Endogenous serum or plasma creatine concentrations in healthy adults are normally in a range of 2–12 mg/L. A single 5 g (5000 mg) oral dose in healthy adults results in a peak plasma creatine level of approximately 120 mg/L at 1–2 hours post-ingestion. Creatine has a fairly short elimination half-life, averaging just less than 3 hours, so to maintain an elevated plasma level it would be necessary to take small oral doses every 3–6 hours throughout the day. After the "loading dose" period (1–2 weeks, 12–24 g a day), it is no longer necessary to maintain a consistently high serum level of creatine. As with most supplements, each person has their own genetic "preset" amount of creatine they can hold. The rest is eliminated as waste. A typical post-loading dose is 2–5 g daily.[52][53][54]
Osteoblast cells are known to express creatine kinase.[39][417] Bone growth factors such as IGF-1,[418] PTH,[419] and even Vitamin D[420][421] seem to induce bone growth alongside increases in creatine kinase activity. Vitamin D has been noted to work indirectly by increasing the cellular energy state (these hormones increase creatine kinase in order to do so) in order to make bone cells more responsive to estrogen.[420] This evidence, paired with enhanced growth rates of osteoblasts in the presence of higher than normal (10-20mM) concentrations of creatine[422] suggest a role of creatine in promoting osteoblastic and bone growth, secondary to increasing energy availability.

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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]
In nonelite swimmers conducting an intermittent sprint protocol (Six 50m sprints every two minutes), supplementation of a creatine loading period was able to reduce the decrement in speed during the third sprint (2% decrement rather than a 5% decrement) but not the sixth sprint. There were no changes in plasma lactate or other biomarkers of fatigue.[396] When examining a single 50m sprint in amateur swimmers, a creatine loading period is able to reduce the time to complete the sprint by 4.6%, while it had no benefit for the 100m sprint.[397] When the loading phase was followed by three weeks maintenance in youth, there was no apparent benefit to sprint performance (50m sprint with five minutes rest followed by a 100m freestyle) despite benefits to a swim bench test (30s sprints with a five minute break in between).[398]
^ The effect of HMB on skeletal muscle damage has been assessed in studies using four different biomarkers of muscle damage or protein breakdown: serum creatine kinase, serum lactate dehydrogenase, urinary urea nitrogen, and urinary 3-methylhistidine.[38][41][42] When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during long-distance running or progressive overload, HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.[38][42]

That said, many people experience stomach cramps when they consume creatine monohydrate and it’s possible that taking a creatine with a different pH — usually creatine hydrochloride — can have a different effect on stomach acid and make for a creatine that digests more easily. As far as we know, the easier digestion doesn’t necessarily mean it’s more effective or that you need less of it to achieve the desired result.

A double-blind study provided 20 g/day of creatine monohydrate for 5 days to qualified sprinters and jumpers who performed 45 seconds of continuous jumping and 60 seconds of continuous treadmill running. Supplementation enhanced performance in the jumping test by 7% for the first 15 seconds and 12% for the next 15 seconds, but there was no difference for the final 15 seconds. There was a 13% improvement in the time of intensive running to exhaustion [12].
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]
If you’ve been training longer than 6–12 months, you can split your workouts into upper- and lower-body days. The most common setup is to train upper body one day and lower the next so that each area gets trained twice in one week. If you train four days per week, you can train upper body on Monday, lower Tuesday, rest Wednesday, and then do upper body again on Thursday, lower body on Friday, and then rest on the weekend.
A muscle imbalance—when one muscle is stronger than its opposing muscle—can limit your ability to exercise effectively, and could lead to injury down the line. “It’s important to recognize whether you’re really working the muscles you think you are and recognize if you’ve developed an imbalance that alters your movement pattern,” says Eric Ingram, physical therapist at Louisiana Physical Therapy Centers of Pineville. One common imbalance in women is stronger quads and weaker, tighter hamstrings, thanks to prolonged sitting, high heels, and improper training. If you suspect you have a muscle imbalance, make an appointment with a physical therapist, who will prescribe exercises to even you out.
Jason Ferruggia is a highly sought after, world renowned strength & conditioning specialist and muscle building expert. Over the last 17 years he has personally trained more than 700 athletes from over 90 different NCAA, NFL, NHL and MLB organizations. He has also worked extensively with firefighters, police officers, military personnel, Hollywood stars and entertainers. Most importantly, Jason has helped over 53,000 skinny guys and hard gainers in 126 different countries build muscle and gain weight faster than they every thought possible.
You have to fuel your body with high-quality, real, wholesome food. Eating pizza, burgers, ice cream, and fast food just because it’s high in calories is a really bad plan. You’ll feel terrible, and while the extra calories will help muscle gains to an extent, most of them will turn to fat. It’s not worth it. Your recovery will be slower and you will be riddled with inflammation.

A meta-analysis of 16 studies conducted on creatine and its influence on power and strength,[368][369] (with or without exercise in all age groups above 16, but placebo controlled and without crossover[368]) compiled studies utilizing a 5-7 day loading period with continued maintenance thereafter and studies assessing 1-3 rep bench press strength in trained young men. Seven studies (four of which are online[370][371][372][373]) totaling 70 people using creatine and 73 people in placebo showed a 6.85kg increase in strength relative to placebo, the benefits of which peaked at 8 weeks.[368] This meta-analysis also quantified a significant increase in squat strength (9.76kg) yet failed to find a significant influence on peak bicep contraction power, which may have been influenced by the two null studies[374][375] being in elderly people while the positive study[376] was statistically outweighed, but noted an 1.8-fold increase in power associated with creatine over placebo. The other meta-analysis conducted the following year[369] calculated effect sizes for creatine supplementation and noted no significant differences between genders or when comparing trained and untrained individuals. The mean effect size of exercises lasting below 30s (those that use the creatine-phosphate system) was 0.24+/-0.02 and performed significantly better than placebo, where exercise increased performance by 4.2+/-0.6% while the addition of creatine enhanced this effect to 7.5+/-0.7%.[369]


Creatine non-response is when muscular loading of creatine is under a certain threshold (10mmol/L), while “response” to creatine means having more muscular creatine loading (20mol/L or more). There also exists a “grey area” inbetween, where some benefits are achieved but not as many as pure responders will experience. Response appears to be positively correlated with muscle mass and type II muscle fibers.

No need to worry! This myth that caffeine counteracts creatine came from the simple, but wrong logic that because caffeine accelerates the nervous system and uses more water, it would counteract creatine because creatine helps your body retain water. While both of these statements are true, it does not mean they “cancel” eachother out, all that it means is that your body will be able to stay hydrated longer if you are taking creatine and caffeine opposed to just taking caffeine.


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.
One pilot study using 150mg/kg creatine monohydrate for a five day loading phase followed by maintenance (60mg/kg) for the remainder of the five weeks noted that supplementation was associated with fewer muscle symptoms and complaints alongside improved muscular function,[572] yet a later trial trying to replicate the obsevations using 150mg/kg daily for five weeks noted the opposite, that creatine supplementation exacerbated symptoms.[573] 
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