting that strength training shows potential for cardiovascular exercise. However, a 2007 meta-analysis found that, though aerobic training is an effective therapy for heart failure patients, combined aerobic and strength training is ineffective; "the favorable antiremodeling role of aerobic exercise was not confirmed when this mode of exercise was combined with strength training".[36] 

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Creatine supplementation in the under 18 population has not received a great deal of attention, especially in regards to sports/exercise performance. Despite this, creatine is being supplemented in young, <18 years old, athletes [52,53]. In a 2001 report [52] conducted on pupils from middle and high school (aged 10 – 18) in Westchester County (USA) 62 of the 1103 pupils surveyed were using creatine. The authors found this concerning for 2 main reasons: firstly, the safety of creatine supplementation is not established for this age group and is therefore not recommended. Secondly, it was speculated that taking creatine would lead on to more dangerous performance enhancing products such as anabolic steroids. It is important to point out that this potential escalation is speculation. Furthermore, a questionnaire was used to determine creatine use amongst this age group and does not necessarily reflect the truth.
Spero Karas, MD, assistant professor of orthopaedics in the division of sports medicine at Emory University, says that testosterone, the male hormone responsible for muscle growth, maxes out between the ages of 16 and 18. It reaches a plateau during the 20s and then begins to decline. As a result, muscle building after the adolescent years can be challenging, he says.
To meet the demands of a high-intensity exercise, such as a sprint, muscles derive their energy from a series of reactions involving adenosine triphosphate (ATP), phosphocreatine (PCr), adenosine diphosphate (ADP), and creatine. ATP, the amount of which is relatively constant, provides energy when it releases a phosphate molecule and becomes ADP. ATP is regenerated when PCr donates a phosphate molecule that combines with ADP. Stored PCr can fuel the first 4-5 seconds of a sprint, but another fuel source must provide the energy to sustain the activity. Creatine supplements increase the storage of PCr, thus making more ATP available to fuel the working muscles and enable them to work harder before becoming fatigued [1].
If you stop getting the results you want after several weeks of working out, it's time to mix things up. You need to challenge or "confuse" your muscles often to keep them growing. You can do this by putting a twist on your basic moves. Do a biceps curl with a reverse grip, for example. Or find a bench for the step-up move shown here. Change up your workout at least every 4 to 6 weeks for the best results.
Using clinically effective doses of potent ingredients, Transparent Labs' StrengthSeries Creatine HMB combines creatine monohydrate with HMB in order to boost strength, lengthen endurance, and reduce fat. Along with the addition of BioPerine, StrengthSeries Creatine HMB is able to increase the rate of absorption and dispersion of this powerful creatine formula. Each serving of Creatine HMB contains 5g of Creatine, 2 g of HMB, and 5mg of BioPerine! Keep Reading »
Unfortunately, some people are intolerant to milk, due to the casein (one of the proteins in dairy) and have trouble digesting the sugar in milk, called lactose. If this is the case, stick to whey-only protein shakes. Maximuscle uses Biomax Whey True Protein - a unique blend of whey proteins including whey protein concentrate, isolate and hydrolysate, which are lower in lactose. Biomax Whey True Protein is used in a number of Maximuscle products (Promax and Cyclone).
An upper/lower split can last you forever. A lot of massive, strong powerlifters stick with that throughout their entire lifting careers. However, if you’re older and/or have some trouble recovering, you may prefer a push/pull/legs split that has you training everything directly once per week. This is how most famous bodybuilders have trained in the past and many still do.

Of course, cardio is an important part of fitness too, but the benefits of strength training are major. Strength training helps build muscle, and lean muscle is better at burning calories when the body is at rest, which is important whether you're trying to lose weight or maintain it. It also helps strengthens joints and bones, avoid injury, improve your muscular endurance, and will help you give it your all during your other workouts, whether that means setting a new PR if you're a runner or pushing (and pulling) a little harder with your legs during your favorite indoor cycling class.

Tribulus Terrestris: A fruit from the Mediterranean, this supplement has been used in the Indian traditional medicine of Ayurveda. In addition to helping increase testosterone, many people take it to increase libido and as a cardioprotective aid. (10) Unfortunately, despite the fact that there are claims that tribulus terrestris can increase testosterone levels, studies don’t back up these claims.  There is some evidence, however, that it may improve athletic performance. If you want to choose one of the supplements for men, this should be your pick.


A: If your goal is the largest accrual of muscle mass possible then there may be some benefit to ingesting nutrients with a period of 30-60 minutes after your workout. Does this have to be a protein shake? No, but ideally it should be a meal lower in fat to enhance the digest rate of nutrients within the gastrointestinal tract. However, if you have just eaten a mixed macronutrient meal pre-workout then you should keep in mind that that meal is still likely digesting so there’s no need to throw down the weights after your last set and rush to your locker to slam a protein shake.
Before getting into the nitty-gritty details about supplements, it’s important to have a good understanding of how muscle growth works. When you take a muscle growth supplement, the role it plays in helping you reach your goals should be very clear. With the supplements available on the market, you can be sure that while some serve an important purpose, others are gimmicks. It’s easier to identify the money wasters if you know how muscle building works.

Creatine synthesis primarily occurs in the liver and kidneys.[2][16] On average, it is produced endogenously at an estimated rate of about 8.3 mmol or 1 gram per day in young adults.[16][17] Creatine is also obtained through the diet at a rate of about 1 gram per day from an omnivorous diet.[16][18] Most of the human body's total creatine and phosphocreatine stores are found in skeletal muscle, while the remainder is distributed in the blood, brain, and other tissues.[17][18]


Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis.[26] Insulin has steroid-like effects in terms of muscle gains.[27] It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass.[28] Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.[29]
Without a doubt, you can add muscle simply by eating right and lifting weights. But to truly maximize your growth potential, supplements are a requirement. Hence, we've compiled a rundown of the 11 best mass-gain supplements on which to spend your hard-earned cash. They're listed in order of priority, from the absolute most critical, can't-do-without supplements to the less crucial yet still highly effective ingredients for packing on size. The point is to help those on a tight budget decide which supplements to buy. If money is no object, then by all means knock yourself out and use them all as directed. Because after all, as far as we're concerned, you can never have too much muscle.
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Build an effective exercise routine. A good diet is required for your body to be able to maximize your potential, but there's no potential at all until you start the process of tearing down your old muscles and rebuilding them bigger, bulkier, and stronger. The best way to do that is to start at the beginning. If you're not sure where to begin, find a solid workout program online and try it out for a while. Don't immediately jump from one program to the next - you'll end up keeping yourself from making steady progress.
In humans, studies that investigate links between serotonin and creatine supplementation find that 21 trained males, given creatine via 22.8g creatine monohydrate (20g creatine equivalent) with 35g glucose, relative to a placebo of 160g glucose, was found to reduce the perception of fatigue in hot endurance training, possibly secondary to serotonergic modulation, specifically attentuating the increase of serotonin seen with exercise (normally seen to hinder exercise capacity in the heat[233]) while possibly increasing dopaminergic activity (conversely seen to benefit activity in the heat[234]).[155]

Creatine is a hydrophilic polar molecule that consists of a negatively charged carboxyl group and a positively charged functional group [64]. The hydrophilic nature of creatine limits its bioavailability [65]. In an attempt to increase creatines bioavailability creatine has been esterified to reduce the hydrophilicity; this product is known as creatine ethyl ester. Manufacturers of creatine ethyl ester promote their product as being able to by-pass the creatine transporter due to improved sarcolemmal permeability toward creatine [65]. Spillane et al [65] analyzed the effects of a 5 days loading protocol (0.30 g/kg lean mass) followed by a 42 days maintenance phase (0.075 g/kg lean mass) of CM or ethyl ester both combined with a resistance training program in 30 novice males with no previous resistance training experience. The results of this study [65] showed that ethyl ester was not as effective as CM to enhance serum and muscle creatine stores. Furthermore creatine ethyl ester offered no additional benefit for improving body composition, muscle mass, strength, and power. This research did not support the claims of the creatine ethyl ester manufacturers.

Creatine was first identified in 1832 when Michel Eugène Chevreul isolated it from the basified water-extract of skeletal muscle. He later named the crystallized precipitate after the Greek word for meat, κρέας (kreas). In 1928, creatine was shown to exist in equilibrium with creatinine.[3] Studies in the 1920s showed that consumption of large amounts of creatine did not result in its excretion. This result pointed to the ability of the body to store creatine, which in turn suggested its use as a dietary supplement.[4]
Nephrotoxic drugs. Because taking high doses of creatine might harm your kidneys, there is concern about combining creatine with drugs that might damage the kidneys (nephrotoxic drugs). Potentially nephrotoxic drugs include nonsteroidal anti-inflammatory drug (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), cyclosporine (Neoral, Sandimmune) and others.
After the ingestion of 5g creatine in otherwise healthy humans, serum levels of creatine were elevated from fasting levels (50-100µM) to 600-800µM within one hour after consumption.[135] The receptor follows Michaelis-Menten kinetics with a Vmax obtained at concentrations higher than 0.3-0.4mmol/L,[136] with prolonged serum concentrations above this amount exerting most of its saturation within two days.[137]
In addition to ALL of the above, strength training is fun! Whether you are looking for the most effective 20-30 minute workout (to stay fit and look great naked), or are looking for a competitive sport that you can really get into, strength training can help you meet your goals. It’s easy and fun to see progress as you strength train, almost like leveling up. And if you’re looking to improve in other areas (a sport, traditional cardio, or an activity like rock climbing), strength training is an easy choice!
Perform bent over rows to work your back. Stand with your feet shoulder-width apart, about 6 to 10 inches (15–25 cm) behind the barbell or two dumbbells. Bend slightly at the knees but keep your shins vertical. Bend forward at the waist with your spine and head straight. Lift the weight with an overhand grip up to your lower chest or upper abdomen. Lower slowly until your arms are nearly extended, without touching the ground. 3 x 8.[5] 

While the aforementioned study insinuated that after was better, at this time the “just take it at any time” or maybe more appropriately, “take it when it works for you” is the best way to go. Many people take supplements that include creatine, so if that’s in your pre- or post- workout drink, you should receive all the benefits. Optimal dosing still appears to be between 2 to 5 grams per day. You can “load” for the first 5 to 7 days to help saturate your cells, but beyond that there’s no benefit to taking large amounts. So save your money and take the smaller dose; it’ll still offer maximum results.
Back in the 1970s, scientists discovered that taking creatine in supplement form might enhance physical performance. In the 1990s, athletes started to catch on, and creatine became a popular sports supplement. The supplement is particularly popular among high school, college, and professional athletes, especially football and hockey players, wrestlers, and gymnasts. 
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In particular situations, a coach may advise performing the valsalva maneuver during exercises which place a load on the spine. The vasalva maneuver consists of closing the windpipe and clenching the abdominal muscles as if exhaling, and is performed naturally and unconsciously by most people when applying great force. It serves to stiffen the abdomen and torso and assist the back muscles and spine in supporting the heavy weight. Although it briefly increases blood pressure, its is still recommended by weightlifting experts such as Rippetoe since the risk of a stroke by aneurysm is far lower than the risk of an orthopedic injury caused by inadequate rigidity of the torso.[10] Some medical experts warn that the mechanism of building "high levels of intra-abdominal pressure (IAP)...produced by breath holding using the Valsava maneuver", to "ensure spine stiffness and stability during these extraordinary demands", "should be considered only for extreme weight-lifting challenges — not for rehabilitation exercise".[11]

Ghost Size takes the cake for muscle growth. The key to this formula is epicatechin, an antioxidant found in chocolate and certain plants that is linked to a wide array of benefits. These include increased nitric oxide produciton, better oxygenation to the brain, and muscle growth: epicatechin appears to inhibit myostatin, which suppresses muscle growth, and the dosage found in Ghost Size is in line with studies that examined this effect.
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