Do you know what happens when a person attempts to build muscle faster than they legitimately can? They fail, and then they wonder why it’s not working as quickly as they thought it would. From there, they’ll jump from workout to workout, diet to diet and useless supplement to useless supplement in the hopes of finally finding the missing link that will make it happen. But they’re never going to find it. They’ll just keep wasting their time, effort and money searching for something that doesn’t exist. 

We’ll be talking more about this later, but for now, just give it a shot! In strength training you can see your progress so clearly that as you can do more and more, you’ll also be rewarded by seeing your strength progress from level 1 to level 50! If you aren’t a fan of the downtime, put on a book on tape or throw on your favorite playlist while circuit training to ensure you’re always moving (instead of sitting and waiting in between sets).
Children: Creatine is POSSIBLY SAFE in children when taken by mouth appropriately. Creatine 3-5 grams daily for 2-6 months has been taken safely in children 5-18 years of age. Creatine 2 grams daily for 6 months has been taken safely in children 2-5 years of age. Additionally, creatine 0.1-0.4 grams/kg daily for up to 6 months has been taken safely in both infants and children.
To meet the demands of a high-intensity exercise, such as a sprint, muscles derive their energy from a series of reactions involving adenosine triphosphate (ATP), phosphocreatine (PCr), adenosine diphosphate (ADP), and creatine. ATP, the amount of which is relatively constant, provides energy when it releases a phosphate molecule and becomes ADP. ATP is regenerated when PCr donates a phosphate molecule that combines with ADP. Stored PCr can fuel the first 4-5 seconds of a sprint, but another fuel source must provide the energy to sustain the activity. Creatine supplements increase the storage of PCr, thus making more ATP available to fuel the working muscles and enable them to work harder before becoming fatigued [1].
Phosphocreatine is known to be a major source of energy for cardiac tissue alongside fatty acids, which are dominant under periods of normoxia (normal oxygen) while phosphocreatine becomes more important in periods of hypoxic stress.[281][282][283] The entire CK system plays a role in the recovery of the heart following ischemic/hypoxic stress, since blocking CK activity impairs recovery[284][285] and overexpressing CK activity promotes it.[286] This is due to the heart tissue needing high energy phosphate groups at this time, and the ischemic stress reduces CK activity and the ability of CK to donate these groups.[287][288]

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(1):151-155. View abstract.

The neuroprotective effects of creatine appear to exist in regard to dopamine biosynthesis, and the suppression of dopamine synthesis seen with some neurological toxins appears to be partially attenuated with dietary intake of creatine. The protective effect is weak to moderate in animal research, but appears to be additive with anti-inflammatories.
Compound exercises work several muscle groups at once, and include movement around two or more joints. For example, in the leg press, movement occurs around the hip, knee and ankle joints. This exercise is primarily used to develop the quadriceps, but it also involves the hamstrings, glutes and calves. Compound exercises are generally similar to the ways that people naturally push, pull and lift objects, whereas isolation exercises often feel a little unnatural.
Creatine retention (assessed by urinary analysis) tends to be very high on the first loading dose (65±11%) and declines throughout the loading phase (23±27%).[203] This is likely due to increased muscular uptake when creatine stores are relatively low, which has been noted in vegetarians. So, creatine absorption is very high initially, but decreases througout the loading phase, as muscle creatine stores increase.[204]
If you're using a resistance band, keep in mind that one band might not cut it for your entire body. Different muscles have different strengths, so you may want to buy two different resistance bands in different thickness, which determines how difficult they'll be to use. In general, if you're able to complete 8 reps of an exercise using a band, you'll want to select another that provides a greater amount of resistance. 
If you're using a resistance band, keep in mind that one band might not cut it for your entire body. Different muscles have different strengths, so you may want to buy two different resistance bands in different thickness, which determines how difficult they'll be to use. In general, if you're able to complete 8 reps of an exercise using a band, you'll want to select another that provides a greater amount of resistance. 
In recent years, the related areas of fitness and figure competition have increased in popularity, surpassing that of female bodybuilding, and have provided an alternative for women who choose not to develop the level of muscularity necessary for bodybuilding. McLish would closely resemble what is thought of today as a fitness and figure competitor, instead of what is now considered a female bodybuilder. Fitness competitions also have a gymnastic element to them. A study by the Clinical Journal of Sport Medicine found that female bodybuilders who are taking anabolic steroids are more likely to have qualified for substance dependence disorder, to have been diagnosed with a psychiatric illness, or to have a history of sexual abuse.[14]
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).[545] Creatine has elsewhere failed to benefit lung function at 5g daily for months relative to control[546] and failed to significantly attenuate the rate of lung function deterioration over 16 months at 10g daily[505] and 5g daily over nine months.[507]
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]
So, for example, with the moves above you'd do 15 squats followed by 15 push-ups. Take a little breather then repeat that two more times. Then you move on to your walking lunges and lat pull-downs (and repeat those three times total, too). You can really do anywhere from eight reps to 15 (and even just two sets, if you don't have time for three), but "it’s not a bad idea for beginners to start with a 15-rep range to get comfortable with the exercises," says Davis. And while there's some debate over whether three sets of an exercise is really best, "it’s a great beginner model," says Davis. Don't overcomplicate things when you're just getting started.

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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.
If you are underweight or have a naturally scrawny build, you may struggle to gain weight, let alone muscle mass, no matter what you do. Eating at all hours of the day and night can be exhausting and require frequent trips to the grocery store. Unless you are overweight, you likely need to create a caloric surplus in order to gain muscle. With a weight gainer powder, you can supplement a healthy diet with the additional calories you need to gain weight in muscle.

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]

Bryant, a lawyer and sports agent, opened a case of manila file folders and spread them on the desk like playing cards. Each was labeled: Phil Heath Enterprises, Sponsors, Taxes, Travel and so on. Bryant, Heath and Cremona discussed Heath’s clothing line and his sponsorships. They talked about his desire for a shoe deal and a larger hyperbaric chamber at his house.


A typical creatine supplementation protocol consists of a loading phase of 20 g CM/d or 0.3 g CM/kg/d split into 4 daily intakes of 5 g each, followed by a maintenance phase of 3-5 g CM/d or 0.03 g CM/kg/d for the duration of the supplementation period [5]. Other supplementation protocols are also used such as a daily single dose of around 3 – 6 g or between 0.03 to 0.1 g/kg/d [15,55] however this method takes longer (between 21 to 28 days) to produce ergogenic effects [5]. Sale et al [56] found that a moderate protocol consisting of 20 g CM taken in 1g doses (evenly ingested at 30-min intervals) for 5 days resulted in reduced urinary creatine and methylamine excretion, leading to an estimated increase in whole body retention of creatine (+13%) when compared with a typical loading supplementation protocol of 4 x 5 g/d during 5 days (evenly ingested at 3 hour intervals). This enhancement in creatine retention would lead to a significantly higher weight gain when people follow a moderate protocol ingestion of several doses of small amounts of CM evenly spread along the day.
As a ingredient that has been tested time and time again and shown to positively affect the building of muscle, GAT has taken the highest-quality compound to create Essentials Creatine. Using HPLC-tested pharmaceutical grade creatine that's tested to be 99.9% pure, Essentials Creatine provides 5 grams in every serving which can increase muscle size, boost strength, and enhance muscle recovery.	Keep Reading » 

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.
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.

*Always remember: weight loss results & health changes/improvements vary from individual to individual. Just because these studies cite certain data does not mean you will experience these results/outcomes. Always consult with your doctor before making decisions about your health. This is not medical advice – simply well-researched information and tips to sleep better. Thanks for reading!
The creatine kinase system appears to be detectable in endothelial cells.[314][315] Under basal conditions, creatine itself is expressed at around 2.85+/-0.62μM[316] (three-fold higher than HUVEC cells[314]). When incubating the medium with 0.5mM creatine, endothelial cells can take up creatine via the creatine transporter (SLC6A8) and increase both creatine (almost doubling) and phosphocreatine (nearly 2.5-fold) concentrations.[316]
A: At the end of the day, the most important variable regarding weight gain or loss is calorie consumption. However, meal frequency and timing around activity can both influence workout intensity and duration thus potentially allowing for further improvements in body composition. Remember, muscle growth isn’t a pulsatile process, it doesn’t just acutely spike and then return to baseline so if there aren’t circulating amino acids within the blood stream then they’ll have to be broken down from muscle as this is the highest form of concentrated amino acids within the body. That being said, it would probably be a good idea to consume anywhere from 3-6 meals spread throughout the day depending upon your schedule and preference. Ideally, we want to stimulate anabolism through food every 3-5 hours.
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]
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.
In contrast to the above null effects, ingestion of creatine both before and after a workout (alongside protein and carbohydrate) over 10 weeks seems to promote muscle growth more than the same supplement taken in the morning, farther away from the time of the workout.[386] The benefits of creatine around the workout, relative to other times, have been hypothesized[387] to be related to an upregulation of creatine transport secondary to muscle contraction, a known phenomena.[153]
If you're a beginner, just about any workout will be intense enough to increase protein synthesis. But if you've been lifting for a while, you'll build the most muscle quickest if you focus on the large muscle groups, like the chest, back, and legs. Add compound lifts like squats, deadlifts, pullups, bent-over rows, bench presses, dips, and military presses to your workout to work them the most efficiently.

Due to this relative deficiency-state in vegetarians and vegans, some aspects of creatine supplementation are seen as more akin to normalizing a deficiency, rather than providing the benefits of supplementation. In young vegetarians, but not omnivores, creatine supplementation can enhance cognition.[60][61] The increased gain in lean mass may be more significant in vegetarians, relative to omnivores.[59] Supplementation of creatine in vegetarians appears to normalize the gap in storage between vegetarians and omnivores.[62] This is possibly related to a correlation seen in survey research, where vegetarianism and veganism appear to be more commonly affected by some mental disorders like anxiety and depression.[63]
Universal Real Gains is a powerful mass gainer -- each serving contains 602 calories with 53 grams of protein, 84 grams of effective carbohydrates and 5 grams of fiber. It also includes over 15 amino acids and 10 vitamins and minerals to support your muscle building quest. This easy to mix formula is a convenient addition to any shake so you can put on mass and size. You will not find a mass gainer like this anywhere else on the market. Keep Reading »

“I would really focus on learning how macros work, how your body works and how it reacts to certain foods, and what your body requires each day to maintain your weight,” he advises. “Then you can start playing around with increasing calories [to bulk up], and decreasing calories when you're dieting.” Our beginner's guide to macros will definitely help.
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.
Cornelissen et al [80] analyzed the effects of 1 week loading protocol (3 X 5 g/d CM) followed by a 3 month maintenance period (5 g/d) on cardiac patients involved in an endurance and resistance training program. Although CM supplementation did not significantly enhance performance, markers of renal and liver function were within normal ranges indicating the safety of the applied creatine supplementation protocol.
Another part of training isn't just doing the exercises, it's resting between the exercises. This comes with experience, but the general rule is, the higher the reps, the shorter the rest. So, if you're doing 15 reps, you might rest about 30 to 60 seconds between exercises. If you're lifting very heavy, say 4 to 6 reps, you may need up to two or more minutes.
One of the biggest goals of bodybuilders is to increase their muscle size and strength. Bodybuilding supplements often contain many ingredients that help to encourage this. Branched-chain amino acids are a common ingredient that can significantly increase muscle growth. Other ingredients help to increase the levels of hormones, such as growth hormone and testosterone, that can also stimulate muscle growth.
If you touch your phone between exercise sets, it better be to set its timer to 30 to 90 seconds. When lifting for hypertrophy, rest periods of 30 to 90 seconds encourage a quick release in muscle-building hormones (including testosterone and human growth hormone) while also making sure that you really, truly fatigue your muscles, according to Fitzgerald.

Han:SPRD‐cy rats (human polycystic kidney disease model[514][515]) have pre-existing renal damage, which is accelerated upon ingestion of creatine supplementation at 0.3% of the diet for five days and 0.03-0.05% for the next 35 days (equivalent to human loading and maintenance).[516] During this particular disease state, renal water content and size progressively increases.[514][515] Since creatine supplementation furthered the increase by an additional 2.1%, it was thought that this property of creatine explained the 23% increased cyst scores seen relative to control.[516]


Pro Tip: Zane also suggests that directed concentration is exceptionally important to getting the most from your training and is much easier with lower weight. If you can concentrate on the muscle through its whole movement, you will notice that the intensity will be just as strong, without the risk. We teach you this in our “Mind Muscle Connection” Bonus Guide that we include in our Old School Muscle 8-Week Program.

In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline).[485] This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.[485]

That soreness you feel post-strength session may seem like a setback. Yet over time, you’ll come to acknowledge that it signifies you’re getting stronger. “You think, ‘I’ve done something worthwhile. My body is telling me I’ve had a workout.’ You look forward to the fatigue and interpret it in a positive way,” says John Spence, PhD, professor of physical education and recreation at the University of Alberta in Canada, who wrote a review on the effect of exercise on self-esteem. (Wondering how sore is too sore to work out? Here’s your answer.)


Include cardio training. Good cardiovascular health improves blood flow, a requirement for muscle growth. Doing cardio also improves your cardiovascular fitness, which allows you to use your muscle gains for various sports and activities. The standard recommendation is 150 minutes of moderate cardio each week, or 75 minutes of vigorous cardio, or an equivalent combination of the two. A good place to start would be doing 30-60 minutes of cardiovascular activity every other day or 3 times a week. Examples of cardio include running, biking, swimming, and any sport that involves constant movement.
Researchers have long been interested in how exercise improves cognitive thinking — and whether it can ward off dementia later in life. Now, a whole slew of new studies is comparing whether strength training affects the brain differently than cardio. One Italian study of 80 older people found that those who completed a 12-week strength regimen showed improved capacity for practical skills, whereas cardio training helped bolster them on analytic tasks. Researchers are still trying to understand the “why” behind this study — but so far, we’re impressed.

When it comes to building muscle, your body only knows or cares about the tension, fatigue and damage an exercise is generating… not the type of equipment you were using when performing that exercise. It really couldn’t give the slightest crap about that. For this reason, ALL types of exercises and ALL types of equipment are capable of stimulating muscle growth.


In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline).[485] This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.[485]
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]
Bodybuilders often split their food intake for the day into 5 to 7 meals of roughly equal nutritional content and attempt to eat at regular intervals (e.g. every 2 to 3 hours). This method can serve two purposes: to limit overindulging in the cutting phase, and to physically allow for the consumption of large volumes of food during the bulking phase. Contrary to popular belief, eating more frequently does not increase basal metabolic rate when compared to the traditional 3 meals a day. While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.[38][39][40]

Many other important bodybuilders in the early history of bodybuilding prior to 1930 include: Earle Liederman (writer of some of bodybuilding's earliest books), Zishe Breitbart, Georg Hackenschmidt, Emy Nkemena, George F. Jowett, Finn Hateral (a pioneer in the art of posing), Frank Saldo, Monte Saldo, William Bankier, Launceston Elliot, Sig Klein, Sgt. Alfred Moss, Joe Nordquist, Lionel Strongfort ("Strongfortism"),[6] Gustav Frištenský, Ralph Parcaut (a champion wrestler who also authored an early book on "physical culture"), and Alan P. Mead (who became an impressive muscle champion despite the fact that he lost a leg in World War I). Actor Francis X. Bushman, who was a disciple of Sandow, started his career as a bodybuilder and sculptor's model before beginning his famous silent movie career.

Eat 1.5–3 grams of carbs per pound of your body weight. As with fat, this amount can vary greatly, depending on your personal needs and preferences, so consider these numbers only a starting point. If you’re very skinny and feel that you handle carbs well (i.e. you can eat a lot of them without getting fat), go ahead and eat according to the higher end of the spectrum. The same applies if you’re desperate to gain weight—you should increase your carb intake. If you’re prone to weight gain or feel lethargic on higher carbs, you should eat fewer of them. Again, see our keto guide for more details and options.
While the aforementioned study insinuated that after was better, at this time the “just take it at any time” or maybe more appropriately, “take it when it works for you” is the best way to go. Many people take supplements that include creatine, so if that’s in your pre- or post- workout drink, you should receive all the benefits. Optimal dosing still appears to be between 2 to 5 grams per day. You can “load” for the first 5 to 7 days to help saturate your cells, but beyond that there’s no benefit to taking large amounts. So save your money and take the smaller dose; it’ll still offer maximum results.
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.
Consult your physician and follow all safety instructions before beginning any exercise program or using any supplement or meal replacement product, especially if you have any unique medical conditions or needs. The contents on our website are for informational purposes only, and are not intended to diagnose any medical condition, replace the advice of a healthcare professional, or provide any medical advice, diagnosis, or treatment.

Now, if you are somebody that is more of the “do-it-yourself” type, check out our self-paced online course, the Nerd Fitness Academy. The Academy has 20+ workouts for both bodyweight or weight training, a benchmark test to determine your starting workout, HD demonstrations of every movement, boss battles so you know when you to level up your routine, meal plans, a questing system, and supportive community.
The winner of the annual IFBB Mr. Olympia contest is generally recognized as the world's top male professional bodybuilder. The winner of the Women's Physique portion of the competition is widely regarded as the world's top female professional bodybuilder. The title is currently held by Juliana Malacarne, who has won every year since 2014. Since 1950, the NABBA Universe Championships have been considered the top amateur bodybuilding contests, with notable winners such as Reg Park, Lee Priest, Steve Reeves, and Arnold Schwarzenegger. Winners generally go on to become professional athletes.
Legion’s Recharge is a good pick for muscle growth. Besides the creatine itself, it contains a hefty 2.1 grams of l-carnitine l-tartrate, which has solid links with improving muscle repair in addition to increasing focus during workouts. It’s also delicious, naturally sweetened, and it contains ingredients that may improve insulin sensitivity and help the body to better utilize carbs for recovery.

^ Jump up to: a b Barcelos RP, Stefanello ST, Mauriz JL, Gonzalez-Gallego J, Soares FA (2016). "Creatine and the Liver: Metabolism and Possible Interactions". Mini Reviews in Medicinal Chemistry. 16 (1): 12–8. doi:10.2174/1389557515666150722102613. PMID 26202197. The process of creatine synthesis occurs in two steps, catalyzed by L-arginine:glycine amidinotransferase (AGAT) and guanidinoacetate N-methyltransferase (GAMT), which take place mainly in kidney and liver, respectively. This molecule plays an important energy/pH buffer function in tissues, and to guarantee the maintenance of its total body pool, the lost creatine must be replaced from diet or de novo synthesis.
Branched-chain amino acids (leucine, isoleucine, valine) play important roles in muscle building. Some researchers have found that following exercise, the branched-chain amino acids, especially leucine, increase the rate of protein synthesis and decrease the rate of protein catabolism (Blomstrand, 2006). The billion dollar supplement industry has been quick to respond; leucine supplements are widely available in health food stores, with a cost upwards of $50 per container. However, because the research findings are inconsistent and little is known about the safety of these products, the American Dietetic Association (soon to be renamed the Academy of Nutrition and Dietetics) advises against individual amino acid supplementation and protein supplementation overall (Rodriquez, 2009). It may be that food sources of these proteins and amino acids provide the same effect for a small fraction of the cost.
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).[545] Creatine has elsewhere failed to benefit lung function at 5g daily for months relative to control[546] and failed to significantly attenuate the rate of lung function deterioration over 16 months at 10g daily[505] and 5g daily over nine months.[507]
Han:SPRD‐cy rats (human polycystic kidney disease model[514][515]) have pre-existing renal damage, which is accelerated upon ingestion of creatine supplementation at 0.3% of the diet for five days and 0.03-0.05% for the next 35 days (equivalent to human loading and maintenance).[516] During this particular disease state, renal water content and size progressively increases.[514][515] Since creatine supplementation furthered the increase by an additional 2.1%, it was thought that this property of creatine explained the 23% increased cyst scores seen relative to control.[516]
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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