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]
Creatine is normally metabolized into creatinine (note the difference in spelling), which is eliminated by the kidneys under normal conditions. When the kidneys fail and cannot clear the blood as effectively, many metabolites get “backlogged” in the blood. Creatinine is easy to measure and as such it is a biomarker of kidney damage.[623][624] If serum creatinine levels are elevated, the doctor may suspect some kidney damage. Low-dose creatine (≤5 g/day) may not cause alterations in this biomarker in otherwise normal adults[524][625][525] but high doses of supplemental creatine may cause a false positive (an increase in creatinine, due to creatine turning into creatinine, which does not signify kidney damage) and is a diagnostic error.[520][518][626][523][517] Most studies, however, have noted only a small increase in creatinine levels even with doses ≈20 g/day.[524][626][627]
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]

If you're a beginner, start with a basic total body strength workout to build a strong foundation in all your muscle groups. Taking this time will help you figure out any weaknesses you have, as well as any issues you may need to address with your doctor, and learn the basic exercises you need for a strong, fit body. Your first step is to figure out where you're going to exercise.
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]
There is a great amount of research published on creatine supplementation; protocols of administration, forms of creatine, as well as potential side effects. Despite this, the mechanisms by which creatine acts in the human body to improve physical and cognitive performance are still not clear. The main objectives of this review are to analyze the more recent findings on the effects and mechanisms of creatine supplementation in sports and health. As a secondary purpose, we will analyze the most recommended protocols of ingestion and its potential side effects.
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.
^ The effect of HMB on skeletal muscle damage has been assessed in studies using four different biomarkers of muscle damage or protein breakdown: serum creatine kinase, serum lactate dehydrogenase, urinary urea nitrogen, and urinary 3-methylhistidine.[38][41][42] When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during long-distance running or progressive overload, HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.[38][42]
As a ingredient that has been tested time and time again and shown to positively affect the building of muscle, GAT has taken the highest-quality compound to create Essentials Creatine. Using HPLC-tested pharmaceutical grade creatine that's tested to be 99.9% pure, Essentials Creatine provides 5 grams in every serving which can increase muscle size, boost strength, and enhance muscle recovery. Keep Reading »
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.

Creatine is marketed as "nature's muscle builder" and "the most legitimate sports supplement around." Professional and amateur athletes alike are gobbling up this alleged ergogenic aid, hoping to increase their strength and performance. Creatine supplementation is claimed to increase muscle power by playing a role in the transfer of energy to help the muscle contract. Supplement labels state that "creatine is converted to phosphocreatine, which is important for short energy bursts such as sprinting and weight lifting" and that "depletion of phosphocreatine can result in muscle fatigue and fading muscle power." Claims are also made that supplementation increases muscle body mass.
Different forms of creatine in combination with other sports supplements as well as varying doses and supplementation methodology should continue to be researched in an attempt to understand further application of creatine to increase sports and exercise performance of varying disciplines. It is important to remain impartial when evaluating the safety of creatine ingested as a natural supplement. The available evidence indicates that creatine consumption is safe. This perception of safety cannot be guaranteed especially that of the long term safety of creatine supplementation and the various forms of creatine which are administered to different populations (athletes, sedentary, patient, active, young or elderly) throughout the globe.
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]
Most experts recommend starting with your larger muscle groups and then proceeding to the smaller ones. 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.

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].
Creatine ingested through supplementation is transported into the cells exclusively by CreaT1. However, there is another creatine transporter Crea T2, which is primarily active and present in the testes [12]. Creatine uptake is regulated by various mechanisms, namely phosphorylation and glycosylation as well as extracellular and intracellular levels of creatine. Crea T1 has shown to be highly sensitive to the extracellular and intracellular levels being specifically activated when total creatine content inside the cell decreases [12]. It has also been observed that in addition to cytosolic creatine, the existence of a mitochondrial isoform of Crea T1 allows creatine to be transported into the mitochondria. Indicating another intra-mitochondrial pool of creatine, which seems to play an essential role in the phosphate-transport system from the mitochondria to the cytosol [13]. Myopathy patients have demonstrated reduced levels of total creatine and phosphocreatine as well as lower levels of CreaT1 protein, which is thought to be a major contributor to these decreased levels [14].
The NitroSurge pre-workout supplement by Jacked Factory aims to get you pumped and focused before a gym session. Besides L-Citrulline, this supplement also contains performance-enhancing betaine anhydrous and beta alanine. It also contains L-theanine which has shown to inhibit nerve cell damage in one study.  For energy-boosting benefits, the NitroSurge is also equipped with caffeine and AstraGin for energy metabolism. Before you buy, consider if you fall under the following circumstances in which this pre-workout would be beneficial to you:
A double-blind study provided 20 g/day of creatine monohydrate for 5 days to qualified sprinters and jumpers who performed 45 seconds of continuous jumping and 60 seconds of continuous treadmill running. Supplementation enhanced performance in the jumping test by 7% for the first 15 seconds and 12% for the next 15 seconds, but there was no difference for the final 15 seconds. There was a 13% improvement in the time of intensive running to exhaustion [12].
Post workout, it’s important to restore your body’s energy by consuming protein and carbs. When you’re trying to build muscle, this is an especially important step. Protein powder is a great muscle builder for your post-workout routine, as long as you include a carbohydrate as well. You can get this by eating a banana or adding oats or banana to your protein shake. Or simply cook up a batch of healthy oatmeal muffins and include protein powder in your recipe. Then, enjoy your post-workout supplement as a delicious snack!
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.
Always consult your doctor before you begin taking a creatine supplement to make sure that there are no negative interactions with whatever diabetes medication you are on. If they deem you to be safe to take creatine, we recommend this unflavored powder from MET-Rx. It’s made without artificial sweeteners, flavors, and colors, so it's just pure creatine monohydrate powder to promote increased muscle strength. One reviewer noted the product is easy to mix and another said the formula was effect for their needs.
Bodybuilding became more popular in the 1950s and 1960s with the emergence of strength and gymnastics champions, and the simultaneous popularization of bodybuilding magazines, training principles, nutrition for bulking up and cutting down, the use of protein and other food supplements, and the opportunity to enter physique contests. The number of bodybuilding organizations grew, and most notably the International Federation of Bodybuilders (IFBB) was founded in 1946 by Canadian brothers Joe and Ben Weider. Other bodybuilding organizations included the Amateur Athletic Union (AAU), National Amateur Bodybuilding Association (NABBA), and the World Bodybuilding Guild (WBBG). Consequently, the male-dominated contests grew both in number and in size. Besides the many "Mr. XXX" (insert town, city, state, or region) championships, the most prestigious titles[according to whom?] were Mr. America, Mr. World, Mr. Universe, Mr. Galaxy, and ultimately Mr. Olympia, which was started in 1965 by the IFBB and is now considered the most important bodybuilding competition in the world.
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Bodybuilders do cardio training such as running and using a StairMaster StepMill to burn fat and make their muscles more visible. “Do cardio throughout the year at least three days a week for at least 30-40 minutes, whether it be first thing in the morning on an empty stomach or after a post-workout protein shake,” says Heath. “Cardio won’t kill your gains as much as you think, you’ll see how much muscle you really have.” Break a sweat to stay lean ’round the clock.
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.
Creatine may preserve dopamine synthesis in the striatum of mice (while protecting against dopaminergic depletion) when fed to mice at 2% of the diet for one week prior to MPTP toxicity[230]. This is possibly secondary to increasing tyrosine hydroxylase activity, the rate-limiting step of dopamine biosynthesis.[210][235] Two percent creatine was as protective as 0.005% rofecoxib (a COX2 inhibitor), but the two were additive in their protective effects (highly synergistic in regard to DOPAC by normalizing it, but not synergistic in preserving HVA).[230]

Despite creatine not interfering with UV(A) irradiation acting upon a cell or the production of oxidation due to it, creatine appears to prevent the functional consequences (such as mitochondrial DNA damage) due to preventing an ATP depletion in the cell, which would normally precede a reduction in mitochondrial membrane potential and mutagenesis, but this effect is prevented for as long as creatine stores are sufficient.[446] Creatine has also been noted to near-fully protect mitochondrial DNA from hydroxyl radicals and oxidative damage, although there was no protective effect for nuclear DNA, due to it being less sensitive to hydroxyl radicals.[447]
Bodybuilders also understand how to diet. This is perhaps the most important aspect other athletes can learn from. I can’t think of any athlete that comes close to bodybuilders who know how to build massive amounts of muscle and then can diet with the type of precision that gets them absolutely shredded on a specific date. Most resistance training sports use weight classes to compete. It doesn’t take a rocket scientist to see that shedding body fat without losing muscle can be a major advantage. Competing at a lower weight class because you are leaner while maintaining strength and performance is a very valuable and effective strategy. Diet to build LEAN muscle to keep weight low for a competitive advantage.
Bryant, a lawyer and sports agent, opened a case of manila file folders and spread them on the desk like playing cards. Each was labeled: Phil Heath Enterprises, Sponsors, Taxes, Travel and so on. Bryant, Heath and Cremona discussed Heath’s clothing line and his sponsorships. They talked about his desire for a shoe deal and a larger hyperbaric chamber at his house.
Maughan RJ, King DS, Lea T. Dietary supplements. J Sports Sci. 2004 Jan;22(1):95-113.Kreider RB. Dietary supplements and the promotion of muscle growth with resistance exercise. Sports Med. 1999 Feb;27(2):97-110.Kerksick CM, Rasmussen CJ, Lancaster SL, et al. The effects of protein and amino acid supplementation on performance and training adaptations during ten weeks of resistance training. J Strength Cond Res. 2006 Aug;20(3):643-53.Update of Cochrane Database Syst Rev. 2001;(1):CD002946. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD002946.AIS Sports Nutrition - AIS Sports Supplement Program 2007.
When it comes to building muscle, there are numerous theories, methods, and preferences. Whether the goal is improved health, aesthetics, performance, or a combination of all three, there is no shortage of advice to help you get there. So much so that it can sometimes become overly complicated and you forget about the basic facts. But, it’s simpler than it seems.
Longer rest periods are more ideal for making progressive tension overload happen, and shorter rest periods are more ideal for generating metabolic fatigue. So, if you’re doing an exercise that is better suited for progressive overload (i.e. primary compound exercises), you’re going to want to rest longer between sets to maximize strength output. And if you’re doing an exercise that is better suited for metabolic fatigue (i.e. isolation exercises), you’re going to want to rest less between sets to make that happen. And if you’re doing an exercise that is suited equally for a combination of the two (i.e. secondary compound exercises), you’re usually going to want a moderate rest period somewhere in between.

Take your vitamins. In addition to a well-balanced diet, include a multivitamin supplement to your dietary regimen. It will ensure that your body is getting the full amount of vitamins and minerals it needs to stay healthy. There are many options, depending on your age, your sex, and your particular health and diet needs. Find the one that's right for you, and make it part of your daily routine.


Myotonic Dystrophy type I (DM1) is an inhereted muscular disorder caused by an expanded CTG repeat in the DMPK gene on chromosome 19q13.3 (genetic cause of the disorder[561]) resulting in muscular degeneration and myotonia. The related myopathy, Myotonic Dystrophy type II (DM2) which is also known as proximal myotonic myopathy (PROMM) is due to a CCTG repeat on 3q,[562] and is less affected by myotonia and more by muscular pain and weakness. There is no cure for either because they are genetic disorders, so current therapies are aimed at reducing side-effects. Therapies include modafinil for the somnolence[563] and perhaps creatine for the reduction in strength and functionality.[548]
Honestly, I did a lot of research on this one, because I wanted to find a single group of people who should not strength train.  I even found studies on how strength training can be beneficial for paraplegics.  Not to mention it can be safe for children, adolescents, and pregnant women.  Obviously, you should take a break from strength training if you’re injured, and always check with your doctor before you start any sort of strength training program, but it’s natural for us, as humans, to move around and carry things.
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]
In general, muscle content of creatine tends to be elevated to 15-20% above baseline (more than 20mM increase) in response to oral supplementation. People who get a sufficiently high influx of creatine are known as responders.[150][151][152][153] A phenomena known as “creatine nonresponse” occurs when people have less than a 10mM influx of creatine into muscle after prolonged supplementation.[154] Quasi-responders (10-20mM increase) also exist.[154] Nonresponse is thought to explain instances where people do not benefit from creatine supplementation in trials, since some trials that find no significant effect do find one when only investigating people with high creatine responsiveness.[155] There are clear differences between those who respond and those who do not, in regard to physical performance.[156] People who are creatine responsive tend to be younger, have higher muscle mass and type II muscle fiber content, but this has no correlation with dietary protein intake.[154][157]
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].
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]
The creatine transporter is a sodium[139][140] and chloride[141][142] dependent membrane-associated transporter that belongs to the Na+/Cl-dependent family of neurotransmitter transporters.[143] In muscle cells and most other cell types,[131][141] the isomer of the creatine transporter is known as SLC6A8 (solute carrier family 6, member 8). SLC6A8 is encoded by the gene present on the Xq28 region of the human X-chromosome and is expressed in most tissues.[144] A related gene encoding a creatine transporter variant has also been identified at 16p11.1 that is expressed exclusively in the testes.[145] These two transporters share 98% homology.[144][145]
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] 
Forbes, S. C., Sletten, N., Durrer, C., Myette-Côté, E , Candow, D., & Little, J. P. (2017, June). Creatine monohydrate supplementation does not augment fitness, performance, or body composition adaptations in response to four weeks of high-intensity interval training in young females. Human Kinetics Journals, 27(3), 285-292. Retrieved from http://journals.humankinetics.com/doi/abs/10.1123/ijsnem.2016-0129

Despite all the awesomeness of hypertrophy, athletes may be more interested in effects on power. Power is the ability to generate high amounts of force in relatively short periods of time — more power means you can pull more weight in low-rep sets — and independent of the hypertrophy, just five to ten grams of creatine per day appears to improve power output by 12 to 26 percent.
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.
After all, you’ve probably seen the countless workouts, diets, supplements, programs, products and people claiming that super fast muscle growth is possible. You’ve probably also seen the click-bait headlines (“How To Build 20lbs Of Muscle In Just 6 Weeks!”) and the unbelievable transformations of supposedly “natural” people (bodybuilders, celebrities, athletes, fitness gurus on social media, etc.) that clearly prove it can happen faster than this.
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