Our bodies store creatine in our muscles so that we have quick access to it for fast, high-intensity movements, like sprinting or powerlifting, explains Autumn Bates, a certified clinical nutritionist and sports nutritionist in private practice in Manhattan Beach, California. “It's a nonessential amino acid, meaning your body creates it and you don't need to primarily get it from food.”
Creatine supplementation appears to augment the anti-cancer effects of Vitamin C and methylglyoxal,[463] a metabolic by-product of glycolysis.[464] Methylglycoxal appears to inhibit step 1 of the electron transport chain in isolated mitochondria and cancerous mitochondria, but has not been implicated in doing so in normal tissue, as protective measures in normal cells appear to exist.[465][464]
One pilot study using 150mg/kg creatine monohydrate for a five day loading phase followed by maintenance (60mg/kg) for the remainder of the five weeks noted that supplementation was associated with fewer muscle symptoms and complaints alongside improved muscular function,[572] yet a later trial trying to replicate the obsevations using 150mg/kg daily for five weeks noted the opposite, that creatine supplementation exacerbated symptoms.[573] 
2-4 Minutes Rest: Ideal for “tension exercises,” which includes most primary compound exercises. I personally take 3 minutes for the big stuff, sometimes going into the 3-4 minute range depending on exactly what I’m doing and what I feel like I need at the time. Since making strength gains is the main focus of these exercises, longer rest periods like this will be optimal for making it happen.
^ Burd, Nicholas A.; Yang, Yifan; Moore, Daniel R.; Tang, Jason E.; Tarnopolsky, Mark A.; Phillips, Stuart M. (2012). "Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. Micellar casein at rest and after resistance exercise in elderly men". British Journal of Nutrition. 108 (6): 958–62. doi:10.1017/S0007114511006271. PMID 22289570.
Trimethylglycine (TMG, betaine) is a dietary supplement and component of beet root, which is a methyl donor. It contributes to metabolic processes in the body which require a methyl group either directly (the methylation of homocysteine) or indirectly via replenishing the active form of folate or via replenishing S-adenosyl methionine (SAMe). As the synthesis of creatine (via GAMT) requires a donation from SAMe,[597] it is thought that TMG can aid in creatine synthesis, which has been noted in the rat liver in the absence of creatine supplementation.[598]
Generally, you should consume about 20 grams of protein with some carbs shortly after a workout. During the post-workout anabolic window, you’ll also want to limit fats, which can slow the absorption of protein. While there is some recent research that suggests the window may actually extend up to several hours following exercise, there’s no harm in getting nutrients in early as long as you’re sticking to your overall caloric and macronutrient goals.

Creatine levels in the blood tend to return to baseline (after a loading with or without the maintenance phase) after 28 days without creatine supplementation.[152][200][201] This number may vary slightly from one individual to another, and for some may exceed 30 days.[202] Assuming an elimination rate of creatinine (creatine’s metabolite) at 14.6mmol per day,[35][201] six weeks of cessation is approaching the upper limit for serum creatine to completely return to baseline.


Creatine supplementation (11.4g) with glycerol (1g/kg; per se effective[394][395]) and glucose (75g) in endurance runners in the heat appears to attenuate the increase in internal temperature associated with an increase in total body water of 0.71+/-0.42L, while performance (VO2 max and running economy) were unaffected over 30 minutes.[3] Creatine is effective without glycerol (20g daily with 140g of glucose polymer over a week),[346] again without an improvement in physical performance.
Do a single set of repetitions. Theories on the best way to approach weight training abound, including countless repetitions and hours at the gym. But research shows that a single set of exercise with a weight that fatigues your muscle after about 12 to 15 repetitions can build muscle efficiently in most people and can be as effective as three sets of the same exercise.
MET-Rx Advanced Creatine Blast also contains a lot of ingredients that work synergistically with creatine. There’s the 33 grams of carbohydrates, which may help to drive creatine to the muscles, plus there’s some taurine to help with recovery and two grams of branched chain amino acids, which may help with muscle retention. However, it contains creatine ethyl ester, which is probably less effective than monohydrate.
Men appear to have higher active creatine-kinase systems, and racial differences favor black people over hispanic people over white people in terms of the activity of the creatine-kinase system. This system is more variable in men, independent of supplementation. Exercise may increase the activity of the creatine-kinase system independent of supplementation.
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.
Intensive weight training causes micro-tears to the muscles being trained; this is generally known as microtrauma. These micro-tears in the muscle contribute to the soreness felt after exercise, called delayed onset muscle soreness (DOMS). It is the repair of these micro-traumas that results in muscle growth. Normally, this soreness becomes most apparent a day or two after a workout. However, as muscles become adapted to the exercises, soreness tends to decrease.[22]
I HATE that the resistance training community can be so tribal. I have been preaching to bodybuilders for years about the benefits of powerlifting, or Olympic lifting or kettlebells or even Crossfit style conditioning and many have been receptive. Learn from each other and achieve levels of fitness you simply could not have otherwise. Don’t brush off bodybuilding wisdom…it could be the missing factor in your program.
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]
A: Eat more frequently, drink less liquids while eating (they compete for stomach volume along with food), eat from larger plates and bowls, add lime or lemon juice to your water with meals (can help to increase production of hydrochloric acid that breaks down food), and consume more liquid calories (especially around the workout if appetite is suffering the rest of the day).
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.
You may be wondering what conditions and medications contraindicate the use of creatine supplements. Creatine is contraindicated in people with kidney insufficiency or kidney disease. If you take diabetes medication, diuretics or acetaminophen, do not take a creatine supplement. Use caution if you regularly consume caffeine while taking a creatine supplement. Overall, if you are healthy and have gotten clearance from your doctor, consider this non-GMO creatine supplement.
The two workouts listed above are completely free and highly recommended. If, however, you’re looking for additional workouts, my book – Superior Muscle Growth – contains ALL of the muscle building routines that I’ve personally used and designed for others (11 different workouts, 40+ different versions). Feel free to check it out to learn more about what’s included.
However, the basis of “take creatine after your workout” comes from a 2013 study published in the JISSN, which can be found here (open access too!). In this study, recreational male bodybuilders (19 men overall) were given five grams of creatine either before or after their workouts. They trained five days per week but were also directed to consume 5g on their rest days at any time they wanted. The workouts were fairly similar to most gym workouts, and the methodology (what they did and how they did it) suggests that the findings would apply to most weightlifters.

There is a genetic condition known as gyrate atrophy of the choroid and retina, which is associated with a high level of Ornithine in the blood and a relative decrease in Arginine, which causes a relative creatine deficiency due to L-arginine being required to make creatine[478][479] and because high ornithine can suppress creatine synthesis (AGAT) in the glial cells of the retina.[475] This condition can be attenuated by either reducting ornithine in the diet[480] or by supplementing creatine, which is, in this instance, therapeutic.[481][482]
When assessing type I muscle (slow twitch) against type II muscles (fast twitch) in response to creatine supplementation, it seems that glycogen accumulation may only occur in the latter as assessed in rats,[359] where the soleus muscle is a model for slow twitch muscle fibers and the gastrocnemius is a model for fast twitch. This is similar to human creatine distribution, which seems to accumulate in type II muscles rather than type I.[367]
Aim to eat roughly 250 to 500 extra calories per day. To make sure that any weight gained is from muscle, Fitzgerald recommends that the bulk of those calories come from protein. In a 2014 Pennington Biomedical Research Center study, people who ate a high-calorie diet rich in protein stored about 45 percent of those calories as muscle, while those following a low-protein diet with the same number of calories stored 95 percent of those calories as fat.
Endogenous serum or plasma creatine concentrations in healthy adults are normally in a range of 2–12 mg/L. A single 5 g (5000 mg) oral dose in healthy adults results in a peak plasma creatine level of approximately 120 mg/L at 1–2 hours post-ingestion. Creatine has a fairly short elimination half-life, averaging just less than 3 hours, so to maintain an elevated plasma level it would be necessary to take small oral doses every 3–6 hours throughout the day. After the "loading dose" period (1–2 weeks, 12–24 g a day), it is no longer necessary to maintain a consistently high serum level of creatine. As with most supplements, each person has their own genetic "preset" amount of creatine they can hold. The rest is eliminated as waste. A typical post-loading dose is 2–5 g daily.[52][53][54]
Mercimek-Mahmutoglu, S., Stoeckler-Ipsiroglu, S., Adami, A., Appleton, R., Araujo, H. C., Duran, M., Ensenauer, R., Fernandez-Alvarez, E., Garcia, P., Grolik, C., Item, C. B., Leuzzi, V., Marquardt, I., Muhl, A., Saelke-Kellermann, R. A., Salomons, G. S., Schulze, A., Surtees, R., van der Knaap, M. S., Vasconcelos, R., Verhoeven, N. M., Vilarinho, L., Wilichowski, E., and Jakobs, C. GAMT deficiency: features, treatment, and outcome in an inborn error of creatine synthesis. Neurology 8-8-2006;67:480-484. View abstract.

However, protein isn’t everything. Contrary to popular belief, carbohydrates and calories from fats are also important. To gain muscle, people who are slender or scrawny need to create a calorie surplus in order to bulk up. That means you need proteins and plenty of healthy carbs, vegetables and even some fats (think healthy fats like nuts, avocado, olive oil, etc.). Carbohydrates play a key role in building muscle. This macronutrient has gotten a bad rap for making people fat. However, if you work out properly, eating plenty of carbs is in your best interest. After training, it’s ideal to ingest some carbs in combination with protein to help replenish your muscles’ glycogen stores.

Creatine ethyl ester increases muscle levels of creatine to a lesser degree than creatine monohydrate.[72] It may also result in higher serum creatinine levels[73] due to creatine ethyl ester being converted into creatinine via non-enzymatic means in an environment similar to the digestive tract.[74][75] At equal doses to creatine monohydrate, ethyl ester has failed to increase water weight after 28 days of administration (indicative of muscle deposition rates of creatine, which are seemingly absent with ethyl ester).[76] 


Moving through repetitions too quickly, going too fast; there is nothing gained by lifting weights fast. Some of the perks of lifting weight in a slow and controlled manner, include more total muscle tension and force produced, more muscle-fiber activation both slow and fast twitch fibers, and less tissue trauma. Remember, a joint is only as strong as the muscles that cross it; if you haven't lifted in a long time, or ever, be careful what you ask of your joints.
Yang, L., Calingasan, N. Y., Wille, E. J., Cormier, K., Smith, K., Ferrante, R. J., & Beal, M. F. (2009, June). Combination therapy with coenzyme Q10 and creatine produces additive neuroprotective effects in models of Parkinson's and Huntington's diseases [Abstract]. Journal of Neurochemistry. 109(5):1427-39. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19476553
Entry into neural tissues in general is mediated by the secondary creatine transporter (CrT-2) known as SLC6A10,[186] which is the same transporter that is active in a male’s testicles.[145] CrT-2 belongs to the family of SLC6 transporters that act to move solutes across the membrane by coupling transport with sodium and chloride.[187][188] Genetic deletions in the 16p11.2 region, which encodes both SLC6A8[189] and SLC6A10[186] can result in severe mental retardation in humans and is one of the causes of “Creatine Deficiency Syndrome.” Creatine Deficiency Syndrome is not only caused by lack creatine transporter expression, however, as creatine synthesis is also critical for neural function.[190].[189] Retardation caused by defective creatine synthesis[31] can be reversed with creatine supplementation and dietary changes.[191]
Don’t take sets to the point of failure—where you absolutely can’t perform another rep. You should never get to where you’re turning purple and screaming like you’re getting interviewed by “Mean” Gene Okerlund before WrestleMania. Most of the time, you want to end your sets two reps before total failure. Not sure when that is? The moment your form breaks down, or you’re pretty sure it’s going to break down, end the set.
It’s true—your genes can play a role when it comes to building muscle. In general, there are two types of muscle fibers: Type I, which are slow twitch, and Type II, which are fast twitch. Depending on which you have more of, you may have an easier or harder time gaining muscle. “Fast twitch muscle fibers are two times as thick as slow twitch muscle fibers, lending to the overall thickness of the muscle without any activity,” explains Lovitt. “Those people with a genetic predisposition of a high percentage of these fibers can increase muscle size very easily while the people with a higher percentage of slow twitch muscle fibers have to work really hard to put on mass.” It’s the reason why a world-class sprinter genetically has more fast twitch muscle fibers than a world-class marathoner—it comes down to what we’re born with.
Creatine has been found to increase skeletal muscle glycogen when given to sedentary adults for a loading and maintenance phase for 37 days at 2g (13.5% after five days of loading, but returning to baseline at the end of the trial). Exercise was not enforced in this study.[207] This study also noted that, despite a normalization of glycogen after the trial, total creatine and ATP was still higher than placebo,[207] and a loading protocol appears to have failed elsewhere in increasing glycogen stores in sedentary people subject to an aerobic exercise test before and after the loading phase.[349]
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.

xEndurance’s Creatine-JB is a fantastic, all-natural creatine for athletes. It’s a little expensive at a dollar per serving, but it has a really pleasant citrus flavor and it contains a gram of lactate, which has been shown in some studies to improve time to exhaustion in short duration, high intensity workouts. It’s also third party tested by Labdoor and Informed Choice.


In complex training, weight training is typically combined with plyometric exercises in an alternating sequence. Ideally, the weight lifting exercise and the plyometric exercise should move through similar ranges of movement i.e. a back squat at 85-95% 1RM followed by a vertical jump. An advantage of this form of training is that it allows the intense activation of the nervous system and increased muscle fibre recruitment from the weight lifting exercise to be utilized in the subsequent plyometric exercise; thereby improving the power with which it can be performed. Over a period of training, this may enhance the athlete's ability to apply power.[39] The plyometric exercise may be replaced with a sports specific action. The intention being to utilize the neural and muscular activation from the heavy lift in the sports specific action, in order to be able to perform it more powerfully. Over a period of training this may enhance the athlete's ability to perform that sports specific action more powerfully, without a precursory heavy lift being required.
Dips. You should be able to manipulate your bodyweight in space against the influence of gravity. If you can’t perform simple movements such as pushups, dips, and chin-ups then you need to work on your relative strength. That being said, dips are an excellent muscle builder for the chest, triceps, and shoulders if they are progressively overloaded with weight. 
Most people require around 20 calories per pound (or 44 kcal / kg) of bodyweight to gain muscle mass. Using a 180-pound (82kg) male as an example, the required daily calorie intake is 3600 calories (20 kcal x 180 lb = 3600 kcal). When it comes to gaining weight, it is likely that you may put on a few pounds of fat along the way, but if you do find your body fat increasing, either increase the amount of aerobic exercise (moderate intensity) you are doing or slightly reduce the total number of calories you are consuming. Remember you can’t force feed muscle gain!

There you have it — our five favorite creatine products on the market. But when you’ve tried as many creatines as we have, there were a lot of others that we loved but didn’t make the very top of our list for the previous categories. That’s why we’ve also come up with a list of the best creatines for men, best creatines for women, best creatines for muscle growth, for bulking, for the brain, and the best micronized creatine. Keep reading for our favorite picks!
Weight training also requires the use of 'good form', performing the movements with the appropriate muscle group, and not transferring the weight to different body parts in order to move greater weight (called 'cheating'). Failure to use good form during a training set can result in injury or a failure to meet training goals; since the desired muscle group is not challenged sufficiently, the threshold of overload is never reached and the muscle does not gain in strength. At a particularly advanced level; however, "cheating" can be used to break through strength plateaus and encourage neurological and muscular adaptation.
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).
This suppression of creatine synthesis is thought to actually be beneficial, since creatine synthesis requires s-adenosyl methionine as a cofactor and may use up to 40-50% of SAMe for methylation[35][36][122] (initially thought to be above 70%, but this has since been re-evaluated[122]) though the expected preservation of SAMe may not occur with supplementation.[487] Reduced creatine synthesis, via preserving methyl groups and trimethylglycine (which would normally be used up to synthesize SAMe), is also thought to suppress homocysteine levels in serum,[37] but this may also not occur to a practical level following supplementation.[487]

Although creatine is a natural component of food, the amount of food required to supersaturate the muscle with PCr may not be feasible. For example, it could require 22 pounds of meat daily [8]. If creatine monohydrate is proven to be a safe and effective ergogenic aid, creatine supplementation may be the simplest way to increasing muscle stores. It may be beneficial to avoid caffeine if taking creatine supplements. One study showed that caffeine diminished strength gains seen with creatine use [9].
Co-ingesting creatine with caffeine partially negated the benefits of creatine supplementation (at 5mg/kg bodyweight) during the loading phase in one study.[590] The exact mechanism responsible for this effect is not known, but might be related to opposing actions on muscle contraction time.[591] However, another study in trained men found that co-ingestion of 300mg caffeine per day during creatine loading at 20g per day (split into 4 doses) had no effect on bench press 1RM, time to fatigue, or sprinting ability.[592] However, this study also found that creatine alone or when combined with caffeine had no effect on any of these parameters over placebo, either. Thus, the study may have been underpowered or done in too short a time frame (the test was done after only 5 days of loading) to observe any possible effects.[592]
Naturally produced in the kidneys, pancreas and liver, creatine is transported to muscle tissue where it is transformed into creatine phosphate, from which the energy molecule ATP is produced to regenerate the muscles' ability to contract and generate power during short-burst (anaerobic) activity. This translates to more productive workouts and faster muscle growth.
While many of the claims are based on scientifically based physiological or biochemical processes, their use in bodybuilding parlance is often heavily colored by bodybuilding lore and industry marketing and as such may deviate considerably from traditional scientific usages of the terms. In addition, ingredients listed have been found at times to be different from the contents. In 2015, Consumer Reports reported unsafe levels of arsenic, cadmium, lead and mercury in several of the protein powders that were tested.[7]
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]

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.

According to BodyBuilding.com, adenosine triphosphate (ATP) is made up of a nucleotide bonded to three phosphate groups. When one of those phosphate groups is cleaved from the ATP molecule, a lot of energy is made available. That energy is used to fuel chemical reactions in cells, and ATP becomes adenosine diphosphate (ADP). Creatine enables the release of energy from stored ATP and is converted to creatinine.
Other areas of research include therapeutic uses of creatine to help patients with muscle wasting caused by disease states such as muscular dystrophy and amyotrophic lateral sclerosis (ALS). Small-scale preliminary studies show some gains in strength may be possible for these patients, which could improve their quality of life. One study of 81 patients with various neurologic diseases found that giving 10 g/day of creatine for five days, followed by 5 grams for another week, increases their muscle strength by about 10% [20]. Large-scale studies should be done before recommendations are made to such patients.
This is another thing I am very tired of hearing. 'No matter what I do or what I eat, I can't gain weight'. I have heard this countless times and I am here to tell you that you are dead wrong. That's OK, because I actually said the same thing until I realized the truth. Most people think they are eating a lot and you just may be. But no matter what you are eating, if you are not gaining, you are not eating enough. Most times, you should re-evaluate your diet as well and focus on more calorie dense foods. But you need to eat more if you are not gaining.
Glycogen synthesis is known to respond directly and positively to cellular swelling. This was demonstrated in an earlier study, during which rat muscle cells were exposed to a hypotonic solution in vitro to induce cell swelling, which increased glycogen synthesis by 75%. In contrast, exposing these same cells to a hypertonic solution hindered glycogen synthesis by 31%. These changes were not due to alterations in glucose uptake, but are blocked by hindering the PI3K/mTOR signaling pathway.[112] It was later noted that stress proteins of the MAPK class (p38 and JNK) as well as heat shock protein 27 (Hsp27) are activated in response to increasing osmolarity.[113][114] Furthermore, activation of MAPK signaling in skeletal muscle cells is known to induce myocyte differentiation[115] via GSK3β and MEF2 signaling, which can induce muscle cell growth.[116][117]
Skin degradation is caused by a loss of collagen and degradation of the extracellular matrix,[536] which is enhanced by UV radiation (produces reactive oxygen species which stimulate MMPs[537]) and contributes to skin integrity loss and wrinkling. Due to the stimulation of collagen being associated with a cellular surplus of energy[538] and intracellular stores of energy declining with age,[539][540] creatine has been investigated as a topical anti-aging agent. In vitro, creatine appears to be rapidly absorbed through the skin (52% within an hour, remaining similar at 3 hours) with most creatine found in the stratum corneum (79.6-86.5%) follwed by the epidermis (9-13.2%) and dermis (4.5-7.1%).[541] It is successful in stimulating collagen expression and procollagen secretion in fibroblasts, with the latter increasing to 449+/-204% of control.[541]
The benefits of weight training overall are comparable to most other types of strength training: increased muscle, tendon and ligament strength, bone density, flexibility, tone, metabolic rate, and postural support. This type of training will also help prevent injury for athletes. There are benefits and limitations to weight training as compared to other types of strength training. Contrary to popular belief, weight training can be beneficial for both men and women.
Every 4-8 weeks, vary your routine. As your body adapts to stress, you'll hit a plateau where the benefits of weight training will begin to diminish. The only way to prevent this from happening is to change things up, such as by increasing weight and changing exercises. Try a week of really piling the weights on, and do six to eight reps per set at the maximum weight you can manage with proper form. The more lifting experience you have, the more often you should vary your routine.
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]
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.[616] 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.[617] Some studies involving athletes and various dietary supplements have attempted to draw a correlation with creatine and cases of rhabdomyolysis.[618][619][620][621] 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.[622]
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