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(4):212-222. View abstract.
If you are somebody that is tired of not getting results, wants to avoid trial-and-error, or you just want to be told exactly what to do to reach your goals, check out our popular 1-on-1 coaching program. You’ll work with our certified NF instructors who will get to know you better than you know yourself and program your workouts and nutrition strategy for you.
Objective: Are you getting stronger? Increasing either weight or reps? If you're measuring individual markers on a daily basis like vertical jump, grip strength, or resting heart rate then what sort of trends are you noticing in these variables? If they're staying the same while your strength is increasing, then you're recovering well. If they're decreasing and you find yourself weaker over time then you're not recovering well.
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]
Kilduff, L. P., Georgiades, E., James, N., Minnion, R. H., Mitchell, M., Kingsmore, D., Hadjicharlambous, M., and Pitsiladis, Y. P. The effects of creatine supplementation on cardiovascular, metabolic, and thermoregulatory responses during exercise in the heat in endurance-trained humans. Int J Sport Nutr Exerc Metab 2004;14:443-460. View abstract.
Several review studies assessing the safety of creatine supplementation tend to make note of increases in formaldehyde and possible carcinogenic results.[451][452] Specifically, creatine is metabolized into an intermediate called methylamine, which can be converted to formaldehyde by the SSAO enzyme.[453] An increase in urinary formaldehyde has been noted in youth given 21g of creatine for one week, during which both methylamine (820% increase) and formaldehyde (350%) were increased, relative to control.[454] However, a more prolonged study using 300mg/kg (loading dose of around 20g) in adults for ten weeks failed to replicate these effects.[455]
It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
2-[carbamimidoyl(methyl)amino]acetic acid, Cr, Creatin, Creatina, Créatine, Créatine Anhydre, Creatine Anhydrous, Creatine Citrate, Créatine Citrate, Creatine Ethyl Ester, Créatine Ethyl Ester, Creatine Ethyl Ester HCl, Créatine Ethyl Ester HCl, Creatine Gluconate, Creatine Hydrochloride, Créatine Kré Alkaline, Creatine Malate, Créatine Malate, Creatine Monohydrate, Créatine Monohydrate, Créatine Monohydratée, Creatine Pyroglutamate, Créatine Pyroglutamate, Creatine Pyruvate, Créatine Pyruvate, Dicreatine Malate, Dicréatine Malate, Di-Creatine Malate, Éthyle Ester de Créatine, Glycine, Kreatin, Kre-Alkalyn Pyruvate, Malate de Tricréatine, N-(aminoiminométhyl)-N-Méthyl, N-(aminoiminomethyl)-N methyl glycine, N-amidinosarcosine, Phosphocreatine, Phosphocréatine, Tricreatine HCA, Tricréatine HCA, Tricreatine Malate, Tricréatine Malate.
I bought this for my husband since he recently started lifting again. I knew that he wanted to gain as much muscle mass as possible and this looked like a pretty good product. It comes in a nice black bottle with good labeling. The bottle contains 90 capsules, which is about a month and a half worth of supplements. He has been taking 2 capsules before bed each night and for the past few weeks and has had no negative side effects. It's also really easy to remember since you take the both at the same time instead of spread throughout the day. He says that he has noticed a difference most of all in his muscle tone and just an overall feeling of being refreshed.

Liquid creatine has been shown to be less effective than creatine monohydrate.[69] This reduced effect is due to the passive breakdown of creatine over a period of days into creatinine, which occurs when it is suspended in solution.[70] This breakdown is not an issue for at-home use when creatine is added to shakes, but it is a concern from a manufacturing perspective in regard to shelf-life before use.
In elite swimmers, the growth hormone response to sprints appears to be attenuated (39%) following creatine loading, although after a 3g maintenance phase (22-27 weeks), this attenuation was reduced to less than 5%.[404] Elsewhere in swimmers, resting growth hormone was unaffected by the loading phase,[397] suggesting that this is an exercise-exclusive effect.
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.
Without supplementation, approximately 14.6mmol (2g) of creatinine, creatine’s urinary metabolite, is lost on a daily basis in a standard 70kg male ages 20-39. The value is slightly lower in females and the elderly due to a presence of less muscle mass.[35] This amount is considered necessary to obtain in either food or supplemental form to avoid creatine deficiency. Requirements may be increased in people with higher than normal lean mass.[35][198] Creatine excretion rates on a daily basis are correlated with muscle mass, and the value of 2g a day is derived from the aforementioned male population with about 120g creatine storage capacity.[35] Specifically, the rate of daily creatine losses is about 1.6%[199]-1.7%,[25] and mean losses for women are approximately 80% that of men due to less average lean mass.[35] For weight-matched elderly men (70kg, 70-79 years of age) the rate of loss of 7.8mmol/day,[49] or about half (53%) that of younger men.
Creatine is stored in the body in the form of creatine and as creatine phosphate, otherwise known as phosphocreatine, which is the creatine molecule bound to a phosphate group.[39] Creatine phosphate is thought to maintain the ATP/ADP ratio by acting as a high-energy phosphate reservoir.[40] The more ATP a muscle has relative to ADP, the higher its contractility is, and thus its potential strength output in vivo.[41][42] This pro-energetic mechanism also affects nearly all body systems, not just skeletal muscle. [39] During periods of rest and anabolism, creatine can gain a phosphate group through the creatine-kinase enzyme pathway, up to a cellular concentration of 30uM[24] to be later used for quick ATP resupply, when needed.[43][44] 
It’s true—your genes can play a role when it comes to building muscle. In general, there are two types of muscle fibers: Type I, which are slow twitch, and Type II, which are fast twitch. Depending on which you have more of, you may have an easier or harder time gaining muscle. “Fast twitch muscle fibers are two times as thick as slow twitch muscle fibers, lending to the overall thickness of the muscle without any activity,” explains Lovitt. “Those people with a genetic predisposition of a high percentage of these fibers can increase muscle size very easily while the people with a higher percentage of slow twitch muscle fibers have to work really hard to put on mass.” It’s the reason why a world-class sprinter genetically has more fast twitch muscle fibers than a world-class marathoner—it comes down to what we’re born with.

Creatine is used up as energy during high intensity exercise. Due to this usage, the amount of glucose required from glycogen is decreased a bit. This both preserves glycogen concentrations in skeletal muscle and reduces lactate production, which is produced when glucose is oxidized for energy. There do not appear to be any alterations in the bioenergetic status of muscle cells during low to moderate intensity exercise.


Bird, L. M., Tan, W. H., Bacino, C. A., Peters, S. U., Skinner, S. A., Anselm, I., Barbieri-Welge, R., Bauer-Carlin, A., Gentile, J. K., Glaze, D. G., Horowitz, L. T., Mohan, K. N., Nespeca, M. P., Sahoo, T., Sarco, D., Waisbren, S. E., and Beaudet, A. L. A therapeutic trial of pro-methylation dietary supplements in Angelman syndrome. Am J Med Genet.A 2011;155A:2956-2963. View abstract.
The type of exercise performed also depends on the individual's goals. Those who seek to increase their performance in sports would focus mostly on compound exercises, with isolation exercises being used to strengthen just those muscles that are holding the athlete back. Similarly, a powerlifter would focus on the specific compound exercises that are performed at powerlifting competitions. However, those who seek to improve the look of their body without necessarily maximizing their strength gains (including bodybuilders) would put more of an emphasis on isolation exercises. Both types of athletes, however, generally make use of both compound and isolation exercises.
According to the two meta-analyses on the topic, creatine significantly increases power when supplemented in both sexes over a period of time up to 8 weeks, during which improvement over placebo is maintained, rather than being enhanced further. The rate at which power is derived from a resistance training regimen appears to be up to 78.5% greater with creatine relative to placebo, and in active trained men who are naive to creatine, this can be quantified at about 7kg for the bench press and 10kg for the squat over 8 weeks.
The United States Army is about to undertake a dramatic and unprecedented overhaul to the way it tests, and promotes, military fitness. The man who headed the research into the new standards talks with us about how and why, as well as the future of Army nutrition and how the Army plans to circulate 80,000 kettlebells to bases around the globe. January 22, 2019 • 43 min read
Trimethylglycine (TMG, betaine) is a dietary supplement and component of beet root, which is a methyl donor. It contributes to metabolic processes in the body which require a methyl group either directly (the methylation of homocysteine) or indirectly via replenishing the active form of folate or via replenishing S-adenosyl methionine (SAMe). As the synthesis of creatine (via GAMT) requires a donation from SAMe,[597] it is thought that TMG can aid in creatine synthesis, which has been noted in the rat liver in the absence of creatine supplementation.[598]
However, caffeine does not negate the benefits of creatine loading when not coingested, but just taken before exercise in the same dosage.[593] This result indicates that loading creatine without caffeine on a daily basis, but saving caffeine for select workouts, may be an effective strategy, as creatine does not adversely affect caffeine’s ergogenic effects[593][594] and may enhance creatine’s effectiveness in anaerobic exertion if the two compounds are alternated.[595]
There’s no need to go overboard on creatine intake, though, in search of crazy muscle growth: “The maximum amount of creatine that you can hold depends on the amount of muscle mass you have,” explains Bates. “So if you have more muscle, then your body can store more creatine. In general, the muscle can hold about 2 to 3 g of creatine per kilogram of muscle mass. So the amount of creatine you use will depend on the amount of muscle mass you have.” (7)
The high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[24] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[25]

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.
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.

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]
Creatine is known to increase skeletal muscle cellular volume alongside increases in water weight gain.[346] Since glycogen itself also increases the osmolytic balance of a cell (draws in water)[347][348] and preliminary evidence shows a strong trend of creatine augmenting glycogen loading,[153] creatine is thought to be related to an increase in cell volume, which is known to promote glycogen synthesis.[112]
For several years, research studies have shown that adolescents concerned with both athletics and appearance are taking performance-enhancing supplements. A study by the American Academy of Pediatrics of middle-school and high-school students ages 10 to 18 years found creatine use in all grades 6 through 12. About 5.6% of the study participants and 44% of high-school senior athletes admitted taking creatine.
Recently, studies are coming out that show a general decline in testosterone levels of men in the United States and around the world. The trend is across the board and doesn’t appear to be caused simply by a decline in health, aging or an increase in obesity rates. It could be caused because of chemicals or environmental factors. In any case, low levels of testosterone can affect many areas of your health, including your ability to build muscle. If you suspect that you have low testosterone levels, you can ask your doctor to test you for it. In addition to traditional hormone therapies, there are also many natural ways to boost your levels including through supplements, some of which will be discussed later in this article.
In humans, studies that investigate links between serotonin and creatine supplementation find that 21 trained males, given creatine via 22.8g creatine monohydrate (20g creatine equivalent) with 35g glucose, relative to a placebo of 160g glucose, was found to reduce the perception of fatigue in hot endurance training, possibly secondary to serotonergic modulation, specifically attentuating the increase of serotonin seen with exercise (normally seen to hinder exercise capacity in the heat[233]) while possibly increasing dopaminergic activity (conversely seen to benefit activity in the heat[234]).[155]
Creatine is known to be present in the retina due to the expression of creatine kinase (CK)[466][39] and the GAMT enzyme of creatine synthesis, which is also present in the mammalian retina.[467] Creatine in the blood can be transported into the retina via the creatine transporter (confirmed in humans[468]), and inhibiting transporter activity (by depleting the medium of chloride and sodium) reduces uptake by 80%.[469] The fact that not all uptake was inhibited suggests that another transporter, such as the monocarboxylate transporter MCT12 (or SLC16A12),[470] plays a role, perhaps moreso in the lens, where its levels were comparable to that of the major creatine transporter SLC6A8.[470] 
“Reg Park’s theory was that first you have to build the mass and then chisel it down to get the quality; you work on your body the way a sculptor would work on a piece of clay or wood or steel. You rough it out””the more carefully, the more thoroughly, the better”” then you start to cut and define. You work it down gradually until it’s ready to be rubbed and polished. And that’s when you really know about the foundation. Then all the faults of poor early training stand out as hopeless, almost irreparable flaws. [..]
A: The literature supports roughly 0.8-1 gram per pound of bodyweight in young adults. Can you eat more? As long as you have healthy, functioning kidneys, yes. Will you receive any further physiological benefit from it? Most likely, no. Not only that, since our calories are set, if we choose to overconsume protein then we must reduce either carbohydrates and/or fat in order to keep caloric expenditure within our set range. Once protein needs are met (~0.8-1g/lb of bodyweight) you will likely see greater benefits from higher carbohydrate consumptions given the influence they have on anabolism and the anaerobic energy pathway. However, as I mentioned above, these recommendations will differ for older trainees given the blunted anabolic response from the ingestion of amino acids. 
In young rats given creatine in the diet at 2% of the diet for eight weeks, supplementation appears to increase bone mineral density (BMD) in the lumbar spine with a nonsignificant trend to increase BMD in the femur.[426] Despite the trend, the femur appeared to be 12.3% more resistant to snapping from mechanical stress associated with increased thickness.[426] Menopausal rats (ovarectomized) experience similar benefits, as supplementation of creatine (300mg/kg) for eight weeks during ovarectomy is able to increase phosphorus content of the bone and other biomarkers of bone health, although bone stress resistance was not tested.[427]

This concept of timing has been applied to everything from fat burners, protein supplements, carbohydrates, and various other supplements. In some cases, you can see a difference based on when you take a product. But more often, the timing is based more on anecdotal evidence than any hard science. Recently, this nutrient timing aspect has even been extended to creatine, a product that is so effective that it’s worth the investigation of determining if there’s an element that can give you even greater benefits.
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.

Nephrotoxic drugs. Because taking high doses of creatine might harm your kidneys, there is concern about combining creatine with drugs that might damage the kidneys (nephrotoxic drugs). Potentially nephrotoxic drugs include nonsteroidal anti-inflammatory drug (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), cyclosporine (Neoral, Sandimmune) and others.
Isometric exercise provides a maximum amount of resistance based on the force output of the muscle, or muscles pitted against one another. This maximum force maximally strengthens the muscles over all of the joint angles at which the isometric exercise occurs. By comparison, weight training also strengthens the muscle throughout the range of motion the joint is trained in, but only maximally at one angle, causing a lesser increase in physical strength at other angles from the initial through terminating joint angle as compared with isometric exercise. In addition, the risk of injury from weights used in weight training is greater than with isometric exercise (no weights), and the risk of asymmetric training is also greater than with isometric exercise of identical opposing muscles.
Antioxidants in the diet protect against natural and synthetic chemical fragments called free radicals that are a part of daily living. Lifestyle challenges may increase your requirements for antioxidants. Vitamin C and E are the main antioxidants in the normal diet although many other plant nutrients contribute to this effect. Pollution, stress, smoking, strenuous exercise, and illness may increase your requirements for antioxidant protection.
In otherwise healthy adults subject to leg immobilization for two weeks while taking 20g creatine daily during immobilization and then 5g daily during eight weeks of rehabilitation, it was noted that the creatine group failed to reduce atrophy during the immobilization (10% reduction in cross sectional area and 22-25% reduction in force output) despite preventing a decrease in phosphocreatine, yet experienced a significantly enhanced rate of regrowth and power recovery.[358] A similarly structured and dosed study has also noted greater expression of skeletal muscle, GLUT4 expression, and a 12% increase in muscle phosphocreatine content.[330]
Overload: The first thing you need to do to build lean muscle tissue is use more resistance than your muscles are used to. This is important because the more you do, the more your body is capable of doing, so you should increase your workload to avoid plateaus. In plain language, this means you should be lifting enough weight that you can only complete the desired number of reps. You should be able to finish your last rep with difficulty, but also with good form.
Creatine levels in the blood tend to return to baseline (after a loading with or without the maintenance phase) after 28 days without creatine supplementation.[152][200][201] This number may vary slightly from one individual to another, and for some may exceed 30 days.[202] Assuming an elimination rate of creatinine (creatine’s metabolite) at 14.6mmol per day,[35][201] six weeks of cessation is approaching the upper limit for serum creatine to completely return to baseline.
As scientific research progressed, it became apparent that the best types of protein came from milk and eggs. That led to the next great revolution in sports nutrition, namely the engineered food, pioneered by Scott Connelly, M.D., a critical care specialist from Northern California who teamed with a young entrepreneur named Bill Phillips from Golden, Colorado.
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(1):151-155. View abstract.
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. 
More recent studies on the regulation of CrT creatine transport activity have identified the protein kinase (Janus-Activating Kinase 2) JAK2, which suppresses the rate of creatine uptake via CrT without affecting creatine binding.[181] JAK2 is a regulatory protein involved in stabilizing the cellular membrane and controlling water concentrations in response to osmotic stress.[182][183] Similar to c-Src (a positive creatine transport regulator), Jak2 can also be activated by growth hormone signaling.[169][184] The growth hormone receptor seems to activate these two factors independently, as gh-mediated activation of c-Src does not require JAK2.[168] Given that c-Src is a positive regulator of CrT, JAK2 is a negative regulator, and the fact that downstream signals from both are induced by growth hormone, it is tempting to speculate that JAK2 activation downstream of the gh receptor may function as a homeostatic response to limit c-src induced creatine uptake. This has not been studied, however, and the effects of gh-induced JAK2 signaling on CrT activity have not been examined.
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.
Pro Tip: Zane also suggests that directed concentration is exceptionally important to getting the most from your training and is much easier with lower weight. If you can concentrate on the muscle through its whole movement, you will notice that the intensity will be just as strong, without the risk. We teach you this in our “Mind Muscle Connection” Bonus Guide that we include in our Old School Muscle 8-Week Program.
Gain mass: One of the most popular reasons for people to take body building supplements is to gain weight and that is why protein powder is much sought after. Protein is the building block of muscles and therefore, bodybuilders use protein powder to help repair muscles, speed recoveries and preserve muscle mass. They usually consume 1 to 2 grams of protein per pound of body weight every day. 

Overload: The first thing you need to do to build lean muscle tissue is use more resistance than your muscles are used to. This is important because the more you do, the more your body is capable of doing, so you should increase your workload to avoid plateaus. In plain language, this means you should be lifting enough weight that you can only complete the desired number of reps. You should be able to finish your last rep with difficulty, but also with good form.
These effects were noted before in a preliminary study of depressed adolescents (with no placebo group) showing a 55% reduction in depressive symptoms at 4g daily when brain phosphocreatine levels increased.[231] Other prelimnary human studies suggest creatine might lessen unipolar depression[256] and one study on Post-Traumatic Stress Disorder (PTSD) noted improved mood as assessed by the Hamilton Depression Rating Scale.[232] 
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