Different forms of creatine in combination with other sports supplements as well as varying doses and supplementation methodology should continue to be researched in an attempt to understand further application of creatine to increase sports and exercise performance of varying disciplines. It is important to remain impartial when evaluating the safety of creatine ingested as a natural supplement. The available evidence indicates that creatine consumption is safe. This perception of safety cannot be guaranteed especially that of the long term safety of creatine supplementation and the various forms of creatine which are administered to different populations (athletes, sedentary, patient, active, young or elderly) throughout the globe.

McArdle’s disease is a myopathy associated with impaired glucose release from glycogen and impairments in muscle function at times when glucose would be the primary energy substrate. Creatine is thought to be therapeutic, but has shown differing effects in the two trials so far (both benefit and worsening of symptoms) for currently unknown reasons.


In today's extra-large society, we tend to focus on the admirable guys who train hard and switch up their diet to transform their bodies by losing weight. We highlight their quests to lead healthier lives every chance we get — but there's another side of the wellness scale that can be just as difficult, depending on your body's makeup: Gaining mass and muscle.
People sometimes walk up and touch him, as if unsure if he is a man or a machine. What they do not realize is that beneath the stony exterior and self-assuredness is a squishy sense of anxiety and vulnerability. Heath gets nervous every time he strips to his posing trunks. He is rarely satisfied with what he sees in the mirror. He is persistently worried about imperfections others might find, too.
Spero Karas, MD, assistant professor of orthopaedics in the division of sports medicine at Emory University, says that testosterone, the male hormone responsible for muscle growth, maxes out between the ages of 16 and 18. It reaches a plateau during the 20s and then begins to decline. As a result, muscle building after the adolescent years can be challenging, he says.
Creatine synthesis primarily occurs in the liver and kidneys.[2][16] On average, it 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.[16][18] Most of the human body's total creatine and phosphocreatine stores are found in skeletal muscle, while the remainder is distributed in the blood, brain, and other tissues.[17][18]

A meta-analysis found that creatine treatment increased muscle strength in muscular dystrophies, and potentially improved functional performance.[57] Creatine treatment does not appear to improve muscle strength in people who have metabolic myopathies.[57] High doses of creatine lead to increased muscle pain and an impairment in activities of daily living when taken by people who have McArdle disease.[57]
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.
In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline).[485] This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.[485]
One case study on a subject with a methylentetrahydrofolate reductase (MTHFR) 677TT homozygote, a relatively common genetic mutation known as “mild MTHFR deficiency,” which causes mild homocysteinemia,[310] has seen benefits due to creatine supplementation where homocysteine was approximately halved (49% reduction) while CT heterozygotes and CC homozygotes (n=9) were unaffected.[311] Additionally, one rat study suggested a possible role for creatine in reducing homocysteine levels in a model of high uric acid levels (model for end stage renal disease[312]) but this was not replicated when investigated in humans.[313]
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]
The structure of cyclocreatine is fairly flat (planar), which aids in passive diffusion across membranes. It has been used with success in an animal study, where mice suffered from a SLC6A8 (creatine transporter at the blood brain barrier) deficiency, which is not responsive to standard creatine supplementation.[97] This study failed to report increases in creatine stores in the brain, but noted a reduction of mental retardation associated with increased cyclocreatine and phosphorylated cyclocreatine storages.[97] As demonstrated by this animal study and previous ones, cyclocreatine is bioactive after oral ingestion[97][98] and may merely be a creatine mimetic, able to phosphorylate ADP via the creatine kinase system.[97]
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.
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.
Although some have voiced concerns about kidney damage with creatine supplementation, it’s generally regarded as a safe supplement when taken responsibly. The Mayo Clinic advises against taking it if you have an allergy. When used properly, the incidence of potential side effects such as low blood sugar and dehydration, are minor in healthy people taking a safe dosage.

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]

Earlier during your workout, you might have thought you were starting to see some muscle definition. "Called transient hypertrophy, or a muscle pump, this physiological phenomenon occurs when blood rushes to your muscles to supply them with workout-powering fuel and even jump-start the recovery process," explains certified strength and conditioning specialist Samuel Simpson, co-owner and vice president of B-Fit Training Studio in Miami. He notes that this muscle pump often starts mid-workout and subsides within a few hours after leaving the gym. And as the muscle pump deflates, it's easy to lose determination.

It was later noted that creatine was able to nonsignificantly augment various proinflammatory cytokines (CCL2, iNOS, ICAM-1, TGF-β, TIMP-1) and the presence of eosinophils in lung tissue, as well as to per se cause lung infiltration of these immune cells without requiring the presence of the allergen.[442] Neutrophils and macrophages were unaffected,[442] reflecting the past study of no influence on macrophages,[440] but the only instance where creatine appeared to either significantly add to ovalbumin or to per se induce statistically significant increases were in IL-5 secretion and goblet cell infiltration, although VCAM-1 expression was close. While creatine per se increased nF-κB activity, it suppressed the ovalbumin-induced increase.[442]
Earlier during your workout, you might have thought you were starting to see some muscle definition. "Called transient hypertrophy, or a muscle pump, this physiological phenomenon occurs when blood rushes to your muscles to supply them with workout-powering fuel and even jump-start the recovery process," explains certified strength and conditioning specialist Samuel Simpson, co-owner and vice president of B-Fit Training Studio in Miami. He notes that this muscle pump often starts mid-workout and subsides within a few hours after leaving the gym. And as the muscle pump deflates, it's easy to lose determination.
Overtraining occurs when a bodybuilder has trained to the point where his workload exceeds his recovery capacity. There are many reasons why overtraining occurs, including lack of adequate nutrition, lack of recovery time between workouts, insufficient sleep, and training at a high intensity for too long (a lack of splitting apart workouts). Training at a high intensity too frequently also stimulates the central nervous system (CNS) and can result in a hyperadrenergic state that interferes with sleep patterns.[51] To avoid overtraining, intense frequent training must be met with at least an equal amount of purposeful recovery. Timely provision of carbohydrates, proteins, and various micronutrients such as vitamins, minerals, phytochemicals, even nutritional supplements are acutely critical. A mental disorder informally called “bigorexia” (by analogy with anorexia) may be held accountable of some people overtraining. Sufferers feel as if they are never big enough or muscular enough, which forces them to overtrain in order to try and reach their goal physique.[52]

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.

Muscle imbalances are quite common among strength athletes and are arguably the most common cause of their injuries. Many times this is due to a “weak link” in the kinetic chain of muscles that activate during their activity. Identifying the “weak” muscle and being able to feel, isolate and contract that “weak” muscle makes correctional exercise and rehab much easier. Bodybuilding training, with its focus on “feel” rather than movement, helps to train and develop the mind to muscle connection. This comes in handy when you need to train a muscle imbalance with correctional exercise and, in the case of injury, for rehab.
Escolar, D. M., Buyse, G., Henricson, E., Leshner, R., Florence, J., Mayhew, J., Tesi-Rocha, C., Gorni, K., Pasquali, L., Patel, K. M., McCarter, R., Huang, J., Mayhew, T., Bertorini, T., Carlo, J., Connolly, A. M., Clemens, P. R., Goemans, N., Iannaccone, S. T., Igarashi, M., Nevo, Y., Pestronk, A., Subramony, S. H., Vedanarayanan, V. V., and Wessel, H. CINRG randomized controlled trial of creatine and glutamine in Duchenne muscular dystrophy. Ann Neurol 2005;58:151-155. View abstract.
In standard dosages (5-10g creatine monohydrate) the bioavailability of creatine in humans is approximately 99%,[68][83] although this value is subject to change with different conjugates (forms) of creatine and dosages.[83] Coingestion of cyclocreatine (an analogue) can reduce uptake by about half[131] and coincubation of taurine, choline, glycine, or beta-alanine had minimal attenuation of absorption, which is likely not practically relevant.[131] The inhibition noted with cyclocreatine may be due to receptor saturation.
Don’t get us wrong—cardio is important for keeping your body fat down and keeping your heart health in check. (Bonus points if you run or bike, since outdoor exercise is linked to better energy and improved mental health.) But when it comes to building muscle, hitting the treadmill won't help you much. “Every component of exercise, minus cardio, can help with muscle hypertrophy,” which is the scientific term for muscle building, says Michelle Lovitt, an exercise physiologist and trainer in Los Angeles. “Cardio tends to burn calories and puts your body in a deficit, which is great for leaning out, but not building mass.”
In regard to the blood brain barrier (BBB), which is a tightly woven mesh of non-fenestrated microcapillary endothelial cells (MCECs) that prevents passive diffusion of many water-soluble or large compounds into the brain, creatine can be taken into the brain via the SLC6A8 transporter.[192] In contrast, the creatine precursor (guanidinoacetate, or GAA) only appears to enter this transporter during creatine deficiency.[192] More creatine is taken up than effluxed, and more GAA is effluxed rather than taken up, suggesting that creatine utilization in the brain from blood-borne sources[192] is the major source of neural creatine.[193][192] However, “capable of passage” differs from “unregulated passage” and creatine appears to have tightly regulated entry into the brain in vivo[193]. After injecting rats with a large dose of creatine, creatine levels increased and plateaued at 70uM above baseline levels. These baseline levels are about 10mM, so this equates to an 0.7% increase when superloaded.[193] These kinetics may be a reason for the relative lack of neural effects of creatine supplementation in creatine sufficient populations.
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