One study on 27 otherwise healthy men supplementing creatine (0.3g/kg loading for a week, 0.05g/kg thereafter for 8 weeks) with a thrice weekly exercise regiment noted that alongside greater increase in lean mass and power relative to placebo at 4 and 8 weeks, myostatin in serum decreased to a greater extent with creatine (around 17% at 8 weeks, derived from graph) than it did with placebo (approximately 7%).[356] Increases in GASP-1, a serum protein that inhibits the actions of myostatin by directly binding to it,[357] were not different between groups.[356]

A dose of 5g daily has strong evidence supporting it not causing any adverse side effects[605] and 10g has been used daily for 310 days in older adults (aged 57+/-11.1) with no significant differences from placebo.[519] Such a dose has also been demonstrated for long-term safety for people with Parkinson’s disease,[606] and at least one small retrospective study in athletes (surverying people taking creatine for up to or over a year) failed to find any significant differences in a battery of serum health parameters.[502] Other studies measuring serum parameters have also failed to find abnormalities outside the normal range.[607]
Despite creatine not interfering with UV(A) irradiation acting upon a cell or the production of oxidation due to it, creatine appears to prevent the functional consequences (such as mitochondrial DNA damage) due to preventing an ATP depletion in the cell, which would normally precede a reduction in mitochondrial membrane potential and mutagenesis, but this effect is prevented for as long as creatine stores are sufficient.[446] Creatine has also been noted to near-fully protect mitochondrial DNA from hydroxyl radicals and oxidative damage, although there was no protective effect for nuclear DNA, due to it being less sensitive to hydroxyl radicals.[447]

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]
Different forms of creatine in combination with other sports supplements as well as varying doses and supplementation methodology should continue to be researched in an attempt to understand further application of creatine to increase sports and exercise performance of varying disciplines. It is important to remain impartial when evaluating the safety of creatine ingested as a natural supplement. The available evidence indicates that creatine consumption is safe. This perception of safety cannot be guaranteed especially that of the long term safety of creatine supplementation and the various forms of creatine which are administered to different populations (athletes, sedentary, patient, active, young or elderly) throughout the globe.
Lifters who follow high-volume or high-intensity resistance-training programs, as many bodybuilders do, may also benefit from carbohydrate intake immediately post-workout. Compared with a placebo, carbohydrates combined with protein immediately post-workout and one hour after a bout of resistance exercise have been shown to increase insulin levels and rates of glycogen resynthesis.[19]
Electrolytes derive mainly from minerals in the diet and they maintain fluid balance and assist the nervous system to perform muscle contractions. Electrolytes are sodium, potassium, magnesium, calcium and chloride, bicarbonate, phosphate, sulfate. Exercisers are particularly dependent on sodium and potassium balance. Carbohydrates are important for fueling exercise, including vigorous weight training, and in post-exercise energy replacement nutrition. Carbohydrates, mostly sugars, are formulated in sports drinks with electrolytes such as sodium chloride and potassium and sometimes magnesium.

After your standard whey protein powder, creatine may be the most popular sports supplement on Earth, and with good reason. A lot of supplements out there have a few promising studies suggesting they may improve some aspect of performance. Creatine has hundreds of them, and study after study has shown that among most people (a small percentage of are non-responders) it can have a significant effect on several areas of performance.

Some of the most common minor side effects include stomach discomfort, nausea, and increased bowel movements. Other potential side effects may include headaches, bloating, and increased thirst. There is always the chance that a supplement could cause an allergic reaction. This can result in rashes, swelling, or difficulty breathing, depending on the severity of the reaction. This is another reason why starting out with lower doses of new products is advisable.

^ Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DS (February 2009). "The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels". Journal of the International Society of Sports Nutrition. 6 (1): 6. doi:10.1186/1550-2783-6-6. PMC 2649889. PMID 19228401.
Now, while all three are definitely beneficial to the process, I’d consider metabolic stress and muscular damage to be of secondary and tertiary importance, respectively. In addition, they are also things that will pretty much take care of themselves when implementing the workout guidelines and recommendations we’ve already covered (namely for volume, rep ranges, rest periods and exercise selection).
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When it comes to building lean muscle, size bodybuilders are king. That’s their ultimate goal. Sure, Crossfit, powerlifting and all the other modalities will build muscle, but that’s not their focus. They want performance and any muscle they build is a side effect. Not so with bodybuilding where muscle size and shape are the priorities. Learning how to build muscle for the sake of building muscle has some benefits to the performance athlete. It allows for ais less injury prone. Its also a fact that bigger muscle contract harder regardless of technique or form, so it’s a good strategy to throw in some bodybuilder muscle building sessions here and there to give yourself stronger muscles to then train for performance. Build the muscle bigger, then train it to perform better.
However, not all proteins are created equal in the muscle building stakes. Always remember the better the quality (biological value) of protein consumed, the more of it will be used for muscle building. To maximise muscle growth, stick to high-quality proteins, such as whey, milk, eggs, fish or lean meats. However, combining lower quality or incomplete protein from plant-based sources, such as nuts and beans, can still be a valuable protein source for muscle building.
Prohormones are precursors to hormones and are most typically sold to bodybuilders as a precursor to the natural hormone testosterone. This conversion requires naturally occurring enzymes in the body. Side effects are not uncommon, as prohormones can also convert further into DHT and estrogen. To deal with this, many supplements also have aromatase inhibitors and DHT blockers such as chrysin and 4-androstene-3,6,17-trione. To date most prohormone products have not been thoroughly studied, and the health effects of prolonged use are unknown. Although initially available over the counter, their purchase was made illegal without a prescription in the US in 2004, and they hold similar status in many other countries. They remain legal, however, in the United Kingdom and the wider European Union. Their use is prohibited by most sporting bodies.