Many athletes follow a "loading" protocol of around 25 grams a day for five days, but this isn't essential. But as Ciaran Fairman notes in the article "Do I Need to Load With Creatine," you can also get the same benefits with around 5 grams a day, potentially with none of the mild side effects of the loading protocol, which include stomach pain and water weight gain. The catch is that you have to take it consistently. Don't skip it!
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] 

A previous meta-analysis [28] reported an overall creatine supplementation effect size (ES) of 0.24 ± 0.02 for activities lasting ≤30 s. (primarily using the ATP- phosphocreatine energy system). For this short high-intensity exercise, creatine supplementation resulted in a 7.5 ± 0.7% increase from base line which was greater than the 4.3 ± 0.6% improvement observed for placebo groups. When looking at the individual selected measures for anaerobic performance the greatest effect of creatine supplementation was observed on the number of repetitions which showed an ES of 0.64 ± 0.18. Furthermore, an increase from base line of 45.4 ± 7.2% compared to 22.9 ± 7.3% for the placebo group was observed. The second greatest ES was on the weight lifted at 0.51 ± 0.16 with an increase from base line of 13.4 ± 2.7% for the placebo group and 24.7 ± 3.9% for the creatine group. Other measures improved by creatine with a mean ES greater than 0 were for the amount of work accomplished, weight lifted, time, force production, cycle ergometer revolutions/min and power. The possible effect of creatine supplementation on multiple high intensity short duration bouts (<30 s) have shown an ES not statistically significant from 0. This would indicate that creatine supplementation might be useful to attenuate fatigue symptoms over multiple bouts of high-intensity, short duration exercise. The ES of creatine on anaerobic endurance exercise (>30 – 150s), primarily using the anaerobic glycolysis energy system, was 0.19 ± 0.05 with an improvement from baseline of 4.9 ± 1.5 % for creatine and -2.0 ± 0.6% for the placebo. The specific aspects of anaerobic endurance performance improved by creatine supplementation were work and power, both of which had a mean ES greater than 0. From the findings of this previous meta-analysis [28] it would appear that creatine supplementation has the most pronounced effect on short duration (<30s) high intensity intermittent exercises.


Despite the fact that BCAAs may offer some benefits, you should keep in mind that these three amino acids are also present in any quality whey protein that you purchase. You can also get these essential amino acids from food sources. Basically, as long as you’re meeting your daily protein intake goals, you’re probably getting enough of these essential amino acids. Research supports this approach. So, why spend more on another supplement?
^ The effect of HMB on skeletal muscle damage has been assessed in studies using four different biomarkers of muscle damage or protein breakdown: serum creatine kinase, serum lactate dehydrogenase, urinary urea nitrogen, and urinary 3-methylhistidine.[38][41][42] When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during long-distance running or progressive overload, HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.[38][42]

Bird, L. M., Tan, W. H., Bacino, C. A., Peters, S. U., Skinner, S. A., Anselm, I., Barbieri-Welge, R., Bauer-Carlin, A., Gentile, J. K., Glaze, D. G., Horowitz, L. T., Mohan, K. N., Nespeca, M. P., Sahoo, T., Sarco, D., Waisbren, S. E., and Beaudet, A. L. A therapeutic trial of pro-methylation dietary supplements in Angelman syndrome. Am J Med Genet.A 2011;155A(12):2956-2963. View abstract.


When it comes to finding the right meal plan, you have to start somewhere. Start with writing down what you eat in a food diary, calculate the calories you’re consuming daily (ex: 3,000 without protein shakes), and break those up into six meals (ex: 500 calories each), says Heath. Then, choose a macronutrient ratio. For example, the 40% protein, 40% carbs, 20% fat ratio is what Heath used to get bigger when he first started bodybuilding. “Buy a food scale, learn how to use it, and you may even have to learn to use the metric system, like grams instead of ounces,” Heath says. “You need to train your body to process food quickly, so eat every three hours.”
"Start with two days for two to three weeks, then add a third day," says Davis*.*"Ideally, you should strength train three to five days per week, but work your way up—starting off at five days a week might shock your body." Here's a comprehensive three-day-per-week plan to get you started. Aim to complete 20-minute sessions, then gradually add on time in ten-minute increments until you're working for 45 to 60 minutes, suggests Davis.
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.
We’re so confident that you’re going to love our supplements that we offer a 30-day guarantee. If you have any questions about any of our products, please don’t hesitate to call our friendly experts at (512) 394-7995, or feel free to email us at [email protected] The right supplements can make a tremendous difference in your workouts, so don’t wait to get started. Shop the best bodybuilding supplements at Bare Performance Nutrition now.
Mercimek-Mahmutoglu, S., Stoeckler-Ipsiroglu, S., Adami, A., Appleton, R., Araujo, H. C., Duran, M., Ensenauer, R., Fernandez-Alvarez, E., Garcia, P., Grolik, C., Item, C. B., Leuzzi, V., Marquardt, I., Muhl, A., Saelke-Kellermann, R. A., Salomons, G. S., Schulze, A., Surtees, R., van der Knaap, M. S., Vasconcelos, R., Verhoeven, N. M., Vilarinho, L., Wilichowski, E., and Jakobs, C. GAMT deficiency: features, treatment, and outcome in an inborn error of creatine synthesis. Neurology 8-8-2006;67:480-484. View abstract.
There is a great amount of research published on creatine supplementation; protocols of administration, forms of creatine, as well as potential side effects. Despite this, the mechanisms by which creatine acts in the human body to improve physical and cognitive performance are still not clear. The main objectives of this review are to analyze the more recent findings on the effects and mechanisms of creatine supplementation in sports and health. As a secondary purpose, we will analyze the most recommended protocols of ingestion and its potential side effects.
Using too much weight, too soon; always start lower than your expected ability and work your way up that first workout. If your form suffers, you are swinging the weight, or using momentum, this indicates you may be using too much weight. Greater momentum increases the potential for injury and reduces the effectiveness to the muscle group being targeted.
Cancel, pause, or adjust your order at any time, hassle free. Your credit card will only be charged when your order ships. The discount applied every time is 15% off. Since it would be weird to subscribe to a kettlebell, the subscriptions and subscription discounts are only for things you'll need often, like supplements, foods, and personal care items.
Ladies!  The images of “bulky” women that you are conjuring up are from bodybuilding magazines. This is one of the biggest myth surrounding strength training. When I started strength training, I didn’t get bulky, I got lean, And I’m no outlier, I’m just one example of the rule: Women who strength train get strong and lean, not bulky.  Like Veronica, who got damn strong and certainly lean.
This move can help lean abs really pop, especially once you've lost any extra belly fat. Sit on the floor, knees bent and heels down. Lean back, keep your back straight, and tense your abs. Place the kettlebell on the floor, switching from one side to the other. For faster results, hold your feet off the floor, but only if you can still use good form.

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.
In contrast to strongman or powerlifting competitions, where physical strength is paramount, or to Olympic weightlifting, where the main point is equally split between strength and technique, bodybuilding competitions typically emphasize condition, size, and symmetry. Different organizations emphasize particular aspects of competition, and sometimes have different categories in which to compete.

Recommended Dose: 3-6 grams before or during exercise. A ratio of two parts leucine to one part each of isoleucine and valine appears to be most beneficial. As Krissy Kendall, PhD, explains in "The Top 7 Supplements to Boost Endurance Performance," BCAAs can be just as effective for endurance athletes like runners, rowers, and cyclists as they can be for lifters and bodybuilders.
In weight training, as with most forms of exercise, there is a tendency for the breathing pattern to deepen. This helps to meet increased oxygen requirements. Holding the breath or breathing shallowly is avoided because it may lead to a lack of oxygen, passing out, or an excessive build up of blood pressure. Generally, the recommended breathing technique is to inhale when lowering the weight (the eccentric portion) and exhale when lifting the weight (the concentric portion). However, the reverse, inhaling when lifting and exhaling when lowering, may also be recommended. Some researchers state that there is little difference between the two techniques in terms of their influence on heart rate and blood pressure.[8] It may also be recommended that a weight lifter simply breathes in a manner which feels appropriate.

There's good news, though: These temporary muscle pumps are critical to improving muscle hypertrophy, or muscle growth, according to 2014 research in the Strength and Conditioning Journal. So you can think of your weight-room pump as a preview of the muscle results that are to come. Speaking of which, here's an expert-endorsed timeline to reach your muscle-building goals.
Studies have deemed staying in the range of 3 to 5 g per day range for maintenance to be safe, and while higher levels have been tested under acute conditions without adverse effects, there isn’t sufficient evidence to determine long-term safety. (8) If you’re interested in upping your creatine consumption, you should work with your doctor or dietitian to make sure it's right for your goals and health history.
Creatine has been shown before in vitro to protect from MPTP-induced toxicity, which targets dopaminergic neurons in the substantia nigra and induce Parkinson’s disease in research animals.[235] Creatine also protected these cells from death induced by low oxygen or glucose.[574] One study noted that dopaminergic cell survival under the influence of creatine was 1.32-fold higher than control cells, the soma (cell body) was enlarged by 1.12-fold in these cells,[574] and creatine showed some growth-enhancing effects while helping reducing destruction of dopaminergic neurons by various insults.[574]

It can be hard not to compare yourself to Schwarzenegger, with his action-star movie career, his stint as a president-appointed fitness ambassador and his election as governor of California. Chang said that Heath’s personality, including his charisma and outspokenness, is similar to that of Schwarzenegger, who is still omnipresent and beloved in the sport.


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.
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.
To do dips, place your hands at shoulder-width apart on a bench, with your body and feet stretched out in front of the bench. Slowly bend your elbows and lower your body down so that your butt nearly touches the floor. Lift back up with your arms to starting position; repeat, doing 3 x 8. If this isn't a high-intensity set for you, increase the resistance by lifting one foot off the floor.

What kind of exercises? Work all major muscle groups, starting with the larger muscles. Always include exercises for opposing muscles: for example, work the biceps and triceps of your arms, and the quadriceps and hamstrings of your thighs. Avoid above-the-shoulder exercises if you have arthritis in your upper body, and talk to your doctor before using leg press machines if you have arthritis in your knees or hips.
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.

While this nonessential amino acid may not deliver earth-shattering PRs or extreme muscle growth, it does play an important role in repair and recovery. Glutamine works by removing excess ammonia, which can accumulate during intense exercise, helping to regulate your body's acid-base balance. Individuals who are engaged in heavy resistance training, two-a-day training splits, or are in a calorie deficit may benefit from the extra support of glutamine supplementation.
Every gym has a guy shaped like a lightbulb. He's the one who neglects his lower body. If you don't want to be that guy, work your major leg muscles on the leg press machine. Place your feet on the plate with knees bent at 90 degrees. Grasp the handles and slowly push the plate out until your knees are straight but not locked. Pause and slowly return to the starting spot.

In otherwise healthy bodybuilders, supplementation of creatine at 5g either immediately before or after a weight training session (with no directive on days without training) over the course of four weeks noted that while both groups improved, there was no significant difference between groups overall.[384] This null result has been found in another study with 0.1g/kg creatine thrice weekly over 12 weeks in otherwise healthy adults.[385] It has been suggested that post-workout timing may be favorable (based on magnitude-based inference) since more individuals experience benefits with post-workout when compared to pre-workout despite no whole-group differences.[384] 

In vitro, creatine (0.125mM or higher) can reduce excitotoxicity from glutamate, which is thought to be secondary to preserving intracellular creatine phosphate levels.[209] Glutamate-induced excitotoxicity is caused by excessive intracellular calcium levels resulting from ATP depletion. Since high levels of calcium inside the cell are toxic, ATP preserves membrane integrity,[210] in part by promoting calcium homeostasis. When ATP is depleted, the sodium-potassium ATPase pump (Na+,K+-ATPase) stops working, leading to sodium accumulation in the cell. This reduces the activity of the sodium-calcium exchange pump, which, alongside a lack of ATP, reduces calcium efflux through the Na+,K+-ATPase. Thus, ATP depletion leads to intracellular calcium overload, loss of membrane potential, and excitotoxic cell death. Therefore, by helping preserve ATP levels, creatine is protective against excitotoxicity. This protective effect was noted after either creatine preloading or addition up to 2 hours after excitotoxicity.[209] Protection from glutamate-induced toxicity also extends to glial cells[211] and is additive with COX2 inhibition.[212]


Many athletes follow a "loading" protocol of around 25 grams a day for five days, but this isn't essential. But as Ciaran Fairman notes in the article "Do I Need to Load With Creatine," you can also get the same benefits with around 5 grams a day, potentially with none of the mild side effects of the loading protocol, which include stomach pain and water weight gain. The catch is that you have to take it consistently. Don't skip it!


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.
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].

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.
Increasing creatine levels in skeletal muscle to 687% of baseline (0.5mM creatine, thought to be equivalent to 5g creatine[135]) doesn’t seem to per se increase glucose uptake, but increases glucose oxidation (140% of baseline)[341] which is due to a two-fold increase in the activity of α1 and α2 subunits of AMPK, a potency comparable to 1mM of the reference drug AICAR.[341] Glucose uptake associated with AMPK has indeed been noted in diabetic people who are undergoing physical exercise[342] and in contracting skeletal muscle cells,[153][330] but according to rat[343][344][345] and in vitro studies of cells not being contracted,[341] this is not a per se effect of non-exercising tissue but an augmentation of exercise-induced glucose uptake.

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.


It’s not just about lifting—it’s about lifting safely and correctly. And if you’re not performing exercises properly, it’s impossible to make any progress. “When someone is just starting to work out, it can help to work closely with a knowledgeable personal trainer in order to learn proper form,” says Ingram. But that goes for experienced lifters, too. If you aren’t sure about a movement, it’s better to ask. “If you’re not working the correct muscles, you can’t expect them to grow,” explains Ingram.
Related to exercise and fitness, BCAAs are taken to help reduce muscle breakdown, which is why they may be known as muscle building supplements. Leucine, in particular, is known for playing an important role in muscle protein synthesis, which can help with muscle gain and maintenance. Some also claim that BCAAs can enhance performance, although many studies also refute this claim.

Ancient Greek sculptures also depict lifting feats. The weights were generally stones, but later gave way to dumbbells. The dumbbell was joined by the barbell in the later half of the 19th century. Early barbells had hollow globes that could be filled with sand or lead shot, but by the end of the century these were replaced by the plate-loading barbell commonly used today.[3]
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.

Beast Creature could be another good option for female athletes. It’s tasty, it contains five types of creatine, and it contains ingredients that could improve fat loss by increasing insulin sensitivity. One potential bonus is that it also has 70 percent of your daily biotin, a nutrient often included in women’s multivitamins due its purported benefits for hair and nails.
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.
Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., … Lopez, H. (2017, June 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). Retrieved from https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z
The creatine transporter (CrT) is positively regulated by proteins known to be involved in sensing and responding to the cellular energy state, including the mammalian target of rapamycin (mTOR[158]). Upon activation, mTOR stimulates SGK1 and SGK3[159][160] to act upon PIKfyve[161] and subsequently PI(3,5)P2[162] to increase CrT activity.[161] Beyond mTOR, SGK1 also is stimulated by intracellular calcium[163] and a lack of oxygen (ischemia).[164] Because transient ischemia is associated with increased reactive oxygen species (ROS) production after blood flow is restored (reperfusion) it has been hypothesized that muscle contraction may increase creatine uptake through a similar ROS-mediated mechanism.[165]
However, a much more accurate determination of how much fluid is necessary can be made by performing appropriate weight measurements before and after a typical exercise session, to determine how much fluid is lost during the workout. The greatest source of fluid loss during exercise is through perspiration, but as long as your fluid intake is roughly equivalent to your rate of perspiration, hydration levels will be maintained.[14]
A retrospective study [81], that examined the effects of long lasting (0.8 to 4 years) CM supplementation on health markers and prescribed training benefits, suggested that there is no negative health effects (including muscle cramp or injuries) caused by long term CM consumption. In addition, despite many anecdotal claims, it appears that creatine supplementation would have positive influences on muscle cramps and dehydration [82]. Creatine was found to increase total body water possibly by decreasing the risk of dehydration, reducing sweat rate, lowering core body temperature and exercising heart rate. Furthermore, creatine supplementation does not increase symptoms nor negatively affect hydration or thermoregulation status of athletes exercising in the heat [83,84]. Additionally, CM ingestion has been shown to reduce the rate of perceived exertion when training in the heat [85].
The 1960s saw the gradual introduction of exercise machines into the still-rare strength training gyms of the time. Weight training became increasingly popular in the 1970s, following the release of the bodybuilding movie Pumping Iron, and the subsequent popularity of Arnold Schwarzenegger. Since the late 1990s increasing numbers of women have taken up weight training, influenced by programs like Body for Life; currently nearly one in five U.S. women engage in weight training on a regular basis.[4]
The right amount of workout: It is highly possible that the protein powder you are taking doesn’t work on your body. Supplements should only be taken if you have a rigorous workout schedule or else, it will turn out to be of no value. Most people just purchase a box of supplements without really doing the math, which is very important. Unless you find out the dosage that suits you, the amount of time you should dedicate for the workout and so on, you must not expect daydream the results. 
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.
Makes You Healthier: If you’re looking for a workout in which you get the biggest bang for your buck, strength training is it. Strength training increases bone density, builds a stronger heart, reduces your resting blood pressure, improves blood flow, halts muscle loss, helps control blood sugar, improves cholesterol levels, and improves your balance and coordination (turning you from this, to this).
At the end of the day, you have to focus on how you feel. “Listen to your body,” says Davis. “It tells you when it needs a day off.” As a rule of thumb, take a rest day if your perceived pain is above a seven on a scale of 10, Davis advises. Or, focus on a different body part (say, if your legs are sore, focus on upper-body moves). Can't stop, won't stop—at least, till your next rest day.

In addition to the HIIT sessions, it’s always a good idea to go for a 30–60-minute walk as many days per week as you can. I recommend getting a minimum of 10,000 steps every day. Use a phone app to track them. If you’re into jogging, swimming, hiking, or some other form of long-duration, fairly low-intensity cardio, that is fine to do as well, and as often as you like.
Safety. In general health terms, most medical opinion is that up to three cups of coffee a day are not harmful, and may even have some benefits, although some people respond to the stimulant properties with more problems than others. Heart palpitations and restlessness are experienced by some caffeine drinkers. In pregnancy, one or two cups each day are thought to be without harm to the fetus.
Our bodies store creatine in our muscles so that we have quick access to it for fast, high-intensity movements, like sprinting or powerlifting, explains Autumn Bates, a certified clinical nutritionist and sports nutritionist in private practice in Manhattan Beach, California. “It's a nonessential amino acid, meaning your body creates it and you don't need to primarily get it from food.”
You’d have to look hard to find a fitness expert who doesn’t recommend taking supplemental protein powder for building muscle. It’s one of the best supplements for building muscle on the market! In addition to serving as a muscle building supplement, protein powder can be the perfect complement to a successful weight loss plan. Studies show that the supplement can prevent loss of muscle mass, helping you lose fat exclusively instead.
Genetic deficiencies in the creatine biosynthetic pathway lead to various severe neurological defects.[26] Clinically, there are three distinct disorders of creatine metabolism. Deficiencies in the two synthesis enzymes can cause L-arginine:glycine amidinotransferase deficiency caused by variants in GATM and guanidinoacetate methyltransferase deficiency, caused by variants in GAMT. Both biosynthetic defects are inherited in an autosomal recessive manner. A third defect, creatine transporter defect, is caused by mutations in SLC6A8 and inherited in a X-linked manner. This condition is related to the transport of creatine into the brain.[27]
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