Despite a possible decreasing creatine content in the muscles when maintenance is deemed suboptimal, the overall retention of weight and lean mass is merely additive over time. This is thought to be due to increases in skeletal muscle production (increase in body weight) compensating for the progressive declines in water and glycogen content (decreases in body weight).

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 quantitative, comprehensive scientific summary and view of knowledge up to 2007 on the effects of creatine supplementation in athletes and active people was published in a 100 citation review position paper by the International Society of Sports Nutrition[5]. More recent literature has provided greater insight into the anabolic/performance enhancing mechanisms of creatine supplementation [15,25] suggesting that these effects may be due to satellite cell proliferation, myogenic transcription factors and insulin-like growth factor-1 signalling [16]. Saremi et al [26] reported a change in myogenic transcription factors when creatine supplementation and resistance training are combined in young healthy males. It was found that serum levels of myostatin, a muscle growth inhibitor, were decreased in the creatine group.
Lyoo, I. K., Yoon, S., Kim, T. S., Hwang, J., Kim, J. E., Won, W., Bae, S., & Renshaw, P. F. (2012, September). A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder. American Journal of Psychiatry. 169(9):937-45. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22864465
When it comes to building lean muscle, size bodybuilders are king. That’s their ultimate goal. Sure, Crossfit, powerlifting and all the other modalities will build muscle, but that’s not their focus. They want performance and any muscle they build is a side effect. Not so with bodybuilding where muscle size and shape are the priorities. Learning how to build muscle for the sake of building muscle has some benefits to the performance athlete. It allows for ais less injury prone. Its also a fact that bigger muscle contract harder regardless of technique or form, so it’s a good strategy to throw in some bodybuilder muscle building sessions here and there to give yourself stronger muscles to then train for performance. Build the muscle bigger, then train it to perform better.
It’s not just about lifting—it’s about lifting safely and correctly. And if you’re not performing exercises properly, it’s impossible to make any progress. “When someone is just starting to work out, it can help to work closely with a knowledgeable personal trainer in order to learn proper form,” says Ingram. But that goes for experienced lifters, too. If you aren’t sure about a movement, it’s better to ask. “If you’re not working the correct muscles, you can’t expect them to grow,” explains Ingram.
Rheumatoid arthritis. Early research shows that taking creatine by mouth daily increases lean muscle mass and may improve muscle strength, but does not improve physical functioning in adults with rheumatoid arthritis. In children, taking a specific supplement containing creatine and fatty acids twice daily for 30 days might reduce pain and swelling. But the effects of creatine alone are not clear.
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]
One case study on a subject with a methylentetrahydrofolate reductase (MTHFR) 677TT homozygote, a relatively common genetic mutation known as “mild MTHFR deficiency,” which causes mild homocysteinemia,[310] has seen benefits due to creatine supplementation where homocysteine was approximately halved (49% reduction) while CT heterozygotes and CC homozygotes (n=9) were unaffected.[311] Additionally, one rat study suggested a possible role for creatine in reducing homocysteine levels in a model of high uric acid levels (model for end stage renal disease[312]) but this was not replicated when investigated in humans.[313]
Note that this recommendation is for total weekly volume, which means it would need to be divided up based on how many times you’re training each muscle group per week. So, for example, someone training everything twice per week would do 30-70 reps for each bigger muscle group in each of those workouts, and 15-35 reps for each smaller muscle group in each of those workouts.
So how does that play out in the real world? Well, if, for example, a woman adds 10 pounds of muscle and loses 10 pounds of fat, she’ll burn 40 extra calories per day. Forty calories a day isn’t nearly as significant as a dietary change could be, but for people who are looking to lose weight, it can still make a minor difference over the long term.
A retrospective study [81], that examined the effects of long lasting (0.8 to 4 years) CM supplementation on health markers and prescribed training benefits, suggested that there is no negative health effects (including muscle cramp or injuries) caused by long term CM consumption. In addition, despite many anecdotal claims, it appears that creatine supplementation would have positive influences on muscle cramps and dehydration [82]. Creatine was found to increase total body water possibly by decreasing the risk of dehydration, reducing sweat rate, lowering core body temperature and exercising heart rate. Furthermore, creatine supplementation does not increase symptoms nor negatively affect hydration or thermoregulation status of athletes exercising in the heat [83,84]. Additionally, CM ingestion has been shown to reduce the rate of perceived exertion when training in the heat [85].
While I’m not well-versed in DNP, it is important to note that most supplements are not regulated by the FDA. The FDA has minimal standards for governing supplements before they make it to the shelves. All supplementation should be a case-by-case basis and under the discretion of a doctor and/or registered dietitian who knows your personal needs. Also, if you are consuming a well-rounded, healthy diet, supplementation may not be needed, even for making gains at the gym.
If you decide to join a gym, know that you're not expected to know how all of the equipment works right off the bat—or what to do with it. Be sure to take advantage of the free orientation so you can learn how to properly use everything that's offered and set up a basic strength-training program. At the gym, machines are preferred for beginners, because they're quite safe: Most require little coordination and offer more stability than free weights while performing the movements. 
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.
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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]
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
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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.
Most experts recommend starting with your larger muscle groups and then proceeding to the smaller muscle groups. The most demanding exercises are those performed by your large muscle groups and you will need your smaller muscles to get the most out of these exercises. But, don't feel limited by that. You can do your exercises in any order you like and changing the order is a great way to challenge yourself in different ways.
Fast twitch (or Type II fibers) fire very quickly, but also fatigue quickly, so they don’t last long.  It gets a bit more complicated, because there are actually two types of fast twitch fibers. Type IIA fibers have some endurance qualities (used for things such as longer sprints). While Type IIX fibers are our “super fast” fibers, used only when a super short burst is needed (like a 100 m sprint or a really heavy lift).
Product reviews – Since the effectiveness of products varies based on a wide number of factors, one of the best things to do is read creatine product reviews. The best rated creatine products will have consistently good reviews, meaning a lot of people use that product and would recommend it. However – remember to take reviews with a grain of salt, as there’s a lot of ignorance and misinformation out there.
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.
However, the basis of “take creatine after your workout” comes from a 2013 study published in the JISSN, which can be found here (open access too!). In this study, recreational male bodybuilders (19 men overall) were given five grams of creatine either before or after their workouts. They trained five days per week but were also directed to consume 5g on their rest days at any time they wanted. The workouts were fairly similar to most gym workouts, and the methodology (what they did and how they did it) suggests that the findings would apply to most weightlifters.
The majority of studies have used nothing but a loading period and the duration, overall, was about a week. This is partially because one study that noted benefit with a loading period failed to note benefit with prolonged supplementation.[156] Lowballing supplementation at 2g a day in high active swimmers does not appear to be sufficient to alter any function in skeletal muscle.[383]
Skin degradation is caused by a loss of collagen and degradation of the extracellular matrix,[536] which is enhanced by UV radiation (produces reactive oxygen species which stimulate MMPs[537]) and contributes to skin integrity loss and wrinkling. Due to the stimulation of collagen being associated with a cellular surplus of energy[538] and intracellular stores of energy declining with age,[539][540] creatine has been investigated as a topical anti-aging agent. In vitro, creatine appears to be rapidly absorbed through the skin (52% within an hour, remaining similar at 3 hours) with most creatine found in the stratum corneum (79.6-86.5%) follwed by the epidermis (9-13.2%) and dermis (4.5-7.1%).[541] It is successful in stimulating collagen expression and procollagen secretion in fibroblasts, with the latter increasing to 449+/-204% of control.[541]
Cornelissen, V. A., Defoor, J. G., Stevens, A., Schepers, D., Hespel, P., Decramer, M., Mortelmans, L., Dobbels, F., Vanhaecke, J., Fagard, R. H., and Vanhees, L. Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. Clin.Rehabil. 2010;24(11):988-999. View abstract.
Creatine is used and researched in a clinical setting to investigate various pathologies or disorders such as myopathies [3,4] and is also used as an ergogenic aid for improving health and sports performance in athletes [5]. As an oral supplement, the most widely used and researched form is creatine monohydrate (CM). When orally ingested, CM has shown to improve exercise performance and increase fat free mass [5-9].
Osteoblast cells are known to express creatine kinase.[39][417] Bone growth factors such as IGF-1,[418] PTH,[419] and even Vitamin D[420][421] seem to induce bone growth alongside increases in creatine kinase activity. Vitamin D has been noted to work indirectly by increasing the cellular energy state (these hormones increase creatine kinase in order to do so) in order to make bone cells more responsive to estrogen.[420] This evidence, paired with enhanced growth rates of osteoblasts in the presence of higher than normal (10-20mM) concentrations of creatine[422] suggest a role of creatine in promoting osteoblastic and bone growth, secondary to increasing energy availability.
Although creatine supplementation has been shown to be more effective on predominantly anaerobic intermittent exercise, there is some evidence of its positive effects on endurance activities. Branch [28] highlights that endurance activities lasting more than 150s rely on oxidative phosphorylation as primary energy system supplier. From this meta analysis [28], it would appear that the ergogenic potential for creatine supplementation on predominantly aerobic endurance exercise diminishes as the duration of the activity increases over 150s. However it is suggested that creatine supplementation may cause a change in substrate utilization during aerobic activity possibly leading to an increase in steady state endurance performance.

Creatine is known to occur in highly concetrated levels in chicken photoreceptors, relative to other parts of the eye (10-15mM[466]) alongside high levels of creatine kinase.[466] The creatine transporter in human eyes also seems to be concentrated in the photoreceptors,[468] which are known to be susceptible to hypoxic cellular death[471][472] which, for humans, usually means retinal detachment.[473]


Terry follows the old-school bodybuilding mentality of isolating each muscle group (back, shoulders, chest, legs and arms) on a five-day cycle. If he’s trying to grow a certain muscle group, he’ll introduce a second workout on the sixth day. Each of Terry’s workouts lasts between 60 and 90 minutes – “any longer and you're either not pushing yourself hard enough or you're talking too much” – and he makes the most of each session by targeting different parts of each muscle.
In regard to the blood brain barrier (BBB), which is a tightly woven mesh of non-fenestrated microcapillary endothelial cells (MCECs) that prevents passive diffusion of many water-soluble or large compounds into the brain, creatine can be taken into the brain via the SLC6A8 transporter.[192] In contrast, the creatine precursor (guanidinoacetate, or GAA) only appears to enter this transporter during creatine deficiency.[192] More creatine is taken up than effluxed, and more GAA is effluxed rather than taken up, suggesting that creatine utilization in the brain from blood-borne sources[192] is the major source of neural creatine.[193][192] However, “capable of passage” differs from “unregulated passage” and creatine appears to have tightly regulated entry into the brain in vivo[193]. After injecting rats with a large dose of creatine, creatine levels increased and plateaued at 70uM above baseline levels. These baseline levels are about 10mM, so this equates to an 0.7% increase when superloaded.[193] These kinetics may be a reason for the relative lack of neural effects of creatine supplementation in creatine sufficient populations.
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