A study showed that 100mg/kg creatine monohydrate daily over four months supplemented by boys with DMD is able to enhance handgrip strength in the dominant hand only (less than 10% increase) and increase whole-body lean mass. While the trend toward whole body strength reduction seen in placebo was ablated and there was no interaction with corticosteroids,[560] this study failed to find an influence on activities of daily living or lung function.[560] Elsewhere in children not on corticosteroids with DMD, supplementation of 5g creatine for eight weeks was confirmed to increase muscular phosphocreatine content[554] and according to a manual muscle test (MMT) there was a significant improvement in muscular function relative to placebo, with more parents reporting benefit with creatine (53.8%) relative to placebo (14%).[554]

Creatine has been shown to influence androgen levels. Three weeks of creatine supplementation has been shown to increase dihydrotestosterone (DHT) levels, as well as the DHT:testosterone ratio with no effects on testosterone levels.[430] In contrast, creatine supplementation has been shown to increase testosterone levels when taken alongside a 10-week resistance training program.[431] A study in male amateur swimmers also noted that a creatine loading phase (20g daily for six days) was able to increase testosterone levels by around 15% relative to baseline.[397] 
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.
It's OK to be a little sore. Your muscles might feel achy or tired the day after a tough training session thanks to DOMS, or delayed onset muscle soreness. When you strength train you're causing microscopic damage to the tissue that will be repaired, that's how you build stronger lean muscle. Speaking of repair and recovery, though, rest days are important. "If you constantly break down muscle without a recovery period, you won’t give the muscle fibers a chance to repair and build back stronger,” explains Davis.
2-4 Minutes Rest: Ideal for “tension exercises,” which includes most primary compound exercises. I personally take 3 minutes for the big stuff, sometimes going into the 3-4 minute range depending on exactly what I’m doing and what I feel like I need at the time. Since making strength gains is the main focus of these exercises, longer rest periods like this will be optimal for making it happen.
There have also been concerns that creatine can cause kidney damage, and doctors warn that people with a history of kidney disease or conditions, such as diabetes, that increase the risk of kidney problems should steer clear of the supplement. Combining creatine with nephrotoxic drugs — drugs that might damage the kidneys — like nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (advil or motrin) and naproxen sodium (Aleve), should also be avoided, according to the U.S. Department of Health and Human Services. (1)
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.

Lyoo, I. K., Yoon, S., Kim, T. S., Hwang, J., Kim, J. E., Won, W., Bae, S., & Renshaw, P. F. (2012, September). A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder. American Journal of Psychiatry. 169(9):937-45. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22864465
Creatine supplementation in the under 18 population has not received a great deal of attention, especially in regards to sports/exercise performance. Despite this, creatine is being supplemented in young, <18 years old, athletes [52,53]. In a 2001 report [52] conducted on pupils from middle and high school (aged 10 – 18) in Westchester County (USA) 62 of the 1103 pupils surveyed were using creatine. The authors found this concerning for 2 main reasons: firstly, the safety of creatine supplementation is not established for this age group and is therefore not recommended. Secondly, it was speculated that taking creatine would lead on to more dangerous performance enhancing products such as anabolic steroids. It is important to point out that this potential escalation is speculation. Furthermore, a questionnaire was used to determine creatine use amongst this age group and does not necessarily reflect the truth.
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.
One rat study that compared male and female rats and used a forced swim test (as a measure of serotonergic activity of anti-depressants[227]) found that a sexual dimorphism existed, and females exerted a serotonin-mediated anti-depressant response while male rats did not.[228] It appears that these anti-depressive effects are mediated via the 5-HT1A subset of serotonin receptors, as the antidepressant effects can be abolished by 5-HT1A inhibitors.[229]

Most people require around 20 calories per pound (or 44 kcal / kg) of bodyweight to gain muscle mass. Using a 180-pound (82kg) male as an example, the required daily calorie intake is 3600 calories (20 kcal x 180 lb = 3600 kcal). When it comes to gaining weight, it is likely that you may put on a few pounds of fat along the way, but if you do find your body fat increasing, either increase the amount of aerobic exercise (moderate intensity) you are doing or slightly reduce the total number of calories you are consuming. Remember you can’t force feed muscle gain!
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.
Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis.[26] Insulin has steroid-like effects in terms of muscle gains.[27] It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass.[28] Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.[29]
However, if you increase the demands you are placing on your body by increasing the weight being lifted, lifting the same weight for additional reps, or just doing something that increases the demands that your body needs to meet, then your body will have no other choice but to make the changes and improvements necessary for it to adapt to this environment and remain capable of performing these tasks.
Sandow organized the first bodybuilding contest on September 14, 1901, called the "Great Competition". It was held at the Royal Albert Hall in London. Judged by Sandow, Sir Charles Lawes, and Sir Arthur Conan Doyle, the contest was a great success and many bodybuilding enthusiasts were turned away due to the overwhelming amount of audience members.[4] The trophy presented to the winner was a gold statue of Sandow sculpted by Frederick Pomeroy. The winner was William L. Murray of Nottingham. The silver Sandow trophy was presented to second-place winner D. Cooper. The bronze Sandow trophy — now the most famous of all — was presented to third-place winner A.C. Smythe. In 1950, this same bronze trophy was presented to Steve Reeves for winning the inaugural NABBA Mr. Universe contest. It would not resurface again until 1977 when the winner of the IFBB Mr. Olympia contest, Frank Zane, was presented with a replica of the bronze trophy. Since then, Mr. Olympia winners have been consistently awarded a replica of the bronze Sandow.

One study on 27 otherwise healthy men supplementing creatine (0.3g/kg loading for a week, 0.05g/kg thereafter for 8 weeks) with a thrice weekly exercise regiment noted that alongside greater increase in lean mass and power relative to placebo at 4 and 8 weeks, myostatin in serum decreased to a greater extent with creatine (around 17% at 8 weeks, derived from graph) than it did with placebo (approximately 7%).[356] Increases in GASP-1, a serum protein that inhibits the actions of myostatin by directly binding to it,[357] were not different between groups.[356]


Osteoblast cells are known to express creatine kinase.[39][417] Bone growth factors such as IGF-1,[418] PTH,[419] and even Vitamin D[420][421] seem to induce bone growth alongside increases in creatine kinase activity. Vitamin D has been noted to work indirectly by increasing the cellular energy state (these hormones increase creatine kinase in order to do so) in order to make bone cells more responsive to estrogen.[420] This evidence, paired with enhanced growth rates of osteoblasts in the presence of higher than normal (10-20mM) concentrations of creatine[422] suggest a role of creatine in promoting osteoblastic and bone growth, secondary to increasing energy availability.
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!
Creatine ethyl ester is more a pronutrient for creatinine rather than creatine,[74] and was originally created in an attempt to bypass the creatine transporter. It is currently being studied for its potential as a treatment for situations in which there is a lack of creatine transporters (alongside cyclocreatine as another possible example).[77] Its efficacy may rely on intravenous administration, however.
Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DS. The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. J Int Soc Sports Nutr. 2009;6:6. doi: 10.1186/1550-2783-6-6. [PMC free article] [PubMed] [CrossRef]
However, caffeine does not negate the benefits of creatine loading when not coingested, but just taken before exercise in the same dosage.[593] This result indicates that loading creatine without caffeine on a daily basis, but saving caffeine for select workouts, may be an effective strategy, as creatine does not adversely affect caffeine’s ergogenic effects[593][594] and may enhance creatine’s effectiveness in anaerobic exertion if the two compounds are alternated.[595]

Research shows that strength training is especially effective at raising EPOC. That’s because, generally speaking, strength-training sessions cause more physiological stress to the body compared to cardiovascular exercise, even higher-intensity cardio intervals. However, it’s worth noting that overall exercise intensity is what makes the biggest impact on EPOC. So squats, deadlifts, and bench presses with heavy weights are going to be much more effective at raising EPOC compared to bicep curls and triceps extensions with light weights.
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