If you're a serious strength or physique athlete, you've surely heard that supplements can help you get the most from your intense training sessions and on-point diet. But which supplements? The market is overstuffed like a bodybuilder in a child's blazer! You might be tempted to wander through a digital forest of get-big blogs and personal guru websites, but unfortunately those places can often be rife with misinformation.
Creatine monohydrate is the most common form of creatine, and if not otherwise mentioned is the default form of creatine used in most studies on creatine. It has fairly decent intestinal absorption (covered more in depth in the pharmacology section) and is the standard form or “reference” form of creatine, which all other variants are pitted against.
A thermogenic is a broad term for any supplement that the manufacturer claims will cause thermogenesis, resulting in increased body temperature, increased metabolic rate, and consequently an increased rate in the burning of body fat and weight loss. Until 2004 almost every product found in this supplement category comprised the "ECA stack": ephedrine, caffeine and aspirin. However, on February 6, 2004 the Food and Drug Administration (FDA) banned the sale of ephedra and its alkaloid, ephedrine, for use in weight loss formulas. Several manufacturers replaced the ephedra component of the "ECA" stack with bitter orange or citrus aurantium (containing synephrine) instead of the ephedrine.
Start with the barbell on the supports of a power rack at about shoulder height. Grab the bar overhand and raise your elbows until your upper arms are parallel to the floor. Now lift the bar off the rack, letting it roll toward your fingers-this is where it should rest throughout the exercise (as long as you keep your elbows raised, you won’t have trouble balancing the bar) . Squat as low as you can , and then drive with your legs to return to the starting position. That’s one rep.
The first open label trial on ALS failed to significantly alter lung function as assessed by FEV (when comparing the rate of decline pretreatment relative to treatment). Creatine has elsewhere failed to benefit lung function at 5g daily for months relative to control and failed to significantly attenuate the rate of lung function deterioration over 16 months at 10g daily and 5g daily over nine months.
A previous meta-analysis  reported an overall creatine supplementation effect size (ES) of 0.24 ± 0.02 for activities lasting ≤30 s. (primarily using the ATP- phosphocreatine energy system). For this short high-intensity exercise, creatine supplementation resulted in a 7.5 ± 0.7% increase from base line which was greater than the 4.3 ± 0.6% improvement observed for placebo groups. When looking at the individual selected measures for anaerobic performance the greatest effect of creatine supplementation was observed on the number of repetitions which showed an ES of 0.64 ± 0.18. Furthermore, an increase from base line of 45.4 ± 7.2% compared to 22.9 ± 7.3% for the placebo group was observed. The second greatest ES was on the weight lifted at 0.51 ± 0.16 with an increase from base line of 13.4 ± 2.7% for the placebo group and 24.7 ± 3.9% for the creatine group. Other measures improved by creatine with a mean ES greater than 0 were for the amount of work accomplished, weight lifted, time, force production, cycle ergometer revolutions/min and power. The possible effect of creatine supplementation on multiple high intensity short duration bouts (<30 s) have shown an ES not statistically significant from 0. This would indicate that creatine supplementation might be useful to attenuate fatigue symptoms over multiple bouts of high-intensity, short duration exercise. The ES of creatine on anaerobic endurance exercise (>30 – 150s), primarily using the anaerobic glycolysis energy system, was 0.19 ± 0.05 with an improvement from baseline of 4.9 ± 1.5 % for creatine and -2.0 ± 0.6% for the placebo. The specific aspects of anaerobic endurance performance improved by creatine supplementation were work and power, both of which had a mean ES greater than 0. From the findings of this previous meta-analysis  it would appear that creatine supplementation has the most pronounced effect on short duration (<30s) high intensity intermittent exercises.
Gains will differ from one individual to another depending on body size and level of experience in the gym. To make sure you're gaining muscle, not fat, don't just consider your scale weight. Instead, rely on what you see in the mirror and use a tape measure twice a month to keep track of your waist and hips (you don't want to gain there) as well as your biceps, chest and quads. Also, don't think that you have to gain a set amount of weight each and every week. "Your mass gain doesn't have to be uniform," Aceto explains. That means you can gain 1/2 pound one week and 1 1/2 the next, perhaps none the third week and still remain on course. "Expecting uniform gains ignores the intricate makeup of the body and the way it gains mass - or loses fat - which is by no means in linear fashion," adds Aceto.
In today's extra-large society, we tend to focus on the admirable guys who train hard and switch up their diet to transform their bodies by losing weight. We highlight their quests to lead healthier lives every chance we get — but there's another side of the wellness scale that can be just as difficult, depending on your body's makeup: Gaining mass and muscle.
One case study exists of a man with focal segmental glomerulosclerosis who experienced an accelerated rate of GFR decline during supplementation (5g thrice daily for loading, then a 2g maintenance for seven weeks) which was partially reversed upon supplement cessation. This was deemed strong circumstantial evidence, and the brand of supplement was not named. Elsewhere, interstitial nephritis associated with creatine supplementation has been reported in a man, although symptoms arose four weeks after supplementation started with no evidence to support correlation. Some studies involving athletes and various dietary supplements have attempted to draw a correlation with creatine and cases of rhabdomyolysis. Finally, one study in a diabetic person ingesting both metformin and creatine resulting in metabolic acidosis has attempted to place causation on creatine, but it did not establish causation or circumstantial evidence.