Creatine is known to increase skeletal muscle cellular volume alongside increases in water weight gain.[346] Since glycogen itself also increases the osmolytic balance of a cell (draws in water)[347][348] and preliminary evidence shows a strong trend of creatine augmenting glycogen loading,[153] creatine is thought to be related to an increase in cell volume, which is known to promote glycogen synthesis.[112]

These effects are secondary to creatine being a source of phosphate groups and acting as an energy reserve. The longer a cell has energy, the longer it can preserve the integrity of the cell membrane by preserving integrity of the Na+/K+-ATPase and Ca2+-ATPase enzymes.[241][235][236] Preserving ATP allows creatine to act via a nongenomic response (not requiring the nuclear DNA to transcribe anything), and appears to work secondary to MAPK and PI3K pathways.[226]
Knowledge – When it comes to building the best physique possible, you have to be willing to experiment and learn from your body. No one will be able to tell you what’s the most effective nutrition or training split for your individual genotype. Not only that, they don’t know your personal preference, injury history, asymmetries, experience level, or current work capacity.

It is known that intracellular energy depletion (assessed by a depletion of ATP) stimulates AMPK activity in order to normalize the AMP:ATP ratio,[333][334] and when activated AMPK (active in states of low cellular energy[335] and colocalizes with creatine kinase in muscle tissue[336]) appears to inhibit creatine kinase via phosphorylation (preserving phosphocreatine stores but attenuating the rate that creatine buffers ATP). While phosphocreatine technically inhibits AMPK, this does not occur in the presence of creatine at a 2:1 ratio.[334] It seems that if the ratio of phosphocreatine:creatine increases (indicative of excess cellular energy status) that AMPK activity is then attenuated, since when a cell is in a high energy status, there is less AMP to directly activate AMPK.[334][336][337]

How much weight? Start with a pair of light dumbbell hand weights (2 to 3 pounds for women and 5 to 8 pounds for men). If you can’t do 12 repetitions (or reps are the number of times you do the exercise) the weight is too heavy. If your muscles don’t feel tired after 12 reps, it’s too light. Adjustable weights that can be strapped to wrists or ankles may be convenient if you have arthritis in your hands. You can also use home or gym weight machines, or resistance bands.


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.
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.
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.
Creatine ethyl ester increases muscle levels of creatine to a lesser degree than creatine monohydrate.[72] It may also result in higher serum creatinine levels[73] due to creatine ethyl ester being converted into creatinine via non-enzymatic means in an environment similar to the digestive tract.[74][75] At equal doses to creatine monohydrate, ethyl ester has failed to increase water weight after 28 days of administration (indicative of muscle deposition rates of creatine, which are seemingly absent with ethyl ester).[76] 
The harder an exercise is – both in terms of technicality and physical/mental demand – the more rest there should usually be. So exercises like squats and deadlifts should have more rest between sets than exercises like leg extensions and leg curls. And exercises like various bench presses, shoulder presses, rows and pull-ups should have more rest between sets than bicep curls, tricep extensions, chest flies and lateral raises.
Besides the high-quality protein content of casein/whey, the newer formulations have little or no lactose (i.e., milk sugar), which some people have negative reactions to. The native milk proteins also provide a host of smaller proteins called peptides, many of which, such as lactoferrin, have vital health benefits. The rich cysteine content of whey acts as a precursor of glutathione, a primary endogenous antioxidant and liver detoxifier in the body.

Chwalbinska-Monteta [34] observed a significant decrease in blood lactate accumulation when exercising at lower intensities as well as an increase in lactate threshold in elite male endurance rowers after consuming a short loading (5 days 20 g/d) CM protocol. However, the effects of creatine supplementation on endurance performance have been questioned by some studies. Graef et al [35] examined the effects of four weeks of creatine citrate supplementation and high-intensity interval training on cardio respiratory fitness. A greater increase of the ventilatory threshold was observed in the creatine group respect to placebo; however, oxygen consumption showed no significant differences between the groups. The total work presented no interaction and no main effect for time for any of the groups. Thompson et al [36] reported no effects of a 6 week 2 g CM/d in aerobic and anaerobic endurance performance in female swimmers. In addition, of the concern related to the dosage used in these studies, it could be possible that the potential benefits of creatine supplementation on endurance performance were more related to effects of anaerobic threshold localization.

The shortest and most preliminary study noted that, over the short term, creatine delivers on its expected improvement in physical strength. However, longer studies that measure the rate of loss for muscle function (deterioration of muscular capacity that is known to occur with ALS) have repeatedly failed to find a benefit with creatine supplementation.

A study using creatine at 0.02% of a face cream (confounded with 8% glycerol and 0.4% Guarana) was able to exert a skin-tightening effect over 6 weeks, reducing wrinkles and jowl volume.[541] Combination therapy has also been used with creatine and folic acid (both in vitro[543] and in vivo), resulting in increased skin firmness and reduced coarse and fine wrinkles.[544]


Mr. Olympia is part of the International Federation of Bodybuilding Professional League. The I.F.B.B. says that it operates under the guidelines of the World Anti-Doping Agency and that competitors are subject to drug testing. Chang, who oversees the Mr. Olympia contest, said that I.F.B.B. testing is random, but is not conducted during the Mr. Olympia contest itself.

As a ingredient that has been tested time and time again and shown to positively affect the building of muscle, GAT has taken the highest-quality compound to create Essentials Creatine. Using HPLC-tested pharmaceutical grade creatine that's tested to be 99.9% pure, Essentials Creatine provides 5 grams in every serving which can increase muscle size, boost strength, and enhance muscle recovery. Keep Reading »
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] 
Creatine is old school and definitely hit a pop culture zenith, but that doesn’t make it out-dated or irrelevant today. Creatine supplementation gets results. For starters, one study from Medicine and Science in Sports and Exercise confirms that creatine supplementation can enhance physical performance, claiming that it “exhibits small but significant physiological and performance changes.”
In the last week leading up to a contest, bodybuilders usually decrease their consumption of water, sodium, and carbohydrates, the former two to alter how water is retained by the body and the latter to reduce glycogen in the muscle. The day before the show, water is removed from the diet, and diuretics may be introduced, while carbohydrate loading is undertaken to increase the size of the muscles through replenishment of their glycogen. The goal is to maximize leanness and increase the visibility of veins, or "vascularity". The muscular definition and vascularity are further enhanced immediately before appearing on stage by darkening the skin through tanning products and applying oils to the skin to increase shine. Some competitors will eat sugar-rich foods to increase the visibility of their veins. A final step, called "pumping", consists in performing exercises with light weights or other kinds of low resistance (for instance two athletes can "pump" each other by holding a towel and pulling in turn), just before the contest, to fill the muscles with blood and further increase their size and density.
Need the motivation to push past your comfort zone and squeeze out one more push-up or bicep curl? Sure, it helps to remember that you’ll get stronger, rock more toned muscles and rev your metabolism, thanks to all that added muscle mass. But if that wasn’t enough, now comes news that all that pump-itude (yes, that’s an SNL reference) has psychological benefits, too.
Cyclocreatine appears to be passively diffused through membranes and not subject to the creatine transporter, which can be beneficial for cases where creatine transporter function is compromised (creatine non-response and SLG6A8 deficiency). Similar to other forms of creatine, it buffers ATP concentrations, although its efficacy as a supplement in otherwise healthy people is currently unknown.
The materials and information provided in this presentation, document and/or any other communication (“Communication”) from Onnit Labs, Inc. or any related entity or person (collectively “Onnit”) are strictly for informational purposes only and are not intended for use as diagnosis, prevention or treatment of a health problem or as a substitute for consulting a qualified medical professional. Some of the concepts presented herein may be theoretical.
The NitroSurge pre-workout supplement by Jacked Factory aims to get you pumped and focused before a gym session. Besides L-Citrulline, this supplement also contains performance-enhancing betaine anhydrous and beta alanine. It also contains L-theanine which has shown to inhibit nerve cell damage in one study.  For energy-boosting benefits, the NitroSurge is also equipped with caffeine and AstraGin for energy metabolism. Before you buy, consider if you fall under the following circumstances in which this pre-workout would be beneficial to you:
Retinol (Vitamin A) B vitamins: Thiamine (B1) Riboflavin (B2) Niacin (B3) Pantothenic acid (B5) Pyridoxine (B6) Biotin (B7) Folic acid (B9) Cyanocobalamin (B12) Ascorbic acid (Vitamin C) Ergocalciferol and Cholecalciferol (Vitamin D) Tocopherol (Vitamin E) Naphthoquinone (Vitamin K) Calcium Choline Chromium Cobalt Copper Fluorine Iodine Iron Magnesium Manganese Molybdenum Phosphorus Potassium Selenium Sodium Sulfur Zinc

While the aforementioned study insinuated that after was better, at this time the “just take it at any time” or maybe more appropriately, “take it when it works for you” is the best way to go. Many people take supplements that include creatine, so if that’s in your pre- or post- workout drink, you should receive all the benefits. Optimal dosing still appears to be between 2 to 5 grams per day. You can “load” for the first 5 to 7 days to help saturate your cells, but beyond that there’s no benefit to taking large amounts. So save your money and take the smaller dose; it’ll still offer maximum results.
Studies that use a dosage range typical of creatine supplementation (in the range of 5g a day following an acute loading period) note increases to total body water of 6.2% (3.74lbs) over 9 weeks and[608] 1.1kg over 42 days.[609] Interestingly, some studies comparing creatine paired with training against training itself fail to find a significant difference in percentage of water gained (which is inherently to activity) with standard oral doses of creatine[609][607][610] (although low dose creatine supplementation of 0.03g/kg or 2.3g daily doesn’t appear to increase water retention[611]) despite more overall water weight being gained, due to an equal gain of dry mass in muscles. One study has quantified the percentage increase in mass of muscle cells to be 55% water, suggesting the two groups are fairly equal.[609]
Creatine is an organic acid naturally occurring in the body that supplies energy to muscle cells for short bursts of energy (as required in lifting weights) via creatine phosphate replenishment of ATP. A number of scientific studies have shown that creatine can improve strength,[32] energy,[33] muscle mass, and recovery times. In addition, recent studies have also shown that creatine improves brain function.[34] and reduces mental fatigue.[35] Unlike steroids or other performance-enhancing drugs, creatine can be found naturally in many common foods such as herring, tuna, salmon, and beef.
Duchenne’s Muscular Dystrophy (DMD) is associated with a reduction in intracellular creatine stores[554] known to only affects males. It is an X-linked progressive myopathy associated with abnormalities in the dystrophin gene.[555] The standard therapy at this moment involves corticosteroids such as prednisone.[556][557] Creatine is thought to be therapeutic since the known targetable abnormalities in DMD (impairment in protein synthesis associated with oxidative stress and increased protein breakdown) is a property of creatine and supplementation showed promise in the first case study[558] and benefit in a group of mixed dystrophinopathies.[559]
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.
Bodybuilders do cardio training such as running and using a StairMaster StepMill to burn fat and make their muscles more visible. “Do cardio throughout the year at least three days a week for at least 30-40 minutes, whether it be first thing in the morning on an empty stomach or after a post-workout protein shake,” says Heath. “Cardio won’t kill your gains as much as you think, you’ll see how much muscle you really have.” Break a sweat to stay lean ’round the clock.
The use of bodybuilding supplements has risen by ten folds. Gone are the times when bodybuilders worked out and consumed nutritious foods to supplement their body. The effect is pretty clear in both the cases. While professional body builders building a natural body remained in shape even after quitting the gym, people who depended on heavy supplements have been found to only lose the shape but also go through premature ageing. The best thing, however, is to eat proper food and take supplements too, which is what bodybuilders usually do. Here are some pros and cons of using bodybuilding supplements.

A: Eat more frequently, drink less liquids while eating (they compete for stomach volume along with food), eat from larger plates and bowls, add lime or lemon juice to your water with meals (can help to increase production of hydrochloric acid that breaks down food), and consume more liquid calories (especially around the workout if appetite is suffering the rest of the day).

^ Burd, Nicholas A.; Yang, Yifan; Moore, Daniel R.; Tang, Jason E.; Tarnopolsky, Mark A.; Phillips, Stuart M. (2012). "Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. Micellar casein at rest and after resistance exercise in elderly men". British Journal of Nutrition. 108 (6): 958–62. doi:10.1017/S0007114511006271. PMID 22289570.
If you are somebody that is tired of not getting results, wants to avoid trial-and-error, or you just want to be told exactly what to do to reach your goals, check out our popular 1-on-1 coaching program. You’ll work with our certified NF instructors who will get to know you better than you know yourself and program your workouts and nutrition strategy for you.
Synthesis primarily takes place in the kidney and liver, with creatine then being transported to the muscles via the blood. The majority of the human body's total creatine and phosphocreatine stores is located in skeletal muscle, while the remainder is distributed in the blood, brain, and other tissues.[17][18][20] Typically, creatine 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.[17][18] Some small studies suggest that total muscle creatine is significantly lower in vegetarians than non-vegetarians, as expected since foods of animal origin are the primary source of creatine. However, subjects happened to show the same levels after using supplements.[21]
Studies of so-called "smart drugs" have also been taken out of context. Some "smart" nutrients, available over the counter, are marketed as a way to "increase mental focus and concentration during training." The problem is that the studies they're based upon involved either animals or people with brain pathology. In normal people the effects of smart drugs remain unproven, except anecdotally.
Skin degradation is caused by a loss of collagen and degradation of the extracellular matrix,[536] which is enhanced by UV radiation (produces reactive oxygen species which stimulate MMPs[537]) and contributes to skin integrity loss and wrinkling. Due to the stimulation of collagen being associated with a cellular surplus of energy[538] and intracellular stores of energy declining with age,[539][540] creatine has been investigated as a topical anti-aging agent. In vitro, creatine appears to be rapidly absorbed through the skin (52% within an hour, remaining similar at 3 hours) with most creatine found in the stratum corneum (79.6-86.5%) follwed by the epidermis (9-13.2%) and dermis (4.5-7.1%).[541] It is successful in stimulating collagen expression and procollagen secretion in fibroblasts, with the latter increasing to 449+/-204% of control.[541]
Naturo Nitro Creatine Chrome could be an interesting choice for women. It’s actually magnesium creatine chelate, a type of creatine that may help to improve performance without increasing water weight. We don’t have a lot of studies on it just yet, but the research we do have suggests it could potentially be a good choice for women who want to improve performance without experiencing the “bloat” of regular creatine.

Casein, the source of the white color of milk, accounts for 70-80% of milk protein. Casein exists in what’s known as a micelle, a compound similar to a soap sud which has a water-averse inside and water-loving outside. This property allows the protein to provide a sustained, slow release of amino acids into the blood stream, sometimes lasting for hours. This makes casein a good protein source immediately before a workout to provide a continual amino acid supply to the muscles. Some studies suggest that combined supplementation with casein and whey offers the greatest muscular strength improvement (Kerksick, 2006).
Creatine has demonstrated neuromuscular performance enhancing properties on short duration, predominantly anaerobic, intermittent exercises. Bazzucch et al [27] observed enhanced neuromuscular function of the elbow flexors in both electrically induced and voluntary contractions but not on endurance performance after 4 loading doses of 5 g creatine plus 15 g maltodextrin for 5/d in young, moderately trained men. Creatine supplementation may facilitate the reuptake of Ca2+ into the sacroplasmic reticulum by the action of the Ca2+ adenosine triphosphatase pump, which could enable force to be produced more rapidly through the faster detachment of the actomyosin bridges.
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.
When you’re doing higher reps, focus on the muscle you are trying to build and squeeze every ounce of effort out of it. Yes, cheesie as it may sound, visualizing the muscles working and growing while you train them can be helpful. A 2016 study in the European Journal of Applied Physiology found that, when lifters thought about their pecs and triceps during a workout, they activated them better.
The first thing you need is a weight training program that signals the muscle building process to begin. Research has shown that a well designed program will generate this “signal” via a combination of progressive tension overload (as in, getting stronger over time), metabolic stress (as in, fatiguing the muscle and getting “the pump”), and muscular damage (as in, actual damage to the muscle tissue itself).
Naturo Nitro Creatine Chrome could be an interesting choice for women. It’s actually magnesium creatine chelate, a type of creatine that may help to improve performance without increasing water weight. We don’t have a lot of studies on it just yet, but the research we do have suggests it could potentially be a good choice for women who want to improve performance without experiencing the “bloat” of regular creatine.
Without supplementation, approximately 14.6mmol (2g) of creatinine, creatine’s urinary metabolite, is lost on a daily basis in a standard 70kg male ages 20-39. The value is slightly lower in females and the elderly due to a presence of less muscle mass.[35] This amount is considered necessary to obtain in either food or supplemental form to avoid creatine deficiency. Requirements may be increased in people with higher than normal lean mass.[35][198] Creatine excretion rates on a daily basis are correlated with muscle mass, and the value of 2g a day is derived from the aforementioned male population with about 120g creatine storage capacity.[35] Specifically, the rate of daily creatine losses is about 1.6%[199]-1.7%,[25] and mean losses for women are approximately 80% that of men due to less average lean mass.[35] For weight-matched elderly men (70kg, 70-79 years of age) the rate of loss of 7.8mmol/day,[49] or about half (53%) that of younger men.
Duchenne’s Muscular Dystrophy (DMD) is associated with a reduction in intracellular creatine stores[554] known to only affects males. It is an X-linked progressive myopathy associated with abnormalities in the dystrophin gene.[555] The standard therapy at this moment involves corticosteroids such as prednisone.[556][557] Creatine is thought to be therapeutic since the known targetable abnormalities in DMD (impairment in protein synthesis associated with oxidative stress and increased protein breakdown) is a property of creatine and supplementation showed promise in the first case study[558] and benefit in a group of mixed dystrophinopathies.[559]
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]

In addition to ALL of the above, strength training is fun! Whether you are looking for the most effective 20-30 minute workout (to stay fit and look great naked), or are looking for a competitive sport that you can really get into, strength training can help you meet your goals. It’s easy and fun to see progress as you strength train, almost like leveling up. And if you’re looking to improve in other areas (a sport, traditional cardio, or an activity like rock climbing), strength training is an easy choice!

In a later study, it was found that biologically relevant concentrations (10-30mM) of creatine bind synthetic membranes with lipid compositions mimicking the inner mitochondrial membrane or plasma membrane in a concentration-dependent manner. This also conferred a degree of protection, increasing membrane stability in response to challenge from a number of destabilizing agents. Phosphocreatine was more effective than creatine in this context, although both were able to bind and stabilize membranes.[119]


Many non-competitive bodybuilders choose not to adopt this conventional strategy, as it often results in significant unwanted fat gain during the "bulking" phase. The attempt to increase muscle mass in one's body without any gain in fat is called clean bulking. Competitive bodybuilders focus their efforts to achieve a peak appearance during a brief "competition season".[citation needed] Clean bulking takes longer and is a more refined approach to achieving the body fat and muscle mass percentage a person is looking for. A common tactic for keeping fat low and muscle mass high would be to have higher calorie and lower calorie days to maintain a balance between gain and loss. Many clean bulk diets start off with a moderate amount of carbs, moderate amount of protein, and a decently low amount of fats. "Gaining lean muscle means going for leaner cuts of meat, like flank steaks and fillets, chicken, and, of course, fish," says White[who?]. "Enjoy your meat with some starch: rice, beans, quinoa, whole-grain couscous, or sweet potato, for example".[20] To maintain a clean bulk it is important to reach calorie goals every day. Macronutrient goals will be different for each person, but, it is ideal to get as close as possible.
Do a single set of repetitions. Theories on the best way to approach weight training abound, including countless repetitions and hours at the gym. But research shows that a single set of exercise with a weight that fatigues your muscle after about 12 to 15 repetitions can build muscle efficiently in most people and can be as effective as three sets of the same exercise. 

Glycogen synthesis is known to respond directly and positively to cellular swelling. This was demonstrated in an earlier study, during which rat muscle cells were exposed to a hypotonic solution in vitro to induce cell swelling, which increased glycogen synthesis by 75%. In contrast, exposing these same cells to a hypertonic solution hindered glycogen synthesis by 31%. These changes were not due to alterations in glucose uptake, but are blocked by hindering the PI3K/mTOR signaling pathway.[112] It was later noted that stress proteins of the MAPK class (p38 and JNK) as well as heat shock protein 27 (Hsp27) are activated in response to increasing osmolarity.[113][114] Furthermore, activation of MAPK signaling in skeletal muscle cells is known to induce myocyte differentiation[115] via GSK3β and MEF2 signaling, which can induce muscle cell growth.[116][117]
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]
Taking creatine supplements may increase the amount of creatine in the muscles. Muscles may be able to generate more energy or generate energy at a faster rate. Some people think that taking creatine supplements along with training will improve performance by providing quick bursts of intense energy for activities such as sprinting and weightlifting.
Based on the limited data on performance and safety, some authors have not identified any conclusions and do not recommend its consumption in regards to creatine supplementation in children and adolescents [52,54]. Conversely, according to the view of the ISSN [5], younger athletes should consider a creatine supplement under certain conditions: puberty is past and he/she is involved in serious competitive training; the athlete is eating a well-balanced caloric adequate diet; he/she as well as the parents approve and understand the truth concerning the effects of creatine supplementation; supplement protocols are supervised by qualified professionals; recommended doses must not be exceeded; quality supplements are administered.
Creatine is most commonly used for improving exercise performance and increasing muscle mass in athletes and older adults. There is some science supporting the use of creatine in improving the athletic performance of young, healthy people during brief high-intensity activity such as sprinting. Because of this, creatine is often used as a dietary supplement to improve muscle strength and athletic performance. In the U.S., a majority of sports nutrition supplements, which total $2.7 billion in annual sales, contain creatine.
^ Jump up to: a b c d e Wilson JM, Fitschen PJ, Campbell B, Wilson GJ, Zanchi N, Taylor L, Wilborn C, Kalman DS, Stout JR, Hoffman JR, Ziegenfuss TN, Lopez HL, Kreider RB, Smith-Ryan AE, Antonio J (February 2013). "International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB)". J. Int. Soc. Sports. Nutr. 10 (1): 6. doi:10.1186/1550-2783-10-6. PMC 3568064. PMID 23374455.
When looking specifically at human studies, there has been a failure of creatine supplementation to induce or exacerbate kidney damage in people with amyotrophic lateral sclerosis (ALS). Subjects do not experience kidney damage for up to or over a year’s worth of supplementation in the 5-10g range.[505][506][507] Postmenopausal women,[517] people with type II diabetes,[518] people on hemodialysis,[313] otherwise healthy elderly,[519] young people,[454][520][521] and athletes do not experience kidney damage either.[324] Moreover, numerous scientific reviews on both the long- and short-term safety of supplemental creatine have consistently found no adverse effects on kidney function in a wide range of doses.[522][523][524][452][525][451][526][527] However, while doses >10 g/day have been found not to impair kidney function, there are fewer long-term trials using such high chronic daily intakes.[527]

In the stomach, creatine can degrade by about 13% due to the digestive hormone pepsin, as assessed by simulated digestion.[127] Although creatinine is a known byproduct of creatine degradation, simulated gastric digestion did not increase creatinine levels, indicating that other breakdown products were formed. However, creatinine was noted to increase in the presence of pancreatin, a mixture of pancreatic enzymes.[127] 
This suppression of creatine synthesis is thought to actually be beneficial, since creatine synthesis requires s-adenosyl methionine as a cofactor and may use up to 40-50% of SAMe for methylation[35][36][122] (initially thought to be above 70%, but this has since been re-evaluated[122]) though the expected preservation of SAMe may not occur with supplementation.[487] Reduced creatine synthesis, via preserving methyl groups and trimethylglycine (which would normally be used up to synthesize SAMe), is also thought to suppress homocysteine levels in serum,[37] but this may also not occur to a practical level following supplementation.[487]

When looking specifically at human studies, there has been a failure of creatine supplementation to induce or exacerbate kidney damage in people with amyotrophic lateral sclerosis (ALS). Subjects do not experience kidney damage for up to or over a year’s worth of supplementation in the 5-10g range.[505][506][507] Postmenopausal women,[517] people with type II diabetes,[518] people on hemodialysis,[313] otherwise healthy elderly,[519] young people,[454][520][521] and athletes do not experience kidney damage either.[324] Moreover, numerous scientific reviews on both the long- and short-term safety of supplemental creatine have consistently found no adverse effects on kidney function in a wide range of doses.[522][523][524][452][525][451][526][527] However, while doses >10 g/day have been found not to impair kidney function, there are fewer long-term trials using such high chronic daily intakes.[527]
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