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]
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.
A 2011 survey of 33 supplements commercially available in Italy found that over 50% of them exceeded the European Food Safety Authority recommendations in at least one contaminant. The most prevalent of these contaminants was creatinine, a breakdown product of creatine also produced by the body.[47] Creatinine was present in higher concentrations than the European Food Safety Authority recommendations in 44% of the samples. About 15% of the samples had detectable levels of dihydro-1,3,5-triazine or a high dicyandiamide concentration. Heavy metals contamination was not found to be a concern, with only minor levels of mercury being detectable. Two studies reviewed in 2007 found no impurities.[41]
CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.
Creatine is not an essential nutrient[19] as it is naturally produced in the human body from the amino acids glycine and arginine, with an additional requirement for methionine to catalyze the transformation of guanidinoacetate to creatine. In the first step of the biosynthesis these two amino acids are combined by the enzyme arginine:glycine amidinotransferase (AGAT, EC: to form guanidinoacetate, which is then methylated by guanidinoacetate N-methyltransferase (GAMT, EC:, using S-adenosyl methionine as the methyl donor. Creatine itself can be phosphorylated by creatine kinase to form phosphocreatine, which is used as an energy buffer in skeletal muscles and the brain.
Using too much weight, too soon; always start lower than your expected ability and work your way up that first workout. If your form suffers, you are swinging the weight, or using momentum, this indicates you may be using too much weight. Greater momentum increases the potential for injury and reduces the effectiveness to the muscle group being targeted.
Homocyteine (normal serum range of 5-14µM) is known to adversely affect motor control in genetically susceptible people when their levels exceed 500µM, which is usually associated with genetically induced deficiencies of B12.[360][361] In these particular instances (assessed by rats fed homocysteine to increase serum levels to such a high level[362][363]) it appears that administration of 50mg/kg creatine (injections) to these rats can protect dysfunction in muscle metabolism (pyruvate kinase activity, Krebs cycle intermediates, and muscle cell viability) induced by homocysteine.[363]
But one question has repeatedly popped up: When is the best time to take creatine? Recent research has suggested that there might be an ideal time. That’s when I decided to speak with the supplement experts at For those of you who don’t know, they have created the world’s largest database of facts about supplements. No marketing BS. Just a bunch of Ph.D’s, PharmD’s, and biomedical researchers who are obsessed with sharing the truth. Their Supplement Guide is the best thing written about supplements since…well…ever. If you’ve ever had a question it’s pack with research and fact-based information to help you make healthier supplement choices.
Creatine is produced endogenously at an amount of about 1 g/d. Synthesis predominately occurs in the liver, kidneys, and to a lesser extent in the pancreas. The remainder of the creatine available to the body is obtained through the diet at about 1 g/d for an omnivorous diet. 95% of the bodies creatine stores are found in the skeletal muscle and the remaining 5% is distributed in the brain, liver, kidney, and testes [1]. As creatine is predominately present in the diet from meats, vegetarians have lower resting creatine concentrations [2].
Consuming sufficient high-quality protein is essential for building muscle. Current recommendations are to consume a minimum of 0.8g of protein for each kg of body weight, however, this is really only applicable to the average sedentary individual. Current evidence shows that to support muscle development, protein intake is the key, therefore the recommended 0.8g per kg should be increased to 1.5-2.0g of protein per kg of body weight. For an 80 kg individual, that would equate to 120-160 grams of protein per day.
Studies have deemed staying in the range of 3 to 5 g per day range for maintenance to be safe, and while higher levels have been tested under acute conditions without adverse effects, there isn’t sufficient evidence to determine long-term safety. (8) If you’re interested in upping your creatine consumption, you should work with your doctor or dietitian to make sure it's right for your goals and health history.
MuscleTech Cell-Tech could also be a solid pick for muscle growth. Detractors may not be a fan of the artificial ingredients, but there is evidence that including carbohydrates and alpha-lipoic acid with creatine may increase muscle creatine content. That said, this product uses a little less alpha-lipoic acid than was used in the study suggesting this synergistic effect.

Caffeine is the naturally occurring alkaloid and stimulant in coffee, tea, cocoa, guarana, cola and other plant product beverages. A strong cup of brewed coffee will give you about 100 milligrams of caffeine, instant coffee around 80 milligrams, often less, and tea down around the 40 milligrams. It varies from product to product and how you prepare the drink.
Crave instant gratification? Strength training is a good motivator because you see progress quickly. “If you put someone on a walking program, it will take time before they perceive their body is changing,” explains Katula. “But with strength training, you can feel a difference in your muscles even after one session.” And it only takes a couple workouts before you’ll notice some muscle definition in the mirror. (Go ahead and flex. We dare you.)
A: Start with the calculations above but don’t be afraid to adjust up or down. Your metabolism and physiology will adapt to more food by trying to maintain homeostasis and regulate your bodyweight. Some may have to increase more than others but the number on the scale doesn’t lie. If it’s not going up, then you probably need to increase your calories. 

It’s an amazing feeling when you graduate from lifting 10-pounders to 15-pounders. “Over time, you get better at something you’re doing, and you develop a sense of mastery and feeling that you’re getting stronger,” explains James Whitworth, a doctoral research fellow in the Biobehavioral Resistance Training Lab at Columbia’s Teachers College in New York City. “It helps your confidence, and that gives you a boost in self-esteem.”
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]
Creatine is known to be present in the retina due to the expression of creatine kinase (CK)[466][39] and the GAMT enzyme of creatine synthesis, which is also present in the mammalian retina.[467] Creatine in the blood can be transported into the retina via the creatine transporter (confirmed in humans[468]), and inhibiting transporter activity (by depleting the medium of chloride and sodium) reduces uptake by 80%.[469] The fact that not all uptake was inhibited suggests that another transporter, such as the monocarboxylate transporter MCT12 (or SLC16A12),[470] plays a role, perhaps moreso in the lens, where its levels were comparable to that of the major creatine transporter SLC6A8.[470] 
Cyclocreatine (1-carboxymethyl-2-iminoimidazolidine) is a synthetic analogue of creatine in a cyclic form. It serves as a substrate for the creatine kinase enzyme system, acting as a creatine mimetic. Cyclocreatine may compete with creatine in the CK enzyme system to transfer phosphate groups to ADP, as coincubation of both can reduce cyclocreatine’s anti-motility effects on some cancer cells.[96] 

While most of these muscle building supplements can be taken at any time of the day, some are best to include in your pre-workout routine. Citrulline malate, in particular, is one that should be taken about an hour ahead of your workout. Because this supplement boosts performance, taking it ahead of your workout will maximize its effect, making sure you get the most out of the supplement.
As mentioned, protein is essential for building muscle. If you are unable to consume the recommended amount of protein through diet alone, add protein powder for building muscle as a supplement. This applies to nearly anyone hoping to gain muscle mass since it’s not easy to pack in nearly 100 grams of protein a day through chicken, eggs and legumes alone.
Citrulline Malate is an amino acid also known as L-Citrulline and is taken for many different medical conditions. There is some research that shows that the amino acid may help improve performance while exercising by reducing fatigue. What does that mean for you? In your muscle building efforts, you can use this supplement to help you make it through longer, harder workouts. This will spur more muscle building in response to the trauma your muscles experience in a tough workout. Not only that, but Citrulline Malate can also help reduce soreness after a workout. Who doesn’t want to avoid feeling sore? Reduced soreness means you can get back to the gym the next day with renewed enthusiasm.
In the 1970s, bodybuilding had major publicity thanks to the appearance of Arnold Schwarzenegger, Franco Columbu, Lou Ferrigno, and others in the 1977 docudrama Pumping Iron. By this time, the IFBB dominated the competitive bodybuilding landscape and the Amateur Athletic Union (AAU) took a back seat. The National Physique Committee (NPC) was formed in 1981 by Jim Manion,[7] who had just stepped down as chairman of the AAU Physique Committee. The NPC has gone on to become the most successful bodybuilding organization in America and is the amateur division of the IFBB. The late 1980s and early 1990s saw the decline of AAU-sponsored bodybuilding contests. In 1999, the AAU voted to discontinue its bodybuilding events.
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.
After a tough sweat, it's important to rehydrate your body: "Drink lots of water and thank your body for what it was just able to accomplish," says Davis. A balanced post-workout snack is also a good idea. Go for one with carbs refuel your glycogen stores (one of your body's main energy sources) and about 10 to 20 grams of protein to help build and repair your muscles. "Don’t overcomplicate it," says Davis. If you're lifting and weight loss is one of your goals, though, it's still important to keep calories in mind—a post-workout snack shouldn't be more than 150 to 200 calories. Here's a guide to how many calories you should be eating for weight loss.

Creatine supplementation appears to attenuate decreases in GLUT4 expression seen with immobility and may increase GLUT4 expression during exercise. While it seems capable of increasing GLUT4 during resting conditions, it has failed to reach significance, suggesting that creatine supplementation works best with some stimuli associated with exercise.

Safety. In general health terms, most medical opinion is that up to three cups of coffee a day are not harmful, and may even have some benefits, although some people respond to the stimulant properties with more problems than others. Heart palpitations and restlessness are experienced by some caffeine drinkers. In pregnancy, one or two cups each day are thought to be without harm to the fetus.

1-3 Minutes Rest: Ideal for “tension and fatigue exercises,” which include most secondary compound exercises. This range is sort of the midpoint between being ideal for strength and being ideal for generating fatigue. So while it’s not entirely what’s best for either, it is what’s perfect for achieving an equal combination of the two… which is exactly what we want from these exercises.
Muscle growth is more difficult to achieve in older adults than younger adults because of biological aging, which leads to many metabolic changes detrimental to muscle growth; for instance, by diminishing growth hormone and testosterone levels. Some recent clinical studies have shown that low-dose HGH treatment for adults with HGH deficiency changes the body composition by increasing muscle mass, decreasing fat mass, increasing bone density and muscle strength, improves cardiovascular parameters, and affects the quality of life without significant side effects.[45][46][unreliable medical source?][47]
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.
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.
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.
A typical creatine supplementation protocol of either a loading phase of 20 to 25 g CM/d or 0.3 g CM/kg/d split into 4 to 5 daily intakes of 5 g each have been recommended to quickly saturate creatine stores in the skeletal muscle. However a more moderate protocol where several smaller doses of creatine are ingested along the day (20 intakes of 1 g every 30 min) could be a better approach to get a maximal saturation of the intramuscular creatine store. In order to keep the maximal saturation of body creatine, the loading phase must be followed by a maintenance period of 3-5 g CM/d or 0.03 g CM/kg/d. These strategies appear to be the most efficient way of saturating the muscles and benefitting from CM supplementation. However more recent research has shown CM supplementation at doses of 0.1 g/kg body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Creatine retention by the body from supplementation appears to be promoted by about 25% from the simultaneous ingestion of carbohydrate and/or protein mediated through an increase in insulin secretion. This combination would produce a faster saturation rate but has not been shown to have a greater effect on performance.
While this nonessential amino acid may not deliver earth-shattering PRs or extreme muscle growth, it does play an important role in repair and recovery. Glutamine works by removing excess ammonia, which can accumulate during intense exercise, helping to regulate your body's acid-base balance. Individuals who are engaged in heavy resistance training, two-a-day training splits, or are in a calorie deficit may benefit from the extra support of glutamine supplementation.
Preparation – If you have physique or aesthetic goals then you’re going to have monitor your nutrition. That being said, it will require a bit of work to prepare some healthy meals and ensuring you’re getting enough calories. Not only that, you must approach training in the same way. If you don’t have your gym bag essentials prepped, you’ll end up wasting time looking for your belt and wrist wraps which should already be packed.
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
Change things up. After six or more weeks of consistent strength training, which is about the amount of time it takes to start seeing improvement in your body, you can change your routine to make it more difficult. Lifting the same weights for the same exercises every week will keep your body in the same place. You can modify weights or repetitions, choose different exercises, or change the order in which you do them. You only have to make one change at a time to make a difference, although more is often better. 
There is some research that suggests that creatine can help people with type 2 diabetes by improving insulin sensitivity, glucose uptake into the cells, and glycemic control. This has led many people with T2 to start supplementing their diets with pure creatine to try and reap the benefits. At this time there has been no conclusive research done into the effectiveness of creatine for type 1 diabetics.
Earlier during your workout, you might have thought you were starting to see some muscle definition. "Called transient hypertrophy, or a muscle pump, this physiological phenomenon occurs when blood rushes to your muscles to supply them with workout-powering fuel and even jump-start the recovery process," explains certified strength and conditioning specialist Samuel Simpson, co-owner and vice president of B-Fit Training Studio in Miami. He notes that this muscle pump often starts mid-workout and subsides within a few hours after leaving the gym. And as the muscle pump deflates, it's easy to lose determination.
Moving through repetitions too quickly, going too fast; there is nothing gained by lifting weights fast. Some of the perks of lifting weight in a slow and controlled manner, include more total muscle tension and force produced, more muscle-fiber activation both slow and fast twitch fibers, and less tissue trauma. Remember, a joint is only as strong as the muscles that cross it; if you haven't lifted in a long time, or ever, be careful what you ask of your joints.
Moving through repetitions too quickly, going too fast; there is nothing gained by lifting weights fast. Some of the perks of lifting weight in a slow and controlled manner, include more total muscle tension and force produced, more muscle-fiber activation both slow and fast twitch fibers, and less tissue trauma. Remember, a joint is only as strong as the muscles that cross it; if you haven't lifted in a long time, or ever, be careful what you ask of your joints.
^ Jump up to: a b c Brioche T, Pagano AF, Py G, Chopard A (April 2016). "Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention". Mol. Aspects Med. 50: 56–87. doi:10.1016/j.mam.2016.04.006. PMID 27106402. In conclusion, HMB treatment clearly appears to be a safe potent strategy against sarcopenia, and more generally against muscle wasting, because HMB improves muscle mass, muscle strength, and physical performance. It seems that HMB is able to act on three of the four major mechanisms involved in muscle deconditioning (protein turnover, apoptosis, and the regenerative process), whereas it is hypothesized to strongly affect the fourth (mitochondrial dynamics and functions). Moreover, HMB is cheap (~30– 50 US dollars per month at 3 g per day) and may prevent osteopenia (Bruckbauer and Zemel, 2013; Tatara, 2009; Tatara et al., 2007, 2008, 2012) and decrease cardiovascular risks (Nissen et al., 2000). For all these reasons, HMB should be routinely used in muscle-wasting conditions especially in aged people. ... 3 g of CaHMB taken three times a day (1 g each time) is the optimal posology, which allows for continual bioavailability of HMB in the body (Wilson et al., 2013).
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.
I mean the first two ‘BS’ items focal point is lifting heavy, and then immediately the article goes into Step 1 – focus on 5-10 rep and 6-8 rep (heavier sets) — given we’re not powerlifting 1 rep or 3 rep max. Generally 6 rep sets we’re lifting heavy still… Does have a lot of good general info, but to me it almost feels like the bullet points of what supposedly not to do is actually a table of contents of what Jason is recommending we do do throughout the article…
Athletic performance. Creatine seems to help improve rowing performance, jumping height, and soccer performance in athletes. But the effect of creatine on sprinting, cycling, or swimming performance varies. The mixed results may relate to the small sizes of the studies, the differences in creatine doses, and differences in test used to measure performance. Creatine does not seem to improve serving ability in tennis players.

You've figured out the exercises you should be doing, but what about the number of sets and repetitions? Your decision should be based on your goals. The American College of Sports Medicine recommends 4 to 6 reps for strength and hypertrophy, 8 to 12 reps for muscular strength and 10 to 15 reps for muscular endurance. They also recommend at least one set of each exercise to fatigue although you'll find that most people perform about 2 to 3 sets of each exercise. In general:
According to the abstract, in the stratified analyses by forms of aerobic exercise, weekly resistance exercise of 1 time or 1-59 minutes was associated with lower risks of total cardiovascular events and cardiovascular disease, regardless of meeting the aerobic exercise guidelines. The analysis showed that resistance training reduced the risk of cardiovascular events in 2 ways: training had a direct association with cardiovascular risk, and resistance training indirectly lowered cardiovascular risk by decreasing body mass index.