So it was popular then, but is it effective now? Just because something is popular doesn’t mean it works. In the case of creatine supplementation, however, you can be confident that increased muscle strength and less fatigue is possible. All thanks to a critical chemical reaction taking place in your muscle cells. Read on and learn how creatine works and why it lives up to that nostalgic ‘90s hype.
Escolar, D. M., Buyse, G., Henricson, E., Leshner, R., Florence, J., Mayhew, J., Tesi-Rocha, C., Gorni, K., Pasquali, L., Patel, K. M., McCarter, R., Huang, J., Mayhew, T., Bertorini, T., Carlo, J., Connolly, A. M., Clemens, P. R., Goemans, N., Iannaccone, S. T., Igarashi, M., Nevo, Y., Pestronk, A., Subramony, S. H., Vedanarayanan, V. V., and Wessel, H. CINRG randomized controlled trial of creatine and glutamine in Duchenne muscular dystrophy. Ann Neurol 2005;58:151-155. View abstract.
Over time, we naturally lose muscle mass in a process called sarcopenia. On average, men lose about 30% of their muscle mass during their lives. Usually, this begins in your 30s and progresses slowly as you age. But, don’t despair. You can rebuild and maintain muscle mass even as you age. Often, diet and exercise are enough. But, sometimes, if the above hormones play a role, your doctor may recommend medications and additional treatments (4).
Creatine is mostly synthesized in the liver via AGAT and GAMT[28][32] (the other locations are neurons,[34] the pancreas, and kidneys[33]) despite it not being stored in high levels in the liver like glycogen or adipose would be. Supplemental creatine is known to suppress AGAT by downregulating transcription,[30] which probably occurs in humans (since the products of AGAT are reduced with creatine supplementation).[38]
Yes, you can pack on size while only doing bodyweight exercises – I did it while traveling the world – and gymnasts train mostly with bodyweight movements. However, this can feel like playing Halo on Legendary difficulty. It can be done, but damn it can be challenging – especially for lower body movements. If your sole goal is to get bigger as fast as possible, access to a barbell for squats and deadlift is almost a requirement.
After supplementation of creatine monohydrate (loading phase, followed by 19 weeks maintenance), creatine precursors are decreased by up to 50% (loading) or 30% (maintenance), which suggests a decrease in endogenous creatine synthesis during supplementation.[38] This appears to occur through creatine’s own positive feedback and suppression of the l-arginine:glycine amidinotransferase enzyme, the rate-limiting step in creatine synthesis, as levels of intermediates before this stage are typically elevated by up to 75%.[38]
Bodybuilders also train small muscles with a similar volume, frequency and intensity of their larger muscles. Strength athletes laugh at this. “Curls are a waste of time” is a common phrase you will hear hurled at a bodybuilder. This is SILLY. Although big compound movements should be most people’s resistance training priority, smaller muscle group focus work has some benefits for every athlete. Bicep tears are quite common among strength athletes, especially strong men and powerlifters. This happens because these competitors will lift tremendous weights with their backs, but their biceps are the weak link. Many of these injuries could be prevented with some good old-fashioned bodybuilder type isolation work. If you are only as strong as your weak link, doesn’t it make sense to make those weak links strong ones?
Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lagging.[54] This is known as "fluffing".[55][56] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[55] It is not restricted, and many brands are available on the Internet.[57] The use of injected oil to enhance muscle appearance is common among bodybuilders,[58][59] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[60] stroke,[55] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[59][61][62] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[63]

In otherwise sedentary and healthy men given a loading phase of creatine followed by 11 weeks of maintenance, the glucose response to an oral glucose tolerance test is reduced by 11-22% (measurements at 4-12 weeks with no time dependence noted) which was not associated with changes in insulin levels or sensitivity.[350] Elsewhere, a study in vegetarians (5g daily for 42 days) failed to find a reduction in postprandial blood glucose.[351]
When splitting a sample into exercisers and non-exercisers, it appears that exercise as a pre-requisite precedes a higher range of activity. Inactive people tend to be on the lower end of creatine kinase activity and relatively clustered in magnitude, while exercise generally increases activity, but also introduces a larger range of possible activity.[56]
Stronger muscles improve performance in a variety of sports. Sport-specific training routines are used by many competitors. These often specify that the speed of muscle contraction during weight training should be the same as that of the particular sport. Sport-specific training routines also often include variations to both free weight and machine movements that may not be common for traditional weightlifting.
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]

Reducing creatine synthesis by supplementing it has preliminary evidence supporting its ability to reduce homocysteine concentrations in the body, since the synthesis of creatine would normally produce some homocysteine as a byproduct. This may apply to a certain subset of people (MTHFR TT homozygotes, about 10% of North Americans) but at the moment there is not enough evidence to suggest that this occurs in all people supplementing creatine.

Each serving of Optimum Nutrition Creatine supplies a full 5 grams (5000 mg) of 99.9% pure Creapure brand Creatine Monohydrate. The patented production method used to produce this Creatine yields a tasteless, odorless powder that mixes easily into water or juice and does not readily settle to the bottom. As a result, the gritty taste or texture you may have experienced with other Creatine powders is not associated with this product. Keep Reading »

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.
Creatine is found in many protein supplements at baseline in the form of creatine monohydrate. If you take a protein supplement, you may already be getting creatine. What makes this creatine so special? Like the protein supplement above, this creatine supplement contains no artificial sweeteners or dyes. It contains 5000mg of creatine per dose and includes certain compounds to increase the bioavailability of the creatine, allowing it to be better absorbed.
Make no mistake: Eating for muscle is just as important as lifting for muscle. The foods you grab in the morning on the way to work, the meals you pack for lunch and mid-afternoon, what you put into your body immediately following your workout, and your final meal of the day impact your results as much as, if not more than, the number of reps you squeeze out at the end of a set. But in reality, it can be tough to stick to a "“clean"” diet when you'’re busy. We know that adding another layer of complexity to life in the form of reading food labels and studying ingredient lists just isn'’t an option for most of us. Not to mention actually preparing all those healthy meals.
Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DS. The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. J Int Soc Sports Nutr. 2009;6:6. doi: 10.1186/1550-2783-6-6. [PMC free article] [PubMed] [CrossRef]
You may have heard hardcore lifters talk about things like "leg day," but when it comes to a beginner strength workout that's only a few days a week, a full-body workout is often the way to go (rather than splitting your days up by body part). "Full-body workouts maximize your caloric burn and the muscles worked each session," says Davis. The best way to do this is to pair one upper body exercise with one lower body exercise. "This way, the lower body has time to recover while the upper body works and vice-versa," says Davis. You should also aim for a balance between movements that feel like pulling and ones that feel like pushing. For example, Davis suggests pairing these exercises together:
A recent review article published in The American Journal of Clinical Nutrition highlighted the benefits of protein supplementation and showed that supplementing with protein during prolonged (greater than 6 weeks) resistance-type training can lead to significantly greater increases in muscle mass and strength when compared to resistance training without a dietary protein intervention.[15]

In people whose kidneys don’t function optimally, supplemental creatine seems to be safe, too.[513][518][313][528] However, studies in people with suboptimal kidney function are fewer than in healthy people, and they are short-term. People with kidney dysfunction, or at risk for developing kidney dysfunction (e.g., people with diabetes, high blood pressure, or family history of kidney disease; people over sixty; and non-Hispanic blacks), might wish to forgo creatine, or otherwise take only the lowest effective dose (3 g/day)[527] after talking to their doctor.

Creatine transport has been shown to increase when muscle creatine stores are depleted. This was only noted to occur in muscle with particular fiber types (soleus and red gastrocnemius), while other fiber types, such as white grastrocnemius, did not show any clear trend.[146] This indicates that transport in relation to total creatine levels varies across different muscle fiber types.
Need the motivation to push past your comfort zone and squeeze out one more push-up or bicep curl? Sure, it helps to remember that you’ll get stronger, rock more toned muscles and rev your metabolism, thanks to all that added muscle mass. But if that wasn’t enough, now comes news that all that pump-itude (yes, that’s an SNL reference) has psychological benefits, too.
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If you’re a beginner, you should train with three full-body workouts per week. In each one, do a compound pushing movement (like a bench press), a compound pulling movement (like a chinup), and a compound lower-body exercise (squat, trap-bar deadlift, for example). If you want to add in 1–2 other exercises like loaded carries or kettlebell swings as a finisher, that’s fine, but three exercises is enough to work the whole body.
Eat 0.4–0.5 grams of fat per pound of your body weight. Fat is essential for hormone optimization, brain function, and joint health. Now, if you’re following a ketogenic diet (or modified keto diet), or you just feel better with more fat in your diet, you can certainly add more fat and lower your protein and carb intake to accommodate it. The 0.4–0.5 grams per pound recommendation just represents a starting point and a minimum so that you don’t eat too little fat, either out of fear that it will make you fat or damage your heart (both untrue). For more about ketogenic diets, see Onnit’s guide HERE.
In a study on Alpha-Lipoic Acid, 1,000mg of ALA paired with 100g sucrose and 20g creatine monohydrate was more effective in increasing muscular creatine levels relative to creatine alone and creatine combined with sucrose.[600] This apparent augmentation of creatine uptake into muscle cells was used alongside a loading period. Another study investigating a nutrient mixture (150g glucose, 20g creatine, 2g/kg bodyweight glycerol) on heat tolerance in trained athletes found that replacing one third (50g) of the glucose with 1g ALA resulted in no significant differences between groups (in regard to heat tolerance and cardiovascular performance) despite the reduction of 50g carbohydrate.[601]

The creatine transporter (CrT) is positively regulated by proteins known to be involved in sensing and responding to the cellular energy state, including the mammalian target of rapamycin (mTOR[158]). Upon activation, mTOR stimulates SGK1 and SGK3[159][160] to act upon PIKfyve[161] and subsequently PI(3,5)P2[162] to increase CrT activity.[161] Beyond mTOR, SGK1 also is stimulated by intracellular calcium[163] and a lack of oxygen (ischemia).[164] Because transient ischemia is associated with increased reactive oxygen species (ROS) production after blood flow is restored (reperfusion) it has been hypothesized that muscle contraction may increase creatine uptake through a similar ROS-mediated mechanism.[165]
Older women with knee osteoarthritis given supplemental creatine at 20g for five days followed by 5g for the rest of the twelve week trial experienced improvements in stiffness (52% reduction), pain (45%), and physical function (41%) as assessed by WOMAC, despite no improvements in physical power output relative to placebo.[425] This study paired supplementation and placebo with a mild exercise regimen.[425]
Women who train hard and reach low body fat levels, say under 10 percent, may be at risk of losing their periods as a result of hormonal disruption to estrogen production. Exercise-induced estrogen declines can result in bone loss in a way similar to that which occurs at the menopause. Loss of periods from athletic training is not uncommon but does require that you see a doctor, or better still, a sports physician and sports nutritionist to assess what is required to address the problem. Calcium supplements may be a part of the solution if bone health is likely to be affected. 
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]
Creatine is produced endogenously at an amount of about 1 g/d. Synthesis predominately occurs in the liver, kidneys, and to a lesser extent in the pancreas. The remainder of the creatine available to the body is obtained through the diet at about 1 g/d for an omnivorous diet. 95% of the bodies creatine stores are found in the skeletal muscle and the remaining 5% is distributed in the brain, liver, kidney, and testes [1]. As creatine is predominately present in the diet from meats, vegetarians have lower resting creatine concentrations [2].
One study lasting 16 months using 10g creatine daily alongside the pharmaceutical riluzole noted that, after 34 of the patients died from ALS, creatine failed to exert protective effects against ALS-related mortality (adjusted hazard ratio of 0.78 with a 95% CI of 0.47–1.48[505]). A smaller study measuring only eight deaths noted that the six in placebo (relative to two in creatine) was too small of a sample size to detect a statistically significant difference.[506] A nonsignificant trend to increase survival has been noted elsewhere with 5g of creatine daily with a similar ratio: 3 deaths in placebo to 1 death in creatine.[507]
Most typical bodybuilding programs have way too many sets and reps and use the wrong exercises. However, if you lower the total volume, go heavier, and use compound movements as I’ve outlined above, there is nothing wrong with a body-part split for advanced lifters. In fact, it’s often less stressful to the joints than your average upper/lower split.
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;114:1749-55.del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids 2012;42:2299-305. View abstract.
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The creatine transporter is a sodium[139][140] and chloride[141][142] dependent membrane-associated transporter that belongs to the Na+/Cl-dependent family of neurotransmitter transporters.[143] In muscle cells and most other cell types,[131][141] the isomer of the creatine transporter is known as SLC6A8 (solute carrier family 6, member 8). SLC6A8 is encoded by the gene present on the Xq28 region of the human X-chromosome and is expressed in most tissues.[144] A related gene encoding a creatine transporter variant has also been identified at 16p11.1 that is expressed exclusively in the testes.[145] These two transporters share 98% homology.[144][145]
Creatine concentration is normally increased in the placenta and brain in the midgestation phase until term, with further increases in the brain for another two weeks after birth.[529] This effect appears to be due to the fetus itself expressing the creatine enzymes of synthesis (AGAT and GAMT) after 5% of the gestation time has passed (0.9 days in spiny mice).[529] Despite creatine normally suppressing AGAT when supplemented at high concentrations,[29][30] it appears that maternal supplementation of the diet with 5% creatine from the halfway point of pregnancy until term does not alter creatine synthesis in the newborn (no alterations in either AGAT or GAMT), nor does it affect the creatine transporter.[530] 
The high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[24] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[25]
Weight training has also been shown to benefit dieters as it inhibits lean body mass loss (as opposed to fat loss) when under a caloric deficit. Weight training also strengthens bones, helping to prevent bone loss and osteoporosis. By increasing muscular strength and improving balance, weight training can also reduce falls by elderly persons. Weight training is also attracting attention for the benefits it can have on the brain, and in older adults, a 2017 meta analysis found that it was effective in improving cognitive performance.[38] 

If you're serious about putting on some muscle, then the most efficient way to do it is with three intense resistance training sessions and two lighter intensity workouts per week. “You need to have consistency in a workout program, hitting at least each muscle group two times a week to build muscle,” explains Lovitt. If you’re looking to switch up exercises, Olson suggests swaps such as sumo squats instead of traditional squats; step-ups on a bench instead of lunges; and then rotating back to the former. “These types of variation can be very effective in developing muscles, but the weights must still be fairly heavy that you’re using,” she says.

After all, you’ve probably seen the countless workouts, diets, supplements, programs, products and people claiming that super fast muscle growth is possible. You’ve probably also seen the click-bait headlines (“How To Build 20lbs Of Muscle In Just 6 Weeks!”) and the unbelievable transformations of supposedly “natural” people (bodybuilders, celebrities, athletes, fitness gurus on social media, etc.) that clearly prove it can happen faster than this.
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