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]
When splitting a sample into exercisers and non-exercisers, it appears that exercise as a pre-requisite precedes a higher range of activity. Inactive people tend to be on the lower end of creatine kinase activity and relatively clustered in magnitude, while exercise generally increases activity, but also introduces a larger range of possible activity.[56]
This is one of the best workouts for your hamstrings and glutes. Start in a standing position, feet shoulder-width apart. Hold the bar in front of you. Lower it to just below your knees. You can lower it further if you can keep a flat back and stable spine. Slowly return to the starting position. Keep the bar close to your body to protect your lower back.
Different exercises will require different weights, but there are some markers that can help guide you towards the right resistance, whether you're using dumbbells, kettlebells, or a barbell. Go for a weight that feel heavy enough to challenge you, but not so heavy that you sacrifice your form. For example, if you're doing 15 reps, you should feel pretty fatigued by the time you hit rep 15. If you can breeze through all your reps, though, that's a sign you should up the weight.
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] 
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.
For beginners, your own body weight might be enough to get you started. However, it can be hard to challenge your body without any additional resistance, so to progress, you'll need some equipment. If you decide to strength train at home, you'll want to invest in some basics, such as resistance bands, weights, and an exercise ball. Try to have a range of weights: a light set (3 to 5 pounds for women, 5 to 8 pounds for men), a medium set (5 to 10 pounds for women, 10 to 15 pounds for men), and a heavy set (10 to 20 pounds for women, 15 to 30 pounds for men).
Foundational supplements are often overlooked for building muscle, because they work behind the scenes. In actuality, foundational supplements are important to take for building muscle, because they assist with overall health and wellness and contribute to the effectiveness of other muscle building supplements.* Some of the top foundational supplements are:
Creatine, the amino acid, naturally helps your body produce more adenosine triphosphate, or ATP, a small molecule that’s actually your body's primary energy source. But research shows that your body is only capable of storing enough ATP for 8 to 10 seconds of high-intensity exercise — and after that, it needs to produce new ATP for you to continue. (9)

According to BodyBuilding.com, adenosine triphosphate (ATP) is made up of a nucleotide bonded to three phosphate groups. When one of those phosphate groups is cleaved from the ATP molecule, a lot of energy is made available. That energy is used to fuel chemical reactions in cells, and ATP becomes adenosine diphosphate (ADP). Creatine enables the release of energy from stored ATP and is converted 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]

Include cardio training. Good cardiovascular health improves blood flow, a requirement for muscle growth. Doing cardio also improves your cardiovascular fitness, which allows you to use your muscle gains for various sports and activities. The standard recommendation is 150 minutes of moderate cardio each week, or 75 minutes of vigorous cardio, or an equivalent combination of the two. A good place to start would be doing 30-60 minutes of cardiovascular activity every other day or 3 times a week. Examples of cardio include running, biking, swimming, and any sport that involves constant movement.
Progression – Throughout the course of your lifting career you should consistently strive for progress both mentally and physically. Initially, you may find that you’re incessantly focused on nutrition and training but as you progress in both maturity and muscular development, you should be focused on improving the balance between lifting and your life. It’s never about having an all or nothing mindset, balance must be incorporated in all aspects but this takes times to develop and occurs with progression over time.

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.
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]

de Salles Painelli V, Alves VT, Ugrinowitsch C, et al. Creatine supplementation prevents acute strength loss induced by concurrent exercise. Eur J Appl Physiol 2014;114:1749-55.del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids 2012;42:2299-305. View abstract.
In a study on Alpha-Lipoic Acid, 1,000mg of ALA paired with 100g sucrose and 20g creatine monohydrate was more effective in increasing muscular creatine levels relative to creatine alone and creatine combined with sucrose.[600] This apparent augmentation of creatine uptake into muscle cells was used alongside a loading period. Another study investigating a nutrient mixture (150g glucose, 20g creatine, 2g/kg bodyweight glycerol) on heat tolerance in trained athletes found that replacing one third (50g) of the glucose with 1g ALA resulted in no significant differences between groups (in regard to heat tolerance and cardiovascular performance) despite the reduction of 50g carbohydrate.[601]
In summary, creatine salts have been show to be less stable than CM. However the addition of carbohydrates could increase their stability [62]. The potential advantages of creatine salts over CM include enhanced aqueous solubility and bioavailability which would reduce their possible gastrointestinal adverse effects [63]. The possibility for new additional formulation such as tablets or capsules is interesting for its therapeutic application due to its attributed better dissolution kinetics and oral absorption compared to CM [63]. However more complete in vivo pharmaceutical analysis of creatine salts are required to fully elucidate their potential advantages/disadvantages over the currently available supplement formulations.
Related to exercise and fitness, BCAAs are taken to help reduce muscle breakdown, which is why they may be known as muscle building supplements. Leucine, in particular, is known for playing an important role in muscle protein synthesis, which can help with muscle gain and maintenance. Some also claim that BCAAs can enhance performance, although many studies also refute this claim.
Some of these athletes take it to an unhealthy — and in some cases illegal — extreme with anabolic steroids, prohormones, diuretics, and potentially harmful substances. In addition to their potential performance-enhancing attributes, many of these substances also can have serious and significant side effects. A telling example of this is the story of ephedra — a once widely-used supplement for bodybuilding that has since been banned and removed from the market due to multiple reports of life-threatening side effects and death after its use.

JAK2 (Janus-Activating Kinase 2) is a novel protein that has been shown to suppress the activity of the creatine transporter CrT in vitro. The effects of JAK2 on CrT are not well-understood in vivo, however. Given that growth hormone activates both c-src (increases CrT activity) and JAK2- which has been found to decrease CrT activity, it is plausible that JAK2 may function as a negative-feedback regulator of creatine uptake. Future research is needed to better understand the role of JAK2 on CrT activity in vivo.
If you’re a beginner, you should train with three full-body workouts per week. In each one, do a compound pushing movement (like a bench press), a compound pulling movement (like a chinup), and a compound lower-body exercise (squat, trap-bar deadlift, for example). If you want to add in 1–2 other exercises like loaded carries or kettlebell swings as a finisher, that’s fine, but three exercises is enough to work the whole body.
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.
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.
Recommended dose: The fastest way to increase muscle creatine stores is to follow the loading method of 20 grams per day for 5-7 days, followed by the standard maintenance dose of 5 grams per day. However, a lower dose of 5 grams for 28 days will also increase creatine stores without causing the 2-4 pound weight gain typically seen with a loading protocol.

When assessing the antioxidant effects of creatine, it does not appear to sequester superoxide and may not be a direct antioxidant.[241] Additionally, creatine failed to protect neurons from H2O2 incubation to induce cell death via pro-oxidative means.[241] These results are in contrast to previously recorded results suggesting creatine acts as a direct anti-oxidant.[242]
Do you know what happens when a person attempts to build muscle faster than they legitimately can? They fail, and then they wonder why it’s not working as quickly as they thought it would. From there, they’ll jump from workout to workout, diet to diet and useless supplement to useless supplement in the hopes of finally finding the missing link that will make it happen. But they’re never going to find it. They’ll just keep wasting their time, effort and money searching for something that doesn’t exist.
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] 
Stash away your scale for several weeks — and set a strength training goal instead. That’s the advice of Lisette Cifaldi, director of behavioral health at Hilton Head Health weight loss resort who counsels patients. “I think strength training shifts your perspective,” she says. “The happiness doesn’t come from achieving a certain number [on the scale]. It comes from the process of getting stronger and feeling empowered that you’re navigating your own success.”
Creatine supplementation in the under 18 population has not received a great deal of attention, especially in regards to sports/exercise performance. Despite this, creatine is being supplemented in young, <18 years old, athletes [52,53]. In a 2001 report [52] conducted on pupils from middle and high school (aged 10 – 18) in Westchester County (USA) 62 of the 1103 pupils surveyed were using creatine. The authors found this concerning for 2 main reasons: firstly, the safety of creatine supplementation is not established for this age group and is therefore not recommended. Secondly, it was speculated that taking creatine would lead on to more dangerous performance enhancing products such as anabolic steroids. It is important to point out that this potential escalation is speculation. Furthermore, a questionnaire was used to determine creatine use amongst this age group and does not necessarily reflect the truth.

In vitro, creatine (0.125mM or higher) can reduce excitotoxicity from glutamate, which is thought to be secondary to preserving intracellular creatine phosphate levels.[209] Glutamate-induced excitotoxicity is caused by excessive intracellular calcium levels resulting from ATP depletion. Since high levels of calcium inside the cell are toxic, ATP preserves membrane integrity,[210] in part by promoting calcium homeostasis. When ATP is depleted, the sodium-potassium ATPase pump (Na+,K+-ATPase) stops working, leading to sodium accumulation in the cell. This reduces the activity of the sodium-calcium exchange pump, which, alongside a lack of ATP, reduces calcium efflux through the Na+,K+-ATPase. Thus, ATP depletion leads to intracellular calcium overload, loss of membrane potential, and excitotoxic cell death. Therefore, by helping preserve ATP levels, creatine is protective against excitotoxicity. This protective effect was noted after either creatine preloading or addition up to 2 hours after excitotoxicity.[209] Protection from glutamate-induced toxicity also extends to glial cells[211] and is additive with COX2 inhibition.[212]
Creatine supplementation appears to attenuate decreases in GLUT4 expression seen with immobility and may increase GLUT4 expression during exercise. While it seems capable of increasing GLUT4 during resting conditions, it has failed to reach significance, suggesting that creatine supplementation works best with some stimuli associated with exercise.

This move can help lean abs really pop, especially once you've lost any extra belly fat. Sit on the floor, knees bent and heels down. Lean back, keep your back straight, and tense your abs. Place the kettlebell on the floor, switching from one side to the other. For faster results, hold your feet off the floor, but only if you can still use good form.

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] 
Studies conducted in vegetarians tend to show cognitive enhancement in youth, possibly due to a creatine deficiency, as compared to omnivores.[272][60][61] Vegetarian diets have lower levels of circulating creatine prior to supplementation, but attain similar circulating levels as omnivores when both groups supplement.[272][273] Building on the latter, supplementation of creatine monohydrate in a loading protocol (20g daily in orange juice) in omnivores does not alter levels of creatine in white matter tissue in the brain (test subjects: competitive athletes).[274] In most of the parameters that vegetarians experience benefits, omnivores fail to experience statistically significant benefits[275], except possibly when sleep deprived, where the cognitive improvements rival that seen in vegetarians.[276] Elderly people who are omnivorous may also experience increases in cognition to a similar level, in regard to long-term memory as well as forward number and spatial recall, although the study in question failed to find any significant benefit on backward recall or random number generation,[38] the latter of which is a test for executive working memory.[277]
All you need to know about low creatinine levels Creatinine is a waste material in the body, and low levels can suggest a shortfall in liver function or activity. This MNT Knowledge Center feature looks at low creatinine levels., as well as information on what creatinine is, how it affects the body, and how to increase low creatinine levels. Read now
The first open label trial on ALS failed to significantly alter lung function as assessed by FEV (when comparing the rate of decline pretreatment relative to treatment).[545] Creatine has elsewhere failed to benefit lung function at 5g daily for months relative to control[546] and failed to significantly attenuate the rate of lung function deterioration over 16 months at 10g daily[505] and 5g daily over nine months.[507]
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.
 Besides the obvious benefits of getting protein into your system, our vegan protein powder offers other benefits too. It’s one of the one of the best bodybuilding supplements for anyone –– regardless of their diet –– because it’s a Smooth Protein™. That means it’s organic, non-GMO, gluten-free, and non-allergenic, and it also doesn’t have that gritty texture and earthy flavor associated with other plant-based protein supplements.
Sandow organized the first bodybuilding contest on September 14, 1901, called the "Great Competition". It was held at the Royal Albert Hall in London. Judged by Sandow, Sir Charles Lawes, and Sir Arthur Conan Doyle, the contest was a great success and many bodybuilding enthusiasts were turned away due to the overwhelming amount of audience members.[4] The trophy presented to the winner was a gold statue of Sandow sculpted by Frederick Pomeroy. The winner was William L. Murray of Nottingham. The silver Sandow trophy was presented to second-place winner D. Cooper. The bronze Sandow trophy — now the most famous of all — was presented to third-place winner A.C. Smythe. In 1950, this same bronze trophy was presented to Steve Reeves for winning the inaugural NABBA Mr. Universe contest. It would not resurface again until 1977 when the winner of the IFBB Mr. Olympia contest, Frank Zane, was presented with a replica of the bronze trophy. Since then, Mr. Olympia winners have been consistently awarded a replica of the bronze Sandow.
Creatine helps create essential adenosine triphosphate (ATP). This is the energy source of muscle contractions. By upping your levels, you can increase the amount of energy available to your muscles, boosting your performance. Because your muscle strength and size increases when you add weight and reps, improving your performance can be a game changer in terms of increasing your muscle mass. If you’re able to lift longer and harder, your muscles will grow. Creatine is certainly a winner among muscle building supplements.
Studies with animal and cellular models demonstrated positive effect of creatine ingestion on neurodegenerative diseases. These effects have been attributed to improved overall cellular bioenergetics due to an expansion of the phosphocreatine pool [50]. Creatine deficiency syndromes, due to deficiency of glycine amidinotransferase and guanidinoacetate methyltransferase, can cause decreases or complete absence of creatine in the central nervous system. Syndromes of this nature have the possibility to be improved by supplementing orally with creatine. Brain creatine deficiency resulting from ineffective crea T1 has been shown not to be effectively treated with oral creatine supplementation [51]. Additionally, oral creatine administration in patients with myopathies has shown conflicting results depending on the type of myopathy and creatine transport systems disorders [4].
Older women with knee osteoarthritis given supplemental creatine at 20g for five days followed by 5g for the rest of the twelve week trial experienced improvements in stiffness (52% reduction), pain (45%), and physical function (41%) as assessed by WOMAC, despite no improvements in physical power output relative to placebo.[425] This study paired supplementation and placebo with a mild exercise regimen.[425]
Back in the 1970s, scientists discovered that taking creatine in supplement form might enhance physical performance. In the 1990s, athletes started to catch on, and creatine became a popular sports supplement. The supplement is particularly popular among high school, college, and professional athletes, especially football and hockey players, wrestlers, and gymnasts. 
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.

This copyrighted, evidence-based medicine resource is provided by Natural Medicines Comprehensive Database Consumer Version. Natural Medicines Comprehensive Database disclaims any responsibility related to consequences of using any product. This monograph should not replace advice from a healthcare professional and should not be used for the diagnosis or treatment of any medical condition.
Most weightlifters, athletes and bodybuilders know about creatine. They know it’s an important substance to take to give you an important edge in your workouts. Kaged Muscle made two different creatine products to give you the purest edge possible. They’re known as Kaged Muscle C-HCL Powder. There is a powder version and a capsule version. Keep Reading »
^ Jump up to: a b c d e f g h Momaya A, Fawal M, Estes R (April 2015). "Performance-enhancing substances in sports: a review of the literature". Sports Med. 45 (4): 517–531. doi:10.1007/s40279-015-0308-9. PMID 25663250. Wilson et al. [91] demonstrated that when non-resistance trained males received HMB pre-exercise, the rise of lactate dehydrogenase (LDH) levels reduced, and HMB tended to decrease soreness. Knitter et al. [92] showed a decrease in LDH and creatine phosphokinase (CPK), a byproduct of muscle breakdown, by HMB after a prolonged run. ... The utility of HMB does seem to be affected by timing of intake prior to workouts and dosage [97]. 

In recent years, the related areas of fitness and figure competition have increased in popularity, surpassing that of female bodybuilding, and have provided an alternative for women who choose not to develop the level of muscularity necessary for bodybuilding. McLish would closely resemble what is thought of today as a fitness and figure competitor, instead of what is now considered a female bodybuilder. Fitness competitions also have a gymnastic element to them. A study by the Clinical Journal of Sport Medicine found that female bodybuilders who are taking anabolic steroids are more likely to have qualified for substance dependence disorder, to have been diagnosed with a psychiatric illness, or to have a history of sexual abuse.[14]
Creatine pyruvate (also known as creatine 2-oxopropanoate) in an isomolar dose relative to creatine monohydrate has been shown to produce higher plasma levels of creatine (peak and AUC) with no discernible differences in absorption or excretion values.[83] The same study noted increased performance from creatine pyruvate at low (4.4g creatine equivalence) doses relative to citrate and monohydrate, possibly due to the pyruvate group.
Kerksick, C. M., Wilborn, C. D., Campbell, W. I., Harvey, T. M., Marcello, B. M., Roberts, M. D., Parker, A. G., Byars, A. G., Greenwood, L. D., Almada, A. L., Kreider, R. B., and Greenwood, M. The effects of creatine monohydrate supplementation with and without D-pinitol on resistance training adaptations. J.Strength.Cond.Res. 2009;23:2673-2682. View abstract.
Sound complicated? Fortunately, there's an easy rule of thumb for increasing your training volume: For each exercise, perform three to six sets of six to 12 reps, resting for 30 to 90 seconds between each set, she says. The weight used should be enough that you can get out your last reps with proper form but wouldn't be able to perform any additional reps.
You don’t have to, but you can. The typical creatine dose is 5 grams once or twice per day, but it’s sometimes suggested that one should “load” creatine by taking 20 to 25 grams per day for the first week of usage. This is then followed with 3 to 4 weeks of 5 grams per day, then a break for a week or two, then repeat. This may bring about more acute increases in strength and muscle size — creatine will “work” more quickly, in other words — but it’s not necessary.
While training intensity can be accomplished trough a targeted training program and an ability to adequately stimulate our muscles is something the motivated and determined bodybuilder often has no problem doing, muscle recovery is another issue. It is especially important at a time of the year when social demands and incorrect eating combine to stifle our progress.
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
Despite creatine not interfering with UV(A) irradiation acting upon a cell or the production of oxidation due to it, creatine appears to prevent the functional consequences (such as mitochondrial DNA damage) due to preventing an ATP depletion in the cell, which would normally precede a reduction in mitochondrial membrane potential and mutagenesis, but this effect is prevented for as long as creatine stores are sufficient.[446] Creatine has also been noted to near-fully protect mitochondrial DNA from hydroxyl radicals and oxidative damage, although there was no protective effect for nuclear DNA, due to it being less sensitive to hydroxyl radicals.[447]
There have been a few reported renal health disorders associated with creatine supplementation [73,74]. These are isolated reports in which recommended dosages are not followed or there is a history of previous health complaints, such as renal disease or those taking nephrotoxic medication aggravated by creatine supplementation [73]. Specific studies into creatine supplementation, renal function and/or safety conclude that although creatine does slightly raise creatinine levels there is no progressive effect to cause negative consequences to renal function and health in already healthy individuals when proper dosage recommendations are followed [73-77]. Urinary methylamine and formaldehyde have been shown to increase due to creatine supplementation of 20 g/d; this however did not bring the production outside of normal healthy range and did not impact on kidney function [56,78]. It has been advised that further research be carried out into the effects of creatine supplementation and health in the elderly and adolescent [73,75]. More recently, a randomized, double blind, 6 month resistance exercise and supplementation intervention [79] was performed on elderly men and women (age >65 years) in which subjects were assigned to either a supplement or placebo group. The supplement group was given 5 g CM, 2 g dextrose and 6 g conjugated linoleic acid/d, whilst the placebo group consumed 7 g dextrose and 6 g safflower oil/d. CM administration showed significantly greater effects to improve muscular endurance, isokinetic knee extension strength, fat free mass and to reduce fat mass compared to placebo. Furthermore the supplement group had an increase in serum creatinine but not creatinine clearance suggesting no negative effect on renal function.
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]
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