When you're in the middle of a strength-training session and something doesn't feel right to you, you feel pain, or if you hear or feel a "pop" during a workout, stop what you're doing. Have a doctor check it out before you go back to training. You may need to change your training or even stop lifting weights for a while to allow the injury to heal.
“Reg Park’s theory was that first you have to build the mass and then chisel it down to get the quality; you work on your body the way a sculptor would work on a piece of clay or wood or steel. You rough it out””the more carefully, the more thoroughly, the better”” then you start to cut and define. You work it down gradually until it’s ready to be rubbed and polished. And that’s when you really know about the foundation. Then all the faults of poor early training stand out as hopeless, almost irreparable flaws. [..]
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The synthesis of creatine (from guanidinoacetate via GAMT) also requires SAMe as a cofactor and is implicated in homocysteine production. While supplementation of guanidinoacetate at 0.36% (prior to SAMe) can increase homocysteine by up to 50% in rats, supplementation of creatine (0.4%) is able to suppress homocysteine by up to 25%, secondary to reducing creatine synthesis,[309] and has been replicated elsewhere with 2% of the rat diet, while a loading phase did not alter the benefits.[124]
Peirano, R. I., Achterberg, V., Dusing, H. J., Akhiani, M., Koop, U., Jaspers, S., Kruger, A., Schwengler, H., Hamann, T., Wenck, H., Stab, F., Gallinat, S., and Blatt, T. Dermal penetration of creatine from a face-care formulation containing creatine, guarana and glycerol is linked to effective antiwrinkle and antisagging efficacy in male subjects. J.Cosmet.Dermatol. 2011;10:273-281. View abstract.
Creatine kinase is expressed in eyes. The eyes can take creatine up from the blood via two different transporters, the classic SCL6A8 (creatine transporter) and MCT12. It seems that expression of the receptors and accumulation of creatine occur in a relatively higher level in photoreceptors, which perceive color. Similarly to many other tissues, they appear to protect the cells during periods of low oxygen availability.
To succeed and thrive as a bodybuilder, it takes more than overwhelming muscular strength or athletic prowess. Judges select bodybuilding champions based on muscle mass, definition, proportion, symmetry, and an athlete’s stage presence. Given the criteria, it is no surprise that most serious bodybuilders consider supplementation to be an essential component of their training regimen.

Legion’s Recharge is a good pick for muscle growth. Besides the creatine itself, it contains a hefty 2.1 grams of l-carnitine l-tartrate, which has solid links with improving muscle repair in addition to increasing focus during workouts. It’s also delicious, naturally sweetened, and it contains ingredients that may improve insulin sensitivity and help the body to better utilize carbs for recovery.
One case study exists of a man with focal segmental glomerulosclerosis who experienced an accelerated rate of GFR decline during supplementation (5g thrice daily for loading, then a 2g maintenance for seven weeks) which was partially reversed upon supplement cessation. This was deemed strong circumstantial evidence, and the brand of supplement was not named.[616] Elsewhere, interstitial nephritis associated with creatine supplementation has been reported in a man, although symptoms arose four weeks after supplementation started with no evidence to support correlation.[617] Some studies involving athletes and various dietary supplements have attempted to draw a correlation with creatine and cases of rhabdomyolysis.[618][619][620][621] Finally, one study in a diabetic person ingesting both metformin and creatine resulting in metabolic acidosis has attempted to place causation on creatine, but it did not establish causation or circumstantial evidence.[622]
If you’re looking to put on extra muscle mass and build strength, there are a few things that need to occur. The first of these, even though it may seem obvious, is that you will need to have an exercise routine. To stimulate maximum muscle growth, you’ll need to challenge yourself in the gym, forcing your muscles to adapt to heavier workloads by increasing in size and strength.
Anti-depressive effects have been noted in woman with major depressive disorder when 5g of creatine monohydrate was supplemented daily for 8 weeks in combination with an SSRI. Benefits were seen at week two and were maintained until the end of the 8-week trial.[253] The improvement in depressive symptoms was associated with significantly increased prefrontal cortex levels of N-acetylaspartate, a marker of neuronal integrity,[254] and rich club connections, which refers to the ability of nerons to make connections to one another.[255]

Competitive and professional bodybuilders, however, can often build up to two to three pounds of muscle per month during dedicated bulking periods. "But they are living and breathing muscle growth. They aren't just in and out of the gym like most people," Simpson says, noting that under extreme conditions, hyperplasia, or the growth in the number of muscle cells in a given muscle tissue, may actually occur, further adding to muscle growth results.
^ Jump up to: a b Barcelos RP, Stefanello ST, Mauriz JL, Gonzalez-Gallego J, Soares FA (2016). "Creatine and the Liver: Metabolism and Possible Interactions". Mini Reviews in Medicinal Chemistry. 16 (1): 12–8. doi:10.2174/1389557515666150722102613. PMID 26202197. The process of creatine synthesis occurs in two steps, catalyzed by L-arginine:glycine amidinotransferase (AGAT) and guanidinoacetate N-methyltransferase (GAMT), which take place mainly in kidney and liver, respectively. This molecule plays an important energy/pH buffer function in tissues, and to guarantee the maintenance of its total body pool, the lost creatine must be replaced from diet or de novo synthesis.

Because I don’t want you to have to waste all the years and money that I did (not to mention the surgeon’s bills), I came up with a method of training and eating specifically for skinny-fat, injury-prone hard-gainers: guys who historically can’t gain muscle doing the workouts they find in magazines or on blogs. It’s also perfect for all guys over age 35 who need to be smarter with their training as they age.

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.
Creatine has been found to increase skeletal muscle glycogen when given to sedentary adults for a loading and maintenance phase for 37 days at 2g (13.5% after five days of loading, but returning to baseline at the end of the trial). Exercise was not enforced in this study.[207] This study also noted that, despite a normalization of glycogen after the trial, total creatine and ATP was still higher than placebo,[207] and a loading protocol appears to have failed elsewhere in increasing glycogen stores in sedentary people subject to an aerobic exercise test before and after the loading phase.[349]
According to research from the University of Stirling, for optimal protein growth, weight lifters need to eat 0.25 to 0.30 grams of protein per kilogram body weight per meal. For a 175-pound person, that works out to 20 to 24 grams of protein at every meal. You’ll get that in three to four eggs, a cup of Greek yogurt, or one scoop of protein powder.
In humans, studies that investigate links between serotonin and creatine supplementation find that 21 trained males, given creatine via 22.8g creatine monohydrate (20g creatine equivalent) with 35g glucose, relative to a placebo of 160g glucose, was found to reduce the perception of fatigue in hot endurance training, possibly secondary to serotonergic modulation, specifically attentuating the increase of serotonin seen with exercise (normally seen to hinder exercise capacity in the heat[233]) while possibly increasing dopaminergic activity (conversely seen to benefit activity in the heat[234]).[155]
The majority of your workouts should be comprised of compound exercises. Common examples include squats, deadlifts, lunges, bench presses, rows, pull-ups, lat pull-downs, overhead presses, and so on. Isolation exercises should definitely also be a part of your program, just a smaller part in comparison. Common examples include bicep curls, tricep extensions, chest flies, lateral raises, leg curls, leg extensions, calf raises, and so on.
Few supplements have the solid scientific foundation that creatine has. Studies show that it's effective for 80 percent of those who use it. Since creatine is found naturally in meat, the more meat you eat, the less likely you'll need creatine supplementation. Vegetarians or those who rarely eat meat, however, can get huge boosts from most creatine supplements.
Contrary to certain rumors that animal-based protein is more suitable to trigger muscle growth than plant-based protein, a study by Mangano et al. (2017) could not provide any evidence for this. In contrast, if combined properly, plant-based protein can even have a higher biological quality. A combination of one part wheat protein (e.g. seitan) and two parts soy protein (e.g. tofu) has thus been favored by many bodybuilders. Some bodybuilders, such as Patrik Baboumian and Robert Cheeke, follow a strict vegan diet.[37]
Lung disease (Chronic obstructive pulmonary disease). Early research on the effects of creatine in people with chronic obstructive pulmonary disease (COPD) is inconsistent. Some research suggests that taking creating daily does not improve lung function. However, other research suggests that taking creatine may improve lung function or exercise capacity.
Now, while all three are definitely beneficial to the process, I’d consider metabolic stress and muscular damage to be of secondary and tertiary importance, respectively. In addition, they are also things that will pretty much take care of themselves when implementing the workout guidelines and recommendations we’ve already covered (namely for volume, rep ranges, rest periods and exercise selection).
Safety. Excess quantities of antioxidants may produce a ‘pro-oxidant’ effect, which is the opposite of what you would take these supplements for. The Australian Institute of Sport recommends that antioxidant vitamin supplements only be taken for a period of a few weeks while the body adjusts to stressful circumstances. Excess vitamin C may promote excess iron absorption, which may not be healthy for everyone.
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]
^ Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL (2017-06-13). "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. doi:10.1186/s12970-017-0173-z. PMC 5469049. PMID 28615996.
Beach muscles and Olympic lifts draw more attention. But the many little stabilizer muscles around your shoulders, hips, and midsection — collectively the core — provide a strong foundation. Challenging the stability and mobility of these key muscles with medicine balls, physioballs, mini-bands, and rotational movements (lifting, chopping) pays huge dividends.

For example, say you are pursuing a muscle power objective in which you have decided to perform 3 sets of 8 repetitions each. You'll want to make sure you don't add too much weight so that you are able to perform all 8 repetitions before your muscles are too tired to finish the set. Conversely you'll want to make sure you add enough weight so that you are not simply breezing past the repetitions and finish your sets of plenty of energy still left in the tank. While it may take a few workout sessions to find the right combination, once you'll do it'll be easy to monitor and increase weight as you progress.
MET-Rx Advanced Creatine Blast also contains a lot of ingredients that work synergistically with creatine. There’s the 33 grams of carbohydrates, which may help to drive creatine to the muscles, plus there’s some taurine to help with recovery and two grams of branched chain amino acids, which may help with muscle retention. However, it contains creatine ethyl ester, which is probably less effective than monohydrate.
It’s an amazing feeling when you graduate from lifting 10-pounders to 15-pounders. “Over time, you get better at something you’re doing, and you develop a sense of mastery and feeling that you’re getting stronger,” explains James Whitworth, a doctoral research fellow in the Biobehavioral Resistance Training Lab at Columbia’s Teachers College in New York City. “It helps your confidence, and that gives you a boost in self-esteem.”
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.
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(5):749-756. View abstract.
If you're using a resistance band, keep in mind that one band might not cut it for your entire body. Different muscles have different strengths, so you may want to buy two different resistance bands in different thickness, which determines how difficult they'll be to use. In general, if you're able to complete 8 reps of an exercise using a band, you'll want to select another that provides a greater amount of resistance. 
If you’re not lifting super-heavy weights, doing high-intensity workouts, or eating a mainly vegan or vegetarian diet, your body probably makes as much creatine as it needs. “Creatine is naturally found in animal-based products,” says Bates, “so your body can make plenty of creatine as long as you have a balanced diet that includes animal-based products.” Protein sources like beef, chicken, pork, and fish help your body produce the creatine it needs — it varies depending on the source, but, in general, a 3-ounce serving of meat will have about 0.4 grams (g) of creatine, Bates says. (6)

Anti-depressive effects have been noted in woman with major depressive disorder when 5g of creatine monohydrate was supplemented daily for 8 weeks in combination with an SSRI. Benefits were seen at week two and were maintained until the end of the 8-week trial.[253] The improvement in depressive symptoms was associated with significantly increased prefrontal cortex levels of N-acetylaspartate, a marker of neuronal integrity,[254] and rich club connections, which refers to the ability of nerons to make connections to one another.[255]
If you'’re looking to add muscle mass to your frame, hitting the weights hard is a given. Quality time in the gym begins a cascade of changes that will stimulate your muscles to grow bigger in response to the challenges you throw their way. It'’s tempting to think that'’s all it takes to add muscle to your body. After all, you can actually feel your biceps growing after an intense set of curls.
Every 4-8 weeks, vary your routine. As your body adapts to stress, you'll hit a plateau where the benefits of weight training will begin to diminish. The only way to prevent this from happening is to change things up, such as by increasing weight and changing exercises. Try a week of really piling the weights on, and do six to eight reps per set at the maximum weight you can manage with proper form. The more lifting experience you have, the more often you should vary your routine.

What are the benefits of konjac? Konjac is a plant with a starchy root, or corm. This corm is used in dietary supplements and in the production of jellies and flour. Find out more about the potential health benefits of konjac, including managing diabetes, reducing cholesterol, and treating constipation. Get some tips, too, on how to use it safely. Read now
Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lagging.[54] This is known as "fluffing".[55][56] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[55] It is not restricted, and many brands are available on the Internet.[57] The use of injected oil to enhance muscle appearance is common among bodybuilders,[58][59] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[60] stroke,[55] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[59][61][62] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[63]

At the same time, this also doesn’t mean that primary compound exercises can never be done for more than 8 reps, or that secondary compound exercise can’t be done for 5-8 or 10-15 reps, or that isolation exercises can’t be done for less than 10 reps. Everything can be done in every rep range. However, these are the rep ranges that each type of exercise is best suited for, and where it should ideally be done most of the time.
Myotonic Dystrophy type I (DM1) is an inhereted muscular disorder caused by an expanded CTG repeat in the DMPK gene on chromosome 19q13.3 (genetic cause of the disorder[561]) resulting in muscular degeneration and myotonia. The related myopathy, Myotonic Dystrophy type II (DM2) which is also known as proximal myotonic myopathy (PROMM) is due to a CCTG repeat on 3q,[562] and is less affected by myotonia and more by muscular pain and weakness. There is no cure for either because they are genetic disorders, so current therapies are aimed at reducing side-effects. Therapies include modafinil for the somnolence[563] and perhaps creatine for the reduction in strength and functionality.[548]

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.


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.
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.
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.

Creatine has been investigated for its effects on depression, due to the significant changes occurring in brain morphology and neuronal structure associated with depression[246] and low brain bioenergetic turnover in depression[247], perhaps related to abnormal mitochondrial functioning, which reduces available energy for the brain.[248][249] The general association of low or otherwise impaired phosphate energy systems (of which creatine forms the energetic basis of) with depression, has been noted previously.[250][247][251] Due to associations with cellular death and impaired bioenergetics with depression, creatine was subsequently investigated.
The motor proteins actin and myosin generate the forces exerted by contracting muscles. Current recommendations suggest that bodybuilders should consume 25–30% of protein per total calorie intake to further their goal of maintaining and improving their body composition.[30] This is a widely debated topic, with many arguing that 1 gram of protein per pound of body weight per day is ideal, some suggesting that less is sufficient, while others recommending 1.5, 2, or more.[31] It is believed that protein needs to be consumed frequently throughout the day, especially during/after a workout, and before sleep.[32] There is also some debate concerning the best type of protein to take. Chicken, turkey, beef, pork, fish, eggs and dairy foods are high in protein, as are some nuts, seeds, beans, and lentils. Casein or whey are often used to supplement the diet with additional protein. Whey protein is the type of protein contained in many popular brands of protein supplements and is preferred by many bodybuilders because of its high Biological Value (BV) and quick absorption rates. Whey protein also has a bigger effect than casein on insulin levels, triggering about double the amount of insulin release.[33] That effect is somewhat overcome by combining casein and whey. Bodybuilders are usually thought to require protein with a higher BV than that of soy, which is additionally avoided due to its claimed estrogenic properties. Still, some nutrition experts believe that soy, flax seeds and many other plants that contain the weak estrogen-like compounds or phytoestrogens, can be used beneficially, as phytoestrogens compete with estrogens for receptor sites in the male body and can block its actions. This can also include some inhibition of pituitary functions while stimulating the P450 system (the system that eliminates hormones, drugs and metabolic waste product from the body) in the liver to more actively process and excrete excess estrogen.[34][35] Cortisol decreases amino acid uptake by muscle, and inhibits protein synthesis.[36]
The last survivors of the pro-hormone supplements, which were removed from sale last January, estrogen-blocking supplements aren't pro-hormones but do inhibit the enzyme aromatase, which converts androgens into estrogens. In normal men that enzyme is ubiquitous, being present in such tissues as muscle, brain and skin. About 20 percent of the free testosterone circulating in the blood is converted into estrogen by way of aromatase.
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]
The maximum amount of creatine the body can store is about 0.3 gram per kilogram of body weight [6]. The creatine content of skeletal (voluntary) muscles averages 125 millimoles per kilogram of dry matter (mmol/kg/dm) and ranges from about 60 to 160 mmol/kg/dm. Approximately 60% of muscle creatine is in the form of PCr. Human muscle seems to have an upper limit of creatine storage of 150 to 160 mmol/kg/dm. Athletes with high creatine stores don't appear to benefit from supplementation, whereas individuals with the lowest levels, such as vegetarians, have the most pronounced increases following supplementation. Without supplementation, the body can replenish muscle creatine at the rate of about 2 g/day [7].

Young adult athletes who reported creatine usage for over two years prior to the study (retrospective design) were not significantly different than controls.[501] Elsewhere, in a similar cohort of athletes reporting creatine usage for up to four years, failed to note significant differences in liver enzymes, although a nonsignificant reduction in LDH was noted.[502]
Beta-alanine is a naturally occurring non-essential amino acid that comes into the body through foods that are rich in protein. The performance-enhancing aspect of beta-alanine (BA) is due to its ability to increase intra-muscular levels of carnosine. Increasing beta-alanine through supplementation may raise carnosine levels by over 60 percent in as quickly as four weeks.[6]
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.
Energy: Energy is found in amino acids, also known as creatine, produced naturally in the body and also found in meat such as beef, chicken and pork. The problem with naturally found creatine is that the amount of protein in it is not high, which therefore, draws bodybuilders to supplement it with a powdered version. Bodybuilders use creatine to increase anaerobic energy; this allows them to lift weights for longer periods of time. Creatine also helps to give volume to the muscle cells by adding more water in them, thus making them look fuller. 
If you are underweight or have a naturally scrawny build, you may struggle to gain weight, let alone muscle mass, no matter what you do. Eating at all hours of the day and night can be exhausting and require frequent trips to the grocery store. Unless you are overweight, you likely need to create a caloric surplus in order to gain muscle. With a weight gainer powder, you can supplement a healthy diet with the additional calories you need to gain weight in muscle.

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.”

Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lagging.[54] This is known as "fluffing".[55][56] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[55] It is not restricted, and many brands are available on the Internet.[57] The use of injected oil to enhance muscle appearance is common among bodybuilders,[58][59] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[60] stroke,[55] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[59][61][62] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[63]
Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[42][43][44] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
Injections of creatine are known to be neuroprotective against low oxygen levels (hypoxia) even to neonatal rats.[532] This is thought to be associated with the increased collective pool of phosphocreatine and creatine.[236] Since oral ingestion of creatine by the mother increases brain concentrations of creatine by 3.6% in the fetus prior to birth,[531] it is thought to be protective in the fetuses subject to hypoxic (low oxygen) stressors, such as a caesarean section.
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] 
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