Syrotuik and Bell [57] investigated the physical characteristics of responder and non-responder subjects to creatine supplementation in recreationally resistance trained men with no history of CM usage. The supplement group was asked to ingest a loading dosage of 0.3 g/kg/d for 5 days. The physiological characteristics of responders were classified using Greenhaff et al [58] criterion of >20 mmol/kg dry weight increase in total intramuscular creatine and phosphocreatine and non responders as <10 mmol/kg dry weight increase, a third group labeled quasi responders were also used to classify participants who fell in between the previously mentioned groups (10-20 mmol/kg dry weight). Overall, the supplemented group showed a mean increase in total resting muscle creatine and phosphocreatine of 14.5% (from 111.12 ± 8.87 mmol/kg dry weight to 127.30 ± 9.69 mmol/kg dry weight) whilst the placebo group remained relatively unaffected (from 115.70 ± 14.99 mmol/kg dry weight to 111.74 ± 12.95 mmol/kg dry weight). However when looking at individual cases from the creatine group the results showed a variance in response. From the 11 males in the supplemented group, 3 participants were responders (mean increase of 29.5 mmol/kg dry weight or 27%), 5 quasi responders (mean increase of 14.9 mmol/kg dry weight or 13.6%) and 3 non-responders (mean increase of 5.1 mmol/kg dry weight or 4.8%). Using muscle biopsies of the vastus lateralis, a descending trend for groups and mean percentage fiber type was observed. Responders showed the greatest percentage of type II fibers followed by quasi responders and non-responders. The responder and quasi responder groups had an initial larger cross sectional area for type I, type IIa and type IIx fibers. The responder group also had the greatest mean increase in the cross sectional area of all the muscle fiber types measured (type I, type IIa and type IIx increased 320, 971 and 840 μm2 respectively) and non-responders the least (type I, type IIa and type IIx increased 60, 46 and 78 μm2 respectively). There was evidence of a descending trend for responders to have the highest percentage of type II fibers; furthermore, responders and quasi responders possessed the largest initial cross sectional area of type I, IIa and IIx fibers. Responders were seen to have the lowest initial levels of creatine and phosphocreatine. This has also been observed in a previous study [17] which found that subjects whose creatine levels were around 150 mmol/Kg dry mass did not have any increments in their creatine saturation due to creatine supplementation, neither did they experience any increases of creatine uptake, phosphocreatine resynthesis and performance. This would indicate a limit maximum size of the creatine pool.
Despite all the awesomeness of hypertrophy, athletes may be more interested in effects on power. Power is the ability to generate high amounts of force in relatively short periods of time — more power means you can pull more weight in low-rep sets — and independent of the hypertrophy, just five to ten grams of creatine per day appears to improve power output by 12 to 26 percent.
Anti-cancer effects have been observed with the creatine analogue cyclocreatine[456][104][457] and have been replicated with creatine itself. These effects tend to be a reduction in which the rate of implanted tumors progresses.[458][459] It is suspected that these observed effects (inhibition of growth or attenuation of the rate of growth) are not due to the bioenergetic effect of creatine, secondary to creatine kinase. These anti-cancer effects do not have a known reliability, as the expression of creatine kinase varies widely based on the type of tumor.[460] However, some studies suggest an inverse relationship between tumor progression in mice and concentrations of creatine in cells, with creatine depletion coinciding with tumor development.[460]
Creatine is a hydrophilic polar molecule that consists of a negatively charged carboxyl group and a positively charged functional group [64]. The hydrophilic nature of creatine limits its bioavailability [65]. In an attempt to increase creatines bioavailability creatine has been esterified to reduce the hydrophilicity; this product is known as creatine ethyl ester. Manufacturers of creatine ethyl ester promote their product as being able to by-pass the creatine transporter due to improved sarcolemmal permeability toward creatine [65]. Spillane et al [65] analyzed the effects of a 5 days loading protocol (0.30 g/kg lean mass) followed by a 42 days maintenance phase (0.075 g/kg lean mass) of CM or ethyl ester both combined with a resistance training program in 30 novice males with no previous resistance training experience. The results of this study [65] showed that ethyl ester was not as effective as CM to enhance serum and muscle creatine stores. Furthermore creatine ethyl ester offered no additional benefit for improving body composition, muscle mass, strength, and power. This research did not support the claims of the creatine ethyl ester manufacturers.

Perform the two workouts (Day 1 and 2) once each per week, resting at least a day between each. Perform the exercises marked with letters as a group. Do one set of A, rest, then one set of B, rest (note that some groups have an exercise “C”), and repeat until all sets are complete. Then go on to the next group. Perform three sets of 8–10 reps for each exercise. After a month, you’ll see how rewarding just a months in the gym can be.

In a mouse model of allergin-induced asthma, where mice were sensitized by ovalbumin for three weeks and then given 500mg/kg creatine, supplementation induced an increase in asthmatic hyperresponsiveness to low but not high doses of methacholine.[440] This hyperresponsiveness was associated with increased eosinophil and neutrophil infiltration into the lungs, and an increase in Th2 cell cytokines (IL-4 and IL-5) alongside an increase in IGF-1,[440] which is known to influence this process.[441] Interestingly, there was a nonsignificant increase in responsiveness in mice not sensitized to ovalbumin.[440]


If you’re new to training, then check out some of the options found on the site and run them exactly as the author intended them to be executed. Too many young guns want to alter every training variable rather than running the program as written and focusing on getting stronger. No, you don’t need an entire day dedicated to arms when you can’t even complete a single chin-up.
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 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.
One study investigating the effects of creatine supplementation on people with osteoarthritis undergoing knee arthroplasty (surgical procedure for osteoarthritis), who received creatine at 10g daily for 10 days prior to surgery and 5g daily for a month afterward, failed to find benefit with supplementation.[424] This study failed to find any differences in muscular creatine stores or weight changes.[424]
If you're a beginner, start with a basic total body strength workout to build a strong foundation in all your muscle groups. Taking this time will help you figure out any weaknesses you have, as well as any issues you may need to address with your doctor, and learn the basic exercises you need for a strong, fit body. Your first step is to figure out where you're going to exercise.
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. 

2-[carbamimidoyl(methyl)amino]acetic acid, Cr, Creatin, Creatina, Créatine, Créatine Anhydre, Creatine Anhydrous, Creatine Citrate, Créatine Citrate, Creatine Ethyl Ester, Créatine Ethyl Ester, Creatine Ethyl Ester HCl, Créatine Ethyl Ester HCl, Creatine Gluconate, Creatine Hydrochloride, Créatine Kré Alkaline, Creatine Malate, Créatine Malate, Creatine Monohydrate, Créatine Monohydrate, Créatine Monohydratée, Creatine Pyroglutamate, Créatine Pyroglutamate, Creatine Pyruvate, Créatine Pyruvate, Dicreatine Malate, Dicréatine Malate, Di-Creatine Malate, Éthyle Ester de Créatine, Glycine, Kreatin, Kre-Alkalyn Pyruvate, Malate de Tricréatine, N-(aminoiminométhyl)-N-Méthyl, N-(aminoiminomethyl)-N methyl glycine, N-amidinosarcosine, Phosphocreatine, Phosphocréatine, Tricreatine HCA, Tricréatine HCA, Tricreatine Malate, Tricréatine Malate.
Key point: Past a certain number of sets, the marginal increases in protein synthesis NO LONGER outweigh the cost of doing more sets. If 8 sets of chest exercises produce 95% of possible muscle protein synthesis… then it makes very little sense to do ANOTHER 10 sets (like most chest workouts) to try and inch out the final 5% of stimulation. Those extra 10 sets are simply damaging your muscle unnecessarily and impairing your ability to recover.
Cyclocreatine (1-carboxymethyl-2-iminoimidazolidine) is a synthetic analogue of creatine in a cyclic form. It serves as a substrate for the creatine kinase enzyme system, acting as a creatine mimetic. Cyclocreatine may compete with creatine in the CK enzyme system to transfer phosphate groups to ADP, as coincubation of both can reduce cyclocreatine’s anti-motility effects on some cancer cells.[96]
Several studies have used either beet root juice or pomegranate extract in multi-ingredient performance supplements and have observed improvements in strength, hypertrophy, and performance in resistance-trained men. At this point, however, it's difficult to determine if these benefits are from beet root juice and pomegranate extract working alone or synergistically with other ingredients.[11,12]
This increased permeability is noted in glioma cells, where it exerts anti-cancer effects related to cell swelling,[99][100] and in other membranes, such as breast cancer cells[101] and skeletal (contractile) muscle cells.[102] The kinetics of cyclocreatine appear to be first-order,[101] with a relative Vmax of 90, Km of 25mM and a KD of 1.2mM.[103]
A meta-analysis of 16 studies conducted on creatine and its influence on power and strength,[368][369] (with or without exercise in all age groups above 16, but placebo controlled and without crossover[368]) compiled studies utilizing a 5-7 day loading period with continued maintenance thereafter and studies assessing 1-3 rep bench press strength in trained young men. Seven studies (four of which are online[370][371][372][373]) totaling 70 people using creatine and 73 people in placebo showed a 6.85kg increase in strength relative to placebo, the benefits of which peaked at 8 weeks.[368] This meta-analysis also quantified a significant increase in squat strength (9.76kg) yet failed to find a significant influence on peak bicep contraction power, which may have been influenced by the two null studies[374][375] being in elderly people while the positive study[376] was statistically outweighed, but noted an 1.8-fold increase in power associated with creatine over placebo. The other meta-analysis conducted the following year[369] calculated effect sizes for creatine supplementation and noted no significant differences between genders or when comparing trained and untrained individuals. The mean effect size of exercises lasting below 30s (those that use the creatine-phosphate system) was 0.24+/-0.02 and performed significantly better than placebo, where exercise increased performance by 4.2+/-0.6% while the addition of creatine enhanced this effect to 7.5+/-0.7%.[369]
Rheumatoid arthritis. Early research shows that taking creatine by mouth daily increases lean muscle mass and may improve muscle strength, but does not improve physical functioning in adults with rheumatoid arthritis. In children, taking a specific supplement containing creatine and fatty acids twice daily for 30 days might reduce pain and swelling. But the effects of creatine alone are not clear.

There appears to be some potential for creatine supplementation. However, many questions remain. Are there any long-term harmful effects from supplementation? Is there a point where enhanced performance levels off from long-term supplement usage? What effect does "stacking" or taking two ergogenic aids simultaneously have on the body? What happens if you immediately stop taking the creatine supplement? Is the enhanced performance great enough to warrant the expense of the supplement? Until further research answers these questions, creatine is not recommended for the average athlete.
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.[64] It has fairly decent intestinal absorption[65][12] (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.
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When you're in the middle of a strength-training session and something doesn't feel right to you, you feel pain, or if you hear or feel a "pop" during a workout, stop what you're doing. Have a doctor check it out before you go back to training. You may need to change your training or even stop lifting weights for a while to allow the injury to heal.
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]
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.
It has also been noted that supplementing creatine (which reduces internal synthesis of creatine and methylation requirements) preserved folate and tetrahydrofolate status (42% and 23%),[312] which acted to preserve methyl groups for other processes. Despite this effect, global DNA methylation decreases by 22% (assessed by the 5-methylcytosine/cytosine ratio) following creatine supplementation, which is usually seen as an anti-cancer effect in developed mammals.[461] This study was unable to demonstrate why this reduction occured[461] and opposing effects have been noted in females with Rett syndrome supplementing 200mg/kg creatine for 1 year, during which global methylation increased, secondary to preserving other methyl donors.[462]

Homocyteine (normal serum range of 5-14µM) is known to adversely affect motor control in genetically susceptible people when their levels exceed 500µM, which is usually associated with genetically induced deficiencies of B12.[360][361] In these particular instances (assessed by rats fed homocysteine to increase serum levels to such a high level[362][363]) it appears that administration of 50mg/kg creatine (injections) to these rats can protect dysfunction in muscle metabolism (pyruvate kinase activity, Krebs cycle intermediates, and muscle cell viability) induced by homocysteine.[363]
After all, if you’re doing more reps in a set, the weight would obviously be lighter and the intensity level lower. If you’re doing fewer reps in a set, the weight is obviously heavier and the intensity is higher. In addition, how close you come to reaching failure – aka the point in a set when you are unable to complete a rep – also plays a role here.
Crave instant gratification? Strength training is a good motivator because you see progress quickly. “If you put someone on a walking program, it will take time before they perceive their body is changing,” explains Katula. “But with strength training, you can feel a difference in your muscles even after one session.” And it only takes a couple workouts before you’ll notice some muscle definition in the mirror. (Go ahead and flex. We dare you.)

MuscleTech Cell-Tech is the best creatine stack. A lot of products claim to be more effective than regular monohydrate and while that’s seldom true, Cell-Tech has the goods. It combines creatine with a big 38 grams of carbohydrates and some alpha-lipolic acid, and some studies actually show that this trifecta could be more effective at sending creatine to the muscles than plain creatine.
The biggest mistake among young would-be bodybuilders is overdoing it, followed by not learning the proper techniques. Take those breaks and follow the correct form, or you'll give your body stress and injuries instead of muscle. Also make sure you're getting a large but balanced diet. Teens going through growth spurts need lots of food, especially when they're working out.
Age-related muscle loss: Many different dosing regimens have been used; however, most use a short-term “loading dose” followed by a long-term maintenance dose. Loading doses are typically 20 grams daily for 4-7 days. Maintenance doses are typically 2-10 grams daily. Older adults seem to only experience benefits from creatine supplementation when it is combined with resistance training.
The exercises that allow you to use the greatest amount of weight are the ones that help you build muscle the fastest. These also happen to be the lifts that allow for the greatest percentage of increases in loading. We’re talking compound (multi-joint) exercises here, done with free weights. You’re not going to grow at nearly the same rate with a workout comprising machine exercises and isolation movements.
A: Start with the calculations above but don’t be afraid to adjust up or down. Your metabolism and physiology will adapt to more food by trying to maintain homeostasis and regulate your bodyweight. Some may have to increase more than others but the number on the scale doesn’t lie. If it’s not going up, then you probably need to increase your calories.
Weight training aims to build muscle by prompting two different types of hypertrophy: sarcoplasmic and myofibrillar. Sarcoplasmic hypertrophy leads to larger muscles and so is favored by bodybuilders more than myofibrillar hypertrophy, which builds athletic strength. Sarcoplasmic hypertrophy is triggered by increasing repetitions, whereas myofibrillar hypertrophy is triggered by lifting heavier weight.[23] In either case, there is an increase in both size and strength of the muscles (compared to what happens if that same individual does not lift weights at all), however, the emphasis is different.
Some of these medications that can harm the kidneys include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.

A study showed that 100mg/kg creatine monohydrate daily over four months supplemented by boys with DMD is able to enhance handgrip strength in the dominant hand only (less than 10% increase) and increase whole-body lean mass. While the trend toward whole body strength reduction seen in placebo was ablated and there was no interaction with corticosteroids,[560] this study failed to find an influence on activities of daily living or lung function.[560] Elsewhere in children not on corticosteroids with DMD, supplementation of 5g creatine for eight weeks was confirmed to increase muscular phosphocreatine content[554] and according to a manual muscle test (MMT) there was a significant improvement in muscular function relative to placebo, with more parents reporting benefit with creatine (53.8%) relative to placebo (14%).[554]
Another study found that one week of creatine supplementation at 25 g/day enhanced muscular performance during repeated sets of bench press and jump squat exercise. Creatine supplementation appeared to allow the subjects to complete their workouts at a higher intensity. The researchers concluded that, over time, working at higher intensities may provide a more intense training stimulus and improved muscular adaptations [10].
A: Start with the calculations above but don’t be afraid to adjust up or down. Your metabolism and physiology will adapt to more food by trying to maintain homeostasis and regulate your bodyweight. Some may have to increase more than others but the number on the scale doesn’t lie. If it’s not going up, then you probably need to increase your calories.
McArdle’s disease is a myopathic disorder associated with fatigue and contractile dysfunction as a result of alterations in the release of glucose from glycogen (via defects in myophosphorylase enzyme function) resulting in an inability to conduct high intensity work as easily.[548] Creatine is thought to be therapeutic because beyond the general strength enhancing properties of creatine, people with McArdle’s disease have an upregulation of phosphofructokinase (PFK) enzyme activity [570] and increasing phosphocreatine storages suppresses the activity of this enzyme.[571]
In regard to liver fat buildup (steatosis), which is normally associated with reduced availability of S-adenosyl methionine[495][496] and a suppression in expression of genes involved in fatty acid oxidation (PPARα and CPT1), creatine supplementation at 1% of the rat diet alongside a diet that induces fatty liver is able to fully prevent (and nonsignificantly reduce relative to the control given standard diets) the aforementioned changes and the state of steatosis, as well as changes in serum biomarkers (glucose and insulin) that accompany steatosis.[125] 
The Branched-Chain Amino Acids, BCAAs for short, are leucine, valine and isoleucine.  Essentially, its a form of protein powder for muscle gain or other uses. These essential amino acids are not made by the body but are found in foods such as meats, dairy products and legumes. In medicine, BCAAs are used for a number of conditions, however, for many uses, further research is necessary to determine whether or not treatment is effective.

Fast twitch (or Type II fibers) fire very quickly, but also fatigue quickly, so they don’t last long.  It gets a bit more complicated, because there are actually two types of fast twitch fibers. Type IIA fibers have some endurance qualities (used for things such as longer sprints). While Type IIX fibers are our “super fast” fibers, used only when a super short burst is needed (like a 100 m sprint or a really heavy lift).
While some supplements may in fact provide health benefits, generally speaking, consumers should purchase and use these products cautiously as they are not closely regulated by the Food and Drug Administration (FDA). Also, bodybuilders are advised to discuss supplementation plans with a registered dietitian or primary care physician prior to use to optimize effectiveness and minimize potential harmful consequences. 
Creatine ethyl ester is more a pronutrient for creatinine rather than creatine,[74] and was originally created in an attempt to bypass the creatine transporter. It is currently being studied for its potential as a treatment for situations in which there is a lack of creatine transporters (alongside cyclocreatine as another possible example).[77] Its efficacy may rely on intravenous administration, however.

For many people in rehabilitation or with an acquired disability, such as following stroke or orthopaedic surgery, strength training for weak muscles is a key factor to optimise recovery.[35] For people with such a health condition, their strength training is likely to need to be designed by an appropriate health professional, such as a physiotherapist.
We hear this from 30 year olds and 60 year olds alike…and, like “I don’t have time,” it is a big fat lie! Even for the frail elderly, studies have shown that drastic results are possible in just 10 weeks of weightlifting (for both men and women in their 70s through their 90s). In fact, weight training has also been shown to delay Alzheimer’s and stave off dementia. So, if you think you might be “too old,” you’re probably the exact type of person that SHOULD be strength training!

Endurance exercise is also known to produce heat from skeletal muscle tissue, and an increase in internal temperature occurs when the production of heat (from metabolism) exceeds release. This increase in heat is accelerated when training in hot environments[390] and it is thought to be beneficial to retain water (hydration) during exercise, since more water allows a preservation of plasma volume (PV) and the sweat response reduces internal temperature.[391][392] This particular phenomena may only apply to endurance exercise, since creatine is able to increase sprint performance in heat, independent of altering the decline in PV and sweat rates.[393]
On January 16, 1904, the first large-scale bodybuilding competition in America took place at Madison Square Garden in New York City. The competition was promoted by Bernarr Macfadden, the father of physical culture and publisher of original bodybuilding magazines such as Health & Strength. The winner was Al Treloar, who was declared "The Most Perfectly Developed Man in the World".[5] Treloar won a $1,000 cash prize, a substantial sum at that time. Two weeks later, Thomas Edison made a film of Treloar's posing routine. Edison had also made two films of Sandow a few years before. Those were the first three motion pictures featuring a bodybuilder. In the early 20th century, Macfadden and Charles Atlas continued to promote bodybuilding across the world. Alois P. Swoboda was an early pioneer in America.
A: Depending upon your experience level, preference, recovery capacity, and time available, you’ll likely find that 3-5 strength training sessions per week is the sweet spot. If you’re just getting started with weight training, then you should stick with 3 days per week and work your way up. Novices and early intermediates can handle 4 days per week with a split such as an upper lower and seasoned intermediate lifters may be able to handle 5 sessions per week depending upon the programming, recovery, and nutrition strategies that are in place.
You've got your equipment ready, now it's time to choose about eight to 10 exercises, which comes out to about one exercise per muscle group. Use the list below to choose at least one exercise per muscle group to start. For the larger muscles, like the chest, back, and legs, you can usually do more than one exercise. These involve a variety of equipment, so you can choose based on what you have available.
Creatine ethyl ester is more a pronutrient for creatinine rather than creatine,[74] and was originally created in an attempt to bypass the creatine transporter. It is currently being studied for its potential as a treatment for situations in which there is a lack of creatine transporters (alongside cyclocreatine as another possible example).[77] Its efficacy may rely on intravenous administration, however.
In otherwise healthy adults subject to leg immobilization for two weeks while taking 20g creatine daily during immobilization and then 5g daily during eight weeks of rehabilitation, it was noted that the creatine group failed to reduce atrophy during the immobilization (10% reduction in cross sectional area and 22-25% reduction in force output) despite preventing a decrease in phosphocreatine, yet experienced a significantly enhanced rate of regrowth and power recovery.[358] A similarly structured and dosed study has also noted greater expression of skeletal muscle, GLUT4 expression, and a 12% increase in muscle phosphocreatine content.[330]
However, if you increase the demands you are placing on your body by increasing the weight being lifted, lifting the same weight for additional reps, or just doing something that increases the demands that your body needs to meet, then your body will have no other choice but to make the changes and improvements necessary for it to adapt to this environment and remain capable of performing these tasks.
A big clue is digestion. He does occasional cleanses. (“There’s no planes that week,” he said. “And no judgment at home.”) The slightest change in a muscle, just a stripe in a striation, is noticed. And while Heath does most workouts alone, he has a trainer, Hany Rambod, who is based in California. They see each other about once a month. In between, Heath sends photos and receives workout and dietary advice in return.
Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[42][43][44] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
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] 
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