When creatine is absorbed it pulls water in with it, causing cells to swell. This “cell volumization” is known to promote a cellular anabolic state associated with less protein breakdown and increased DNA synthesis.[107][108][109] An increase in cellular viability assessed via phase angle (measuring body cell mass[110]) has been noted in humans during supplementation of creatine.[111]
Gordon, P. H., Cheung, Y. K., Levin, B., Andrews, H., Doorish, C., Macarthur, R. B., Montes, J., Bednarz, K., Florence, J., Rowin, J., Boylan, K., Mozaffar, T., Tandan, R., Mitsumoto, H., Kelvin, E. A., Chapin, J., Bedlack, R., Rivner, M., McCluskey, L. F., Pestronk, A., Graves, M., Sorenson, E. J., Barohn, R. J., Belsh, J. M., Lou, J. S., Levine, T., Saperstein, D., Miller, R. G., and Scelsa, S. N. A novel, efficient, randomized selection trial comparing combinations of drug therapy for ALS. Amyotroph.Lateral.Scler. 2008;9:212-222. View abstract.
Previous investigations have shown that a single dose of CM (8 grams) increased the number of repetitions performed during an upper-body resistance training protocol and reduced soreness at 24 and 48 hours post-exercise (compared to a placebo).7 Recently, researchers from Mississippi State University found that a single dose of CM (8 grams) significantly increased the number of lower-body repetitions compared to a placebo group.[8]
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.
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]
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]
“There is a lot of mixed research on creatine’s ability to improve muscle strength,” the government website says. “However, analyses of this research show that creatine seems to modestly improve upper body strength and lower body strength in both younger and older adults.” Creatine has also been shown to improve athletes’ performance in rowing, soccer, and jumping height.

Don’t get us wrong—cardio is important for keeping your body fat down and keeping your heart health in check. (Bonus points if you run or bike, since outdoor exercise is linked to better energy and improved mental health.) But when it comes to building muscle, hitting the treadmill won't help you much. “Every component of exercise, minus cardio, can help with muscle hypertrophy,” which is the scientific term for muscle building, says Michelle Lovitt, an exercise physiologist and trainer in Los Angeles. “Cardio tends to burn calories and puts your body in a deficit, which is great for leaning out, but not building mass.”

The largest determiner of your metabolic rate is actually your total body mass. “The more cells, even fat cells, in your body, the more furnaces you have burning at any given time,” Dr. Church says. Think of it this way: It takes more juice to charge your tablet than it does to charge your phone. People who are taller and have a larger bone structure, therefore, will have a higher BMR than people who are shorter and have a slimmer build. While you can control your body mass to some extent by gaining or losing weight, you can’t change your height or your bone structure. All in all, most of a person’s BMR is determined by genetic factors, Dr. Church says.
“There is a lot of mixed research on creatine’s ability to improve muscle strength,” the government website says. “However, analyses of this research show that creatine seems to modestly improve upper body strength and lower body strength in both younger and older adults.” Creatine has also been shown to improve athletes’ performance in rowing, soccer, and jumping height.
Though weight training can stimulate the cardiovascular system, many exercise physiologists, based on their observation of maximal oxygen uptake, argue that aerobics training is a better cardiovascular stimulus. Central catheter monitoring during resistance training reveals increased cardiac output, suggesting that strength training shows potential for cardiovascular exercise. However, a 2007 meta-analysis found that, though aerobic training is an effective therapy for heart failure patients, combined aerobic and strength training is ineffective; "the favorable antiremodeling role of aerobic exercise was not confirmed when this mode of exercise was combined with strength training".[36]
While seasoned lifters may choose to do different exercises every day during a week-long period (and repeat the same moves the following week), there's no need to follow this type of program when you're just getting comfortable, says Davis. "Stick to the same basic moves two to three times a week to build a basic level of fitness and strength," says Davis. "Why complicate things if you don’t have to? Great results can be made by repeating the same workout but increasing weights as you become stronger." Switching things up can help you avoid a training plateau, explains Davis, but so can increasing weights while doing the same exercises.
Dips. You should be able to manipulate your bodyweight in space against the influence of gravity. If you can’t perform simple movements such as pushups, dips, and chin-ups then you need to work on your relative strength. That being said, dips are an excellent muscle builder for the chest, triceps, and shoulders if they are progressively overloaded with weight. 
Hartman, J. W., Tang, J. E., Wilkinson, S. B., Tarnopolsky, M. A., Lawrence, R. L., Fullerton, A. V., & Phillips, S. M. (2007). Consumption of fat-free fluid milk after resistance exercise promotes greater lean mass accretion than does consumption of soy or carbohydrate in young, novice, male weightlifters. The American Journal of Clinical Nutrition, 86(2), 373-381.
CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.
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]