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].

The largest determiner of your metabolic rate is actually your total body mass. “The more cells, even fat cells, in your body, the more furnaces you have burning at any given time,” Dr. Church says. Think of it this way: It takes more juice to charge your tablet than it does to charge your phone. People who are taller and have a larger bone structure, therefore, will have a higher BMR than people who are shorter and have a slimmer build. While you can control your body mass to some extent by gaining or losing weight, you can’t change your height or your bone structure. All in all, most of a person’s BMR is determined by genetic factors, Dr. Church says.
Rice Protein: An alternative protein powder for muscle gain, rice protein is ideal for people who are lactose intolerant or have a milk allergy. As far as muscle gain and body composition when taken post-workout, this study showed that there was zero difference in outcomes when comparing taking whey protein and rice protein. So, if you prefer using rice protein, you can take it with confidence knowing that you’ll be able to achieve the same results you’d achieve if you were taking whey protein.
Creatine is classified as a "dietary supplement" under the 1994 Dietary Supplement Health and Education Act and is available without a prescription. Creatine is not subjected to FDA testing, and the purity and hygienic condition of commercial creatine products may be questionable [21]. A 1998 FDA report lists 32 adverse creatine-associated events that had been reported to FDA. These include seizure, vomiting, diarrhea, anxiety, myopathy, cardiac arrhythmia, deep vein thromboses and death. However, there is no certainty that a reported adverse event can be attributed to a particular product [22]. A recent survey of 28 male baseball players and 24 male football players, ages 18 to 23, found that 16 (31%) experienced diarrhea, 13 (25%) experienced muscle cramps, 7 (13%) reported unwanted weight gain, 7 (13%) reported dehydration, and 12 reported various other adverse effects [23].
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.)
For the sake of mental focus, it’s best to keep any carbs you eat low during the day when you’re working and active and get the lion’s share of them at night with dinner. A typical breakfast could include eggs, yogurt, and fruit, or a shake, and lunch could be meat or fish and steamed veggies. For dinner, have meat or fish again, along with sweet potatoes or rice, and vegetables.
In October 1994, the Dietary Supplement Health and Education Act (DSHEA) was signed into law in the USA. Under DSHEA, responsibility for determining the safety of the dietary supplements changed from government to the manufacturer and supplements no longer required approval from the U.S. Food and Drug Administration (FDA) before distributing product. Since that time manufacturers did not have to provide FDA with the evidence to substantiate safety or effectiveness unless a new dietary ingredient was added. It is widely believed that the 1994 DSHEA further consolidated the position of the supplement industry and lead to additional product sales.[6]
More specifically, you can expect to end up in the upper half of these ranges ONLY if you are a beginner, younger, and/or have amazing genetics. You can expect to end up in the lower half of these ranges if you are an intermediate or advanced trainee, older, and/or have poor genetics. The average person can expect to end up somewhere in the middle. Additional details here: How Much Muscle Can You Gain?

Transparent Labs’ Creatine HMB really did their homework. The HMB, which stands for hydroxymethylbutyrate, is the main metablite in the branched chain amino acid leucine that prevents the breakdown of muscle protein. Translation: it helps you to retain muscle, and it appears to do so more effectively than leucine alone. One bonus is that combining HMB with creatine also appears to increase strength better than taking either supplement alone. Plus, the blue raspberry flavor is delicious and contains no artificial sweeteners.
The type of exercise performed also depends on the individual's goals. Those who seek to increase their performance in sports would focus mostly on compound exercises, with isolation exercises being used to strengthen just those muscles that are holding the athlete back. Similarly, a powerlifter would focus on the specific compound exercises that are performed at powerlifting competitions. However, those who seek to improve the look of their body without necessarily maximizing their strength gains (including bodybuilders) would put more of an emphasis on isolation exercises. Both types of athletes, however, generally make use of both compound and isolation exercises.
A major benefit of the creatine pills is that they are much more convenient than the powder, so you can just throw a few in your bag without worrying about the mess of a powder spill or having to carry the entire tub around. Reviewers confirm that they’ve seen serious strength and muscle size gains since starting to take this supplement, even after just two weeks of use. One bottle of this creatine includes 90 capsules so you will be set for months of lifting sessions.
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].
Of course, cardio is an important part of fitness too, but the benefits of strength training are major. Strength training helps build muscle, and lean muscle is better at burning calories when the body is at rest, which is important whether you're trying to lose weight or maintain it. It also helps strengthens joints and bones, avoid injury, improve your muscular endurance, and will help you give it your all during your other workouts, whether that means setting a new PR if you're a runner or pushing (and pulling) a little harder with your legs during your favorite indoor cycling class.
The creatine kinase (CK) enzyme in rat heart tissue appears to have a KM around 6mM of creatine as substrate.[280] and is known to positively influence mitochondrial function as higher cytoplasmic phosphocreatine concentrations (not so much creatine per se) increase the oxidative efficiency of mitochondria[280] This is thought to be due to the transfer of high energy phosphate groups.[280]
Studies that use a dosage range typical of creatine supplementation (in the range of 5g a day following an acute loading period) note increases to total body water of 6.2% (3.74lbs) over 9 weeks and[608] 1.1kg over 42 days.[609] Interestingly, some studies comparing creatine paired with training against training itself fail to find a significant difference in percentage of water gained (which is inherently to activity) with standard oral doses of creatine[609][607][610] (although low dose creatine supplementation of 0.03g/kg or 2.3g daily doesn’t appear to increase water retention[611]) despite more overall water weight being gained, due to an equal gain of dry mass in muscles. One study has quantified the percentage increase in mass of muscle cells to be 55% water, suggesting the two groups are fairly equal.[609]
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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.
Heart Failure is one of the single most common complications that face many people today. When a heart ages, the cells collect a yellow-brown layer which is waste and can lead to heart complications. This process is known as lipofuscin, or “aging pigment” which leads to death opposed to someone who can delay that as far as possible. [3] In mice, a study was performed where two groups of mice who had lipofuscin underwent different experiments, one group received creatine supplementation, and one group did not receive supplementation. What they found was that the mice who supplemented creatine lived 9% longer than the ones who did not receive creatine. 9% translated into human years results in almost 7 years, which could suggest that if you suffer from this deterioration, creatine supplementation could potentially increase your longevity by 7 years. [3] 

You burn calories during strength training, and your body continues to burn calories after strength training (just like you do after aerobic exercise), a process called "excess post-exercise oxygen consumption" or EPOC, according to the American Council on Exercise. (13) When you do strength, weight, or resistance training, your body demands more energy based on how much energy you’re exerting (meaning the tougher you’re working, the more energy is demanded). That means more calories burned during the workout, and more calories burned after the workout, too, while your body is recovering to a resting state.
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.
In addition to the proper amount of sleep, do not overdo your training regimen. While you might be tempted to think that "more is better," in fact the opposite is true. You can reach a point known as "over-training", in which you'll lose the ability to "pump" (engorge the muscles with oxygen-rich blood) your muscles, and this can even lead to muscle wasting—exactly the opposite of what you are trying to achieve. Here are some symptoms to be aware of if you think you may be falling into the over-training zone:
In regard to practical interventions, concurrent glycogen loading has been noted to increase creatine stores by 37-46% regardless of whether the tissue was exercised prior to loading phase.[176] It is important to note, however, that creatine levels in response to the creatine loading protocol were compared in one glycogen-depleted leg to the contralateral control leg, which was not exercised.[176] This does not rule out a possible systemic exercise-driven increase in creatine uptake, and the increase in creatine noted above[176] was larger than typically seen with a loading protocol (usually in the 20-25% range). Consistent with an exercise-effect, others have reported that exercise itself increases creatine uptake into muscle, reporting 68% greater creatine uptake in an exercised limb, relative to 14% without exercise.[153]
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]
A 2011 survey of 33 supplements commercially available in Italy found that over 50% of them exceeded the European Food Safety Authority recommendations in at least one contaminant. The most prevalent of these contaminants was creatinine, a breakdown product of creatine also produced by the body.[47] Creatinine was present in higher concentrations than the European Food Safety Authority recommendations in 44% of the samples. About 15% of the samples had detectable levels of dihydro-1,3,5-triazine or a high dicyandiamide concentration. Heavy metals contamination was not found to be a concern, with only minor levels of mercury being detectable. Two studies reviewed in 2007 found no impurities.[41]
Cribb et al (2007) [29] observed greater improvements on 1RM, lean body mass, fiber cross sectional area and contractile protein in trained young males when resistance training was combined with a multi-nutrient supplement containing 0.1 g/kg/d of creatine, 1.5 g/kg/d of protein and carbohydrate compared with protein alone or a protein carbohydrate supplement without the creatine. These findings were novel because at the time no other research had noted such improvements in body composition at the cellular and sub cellular level in resistance trained participants supplementing with creatine. The amount of creatine consumed in the study by Cribb et al was greater than the amount typically reported in previous studies (a loading dose of around 20 g/d followed by a maintenance dose of 3-5 g/d is generally equivalent to approximately 0.3 g/kg/d and 0.03 g/kg/d respectively) and the length of the supplementation period or absence of resistance exercise may explain the observed transcriptional level changes that were absent in previous studies [30,31].
"Eating well" is tough to objectively quantify. One can eat "well" but that doesn't necessarily mean that you are eating enough to build muscle or recover adequately from workouts. Also, taking protein shakes doesn't guarantee that one will start to accrue massive slabs of lean body mass. Muscle anabolism is a fairly complex metabolic process which has a number of contributing factors at the cellular level and can't be reduced to a single supplement or dietary component.
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.

Without a doubt, you can add muscle simply by eating right and lifting weights. But to truly maximize your growth potential, supplements are a requirement. Hence, we've compiled a rundown of the 11 best mass-gain supplements on which to spend your hard-earned cash. They're listed in order of priority, from the absolute most critical, can't-do-without supplements to the less crucial yet still highly effective ingredients for packing on size. The point is to help those on a tight budget decide which supplements to buy. If money is no object, then by all means knock yourself out and use them all as directed. Because after all, as far as we're concerned, you can never have too much muscle.
Heath has 1.8 million Instagram followers, 300,000 Twitter followers, a global fan base and a growing portfolio of muscle magazine covers. He competes in just one competition a year, Mr. Olympia, for which he won the $400,000 first prize this year. He spends the rest of the year staying in shape and flying hundreds of thousands of miles for appearances, conferences and meetings. He has five sponsors, led by Ultimate Nutrition, a supplement company. All told, he earns more than $1 million a year, his agent said.

No need to worry! This myth that caffeine counteracts creatine came from the simple, but wrong logic that because caffeine accelerates the nervous system and uses more water, it would counteract creatine because creatine helps your body retain water. While both of these statements are true, it does not mean they “cancel” eachother out, all that it means is that your body will be able to stay hydrated longer if you are taking creatine and caffeine opposed to just taking caffeine.
Creatine is only taken up by its transporter, and changes in the activity level of this transporter are wholly causative of changes in creatine uptake. The transporter is regulated by mostly cytosolic factors as well as some external factors that affect creatine transport activity, [143] including extracellular creatine.[140] Agents affecting creatine transport are further divided into positive regulators (those that increase activity of the transporter) and negative regulators (those that suppress activity).
When looking specifically at human studies, there has been a failure of creatine supplementation to induce or exacerbate kidney damage in people with amyotrophic lateral sclerosis (ALS). Subjects do not experience kidney damage for up to or over a year’s worth of supplementation in the 5-10g range.[505][506][507] Postmenopausal women,[517] people with type II diabetes,[518] people on hemodialysis,[313] otherwise healthy elderly,[519] young people,[454][520][521] and athletes do not experience kidney damage either.[324] Moreover, numerous scientific reviews on both the long- and short-term safety of supplemental creatine have consistently found no adverse effects on kidney function in a wide range of doses.[522][523][524][452][525][451][526][527] However, while doses >10 g/day have been found not to impair kidney function, there are fewer long-term trials using such high chronic daily intakes.[527]
Creatine monohydrate is highly regarded as one of the most powerful and all-around best bodybuilding supplements for athletes hoping to make big gains fast. Creatine is one of the go-to supplements for building mass because it maximizes power output, strength, endurance, and overall performance, helping you to crush your fitness goals time and time again.
This ingredient also plays a major role in cell growth, recovery, and communication. Increasing the amount of creatine stored in your muscles can speed up the growth of new muscle and help prevent current muscles from being degraded during exercise. By reducing muscle breakdown, creatine can speed up the healing and recovery processes, as there will be less damage to repair.
Some protein powders are loaded with junk. We recommend this grass-fed protein isolate because it is a non-GMO product and contains no artificial sweeteners. It is a US-based product, and the whey protein is cultivated from American cows. With 28 grams of protein in one scoop, one spoonful of this powder may provide the equivalent protein profile of a whole meal. What’s even better is that one scoop is only 120 calories. This powder gives you quite a bit of protein for minimal calories, keeping you lean.
Taking creatine supplements may increase the amount of creatine in the muscles. Muscles may be able to generate more energy or generate energy at a faster rate. Some people think that taking creatine supplements along with training will improve performance by providing quick bursts of intense energy for activities such as sprinting and weightlifting.
Guanidoacetate (made by AGAT) then receives a methyl donation from S-adenosyl methionine via the enzyme guanidinoacetate methyltransferase (GAMT), which produces S-adenosylhomocysteine (as a byproduct) and creatine. Deficiencies in GAMT are more severe (although equally rare) relative to AGAT, resulting in severe mental retardation and autism-like symptoms.[31]

In general, muscle content of creatine tends to be elevated to 15-20% above baseline (more than 20mM increase) in response to oral supplementation. People who get a sufficiently high influx of creatine are known as responders.[150][151][152][153] A phenomena known as “creatine nonresponse” occurs when people have less than a 10mM influx of creatine into muscle after prolonged supplementation.[154] Quasi-responders (10-20mM increase) also exist.[154] Nonresponse is thought to explain instances where people do not benefit from creatine supplementation in trials, since some trials that find no significant effect do find one when only investigating people with high creatine responsiveness.[155] There are clear differences between those who respond and those who do not, in regard to physical performance.[156] People who are creatine responsive tend to be younger, have higher muscle mass and type II muscle fiber content, but this has no correlation with dietary protein intake.[154][157]
According to the abstract, in the stratified analyses by forms of aerobic exercise, weekly resistance exercise of 1 time or 1-59 minutes was associated with lower risks of total cardiovascular events and cardiovascular disease, regardless of meeting the aerobic exercise guidelines. The analysis showed that resistance training reduced the risk of cardiovascular events in 2 ways: training had a direct association with cardiovascular risk, and resistance training indirectly lowered cardiovascular risk by decreasing body mass index.
The harder an exercise is – both in terms of technicality and physical/mental demand – the more rest there should usually be. So exercises like squats and deadlifts should have more rest between sets than exercises like leg extensions and leg curls. And exercises like various bench presses, shoulder presses, rows and pull-ups should have more rest between sets than bicep curls, tricep extensions, chest flies and lateral raises.
Bodybuilders also understand how to diet. This is perhaps the most important aspect other athletes can learn from. I can’t think of any athlete that comes close to bodybuilders who know how to build massive amounts of muscle and then can diet with the type of precision that gets them absolutely shredded on a specific date. Most resistance training sports use weight classes to compete. It doesn’t take a rocket scientist to see that shedding body fat without losing muscle can be a major advantage. Competing at a lower weight class because you are leaner while maintaining strength and performance is a very valuable and effective strategy. Diet to build LEAN muscle to keep weight low for a competitive advantage.
All you need to know about low creatinine levels Creatinine is a waste material in the body, and low levels can suggest a shortfall in liver function or activity. This MNT Knowledge Center feature looks at low creatinine levels., as well as information on what creatinine is, how it affects the body, and how to increase low creatinine levels. Read now
"It'’s especially important to eat a carb- and protein-rich meal immediately after a workout," Aceto says. "Right after training, it turns out that your body is really lousy at taking carbohydrates and sending them down fat-storing pathways,"” he says. "So post-training, carbs will be sent down growth-promoting pathways instead."” And when these carbs are combined with a protein source, you'’ve got a strong muscle-feeding combination because carbohydrates help deliver the amino acids into muscles by boosting insulin levels. This anabolic hormone drives nutrients into the muscle cells and kick-starts the muscle-growth process.

If you are doing this on your own, but are overwhelmed and confused about strength training, I know how that feels. It can be scary enough to keep MOST people from starting, which is actually why we created our 1-on-1 Coaching Program. Our coach gets to know you, builds a program based on your experience and goals, will check your form on each movement (via video), and keep you accountable and on track!
Bodybuilders also train small muscles with a similar volume, frequency and intensity of their larger muscles. Strength athletes laugh at this. “Curls are a waste of time” is a common phrase you will hear hurled at a bodybuilder. This is SILLY. Although big compound movements should be most people’s resistance training priority, smaller muscle group focus work has some benefits for every athlete. Bicep tears are quite common among strength athletes, especially strong men and powerlifters. This happens because these competitors will lift tremendous weights with their backs, but their biceps are the weak link. Many of these injuries could be prevented with some good old-fashioned bodybuilder type isolation work. If you are only as strong as your weak link, doesn’t it make sense to make those weak links strong ones?

Creatine supplementation appears to attenuate decreases in GLUT4 expression seen with immobility and may increase GLUT4 expression during exercise. While it seems capable of increasing GLUT4 during resting conditions, it has failed to reach significance, suggesting that creatine supplementation works best with some stimuli associated with exercise.
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]
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.
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]
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.
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).
Heath suggests incorporating dropsets into your training routine by immediately decreasing the weight and repping out again to failure. “Dropsets overload the muscle with shorter rest periods and increasing volume which you need to grow,” says Heath. “That overload improves your body’s abilities to utilize more nutrients, natural growth hormone, and natural testosterone into those areas and makes the supplements you take more effective.” Heath’s favorite way to do dropsets is on a pin-loaded machine since it’s faster to switch weights.
Syndromes caused by problems metabolizing creatine. Some people have a disorder that prevents their body from making creatine. This can lead to low levels of creatine in the brain. Low levels of creatine in the brain can lead to decreased mental function, seizures, autism, and movement problems. Taking creating by mouth daily for up to 3 years can increase creatine levels in the brain in children and young adults with a disorder of creatine production called guanidinoacetate methyltransferase (GAMT) deficiency. This can help improve movement and reduce seizures. But it doesn't improve mental ability. Arginine-glycine amidinotransferase (AGAT) deficiency is another disorder that prevents the body from making creatine. In children with this condition, taking creatine for up to 8 years seems to improve attention, language, and mental performance. But taking creatine does not seem to improve brain creatine levels, movement, or mental function in children who have a disorder in which creatine isn't transported properly.
Creatine is marketed as "nature's muscle builder" and "the most legitimate sports supplement around." Professional and amateur athletes alike are gobbling up this alleged ergogenic aid, hoping to increase their strength and performance. Creatine supplementation is claimed to increase muscle power by playing a role in the transfer of energy to help the muscle contract. Supplement labels state that "creatine is converted to phosphocreatine, which is important for short energy bursts such as sprinting and weight lifting" and that "depletion of phosphocreatine can result in muscle fatigue and fading muscle power." Claims are also made that supplementation increases muscle body mass.
Neurological and cognitive function has also been shown to be improved by creatine supplementation [47,48]. Rawson and Venezia [49] review the effects of creatine supplementation on cognitive function highlighting that higher brain creatine has been associated with improved neuropsychological performance. Creatine supplementation protocols have been shown to increase brain creatine and phosphocreatine contents. Cognitive processing hindered due to sleep deprivation and natural impairment due to aging can be improved by creatine supplementation. This review also highlights other possible benefits of creatine ingestion to older adults, such as improvements in: fatigue resistance, strength, muscle mass, bone mineral density, and performance of activities of daily living. Some of these benefits occur without concurrent exercise. The authors inform that discrepancies between studies do exist and are hard to explain but may be possibly due to differences in diet, race and/or supplementation protocols. However, the ideal dose of creatine to maximize brain uptake is not known. Patients have been supplemented with 40 g while in healthy adults positive results have been reported with around 20 g per day [49].

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]
Recommended dose: The fastest way to increase muscle creatine stores is to follow the loading method of 20 grams per day for 5-7 days, followed by the standard maintenance dose of 5 grams per day. However, a lower dose of 5 grams for 28 days will also increase creatine stores without causing the 2-4 pound weight gain typically seen with a loading protocol.
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]
Gualano, B., de, Salles Painelli, V, Roschel, H., Lugaresi, R., Dorea, E., Artioli, G. G., Lima, F. R., da Silva, M. E., Cunha, M. R., Seguro, A. C., Shimizu, M. H., Otaduy, M. C., Sapienza, M. T., da Costa, Leite C., Bonfa, E., and Lancha Junior, A. H. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Eur.J.Appl.Physiol 2011;111:749-756. View abstract.

One supplement, which a large body of research has proven effective in building muscle mass when combined with intensive strength training, is creatine (sold as creatine monohydrate). Creatine, a source of rapid energy, is stored in the muscles in small amounts. With creatine loading or supplementation, bodybuilders increase muscle stores of the energy-containing compound which then can be used to provide an extra boost for an intense-high-weight lifting session. Studies support that ingestion of a relatively high dose of creatine (20 to 30 grams per day for up to two weeks) increases muscle creatine stores by 10 to 30 percent and can boost muscle strength by about 10 percent when compared with resistance training alone (Rawson & Volek, 2003). Some athletes report (though research does not necessarily support) muscle cramping in response after using creatine supplements.
Collectively the above investigations indicate that creatine supplementation can be an effective strategy to maintain total creatine pool during a rehabilitation period after injury as well as to attenuate muscle damage induced by a prolonged endurance training session. In addition, it seems that creatine can act as an effective antioxidant agent after more intense resistance training sessions.
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