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]
“Compared to training for strength, intensity is going to drop during the hypertrophy phase of a program, with intensity sitting between 50 and 75 percent of the person’s 1RM, the maximum weight he or she can lift for one rep,” says Ava Fitzgerald, C.S.C.S., C.P.T., a sports performance coach with the Professional Athletic Performance Center in New York.

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!


While they don’t play a big role, your body’s lean body mass and muscle strength is somewhat influenced by genetics. Actually, it’s good that they don’t have too much of an influence. Why? Because that means you have more of an influence on your muscle mass through your lifestyle. You can control it! If genetics were a determining factor, there wouldn’t be much you could do to change your situation.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.

Adequate hydration is essential to muscle building, yet few people get enough water, even without daily exercise. So in addition to the daily 8 to 10 glasses of water recommended by the Dietary Guidelines for Americans, Karas suggests an additional 12 to 16 ounces before working out. He then recommends another 8 to 10 ounces for every 15 minutes of vigorous exercise.


Furthermore, because creatine can help restore ATP levels, increasing energy, it can lead to reduced amounts of heart muscle stress. More energy in your life will result in less pain, stress, and boost morale in everyday life which has a significant role in improving heart health. The increased capacity to exercise is also crucial in maintaining and improving heart health.


Ballistic training incorporates weight training in such a way that the acceleration phase of the movement is maximized and the deceleration phase minimized; thereby increasing the power of the movement overall. For example, throwing a weight or jumping whilst holding a weight. This can be contrasted with a standard weight lifting exercise where there is a distinct deceleration phase at the end of the repetition which stops the weight from moving.[40]
^ Jump up to: a b c d e Cooper R, Naclerio F, Allgrove J, Jimenez A (July 2012). "Creatine supplementation with specific view to exercise/sports performance: an update". Journal of the International Society of Sports Nutrition. 9 (1): 33. doi:10.1186/1550-2783-9-33. PMC 3407788. PMID 22817979. Creatine is produced endogenously at an amount of about 1 g/d. Synthesis predominately occurs in the liver, kidneys, and to a lesser extent in the pancreas. The remainder of the creatine available to the body is obtained through the diet at about 1 g/d for an omnivorous diet. 95% of the bodies creatine stores are found in the skeletal muscle and the remaining 5% is distributed in the brain, liver, kidney, and testes [1].
A double-blind study provided 20 g/day of creatine monohydrate for 5 days to qualified sprinters and jumpers who performed 45 seconds of continuous jumping and 60 seconds of continuous treadmill running. Supplementation enhanced performance in the jumping test by 7% for the first 15 seconds and 12% for the next 15 seconds, but there was no difference for the final 15 seconds. There was a 13% improvement in the time of intensive running to exhaustion [12].
^ Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL (2017-06-13). "International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine". Journal of the International Society of Sports Nutrition. 14: 18. doi:10.1186/s12970-017-0173-z. PMC 5469049. PMID 28615996.
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]
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.
That said, many people experience stomach cramps when they consume creatine monohydrate and it’s possible that taking a creatine with a different pH — usually creatine hydrochloride — can have a different effect on stomach acid and make for a creatine that digests more easily. As far as we know, the easier digestion doesn’t necessarily mean it’s more effective or that you need less of it to achieve the desired result.
If you have been diagnosed with a certain testosterone deficiency, ask your doctor and/or pharmacist to see if TestoFuel could be beneficial for you. Aside from balancing your testosterone, you may experience increased muscle strength while using this supplement during your intense exercise routine. Here are certain instances where TestoFuel could help correct your testosterone problems:
You’ll Feel Better: Not only will you find yourself with more energy and confidence, less stress and anxiety, and a better overall mood, but you’ll actually begin to think better (resistance training has been proven to help increase cognitive function). And while training too close to bedtime can be a bad idea, exercising earlier in the day has been proven to help prevent sleep apnea and insomnia. I even improved my posture – when I started lifting, I was 5’4”.  Now I’m 5’5.5”.
Objective: Are you getting stronger? Increasing either weight or reps? If you're measuring individual markers on a daily basis like vertical jump, grip strength, or resting heart rate then what sort of trends are you noticing in these variables? If they're staying the same while your strength is increasing, then you're recovering well. If they're decreasing and you find yourself weaker over time then you're not recovering well.

Kidney damage (from anything) will cause high levels of creatinine in blood, and creatine can also increase blood creatinine levels in a manner that is not due to damaging the kidneys. This results in a false positive when trying to diagnose kidney damange when the subject also supplements creatine, and does not signify any actual damage to the kidneys.


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.
Sandow was so successful at flexing and posing his physique that he later created several businesses around his fame, and was among the first to market products branded with his name. He was credited with inventing and selling the first exercise equipment for the masses: machined dumbbells, spring pulleys, and tension bands. Even his image was sold by the thousands in "cabinet cards" and other prints. Sandow was a perfect "Gracilian", a standard of ideal body proportions close to those of ancient Greek and Roman statues. Men's physiques were then judged by how closely they matched these proportions.

That means it's an important part of your overall fitness and it benefits people of all ages, plus it may be particularly important for people with health issues such as obesity, arthritis, or a heart condition. The Centers for Disease Control Prevention physical activity guidelines recommend that adults do muscle-strengthening activities on at least two or more days each week (targeting the legs, hips, back, abdomen, chest, shoulders, and arms). (2)
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]
In humans, studies that investigate links between serotonin and creatine supplementation find that 21 trained males, given creatine via 22.8g creatine monohydrate (20g creatine equivalent) with 35g glucose, relative to a placebo of 160g glucose, was found to reduce the perception of fatigue in hot endurance training, possibly secondary to serotonergic modulation, specifically attentuating the increase of serotonin seen with exercise (normally seen to hinder exercise capacity in the heat[233]) while possibly increasing dopaminergic activity (conversely seen to benefit activity in the heat[234]).[155]
Electrolytes derive mainly from minerals in the diet and they maintain fluid balance and assist the nervous system to perform muscle contractions. Electrolytes are sodium, potassium, magnesium, calcium and chloride, bicarbonate, phosphate, sulfate. Exercisers are particularly dependent on sodium and potassium balance. Carbohydrates are important for fueling exercise, including vigorous weight training, and in post-exercise energy replacement nutrition. Carbohydrates, mostly sugars, are formulated in sports drinks with electrolytes such as sodium chloride and potassium and sometimes magnesium.
Creatine is known to occur in highly concetrated levels in chicken photoreceptors, relative to other parts of the eye (10-15mM[466]) alongside high levels of creatine kinase.[466] The creatine transporter in human eyes also seems to be concentrated in the photoreceptors,[468] which are known to be susceptible to hypoxic cellular death[471][472] which, for humans, usually means retinal detachment.[473]
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.

Take time to rest. To give your muscles time to recover, rest one full day between exercising each specific muscle group. You might choose to work the major muscle groups at a single session two or three times a week, or plan daily sessions for specific muscle groups. For example, on Monday work your arms and shoulders, on Tuesday work your legs, and so on.


When lifting any weight, you’ve got a concentric (hard) and eccentric (easy) phase. For instance, as you lower into a squat, you’re performing an eccentric action. When you return to standing, that’s concentric. And, according to research published in the European Journal of Applied Physiology, eccentric work is far better at triggering hypertrophy.

^ Jump up to: a b c d e Cooper R, Naclerio F, Allgrove J, Jimenez A (July 2012). "Creatine supplementation with specific view to exercise/sports performance: an update". Journal of the International Society of Sports Nutrition. 9 (1): 33. doi:10.1186/1550-2783-9-33. PMC 3407788. PMID 22817979. Creatine is produced endogenously at an amount of about 1 g/d. Synthesis predominately occurs in the liver, kidneys, and to a lesser extent in the pancreas. The remainder of the creatine available to the body is obtained through the diet at about 1 g/d for an omnivorous diet. 95% of the bodies creatine stores are found in the skeletal muscle and the remaining 5% is distributed in the brain, liver, kidney, and testes [1].
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] 
Objective: Are you getting stronger? Increasing either weight or reps? If you're measuring individual markers on a daily basis like vertical jump, grip strength, or resting heart rate then what sort of trends are you noticing in these variables? If they're staying the same while your strength is increasing, then you're recovering well. If they're decreasing and you find yourself weaker over time then you're not recovering well.

Anti-depressive effects have been noted in woman with major depressive disorder when 5g of creatine monohydrate was supplemented daily for 8 weeks in combination with an SSRI. Benefits were seen at week two and were maintained until the end of the 8-week trial.[253] The improvement in depressive symptoms was associated with significantly increased prefrontal cortex levels of N-acetylaspartate, a marker of neuronal integrity,[254] and rich club connections, which refers to the ability of nerons to make connections to one another.[255]
A commercially available pre-workout formula comprised of 2.05 g of caffeine, taurine and glucuronolactone, 7.9 g of L-leucine, L-valine, L-arginine and L-glutamine, 5 g of di-creatine citrate and 2.5 g of β-alanine mixed with 500 ml of water taken 10 minutes prior to exercise has been shown to enhance time to exhaustion during moderate intensity endurance exercise and to increase feelings of focus, energy and reduce subjective feelings of fatigue before and during endurance exercise due to a synergistic effect of the before mentioned ingredients [72]. The role of creatine in this formulation is to provide a neuroprotective function by enhancing the energy metabolism in the brain tissue, promoting antioxidant activities, improving cerebral vasculation and protecting the brain from hyperosmotic shock by acting as a brain cell osmolyte. Creatine can provide other neuroprotective benefits through stabilisation of mitochondrial membranes, stimulation of glutamate uptake into synaptic vesicles and balance of intracellular calcium homeostasis [72].

Weight training is primarily an isotonic form of exercise, as the force produced by the muscle to push or pull weighted objects should not change (though in practice the force produced does decrease as muscles fatigue). Any object can be used for weight training, but dumbbells, barbells, and other specialised equipment are normally used because they can be adjusted to specific weights and are easily gripped. Many exercises are not strictly isotonic because the force on the muscle varies as the joint moves through its range of motion. Movements can become easier or harder depending on the angle of muscular force relative to gravity; for example, a standard biceps curl becomes easier as the hand approaches the shoulder as more of the load is taken by the structure of the elbow. Originating from Nautilus, Inc., some machines use a logarithmic-spiral cam to keep resistance constant irrespective of the joint angle.
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]
Weight training is primarily an isotonic form of exercise, as the force produced by the muscle to push or pull weighted objects should not change (though in practice the force produced does decrease as muscles fatigue). Any object can be used for weight training, but dumbbells, barbells, and other specialised equipment are normally used because they can be adjusted to specific weights and are easily gripped. Many exercises are not strictly isotonic because the force on the muscle varies as the joint moves through its range of motion. Movements can become easier or harder depending on the angle of muscular force relative to gravity; for example, a standard biceps curl becomes easier as the hand approaches the shoulder as more of the load is taken by the structure of the elbow. Originating from Nautilus, Inc., some machines use a logarithmic-spiral cam to keep resistance constant irrespective of the joint angle.

If you have been training properly for at least three years, you’ll find that advanced pump-enhancing techniques like rest-pause sets, drop sets, and some of the other old-school bodybuilding techniques you’ve no doubt heard of can be effective when used sparingly. Just be sure not to overdo the use of them. And never get away from the most important rule: setting PR’s to get stronger.
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.
Extracellular creatine (creatine outside of a cell) appears to influence creatine uptake into a cell. It seems that prolonged and excessive levels of creatine actually suppress uptake (a form of negative regulation to prevent excessive influx).[180] In vitro studies in rat muscle cells have shown that including 1mM creatine into cell culture medium substantially reduces creatine uptake into cells. The inhibitory effect was partially negated by protein synthesis inhibitors, suggesting that high levels of creatine induce the expression of a protein that suppresses creatine transporter activity.[180] Similar findings were reported in a later study in cultured mouse myoblasts, which noted a 2.4-fold increase in intracellular creatine levels in the presence of the protein synthesis inhibitor cyclohexamide.[174]

Synthesis primarily takes place in the kidney and liver, with creatine then being transported to the muscles via the blood. The majority of the human body's total creatine and phosphocreatine stores is located in skeletal muscle, while the remainder is distributed in the blood, brain, and other tissues.[17][18][20] Typically, creatine is produced endogenously at an estimated rate of about 8.3 mmol or 1 gram per day in young adults.[16][17] Creatine is also obtained through the diet at a rate of about 1 gram per day from an omnivorous diet.[17][18] Some small studies suggest that total muscle creatine is significantly lower in vegetarians than non-vegetarians, as expected since foods of animal origin are the primary source of creatine. However, subjects happened to show the same levels after using supplements.[21]
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