These protective effects are similar to those seen with trimethylglycine, since they both cause an increase in liver concentrations of phosphatidylcholine (PC, causing an increase in vLDL production and efflux of triglycerides from the liver).[497] Both TMG and creatine are thought to work indirectly by preserving SAMe concentrations,[125][498] since PC synthesis requires SAMe as well (via PEMT[499]) and genes involved in fatty acid metabolism in the liver that were not affected by the diet (VLCAD and CD36) were unaffected by creatine.[125]
This claim has not been demonstrated at this time, and a recent comparative study of buffered creatine against basic creatine monohydrate found no significant differences between the two in 36 resistance trained individuals, in regard to the effects or the accumulation of creatine in muscle tissue.[71] There also were no significant differences in the amount of adverse side-effects reported.
de Salles Painelli V, Alves VT, Ugrinowitsch C, et al. Creatine supplementation prevents acute strength loss induced by concurrent exercise. Eur J Appl Physiol 2014;114(8):1749-55.del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids 2012;42(6):2299-305. View abstract.
A push–pull workout is a method of arranging a weight training routine so that exercises alternate between push motions and pull motions.[28] A push–pull superset is two complementary segments (one pull/one push) done back-to-back. An example is bench press (push) / bent-over row (pull). Another push–pull technique is to arrange workout routines so that one day involves only push (usually chest, shoulders and triceps) exercises, and an alternate day only pull (usually back and biceps) exercises so the body can get adequate rest.[29]
Previous investigations have shown that a single dose of CM (8 grams) increased the number of repetitions performed during an upper-body resistance training protocol and reduced soreness at 24 and 48 hours post-exercise (compared to a placebo).7 Recently, researchers from Mississippi State University found that a single dose of CM (8 grams) significantly increased the number of lower-body repetitions compared to a placebo group.[8]
In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline).[485] This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.[485]
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.