In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline).[485] This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.[485]

Although creatine can be bought commercially as a standalone product it is often found in combination with other nutrients. A prime example is the combination of creatine with carbohydrate or protein and carbohydrate for augmenting creatine muscle retention [5] mediated through an insulin response from the pancreas [69]. Steenge et al [70] found that body creatine retention of 5 g CM was increased by 25% with the addition of 50 g of protein and 47 g of carbohydrate or 96 g carbohydrate when compared to a placebo treatment of 5 g carbohydrate. The addition of 10g of creatine to 75 g of dextrose, 2 g of taurine, vitamins and minerals, induced a change in cellular osmolarity which in addition to the expected increase in body mass, seems to produce an up regulation of large scale gene expression (mRNA content of genes and protein content of kinases involved in osmosensing and signal transduction, cytoskeleton remodelling, protein and glycogen synthesis regulation, satellite cell proliferation and differentiation, DNA replication and repair, RNA transcription control, and cell survival) [25]. Similar findings have also been reported for creatine monohydrate supplementation alone when combined with resistance training [71].
The muscle endurance objective is pursued when you want your muscles to be able to perform the same motions over an extended period of time or in other words when you want your muscles to be strong and not become tired rapidly. You'll want to use at least 4 sets from which at least 16 repetitions are performed. The muscle endurance objective is often used for muscles in your lower body, such as those located in your legs or your buttocks.
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]
^ 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.
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.
How to maximize its effects: Take 20 grams of whey protein powder in the 30 minutes before working out, and take 40 grams within 60 minutes after training. Also consider taking 20-40 grams of whey immediately upon waking every morning to kick-start muscle growth. Your best bet is to choose a whey powder that contains whey protein hydrolysates (whey protein broken down into smaller fragments for faster digestion) or whey protein isolate.

^ "The History of Weightlifting". USA Weightlifting. United States Olympic Committee. Archived from the original on 7 July 2013. Retrieved 3 September 2018. The genealogy of lifting traces back to the beginning of recorded history where man's fascination with physical prowess can be found among numerous ancient writings. A 5,000-year-old Chinese text tells of prospective soldiers having to pass lifting tests.

A typical creatine supplementation protocol of either a loading phase of 20 to 25 g CM/d or 0.3 g CM/kg/d split into 4 to 5 daily intakes of 5 g each have been recommended to quickly saturate creatine stores in the skeletal muscle. However a more moderate protocol where several smaller doses of creatine are ingested along the day (20 intakes of 1 g every 30 min) could be a better approach to get a maximal saturation of the intramuscular creatine store. In order to keep the maximal saturation of body creatine, the loading phase must be followed by a maintenance period of 3-5 g CM/d or 0.03 g CM/kg/d. These strategies appear to be the most efficient way of saturating the muscles and benefitting from CM supplementation. However more recent research has shown CM supplementation at doses of 0.1 g/kg body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Creatine retention by the body from supplementation appears to be promoted by about 25% from the simultaneous ingestion of carbohydrate and/or protein mediated through an increase in insulin secretion. This combination would produce a faster saturation rate but has not been shown to have a greater effect on performance.
The body's pool of creatine can be replenished either from food (or supplements) or through synthesis from precursor amino acids. Dietary sources include beef, tuna, cod, salmon, herring, and pork [2]. The normal dietary intake of creatine is 1-2 g/day, although vegetarians may consume less [3,4]. Dietary creatine is absorbed from the intestines into the bloodstream. If the dietary supply is limited, creatine can be synthesized from the body stores of the amino acids glycine, arginine, and methionine. The kidneys use glycine and arginine to make guanidinoacetate, which the liver methylates to form creatine [1], which is transported to the muscle cells for storage. It is also stored in the kidneys, sperm cells, and brain tissue [5].
These complete proteins include all of the essential amino acids that the body cannot produce itself. Different proteins, such as whey and casein, egg and soy have different absorption rates. Whether you should favor one over another for muscle building is still a subject of popular and scientific debate, although whey protein isolate, a more rapidly absorbed protein, has some support from various scientific studies. For protein powders, assess the value by checking out the protein listed on the label. Combined with resistance training, sufficient protein consumption along with an appropriate diet can lead to increased muscle and reduced body fat. You should read more about The Bodybuilding Diet for supplement timing issues before and after training. 
An exercise should be halted if marked or sudden pain is felt, to prevent further injury. However, not all discomfort indicates injury. Weight training exercises are brief but very intense, and many people are unaccustomed to this level of effort. The expression "no pain, no gain" refers to working through the discomfort expected from such vigorous effort, rather than to willfully ignore extreme pain, which may indicate serious soft tissue injuries. The focus must be proper form, not the amount of weight lifted.[23]
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.
Listen, I know in the beginning of this post I was sympathetic to your problem, but I am also here to say, Suck It Up. I can tell you that to gain weight, you need to focus on making your meals a habit rather than an afterthought. Your body is pre-programmed with your genetic disposition. And in your case, you have a very fast metabolism that digests and burns calories quickly. Focus on having 5-6 calorie-dense meals a day spaced 2-3 hours apart so that your body is constantly being provided with something to metabolize and build muscle.
If your fitness goals are to get strong and build hard, visible muscle, then you’re going to want to train in three phases according to Heath. Strength, conditioning, and a blend of the two that works for you. “If you can get to the gym 4-5 days a week, that would be perfect,” he says. “You can still do chest/tri’s, back/bi’s, legs, shoulders, and make the fifth day a cleanup day, meaning focus on body parts you may be weaker in.” Check out Heath’s guide to finding your best muscle-building routine.
Escolar, D. M., Buyse, G., Henricson, E., Leshner, R., Florence, J., Mayhew, J., Tesi-Rocha, C., Gorni, K., Pasquali, L., Patel, K. M., McCarter, R., Huang, J., Mayhew, T., Bertorini, T., Carlo, J., Connolly, A. M., Clemens, P. R., Goemans, N., Iannaccone, S. T., Igarashi, M., Nevo, Y., Pestronk, A., Subramony, S. H., Vedanarayanan, V. V., and Wessel, H. CINRG randomized controlled trial of creatine and glutamine in Duchenne muscular dystrophy. Ann Neurol 2005;58:151-155. View abstract.
This basic form of creatine comes in two forms, one of which involves the removal of the monohydrate (which results in creatine anhydrous) that converts to creatine monohydrate in an aqueous environment,[66][67] but due to the exclusion of the monohydrate it is 100% creatine by weight despite creatine monohydrate being 88% creatine by weight, as the monohydrate is 12%. This allows more creatine to be present in a concentrated formula, like capsules.[68]
^ "Popular sports supplements contain meth-like compound". USA Today. October 25, 2013. Cohen said researchers informed the FDA in May about finding the new chemical compound in Craze. The team found the compound — N,alpha-diethylphenylethylamine — has a structure similar to methamphetamine, a powerful, highly addictive, illegal stimulant drug. They believe the new compound is likely less potent than methamphetamine but greater than ephedrine.

The failure of creatine to improve physical performance in these conditions is thought to be related to the myopathies in general, which are known to result in less phosphocreatine in skeletal muscle,[568] associated with reduced expression of the creatine transporter.[569] As creatine has once been noted to not accumulate in the skeletal muscle of people with DM1 given supplementation,[566] it is thought that the subjects did not respond to therapy.

This muscle-building, power-enhancing supplement has an extremely high safety profile and a plethora of evidence to support its efficacy. Creatine supplementation works by increasing the availability of creatine and phosphocreatine (PCr) within the muscle, helping to maintain energy during high-intensity exercise such as weightlifting. Furthermore, increasing the availability of PCr may help speed up recovery between sets.
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]
Because so many product labels list scientific references to back up the manufacturers' claims of performance and efficacy, or effectiveness, it's important to understand what constitutes a solid scientific study. A single study, even an optimally designed one, isn't considered scientific proof. The results have to be replicated several times before they're officially accepted as fact.
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] 
In a sample of people with colorectal cancer given creatine supplementation for 8 weeks to assess its interactions with chemotherapy, creatine failed to benefit muscle function or quality of life. Benefits were observed in body cell mass and phase angle (indicative of cellular viability), but only in the subsample with less aggressive chemotherapy.[111]
It can be hard to know where to start when beginning strength training. There are countless exercises you can do, some of which work some muscles, but not others. There are safety concerns to beware of, a wide variety of sometimes confusing equipment to help you in your efforts, and so on. With some familiarity of the basics of getting started with strength training, actually doing so can become far less daunting, and you can begin to craft a routine that is targeted toward helping you achieve your personal goals.