Heart Failure is one of the single most common complications that face many people today. When a heart ages, the cells collect a yellow-brown layer which is waste and can lead to heart complications. This process is known as lipofuscin, or “aging pigment” which leads to death opposed to someone who can delay that as far as possible. [3] In mice, a study was performed where two groups of mice who had lipofuscin underwent different experiments, one group received creatine supplementation, and one group did not receive supplementation. What they found was that the mice who supplemented creatine lived 9% longer than the ones who did not receive creatine. 9% translated into human years results in almost 7 years, which could suggest that if you suffer from this deterioration, creatine supplementation could potentially increase your longevity by 7 years. [3]
Who makes it: This product is manufactured by MuscleTech, a large sports nutrition company that has been in business since 1995. In their 20+ years in the industry, MuscleTech has developed many innovative and effective exercise supplements, and currently holds more than 50 U.S. patents. They have developed quite a following of loyal fans over the years, and for good reason.
If you’re looking to put on extra muscle mass and build strength, there are a few things that need to occur. The first of these, even though it may seem obvious, is that you will need to have an exercise routine. To stimulate maximum muscle growth, you’ll need to challenge yourself in the gym, forcing your muscles to adapt to heavier workloads by increasing in size and strength.
By that logic, a 160-pound man should consume around 160 grams of protein a day—the amount he'd get from an 8-ounce chicken breast, 1 cup of cottage cheese, a roast-beef sandwich, two eggs, a glass of milk, and 2 ounces of peanuts.) If you don't eat meat for ethical or religious reasons, don't worry — you can count on other sources, too. Soy, almonds, lentils, spinach, peas, and beans are packed with protein.

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]
^ Jump up to: a b c d e f g h Momaya A, Fawal M, Estes R (April 2015). "Performance-enhancing substances in sports: a review of the literature". Sports Med. 45 (4): 517–531. doi:10.1007/s40279-015-0308-9. PMID 25663250. Wilson et al. [91] demonstrated that when non-resistance trained males received HMB pre-exercise, the rise of lactate dehydrogenase (LDH) levels reduced, and HMB tended to decrease soreness. Knitter et al. [92] showed a decrease in LDH and creatine phosphokinase (CPK), a byproduct of muscle breakdown, by HMB after a prolonged run. ... The utility of HMB does seem to be affected by timing of intake prior to workouts and dosage [97].

Do a single set of repetitions. Theories on the best way to approach weight training abound, including countless repetitions and hours at the gym. But research shows that a single set of exercise with a weight that fatigues your muscle after about 12 to 15 repetitions can build muscle efficiently in most people and can be as effective as three sets of the same exercise.
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] 
^ Jump up to: a b c d Brosnan ME, Brosnan JT (August 2016). "The role of dietary creatine". Amino Acids. 48 (8): 1785–91. doi:10.1007/s00726-016-2188-1. PMID 26874700. The daily requirement of a 70-kg male for creatine is about 2 g; up to half of this may be obtained from a typical omnivorous diet, with the remainder being synthesized in the body ... More than 90% of the body’s creatine and phosphocreatine is present in muscle (Brosnan and Brosnan 2007), with some of the remainder being found in the brain (Braissant et al. 2011). ... Creatine synthesized in liver must be secreted into the bloodstream by an unknown mechanism (Da Silva et al. 2014a)
It's OK to be a little sore. Your muscles might feel achy or tired the day after a tough training session thanks to DOMS, or delayed onset muscle soreness. When you strength train you're causing microscopic damage to the tissue that will be repaired, that's how you build stronger lean muscle. Speaking of repair and recovery, though, rest days are important. "If you constantly break down muscle without a recovery period, you won’t give the muscle fibers a chance to repair and build back stronger,” explains Davis.
Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., … Lopez, H. (2017, June 13). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(18). Retrieved from https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z
When endothelial cells have a higher creatine concentration, they appear to be mildly less permeable when incubated with 0.5-5mM creatine, while the higher concentration (5mM) is able to fully ablate TNF-α-induced neutrophil adhesion and both E-selectin and ICAM-1 expression.[316] This effect was prevented with ZM241385, an A2A (adenosine) receptor antagonist,[316] and since adenosine released by this receptor is known to be protective of endothelial cells,[317][318] it is thought that creatine works vicariously through this receptor and adenosine release, thought to be due to releasing ATP (occurs in response to stress[319][320]) which protects the cell via the A2A signaling system.[316]
Other human studies have yielded mixed results concerning creatine’s influence on triglyceride levels. In healthy male football players, creatine supplementation (5g monohydrate daily) over eight weeks did not influence triglyceride levels[324] but in martial artists given approximately 3.5g daily, a statistically significant increase in triglycerides was found despite no changes in total cholesterol.[325] In people with cardiovascular complications, given an exercise program and creatine, no significant change in triglycerides was noted relative to a placebo control group, which was also exercising.[326]
Although some have voiced concerns about kidney damage with creatine supplementation, it’s generally regarded as a safe supplement when taken responsibly. The Mayo Clinic advises against taking it if you have an allergy. When used properly, the incidence of potential side effects such as low blood sugar and dehydration, are minor in healthy people taking a safe dosage.
Gualano, B., de, Salles Painelli, V, Roschel, H., Lugaresi, R., Dorea, E., Artioli, G. G., Lima, F. R., da Silva, M. E., Cunha, M. R., Seguro, A. C., Shimizu, M. H., Otaduy, M. C., Sapienza, M. T., da Costa, Leite C., Bonfa, E., and Lancha Junior, A. H. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Eur.J.Appl.Physiol 2011;111(5):749-756. View abstract.
No need to worry! This myth that caffeine counteracts creatine came from the simple, but wrong logic that because caffeine accelerates the nervous system and uses more water, it would counteract creatine because creatine helps your body retain water. While both of these statements are true, it does not mean they “cancel” eachother out, all that it means is that your body will be able to stay hydrated longer if you are taking creatine and caffeine opposed to just taking caffeine.
Using clinically effective doses of potent ingredients, Transparent Labs' StrengthSeries Creatine HMB combines creatine monohydrate with HMB in order to boost strength, lengthen endurance, and reduce fat. Along with the addition of BioPerine, StrengthSeries Creatine HMB is able to increase the rate of absorption and dispersion of this powerful creatine formula. Each serving of Creatine HMB contains 5g of Creatine, 2 g of HMB, and 5mg of BioPerine! Keep Reading »
Anti-cancer effects have been observed with the creatine analogue cyclocreatine[456][104][457] and have been replicated with creatine itself. These effects tend to be a reduction in which the rate of implanted tumors progresses.[458][459] It is suspected that these observed effects (inhibition of growth or attenuation of the rate of growth) are not due to the bioenergetic effect of creatine, secondary to creatine kinase. These anti-cancer effects do not have a known reliability, as the expression of creatine kinase varies widely based on the type of tumor.[460] However, some studies suggest an inverse relationship between tumor progression in mice and concentrations of creatine in cells, with creatine depletion coinciding with tumor development.[460]

Despite the popularity of creatine among young people, there has been very little research conducted in children under age 18. Of those studies, a few have suggested a positive effect but the overall evidence is inconclusive. In one study, teenage swimmers performed better after taking creatine; in another study, it helped high school soccer players sprint, dribble, and jump more effectively.
^ Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DS (February 2009). "The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels". Journal of the International Society of Sports Nutrition. 6 (1): 6. doi:10.1186/1550-2783-6-6. PMC 2649889. PMID 19228401.
The first U.S. Women's National Physique Championship, promoted by Henry McGhee and held in Canton, Ohio in 1978, is generally regarded as the first true female bodybuilding contest—that is, the first contest where the entrants were judged solely on muscularity.[13] In 1980, the first Ms. Olympia (initially known as the "Miss" Olympia), the most prestigious contest for professionals, was held. The first winner was Rachel McLish, who had also won the NPC's USA Championship earlier in the year. The contest was a major turning point for female bodybuilding. McLish inspired many future competitors to start training and competing. In 1985, a movie called Pumping Iron II: The Women was released. It documented the preparation of several women for the 1983 Caesars Palace World Cup Championship. Competitors prominently featured in the film were Kris Alexander, Lori Bowen, Lydia Cheng, Carla Dunlap, Bev Francis, and McLish. At the time, Francis was actually a powerlifter, though she soon made a successful transition to bodybuilding, becoming one of the leading competitors of the late 1980s and early 1990s.
Supplementation of creatine at 5g daily alongside rehabilitation (after limb immobilization for two weeks while taking 20g daily) is associated with a preservation in GLUT4 levels, which were reduced during immobilization. During exercise rehabilitation, it increased to 40% above placebo.[330] This study failed to note an increase in GLUT4 in control, despite exercise normally doing so.[331][332] This effect is thought to be the result of the low frequency of activity. Thus, creatine was thought to augment the increase (insignificant due to low exercise) to significant levels.[330] In other studies, creatine was found to increase GLUT by approximately 30% relative to control, but this effect failed to reach statistical significance. This study did not issue an exercise protocol.[207]
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.”
There are several different available forms of creatine: creatine anhydrous which is creatine with the water molecule removed in order to increase the concentration of creatine to a greater amount than that found in CM. Creatine has been manufactured in salt form: creatine pyruvate, creatine citrate, creatine malate, creatine phosphate, magnesium creatine, creatine oroate, Kre Alkalyn (creatine with baking soda). Creatine can also be manufactured in an ester form. Creatine ethyl ester (hydrochloride) is an example of this, as is creatine gluconate which is creatine bound to glucose. Another form is creatine effervescent which is creatine citrate or CM with citric acid and bicarbonate. The citric acid and bicarbonate react to produce an effervescent effect. When mixed with water the creatine separates from its carrier leaving a neutrally charged creatine, allowing it to dissolve to a higher degree in water. Manufacturers claim that creatine effervescent has a longer and more stable life in solution. When di-creatine citrate effervescent was studied [59] for stability in solution it was found that the di-creatine citrate dissociates to citric acid and creatine in aqueous solutions which in turn forms CM and eventually crystallises out of the solution due to its low solubility. Some of the creatine may also convert to creatinine.
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.
Side-Effects: While the signs of a great body may make one think that there cannot be anything wrong with bodybuilding supplements, the facts speak otherwise. Bodybuilding supplements do have side-effects and you must listen to your trainer before giving in to the thoughts of buying one. Creatine can cause heart problems, kidney problems, dehydration, diarrhoea and muscle cramping. You must also discuss your medical history with the trainer. 
The US FDA reports 50,000 health problems a year due to dietary supplements [14] and these often involve bodybuilding supplements.[15] For example, the "natural" best-seller Craze, 2012's "New Supplement of the Year" by bodybuilding.com, widely sold in stores such as Walmart and Amazon, was found to contain N,alpha-Diethylphenylethylamine, a methamphetamine analog.[16] Other products by Matt Cahill have contained dangerous substances causing blindness or liver damage, and experts say that Cahill is emblematic for the whole industry.[17]
Specifically targeted to be used by natural bodybuilders and powerlifters, Universal Nutrition Animal M-Stak is the ideal supplement for hard-gainers. Containing ingredients that help promote protein synthesis while preventing muscle breakdown, Animal M-Stak is designed to naturally maximize the muscle mass building process. Optimize your performance and strength, and overcome your plateaus with Animal M-Stak. Keep Reading »
Fish oils are an excellent source of omega-3 fatty acids, which provide myriad benefits for the body. For strength athletes and bodybuilders, we're most concerned with their anti-inflammatory and antioxidant properties. Intense resistance training can cause microscopic tears in your muscle fibers, leading to muscle damage and inflammation. While some inflammation is desirable, too much can delay the post-exercise recovery process.

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.

At the same time, this also doesn’t mean that primary compound exercises can never be done for more than 8 reps, or that secondary compound exercise can’t be done for 5-8 or 10-15 reps, or that isolation exercises can’t be done for less than 10 reps. Everything can be done in every rep range. However, these are the rep ranges that each type of exercise is best suited for, and where it should ideally be done most of the time.

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.
de Salles Painelli V, Alves VT, Ugrinowitsch C, et al. Creatine supplementation prevents acute strength loss induced by concurrent exercise. Eur J Appl Physiol 2014;114(8):1749-55.del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids 2012;42(6):2299-305. View abstract.

Creatine is an energy substrate: a small peptide serving as a reservoir for high-energy phosphate groups that can regenerate ATP, the main currency of cellular energy. An increase in creatine intake (through food or supplementation) increases cellular energy stores, promoting the regeneration of ATP in the short term. Stores are limited, however, and glucose or fatty acids are responsible for ATP replenishment over longer durations.
When looking specifically at human studies, there has been a failure of creatine supplementation to induce or exacerbate kidney damage in people with amyotrophic lateral sclerosis (ALS). Subjects do not experience kidney damage for up to or over a year’s worth of supplementation in the 5-10g range.[505][506][507] Postmenopausal women,[517] people with type II diabetes,[518] people on hemodialysis,[313] otherwise healthy elderly,[519] young people,[454][520][521] and athletes do not experience kidney damage either.[324] Moreover, numerous scientific reviews on both the long- and short-term safety of supplemental creatine have consistently found no adverse effects on kidney function in a wide range of doses.[522][523][524][452][525][451][526][527] However, while doses >10 g/day have been found not to impair kidney function, there are fewer long-term trials using such high chronic daily intakes.[527]
I can’t predict what sort of results you’ll see in that first year, but it can be pretty epic if you attack it right! Muscle growth might happen slower than you want, but I expect something different will happen along the way – you’ll fall in love with this idea of building STRENGTH! In fact, getting hooked on progress, and strength training is one of the best things you can do for yourself.
Collectively the above investigations indicate that creatine supplementation can be an effective strategy to maintain total creatine pool during a rehabilitation period after injury as well as to attenuate muscle damage induced by a prolonged endurance training session. In addition, it seems that creatine can act as an effective antioxidant agent after more intense resistance training sessions.
In the early 2000s, the IFBB was attempting to make bodybuilding an Olympic sport. It obtained full IOC membership in 2000 and was attempting to get approved as a demonstration event at the Olympics, which would hopefully lead to it being added as a full contest. This did not happen and Olympic recognition for bodybuilding remains controversial since many argue that bodybuilding is not a sport.[11]
In patients with DM1 given a short loading phase (10.6g for ten days) followed by a 5.3g maintenance for the remainder of an 8-week trial noted that supplementation resulted in a minor improvement in strength (statistical significance only occurred since placebo deteriorated) and no significant difference was noted in self-reported perceived benefits.[565] Maintaining a 5g dosage for four months also failed to significantly improve physical performance (handgrip strength and functional tests) in people with DM1, possible related to a failure to increase muscular phosphocreatine concentrations.[566]
However, in the beginning weeks of starting a new workout routine, the majority of strength gains aren't actually a result of this muscle protein synthesis and hypertrophy. Rather, they are a result of the body's neurological system learning when and how to fire the needed muscle cells, explains Abbie E. Smith-Ryan, associate professor of exercise physiology at the department of exercise and sport science at the University of North Carolina–Chapel Hill. Think of it this way: The first time you perform a new exercise, say a bench press, you likely feel pretty shaky. Your arms aren't totally in sync and the weights may sway a bit from side to side. But by the time you perform your second or third set of that same exercise, the practice gets a little smoother. That's your neurological system at work.
“Imagine you've fasted for over eight hours,” he says. “At breakfast, you're firing your metabolism off really high. If you don't eat for another five hours, your metabolism starts to slow right down and you have to try and kickstart it again with your next meal. If you eat every two and a half to three hours, it's like chucking a log on a burning fire.”
1. Train each muscle group twice per week. To maximize muscle growth, plan to train every major muscle group at least twice per week. According to a 2016 Sports Medicine review, even if you don't work that muscle any harder or longer, by simply dividing your chest, leg or back workout into two days, you'll spur more muscle growth. While the jury is still out on whether training each muscle group three days per week is better than two at spurring hypertrophy, it is likely better suited toward experienced lifters than beginners, Matheny says.
Don’t make the mistake of trying to bulk up when you should be on a diet. While you might have muscle on your mind, most people need to get leaner first. If you’re fat and you start eating for size, you’re only going to get fatter. Get rid of the excess blubber first, to the point where you can see some abs, and then worry about getting big. You should be as low as 12% body fat before you change your diet up to focus on mass gain. That will ensure that your insulin sensitivity is high. When it is, you can eat more carbs and your body won’t store them as fat.
By increasing the overall pool of cellular phosphocreatine, creatine supplementation can accelerate the reycling of ADP into ATP. Since ATP stores are rapidly depleted during intense muscular effort, one of the major benefits of creatine supplementation is its ability to regenerate ATP stores faster, which can promote increased strength and power output. Over 95% of creatine is stored in muscle at a maximum cellular concentration of 30uM. Creatine storage capacity is limited, though it increases as muscle mass increases.[24] A 70 kg male with an average physique is assumed to have total creatine stores of approximately 120g.[25] The body can store a lot more energy as glycogen in the liver, brain, and muscles,[26][27] and even more as fat.
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.

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.
Creatine supplementation at 300mg/kg for one week (loading with no maintenance) in youth subject to six repeated 35m sprints (10s rest, known as the Running-based Anaerobic Sprint Test or RAST) noted that the increased average and peak power output seen in creatine was not met with a reduction in fatigue, although there was an attenuation in inflammation from exercise (TNFα and CRP).[299]
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.
When looking specifically at human studies, there has been a failure of creatine supplementation to induce or exacerbate kidney damage in people with amyotrophic lateral sclerosis (ALS). Subjects do not experience kidney damage for up to or over a year’s worth of supplementation in the 5-10g range.[505][506][507] Postmenopausal women,[517] people with type II diabetes,[518] people on hemodialysis,[313] otherwise healthy elderly,[519] young people,[454][520][521] and athletes do not experience kidney damage either.[324] Moreover, numerous scientific reviews on both the long- and short-term safety of supplemental creatine have consistently found no adverse effects on kidney function in a wide range of doses.[522][523][524][452][525][451][526][527] However, while doses >10 g/day have been found not to impair kidney function, there are fewer long-term trials using such high chronic daily intakes.[527] 

D-aspartic acid can also help to reduce cortisol levels. Cortisol is known as the “stress” hormone because its production increases during stressful situations. High cortisol levels can have many negative side effects, such as weight gain, muscle tissue breakdown, or increased blood sugar. Taking a supplement that includes cortisol can reduce stress and prevent excess fat storage or muscle loss.
"Eating well" is tough to objectively quantify. One can eat "well" but that doesn't necessarily mean that you are eating enough to build muscle or recover adequately from workouts. Also, taking protein shakes doesn't guarantee that one will start to accrue massive slabs of lean body mass. Muscle anabolism is a fairly complex metabolic process which has a number of contributing factors at the cellular level and can't be reduced to a single supplement or dietary component.
You burn calories during strength training, and your body continues to burn calories after strength training (just like you do after aerobic exercise), a process called "excess post-exercise oxygen consumption" or EPOC, according to the American Council on Exercise. (13) When you do strength, weight, or resistance training, your body demands more energy based on how much energy you’re exerting (meaning the tougher you’re working, the more energy is demanded). That means more calories burned during the workout, and more calories burned after the workout, too, while your body is recovering to a resting state.
You are eligible for a full refund if no ShippingPass-eligible orders have been placed. You cannot receive a refund if you have placed a ShippingPass-eligible order. In this case, the Customer Care team will remove your account from auto-renewal to ensure you are not charged for an additional year and you can continue to use the subscription until the end of your subscription term.
Beta-alanine is a naturally occurring non-essential amino acid that comes into the body through foods that are rich in protein. The performance-enhancing aspect of beta-alanine (BA) is due to its ability to increase intra-muscular levels of carnosine. Increasing beta-alanine through supplementation may raise carnosine levels by over 60 percent in as quickly as four weeks.[6]

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.

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].
“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. [..]
2-4 Minutes Rest: Ideal for “tension exercises,” which includes most primary compound exercises. I personally take 3 minutes for the big stuff, sometimes going into the 3-4 minute range depending on exactly what I’m doing and what I feel like I need at the time. Since making strength gains is the main focus of these exercises, longer rest periods like this will be optimal for making it happen.
Studies that use a dosage range typical of creatine supplementation (in the range of 5g a day following an acute loading period) note increases to total body water of 6.2% (3.74lbs) over 9 weeks and[608] 1.1kg over 42 days.[609] Interestingly, some studies comparing creatine paired with training against training itself fail to find a significant difference in percentage of water gained (which is inherently to activity) with standard oral doses of creatine[609][607][610] (although low dose creatine supplementation of 0.03g/kg or 2.3g daily doesn’t appear to increase water retention[611]) despite more overall water weight being gained, due to an equal gain of dry mass in muscles. One study has quantified the percentage increase in mass of muscle cells to be 55% water, suggesting the two groups are fairly equal.[609]
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).
Kornblum, C., Schroder, R., Muller, K., Vorgerd, M., Eggers, J., Bogdanow, M., Papassotiropoulos, A., Fabian, K., Klockgether, T., and Zange, J. Creatine has no beneficial effect on skeletal muscle energy metabolism in patients with single mitochondrial DNA deletions: a placebo-controlled, double-blind 31P-MRS crossover study. Eur J Neurol 2005;12(4):300-309. View abstract.

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.
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.
Spero Karas, MD, assistant professor of orthopaedics in the division of sports medicine at Emory University, says that testosterone, the male hormone responsible for muscle growth, maxes out between the ages of 16 and 18. It reaches a plateau during the 20s and then begins to decline. As a result, muscle building after the adolescent years can be challenging, he says.

Volek, J. S., Ratamess, N. A., Rubin, M. R., Gomez, A. L., French, D. N., McGuigan, M. M., Scheett, T. P., Sharman, M. J., Hakkinen, K., and Kraemer, W. J. The effects of creatine supplementation on muscular performance and body composition responses to short-term resistance training overreaching. Eur.J.Appl.Physiol 2004;91(5-6):628-637. View abstract.
Genetic deficiencies in the creatine biosynthetic pathway lead to various severe neurological defects.[26] Clinically, there are three distinct disorders of creatine metabolism. Deficiencies in the two synthesis enzymes can cause L-arginine:glycine amidinotransferase deficiency caused by variants in GATM and guanidinoacetate methyltransferase deficiency, caused by variants in GAMT. Both biosynthetic defects are inherited in an autosomal recessive manner. A third defect, creatine transporter defect, is caused by mutations in SLC6A8 and inherited in a X-linked manner. This condition is related to the transport of creatine into the brain.[27]