Genetic deficiencies in the creatine biosynthetic pathway lead to various severe neurological defects.[26] Clinically, there are three distinct disorders of creatine metabolism. Deficiencies in the two synthesis enzymes can cause L-arginine:glycine amidinotransferase deficiency caused by variants in GATM and guanidinoacetate methyltransferase deficiency, caused by variants in GAMT. Both biosynthetic defects are inherited in an autosomal recessive manner. A third defect, creatine transporter defect, is caused by mutations in SLC6A8 and inherited in a X-linked manner. This condition is related to the transport of creatine into the brain.[27]
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There is a genetic condition known as gyrate atrophy of the choroid and retina, which is associated with a high level of Ornithine in the blood and a relative decrease in Arginine, which causes a relative creatine deficiency due to L-arginine being required to make creatine[478][479] and because high ornithine can suppress creatine synthesis (AGAT) in the glial cells of the retina.[475] This condition can be attenuated by either reducting ornithine in the diet[480] or by supplementing creatine, which is, in this instance, therapeutic.[481][482]
Healthy sources of fat include: cold water oily fish (such as salmon, mackerel, and sardines), extra-virgin olive oil, peanuts (unsalted), avocado, pecans, almonds, hazelnuts, walnuts or flaxseed. Nuts (any sort, just make sure they are unsalted) are a great food to snack on if you're having trouble gaining weight, as they are not only high in calories, but they contain monounsaturated fats, a good source of protein, fibre and contain a number of essential minerals that are needed for health. For those not consuming any oily fish, you may want to consider taking a fish oil supplement, such as cod liver oil or flaxseeds.
A big clue is digestion. He does occasional cleanses. (“There’s no planes that week,” he said. “And no judgment at home.”) The slightest change in a muscle, just a stripe in a striation, is noticed. And while Heath does most workouts alone, he has a trainer, Hany Rambod, who is based in California. They see each other about once a month. In between, Heath sends photos and receives workout and dietary advice in return.
^ Mangano, Kelsey M.; Sahni, Shivani; Kiel, Douglas P.; Tucker, Katherine L.; Dufour, Alyssa B.; Hannan, Marian T. (February 8, 2017). "Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study". The American Journal of Clinical Nutrition. 105 (3): 714–722. doi:10.3945/ajcn.116.136762. PMC 5320406. PMID 28179224 – via ajcn.nutrition.org.
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]
Collectively the above investigations indicate that creatine supplementation can be an effective strategy to maintain total creatine pool during a rehabilitation period after injury as well as to attenuate muscle damage induced by a prolonged endurance training session. In addition, it seems that creatine can act as an effective antioxidant agent after more intense resistance training sessions.
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