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.
Creatine is one of the most popular and widely researched natural supplements. The majority of studies have focused on the effects of creatine monohydrate on performance and health; however, many other forms of creatine exist and are commercially available in the sports nutrition/supplement market. Regardless of the form, supplementation with creatine has regularly shown to increase strength, fat free mass, and muscle morphology with concurrent heavy resistance training more than resistance training alone. Creatine may be of benefit in other modes of exercise such as high-intensity sprints or endurance training. However, it appears that the effects of creatine diminish as the length of time spent exercising increases. Even though not all individuals respond similarly to creatine supplementation, it is generally accepted that its supplementation increases creatine storage and promotes a faster regeneration of adenosine triphosphate between high intensity exercises. These improved outcomes will increase performance and promote greater training adaptations. More recent research suggests that creatine supplementation in amounts of 0.1 g/kg of body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Finally, although presently ingesting creatine as an oral supplement is considered safe and ethical, the perception of safety cannot be guaranteed, especially when administered for long period of time to different populations (athletes, sedentary, patient, active, young or elderly).

I’m glad you found some good information from this article. For any of these supplements, I would suggest talking to your doctor and pharmacist. I would suggest thinking about why you are interested in taking testosterone. Are you looking to increase muscle size? Bulk up? Knowing your fitness goals will help you determine which products are appropriate for you.
Creatine is most commonly found in the basic form of creatine monohydrate, which is the standard form and usually recommended due to the low price. It can also be micronized to improve water solubility, or the monohydrate can be temporarily removed to concentrate creatine in a small volume supplement. Neither alteration changes the properties of creatine.
Don’t take sets to the point of failure—where you absolutely can’t perform another rep. You should never get to where you’re turning purple and screaming like you’re getting interviewed by “Mean” Gene Okerlund before WrestleMania. Most of the time, you want to end your sets two reps before total failure. Not sure when that is? The moment your form breaks down, or you’re pretty sure it’s going to break down, end the set.
Today I want to share with you some quality advice on how to gain weight. Now I caution you that this is for the really skinny guy looking to really gain weight because they barely have any meat on their bones. I know what it is like when you feel like you eat all the time and have nothing to show for it. I have been there. I also understand the feelings that you feel when people start to resent you because you can eat whatever you want and not ever gain a pound. They don't realize that to skinny guys, this is a curse more than it is a blessing at times.
Those micro-tears that are such a key factor for muscle-building need rest to rebuild themselves and grow stronger. When do they do that? When you’re asleep! “You have to rest and feed your muscles between workouts or you will tear them down and they will become weaker,” says Olson. “Over time, you run the risk of over-training, which can result in injury, and possibly even more sleep troubles.”
Despite the fact that BCAAs may offer some benefits, you should keep in mind that these three amino acids are also present in any quality whey protein that you purchase. You can also get these essential amino acids from food sources. Basically, as long as you’re meeting your daily protein intake goals, you’re probably getting enough of these essential amino acids. Research supports this approach. So, why spend more on another supplement?
If you touch your phone between exercise sets, it better be to set its timer to 30 to 90 seconds. When lifting for hypertrophy, rest periods of 30 to 90 seconds encourage a quick release in muscle-building hormones (including testosterone and human growth hormone) while also making sure that you really, truly fatigue your muscles, according to Fitzgerald.
After your standard whey protein powder, creatine may be the most popular sports supplement on Earth, and with good reason. A lot of supplements out there have a few promising studies suggesting they may improve some aspect of performance. Creatine has hundreds of them, and study after study has shown that among most people (a small percentage of are non-responders) it can have a significant effect on several areas of performance.
The lower the rep range (and therefore the higher the intensity and the heavier the weight), the more rest there should be between sets. So most of the time, exercises being done in the 5-8 rep range need longer rest periods than exercises being done in the 8-10 rep range, which need longer rest periods than exercises being done in the 10-15 rep range.
Tribulus Terrestris: A fruit from the Mediterranean, this supplement has been used in the Indian traditional medicine of Ayurveda. In addition to helping increase testosterone, many people take it to increase libido and as a cardioprotective aid. (10) Unfortunately, despite the fact that there are claims that tribulus terrestris can increase testosterone levels, studies don’t back up these claims.  There is some evidence, however, that it may improve athletic performance. If you want to choose one of the supplements for men, this should be your pick.
However, protein isn’t everything. Contrary to popular belief, carbohydrates and calories from fats are also important. To gain muscle, people who are slender or scrawny need to create a calorie surplus in order to bulk up. That means you need proteins and plenty of healthy carbs, vegetables and even some fats (think healthy fats like nuts, avocado, olive oil, etc.). Carbohydrates play a key role in building muscle. This macronutrient has gotten a bad rap for making people fat. However, if you work out properly, eating plenty of carbs is in your best interest. After training, it’s ideal to ingest some carbs in combination with protein to help replenish your muscles’ glycogen stores.
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.
Creatine has been shown to influence androgen levels. Three weeks of creatine supplementation has been shown to increase dihydrotestosterone (DHT) levels, as well as the DHT:testosterone ratio with no effects on testosterone levels.[430] In contrast, creatine supplementation has been shown to increase testosterone levels when taken alongside a 10-week resistance training program.[431] A study in male amateur swimmers also noted that a creatine loading phase (20g daily for six days) was able to increase testosterone levels by around 15% relative to baseline.[397] 
Another double-blind study supplemented with 18.75 g/day of creatine monohydrate for 5 days prior to high-intensity intermittent work to exhaustion, and then 2.25 g/day during testing. The workouts consisted of cycling to exhaustion using several protocols: (a) nonstop, (b) 60 seconds work/120 seconds rest, (c) 20 seconds work/40 seconds rest, and (d) 10 seconds work/20 seconds rest. Creatine supplementation significantly increased the total work time for all four protocols [13].
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]
That means it takes time for supplements aimed at joint treatment to work. So plan not to feel anything for about two months after you start using glucosamine. After that, pain control with the supplement is comparable to what happens with drug use, according to various studies. The typical doses are 1,200 milligrams daily of glucosamine and 800 of chondroitin, which can be doubled initially.

That said, many people experience stomach cramps when they consume creatine monohydrate and it’s possible that taking a creatine with a different pH — usually creatine hydrochloride — can have a different effect on stomach acid and make for a creatine that digests more easily. As far as we know, the easier digestion doesn’t necessarily mean it’s more effective or that you need less of it to achieve the desired result.


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].

Several studies have used either beet root juice or pomegranate extract in multi-ingredient performance supplements and have observed improvements in strength, hypertrophy, and performance in resistance-trained men. At this point, however, it's difficult to determine if these benefits are from beet root juice and pomegranate extract working alone or synergistically with other ingredients.[11,12]
Creatine supplementation appears to be somewhat similar to TMG supplementation in the sense that they both promote localized synthesis of phosphatidylcholine, effluxing triglycerides from the liver into serum and thus potently protecting from diet-induced fatty liver. The concentration at which this occurs is within the range supplemented by humans.
Increasing creatine levels in skeletal muscle to 687% of baseline (0.5mM creatine, thought to be equivalent to 5g creatine[135]) doesn’t seem to per se increase glucose uptake, but increases glucose oxidation (140% of baseline)[341] which is due to a two-fold increase in the activity of α1 and α2 subunits of AMPK, a potency comparable to 1mM of the reference drug AICAR.[341] Glucose uptake associated with AMPK has indeed been noted in diabetic people who are undergoing physical exercise[342] and in contracting skeletal muscle cells,[153][330] but according to rat[343][344][345] and in vitro studies of cells not being contracted,[341] this is not a per se effect of non-exercising tissue but an augmentation of exercise-induced glucose uptake.
Who makes it: Creapure HMB is made by Transparent Labs, one of the best companies in the sports nutrition industry. Transparent labs is all about, well, transparency! They always clearly list everything that goes into their products. They use pure, simple, and clinically proven ingredients to create products that get real results. Instead of relying on marketing gimmicks to sell their products, Transparent Labs relies on proven science and word-of-mouth. Transparent Labs has grown their business by providing the one ingredient seldom found in sports nutrition products: honesty.
It was later noted that creatine was able to nonsignificantly augment various proinflammatory cytokines (CCL2, iNOS, ICAM-1, TGF-β, TIMP-1) and the presence of eosinophils in lung tissue, as well as to per se cause lung infiltration of these immune cells without requiring the presence of the allergen.[442] Neutrophils and macrophages were unaffected,[442] reflecting the past study of no influence on macrophages,[440] but the only instance where creatine appeared to either significantly add to ovalbumin or to per se induce statistically significant increases were in IL-5 secretion and goblet cell infiltration, although VCAM-1 expression was close. While creatine per se increased nF-κB activity, it suppressed the ovalbumin-induced increase.[442]
Creatine supplementation often causes weight gain that can be mistaken for increase in muscle mass. Increasing intracellular creatine may cause an osmotic influx of water into the cell because creatine is an osmotically active substance [10]. It is possible that the weight gained is water retention and not increased muscle. The retention of water may be connected to reports of muscle cramps, dehydration, and heat intolerance when taking creatine supplements. It would be prudent to encourage proper hydration for creatine users. Further research is needed to investigate these and other possible side effects.
Warm up sets are also important. For example, the same lifter working on his chest would also be advised to complete at least two warm up sets prior to hitting his "core tonnage." Core tonnage refers to the heavier lifts that actually strain your muscles. For example, if the lifter's main sets were at 205 lbs, 225 lbs and 235 lbs on the bench, then a warmup of 5 reps of 135 and 5 reps of 185 would be advisable. Some lifters will warm up with a 50/50 set for example 50% of the target weight for 50% of the target repetitions. When properly warmed up the lifter will then have more strength and stamina since the blood has begun to flow to the muscle groups.[7]

While it'’s okay to chow down on the occasional fast-food choice for convenience, a mass-gain program isn'’t an excuse to gorge on pizza and chocolate sundaes. “"Rebuilding muscle tissue broken down by training requires energy -— in other words, calories,"” says bodybuilding nutritional guru Chris Aceto. "“But many people, including many nutritionists, overestimate the energy needs for gaining mass, encouraging extreme high-calorie intakes. This often leads to an increase in bodyfat, making you bigger, for sure, but also leaving you fat." In general, aim for 300-500 more calories every day than your body burns through exercise and normal functioning (multiply bodyweight by 17). And that'’s divided among six meals a day.
Parameters of lung function (main cause of death in ALS is declining respiratory function) have not benefited after creatine supplementation, and when quality of life is measured, there is no benefit either. Despite one study failing to find any significant differences in mortality risk, two other studies have suggested that creatine may reduce the risk. The results were nonsignificant, but due to all treatments being well tolerated it is thought that creatine may still play a role as an adjuvant.
High extracellular creatine concentrations induce the expression of a factor that inhibits the creatine transporter (CrT). To date, neither the identity of nor mechanism for this putative CrT-suppressing factor has come to light. Future studies that are able to identify this creatine transport-suppressing factor and how it works may provide valuable insight into possible supplementation strategies that might be used to increase creatine uptake into muscle cells.
1. Are you tracking calories? Doesn't have to be religiously but one should have a general idea of where they're at if the goal is mass gain and things have stalled. I'm not talking about weighing every gram of food you put in your mouth and meticulously logging your life on MyFitnessPal. As long as you're aware (within 100-200 calories) of what's going in, you should have an idea of what to adjust.

Creatine is classified as a "dietary supplement" under the 1994 Dietary Supplement Health and Education Act and is available without a prescription. Creatine is not subjected to FDA testing, and the purity and hygienic condition of commercial creatine products may be questionable [21]. A 1998 FDA report lists 32 adverse creatine-associated events that had been reported to FDA. These include seizure, vomiting, diarrhea, anxiety, myopathy, cardiac arrhythmia, deep vein thromboses and death. However, there is no certainty that a reported adverse event can be attributed to a particular product [22]. A recent survey of 28 male baseball players and 24 male football players, ages 18 to 23, found that 16 (31%) experienced diarrhea, 13 (25%) experienced muscle cramps, 7 (13%) reported unwanted weight gain, 7 (13%) reported dehydration, and 12 reported various other adverse effects [23].
The motor proteins actin and myosin generate the forces exerted by contracting muscles. Current recommendations suggest that bodybuilders should consume 25–30% of protein per total calorie intake to further their goal of maintaining and improving their body composition.[30] This is a widely debated topic, with many arguing that 1 gram of protein per pound of body weight per day is ideal, some suggesting that less is sufficient, while others recommending 1.5, 2, or more.[31] It is believed that protein needs to be consumed frequently throughout the day, especially during/after a workout, and before sleep.[32] There is also some debate concerning the best type of protein to take. Chicken, turkey, beef, pork, fish, eggs and dairy foods are high in protein, as are some nuts, seeds, beans, and lentils. Casein or whey are often used to supplement the diet with additional protein. Whey protein is the type of protein contained in many popular brands of protein supplements and is preferred by many bodybuilders because of its high Biological Value (BV) and quick absorption rates. Whey protein also has a bigger effect than casein on insulin levels, triggering about double the amount of insulin release.[33] That effect is somewhat overcome by combining casein and whey. Bodybuilders are usually thought to require protein with a higher BV than that of soy, which is additionally avoided due to its claimed estrogenic properties. Still, some nutrition experts believe that soy, flax seeds and many other plants that contain the weak estrogen-like compounds or phytoestrogens, can be used beneficially, as phytoestrogens compete with estrogens for receptor sites in the male body and can block its actions. This can also include some inhibition of pituitary functions while stimulating the P450 system (the system that eliminates hormones, drugs and metabolic waste product from the body) in the liver to more actively process and excrete excess estrogen.[34][35] Cortisol decreases amino acid uptake by muscle, and inhibits protein synthesis.[36]

Creatine is thought to improve strength, increase lean muscle mass, and help the muscles recover more quickly during exercise. This muscular boost may help athletes achieve bursts of speed and energy, especially during short bouts of high-intensity activities such as weight lifting or sprinting. However, scientific research on creatine has been mixed. Although some studies have found that it does help improve performance during short periods of athletic activity, there is no evidence that creatine helps with endurance sports. Research also shows that not everyone's muscles respond to creatine; some people who use it see no benefit.
Bodybuilding is the use of progressive resistance exercise to control and develop one's musculature for aesthetic purposes.[1] An individual who engages in this activity is referred to as a bodybuilder. In professional bodybuilding, bodybuilders appear in lineups and perform specified poses (and later individual posing routines) for a panel of judges who rank the competitors based on criteria such as symmetry, muscularity, and conditioning. Bodybuilders prepare for competitions through the elimination of nonessential body fat, enhanced at the last stage by a combination of intentional dehydration and carbohydrate loading, to achieve maximum muscular definition and vascularity, as well as tanning to accentuate the contrast of the skin under the spotlights. Bodybuilders may use anabolic steroids and other performance enhancing drugs to build muscles.

A previous meta-analysis [28] reported an overall creatine supplementation effect size (ES) of 0.24 ± 0.02 for activities lasting ≤30 s. (primarily using the ATP- phosphocreatine energy system). For this short high-intensity exercise, creatine supplementation resulted in a 7.5 ± 0.7% increase from base line which was greater than the 4.3 ± 0.6% improvement observed for placebo groups. When looking at the individual selected measures for anaerobic performance the greatest effect of creatine supplementation was observed on the number of repetitions which showed an ES of 0.64 ± 0.18. Furthermore, an increase from base line of 45.4 ± 7.2% compared to 22.9 ± 7.3% for the placebo group was observed. The second greatest ES was on the weight lifted at 0.51 ± 0.16 with an increase from base line of 13.4 ± 2.7% for the placebo group and 24.7 ± 3.9% for the creatine group. Other measures improved by creatine with a mean ES greater than 0 were for the amount of work accomplished, weight lifted, time, force production, cycle ergometer revolutions/min and power. The possible effect of creatine supplementation on multiple high intensity short duration bouts (<30 s) have shown an ES not statistically significant from 0. This would indicate that creatine supplementation might be useful to attenuate fatigue symptoms over multiple bouts of high-intensity, short duration exercise. The ES of creatine on anaerobic endurance exercise (>30 – 150s), primarily using the anaerobic glycolysis energy system, was 0.19 ± 0.05 with an improvement from baseline of 4.9 ± 1.5 % for creatine and -2.0 ± 0.6% for the placebo. The specific aspects of anaerobic endurance performance improved by creatine supplementation were work and power, both of which had a mean ES greater than 0. From the findings of this previous meta-analysis [28] it would appear that creatine supplementation has the most pronounced effect on short duration (<30s) high intensity intermittent exercises.
The genealogy of lifting can be traced back to the beginning of recorded history[1] where humanity's fascination with physical abilities can be found among numerous ancient writings. In many prehistoric tribes, they would have a big rock they would try to lift, and the first one to lift it would inscribe their name into the stone. Such rocks have been found in Greek and Scottish castles.[2] Progressive resistance training dates back at least to Ancient Greece, when legend has it that wrestler Milo of Croton trained by carrying a newborn calf on his back every day until it was fully grown. Another Greek, the physician Galen, described strength training exercises using the halteres (an early form of dumbbell) in the 2nd century.
If you’re not lifting super-heavy weights, doing high-intensity workouts, or eating a mainly vegan or vegetarian diet, your body probably makes as much creatine as it needs. “Creatine is naturally found in animal-based products,” says Bates, “so your body can make plenty of creatine as long as you have a balanced diet that includes animal-based products.” Protein sources like beef, chicken, pork, and fish help your body produce the creatine it needs — it varies depending on the source, but, in general, a 3-ounce serving of meat will have about 0.4 grams (g) of creatine, Bates says. (6)

Creatine supplementation may also be of benefit to injured athletes. Op’t Eijnde et al [39] noted that the expected decline in GLUT4 content after being observed during a immobilization period can be offset by a common loading creatine (20g/d) supplementation protocol. In addition, combining CM 15g/d for 3 weeks following 5 g/d for the following 7 weeks positively enhances GLUT4 content, glycogen, and total muscle creatine storage [39].
Walking, running, and swimming are examples of activity. Aerobic activity strengthens your heart and lungs. Stretching improves your flexibility. Strength training uses resistance, like free weights, weight machines, resistance bands, or a person's own weight, to build muscles and strength. Teens may want to strength train to improve sports performance, treat or prevent injuries, or improve appearance.
The major controversies regarding creatine are its side effects and the best form to use. Nearly all side effects attributed to creatine, such as muscle cramps, kidney disease and gastrointestinal disturbances, haven't proved significant under controlled scientific scrutiny. Although various claims are made for a variety of creatine supplements, creatine monohydrate, which is 99 percent absorbed, is the best form to use.
Researchers found that 5g of creatine four times daily for a week (loading) before sleep deprivation for 12-36 hours was able to preserve cognition during complex tasks of executive function at 36 hours only, without significant influence on immediate recall or mood.[279] A similar protocol replicated the failure to improve memory and attention, but noted less reports of fatigue (24 hours) and less decline of vigor (24 hours) although other mood parameters were not measured.[276]
“Compared to training for strength, intensity is going to drop during the hypertrophy phase of a program, with intensity sitting between 50 and 75 percent of the person’s 1RM, the maximum weight he or she can lift for one rep,” says Ava Fitzgerald, C.S.C.S., C.P.T., a sports performance coach with the Professional Athletic Performance Center in New York.
Creatine is most commonly found in the basic form of creatine monohydrate, which is the standard form and usually recommended due to the low price. It can also be micronized to improve water solubility, or the monohydrate can be temporarily removed to concentrate creatine in a small volume supplement. Neither alteration changes the properties of creatine.

Creatine is found in many protein supplements at baseline in the form of creatine monohydrate. If you take a protein supplement, you may already be getting creatine. What makes this creatine so special? Like the protein supplement above, this creatine supplement contains no artificial sweeteners or dyes. It contains 5000mg of creatine per dose and includes certain compounds to increase the bioavailability of the creatine, allowing it to be better absorbed.
On top of this, you’ll need to consume more calories than you’re burning. Burning more calories each day than you eat is a great way to lose weight, but if your goal is to put on muscle mass, this can make the process much harder. Your body requires calories to build new muscle tissue, but this can’t occur if all the body’s energy is being used up for daily processes. Because of this, some bodybuilding supplements include weight gainers to help you get more healthy calories in your diet. 
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