Keep in mind that while creatine boosts your performance in the gym, helping you achieve better muscle building results, it is also associated with some side effects. One of the main concerns is that creatine may worsen or cause kidney problems. Creatine shouldn’t be taken in combination with diabetes medications, acetaminophen, diuretics or caffeine. As always, speak with your doctor before taking supplements to make sure that the product is safe for you (6). Generally, for most people, the supplement is considered to be among the safer weight lifting supplements.
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.
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:2956-2963. View abstract.
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]

If you stop getting the results you want after several weeks of working out, it's time to mix things up. You need to challenge or "confuse" your muscles often to keep them growing. You can do this by putting a twist on your basic moves. Do a biceps curl with a reverse grip, for example. Or find a bench for the step-up move shown here. Change up your workout at least every 4 to 6 weeks for the best results.

^ Jump up to: a b Wallimann T, Wyss M, Brdiczka D, Nicolay K, Eppenberger HM (January 1992). "Intracellular compartmentation, structure and function of creatine kinase isoenzymes in tissues with high and fluctuating energy demands: the 'phosphocreatine circuit' for cellular energy homeostasis". The Biochemical Journal. 281 ( Pt 1) (Pt 1): 21–40. doi:10.1042/bj2810021. PMC 1130636. PMID 1731757.

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] 
This is another thing I am very tired of hearing. 'No matter what I do or what I eat, I can't gain weight'. I have heard this countless times and I am here to tell you that you are dead wrong. That's OK, because I actually said the same thing until I realized the truth. Most people think they are eating a lot and you just may be. But no matter what you are eating, if you are not gaining, you are not eating enough. Most times, you should re-evaluate your diet as well and focus on more calorie dense foods. But you need to eat more if you are not gaining.
It is possible that females could benefit more than males due to a combined lower creatine kinase activity as well as having altered purine metabolism during depression,[257] but no human comparative studies have been conducted yet. One rat study noted that creatine monohydrate at 2-4% of feed had 4% creatine able to exert anti-depressive and anxiolytic effects in female rats only.[228]
Intensive weight training causes micro-tears to the muscles being trained; this is generally known as microtrauma. These micro-tears in the muscle contribute to the soreness felt after exercise, called delayed onset muscle soreness (DOMS). It is the repair of these micro-traumas that results in muscle growth. Normally, this soreness becomes most apparent a day or two after a workout. However, as muscles become adapted to the exercises, soreness tends to decrease.[22]
Some of the most common minor side effects include stomach discomfort, nausea, and increased bowel movements. Other potential side effects may include headaches, bloating, and increased thirst. There is always the chance that a supplement could cause an allergic reaction. This can result in rashes, swelling, or difficulty breathing, depending on the severity of the reaction. This is another reason why starting out with lower doses of new products is advisable.
Cornelissen VA, Defoor JG, Stevens A, Schepers D, Hespel P, Decramer M, Mortelmans L, Dobbels F, Vanhaecke J, Fagard RH, Vanhees L. Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. Clin Rehabil. 2010;24:988–999. doi: 10.1177/0269215510367995. [PubMed] [CrossRef]

The incidence of liver damage from herbal and dietary supplements is about 16–20% of all supplement products causing injury, with the occurrence growing globally over the early 21st century.[2] The most common liver injuries from weight loss and bodybuilding supplements involve hepatocellular damage with resulting jaundice, and the most common supplement ingredients attributed to these injuries are catechins from green tea, anabolic steroids, and the herbal extract, aegeline.[2]

Parashos, S. A., Swearingen, C. J., Biglan, K. M., Bodis-Wollner, I., Liang, G. S., Ross, G. W., Tilley, B. C., and Shulman, L. M. Determinants of the timing of symptomatic treatment in early Parkinson disease: The National Institutes of Health Exploratory Trials in Parkinson Disease (NET-PD) Experience. Arch Neurol. 2009;66(9):1099-1104. View abstract.
One limitation of many free weight exercises and exercise machines is that the muscle is working maximally against gravity during only a small portion of the lift. Some exercise-specific machines feature an oval cam (first introduced by Nautilus) which varies the resistance, so that the resistance, and the muscle force required, remains constant throughout the full range of motion of the exercise.
Some people do have allergies to soy, or they have an intolerance to soy. If you notice certain symptoms (like a headache) after soy consumption, you may have an intolerance. Discovering your food intolerances/allergies would also be handled by a Dietitian. For the general population who are not allergic/intolerant to soy, however, soy-based products can be a part of a healthy diet. New research has shown that soy is not harmful as people fear. If soy gives you issues, you could always opt for whey protein, pea protein or other forms of vegetable protein. Have you seen our article on protein powders? Click here.
In otherwise sedentary and healthy men given a loading phase of creatine followed by 11 weeks of maintenance, the glucose response to an oral glucose tolerance test is reduced by 11-22% (measurements at 4-12 weeks with no time dependence noted) which was not associated with changes in insulin levels or sensitivity.[350] Elsewhere, a study in vegetarians (5g daily for 42 days) failed to find a reduction in postprandial blood glucose.[351]

Vegetarians and other people who have lower total creatine levels when they start taking creatine supplements seem to get more benefit than people who start with a higher level of creatine. Skeletal muscle will only hold a certain amount of creatine; adding more won't raise levels any more. This "saturation point" is usually reached within the first few days of taking a "loading dose."
Don’t take sets to the point of failure—where you absolutely can’t perform another rep. You should never get to where you’re turning purple and screaming like you’re getting interviewed by “Mean” Gene Okerlund before WrestleMania. Most of the time, you want to end your sets two reps before total failure. Not sure when that is? The moment your form breaks down, or you’re pretty sure it’s going to break down, end the set.
If you’re exercising at your maximum intensity, your body literally can’t produce enough ATP to keep up. (10) That’s where creatine supplements come in: They can help increase your body’s stores of phosphocreatine (an organic compound of creatine and phosphoric acid that’s stored in your muscle tissue) to produce new ATP during high-intensity exercise.
When combined with an appropriate exercise program, dietary supplementation with β-hydroxy β-methylbutyrate (HMB) has been shown to dose-dependently augment gains in muscle hypertrophy (i.e., the size of a muscle),[38][39] muscle strength,[38][40][41] and lean body mass,[38][40][41] reduce exercise-induced skeletal muscle damage,[note 1][38][39][41] and expedite recovery from high-intensity exercise.[38][42] HMB is believed to produce these effects by increasing muscle protein synthesis and decreasing muscle protein breakdown by various mechanisms, including activation of the mechanistic target of rapamycin (mTOR) and inhibition of the proteasome in skeletal muscles.[40][43]

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]
What happened was that, statistically speaking (less than 5% chance what was observed was due to chance means ‘significant’ for this study) there was no significant difference between pre- and post- workout, meaning that both were equally effective. This protocol did note that both groups found benefits with creatine supplementation, but they both found the same amount of benefit.
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If you're a serious strength or physique athlete, you've surely heard that supplements can help you get the most from your intense training sessions and on-point diet. But which supplements? The market is overstuffed like a bodybuilder in a child's blazer! You might be tempted to wander through a digital forest of get-big blogs and personal guru websites, but unfortunately those places can often be rife with misinformation.

^ Jump up to: a b Wallimann T, Wyss M, Brdiczka D, Nicolay K, Eppenberger HM (January 1992). "Intracellular compartmentation, structure and function of creatine kinase isoenzymes in tissues with high and fluctuating energy demands: the 'phosphocreatine circuit' for cellular energy homeostasis". The Biochemical Journal. 281 ( Pt 1) (Pt 1): 21–40. doi:10.1042/bj2810021. PMC 1130636. PMID 1731757.

Without supplementation, creatine is formed primarily in the liver, with minor contributions from the pancreas and kidneys. The two amino acids, glycine and arginine, combine via the enzyme Arginine:Glycine amidinotransferase (AGAT) to form ornithine and guanidoacetate. This is the first of two steps in creatine synthesis, and although rare, any deficiency of this enzyme can result in mild mental retardation and muscular weakness.[28] AGAT is also the primary regulatory step, and an excess of dietary creatine can suppress activity of AGAT to reduce creatine synthesis[29] by reducing AGAT mRNA levels, rather than resulting in competitive inhibition.[30]
Creatine has been incubated in various cell lines (HUVEC, C2C12, U937) and noted to reduce cellular death from various pro-oxidant stressors, such as H2O2 or peroxynitrate in an intracellular range between 0.1-10mM. This protective effect was only noted with preincubation and was comparable to 10-100µM of Trolox.[208] This protective effect did not require conversion into phosphocreatine nor a buffering of ATP, and only worked during a preloading to the stressor, rather than in a rehabilitative manner.[208]
Creatine supplementation has been noted to improve general wellbeing and health status (assessed by St George’s Respiratory questionnaire[582]) of people with COPD over two weeks loading (17.1g daily with carbohydrates) and ten weeks of 5.7g maintenance.[579] The studies that failed to find improvements with creatine supplementation on muscular performance also failed to find improvements in this rating scale, relative to placebo.[580][581]
Listen, I know in the beginning of this post I was sympathetic to your problem, but I am also here to say, Suck It Up. I can tell you that to gain weight, you need to focus on making your meals a habit rather than an afterthought. Your body is pre-programmed with your genetic disposition. And in your case, you have a very fast metabolism that digests and burns calories quickly. Focus on having 5-6 calorie-dense meals a day spaced 2-3 hours apart so that your body is constantly being provided with something to metabolize and build muscle.
It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
"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.
Those are very reasonable starting percentages for your target calories. We can raise or lower your carbohydrate and fat numbers depending on your food preferences (i.e. if you’re more of a rice/potatoes guy… stick with 45% carbs; if you’re more of a bacon and eggs guy… lower your carbs to around 35% and bump your fat percentage to 30% total calories)

In complex training, weight training is typically combined with plyometric exercises in an alternating sequence. Ideally, the weight lifting exercise and the plyometric exercise should move through similar ranges of movement i.e. a back squat at 85-95% 1RM followed by a vertical jump. An advantage of this form of training is that it allows the intense activation of the nervous system and increased muscle fibre recruitment from the weight lifting exercise to be utilized in the subsequent plyometric exercise; thereby improving the power with which it can be performed. Over a period of training, this may enhance the athlete's ability to apply power.[39] The plyometric exercise may be replaced with a sports specific action. The intention being to utilize the neural and muscular activation from the heavy lift in the sports specific action, in order to be able to perform it more powerfully. Over a period of training this may enhance the athlete's ability to perform that sports specific action more powerfully, without a precursory heavy lift being required.


In competitive bodybuilding, bodybuilders aspire to develop and maintain an aesthetically pleasing body and balanced physique.[16][17] In prejudging, competitors do a series of mandatory poses: the front lat spread, rear lat spread, front double biceps, back double biceps, side chest, side triceps, Most Muscular (men only), abdominals and thighs. Each competitor also performs a personal choregraphed routine to display their physique. A posedown is usually held at the end of a posing round, while judges are finishing their scoring. Bodybuilders usually spend a lot of time practising their posing in front of mirrors or under the guidance of their coach.
There are several different available forms of creatine: creatine anhydrous which is creatine with the water molecule removed in order to increase the concentration of creatine to a greater amount than that found in CM. Creatine has been manufactured in salt form: creatine pyruvate, creatine citrate, creatine malate, creatine phosphate, magnesium creatine, creatine oroate, Kre Alkalyn (creatine with baking soda). Creatine can also be manufactured in an ester form. Creatine ethyl ester (hydrochloride) is an example of this, as is creatine gluconate which is creatine bound to glucose. Another form is creatine effervescent which is creatine citrate or CM with citric acid and bicarbonate. The citric acid and bicarbonate react to produce an effervescent effect. When mixed with water the creatine separates from its carrier leaving a neutrally charged creatine, allowing it to dissolve to a higher degree in water. Manufacturers claim that creatine effervescent has a longer and more stable life in solution. When di-creatine citrate effervescent was studied [59] for stability in solution it was found that the di-creatine citrate dissociates to citric acid and creatine in aqueous solutions which in turn forms CM and eventually crystallises out of the solution due to its low solubility. Some of the creatine may also convert to creatinine.
Creatine is normally metabolized into creatinine (note the difference in spelling), which is eliminated by the kidneys under normal conditions. When the kidneys fail and cannot clear the blood as effectively, many metabolites get “backlogged” in the blood. Creatinine is easy to measure and as such it is a biomarker of kidney damage.[623][624] If serum creatinine levels are elevated, the doctor may suspect some kidney damage. Low-dose creatine (≤5 g/day) may not cause alterations in this biomarker in otherwise normal adults[524][625][525] but high doses of supplemental creatine may cause a false positive (an increase in creatinine, due to creatine turning into creatinine, which does not signify kidney damage) and is a diagnostic error.[520][518][626][523][517] Most studies, however, have noted only a small increase in creatinine levels even with doses ≈20 g/day.[524][626][627]
Supplementation of creatine at 5g daily alongside rehabilitation (after limb immobilization for two weeks while taking 20g daily) is associated with a preservation in GLUT4 levels, which were reduced during immobilization. During exercise rehabilitation, it increased to 40% above placebo.[330] This study failed to note an increase in GLUT4 in control, despite exercise normally doing so.[331][332] This effect is thought to be the result of the low frequency of activity. Thus, creatine was thought to augment the increase (insignificant due to low exercise) to significant levels.[330] In other studies, creatine was found to increase GLUT by approximately 30% relative to control, but this effect failed to reach statistical significance. This study did not issue an exercise protocol.[207]

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
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Creatine supplementation has been noted to improve general wellbeing and health status (assessed by St George’s Respiratory questionnaire[582]) of people with COPD over two weeks loading (17.1g daily with carbohydrates) and ten weeks of 5.7g maintenance.[579] The studies that failed to find improvements with creatine supplementation on muscular performance also failed to find improvements in this rating scale, relative to placebo.[580][581]

Focus on form. Good form means you can reap all of the benefits of your workout and avoid injuries at the same time. To maintain proper form, pay attention to your posture (stand tall with chest lifted and abs held tight), move slowly (this ensures you're relying on muscles, not momentum, to do the lifting), and remember to breathe. Many people hold their breath while exerting, but exhaling during the hardest part of the exercise helps fuel the movement.
Side-Effects: While the signs of a great body may make one think that there cannot be anything wrong with bodybuilding supplements, the facts speak otherwise. Bodybuilding supplements do have side-effects and you must listen to your trainer before giving in to the thoughts of buying one. Creatine can cause heart problems, kidney problems, dehydration, diarrhoea and muscle cramping. You must also discuss your medical history with the trainer. 

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.


It has been argued that purposely overtraining for a brief period can be beneficial. One article published by Muscle & Fitness magazine stated that you can "Overtrain for Big Gains". It suggested that if one is planning a restful holiday and does not wish to inhibit their bodybuilding lifestyle too much, they should overtrain before taking the holiday, so the body can recuperate and grow during the prolonged rest period. Overtraining can be used advantageously, as when a bodybuilder is purposely overtrained for a brief period of time to super compensate during a regeneration phase. These are known as "shock micro-cycles" and were a key training technique used by Soviet athletes.[53]

Bench Press. The bench press is about as American as apple pie, fireworks, or bald eagles. If you’re in a gym on a Monday, then you can pretty guarantee at least 85% of the males in the building will be benching. With good reason though, variations such as the flat bench barbell or dumbbell press and the incline bench barbell or dumbbell press are very effective mass builders for the chest, shoulders, and triceps.
I’m glad you found some good information from this article. For any of these supplements, I would suggest talking to your doctor and pharmacist. I would suggest thinking about why you are interested in taking testosterone. Are you looking to increase muscle size? Bulk up? Knowing your fitness goals will help you determine which products are appropriate for you.
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.
The important role of nutrition in building muscle and losing fat means bodybuilders may consume a wide variety of dietary supplements.[41] Various products are used in an attempt to augment muscle size, increase the rate of fat loss, improve joint health, increase natural testosterone production, enhance training performance and prevent potential nutrient deficiencies.
While seasoned lifters may choose to do different exercises every day during a week-long period (and repeat the same moves the following week), there's no need to follow this type of program when you're just getting comfortable, says Davis. "Stick to the same basic moves two to three times a week to build a basic level of fitness and strength," says Davis. "Why complicate things if you don’t have to? Great results can be made by repeating the same workout but increasing weights as you become stronger." Switching things up can help you avoid a training plateau, explains Davis, but so can increasing weights while doing the same exercises.
Creatine Ethyl Ester, or CEE for short, is a powdered form of creatine which has an ethyl group attached to the creatine. This is said to make the creatine more easily absorbed in the human body which would allow you to benefit the most. The studies have not been entirely conclusive as to whether CEE is better than creatine monohydrate. Since Creatine monohydrate is the single most researched form of creatine, it is
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.
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