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.
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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. Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
When Katula started his research on whether weight training would improve quality of life for seniors, he realized that many had never even picked up a dumbbell. “They first had to learn how to use these big intimidating weights and machines,” he says. He recalls the story of one woman who protested that she couldn’t do the leg press machine. Finally, Katula persuaded her to sit in the machine and set the weight at 50 pounds. “I couldn’t believe how fast she whipped out 10 reps,” he says, “When she got out of that machine, she was two inches taller just from increased pride.”
It is known that intracellular energy depletion (assessed by a depletion of ATP) stimulates AMPK activity in order to normalize the AMP:ATP ratio, and when activated AMPK (active in states of low cellular energy and colocalizes with creatine kinase in muscle tissue) appears to inhibit creatine kinase via phosphorylation (preserving phosphocreatine stores but attenuating the rate that creatine buffers ATP). While phosphocreatine technically inhibits AMPK, this does not occur in the presence of creatine at a 2:1 ratio. It seems that if the ratio of phosphocreatine:creatine increases (indicative of excess cellular energy status) that AMPK activity is then attenuated, since when a cell is in a high energy status, there is less AMP to directly activate AMPK.