Unfortunately, some people are intolerant to milk, due to the casein (one of the proteins in dairy) and have trouble digesting the sugar in milk, called lactose. If this is the case, stick to whey-only protein shakes. Maximuscle uses Biomax Whey True Protein - a unique blend of whey proteins including whey protein concentrate, isolate and hydrolysate, which are lower in lactose. Biomax Whey True Protein is used in a number of Maximuscle products (Promax and Cyclone).
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]
Español: aumentar la masa muscular, Deutsch: Muskeln aufbauen, Português: Aumentar a Musculatura, Nederlands: Spieren opbouwen, Français: se muscler le corps, Русский: нарастить мышечную массу, 中文: 增长肌肉, Čeština: Jak budovat svalovou hmotu, Bahasa Indonesia: Membangun Otot, Italiano: Sviluppare Massa Muscolare, 日本語: 筋肉をつける, हिन्दी: बॉडी बनायें (Kaise Body Banaye), العربية: بناء العضلات, 한국어: 근육을 키우는 법, Tiếng Việt: Tạo Cơ bắp, ไทย: สร้างกล้ามเนื้อ, Türkçe: Nasıl Kas Yapılır

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.
A loading phase of 10g creatine monohydrate for two weeks and 4g for the final week in subjects with MELAS (Mitochondrial Encephalomyopathy Lactic Acidosis and Stroke-like episodes) has been noted to increase physical strength relative to baseline, although the poor VO2 max seen in these subjects was not affected.[549] A case study exists in which a patient with a relatively novel mutation in their mitochondrial function (affecting cytochrome B) experienced benefits from creatine at 10g daily.[550] Researchers examining another case of MELAS found both cognitive and physical benefits with 5g creatine supplementation,[551] while four controlled case studies of 100-200mg/kg daily in children with myopathies found improved muscular endurance (30-57%) and muscular power (8-17%) after 100-200mg/kg daily for at least three months.[552]
Oral ingestion of 1-1000mg/kg bodyweight of creatine in mice was able to exert an anti-depressive effect, which was blocked by dopamine receptor antagonists. A low dose of creatine (0.1mg/kg) was able to enhance the dopaminergic effects of dopamine receptor activators, suggesting supplemental creatine can positively influence dopamine signaling and neurotransmission.[252]
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. 

Retinol (Vitamin A) B vitamins: Thiamine (B1) Riboflavin (B2) Niacin (B3) Pantothenic acid (B5) Pyridoxine (B6) Biotin (B7) Folic acid (B9) Cyanocobalamin (B12) Ascorbic acid (Vitamin C) Ergocalciferol and Cholecalciferol (Vitamin D) Tocopherol (Vitamin E) Naphthoquinone (Vitamin K) Calcium Choline Chromium Cobalt Copper Fluorine Iodine Iron Magnesium Manganese Molybdenum Phosphorus Potassium Selenium Sodium Sulfur Zinc
Stash away your scale for several weeks — and set a strength training goal instead. That’s the advice of Lisette Cifaldi, director of behavioral health at Hilton Head Health weight loss resort who counsels patients. “I think strength training shifts your perspective,” she says. “The happiness doesn’t come from achieving a certain number [on the scale]. It comes from the process of getting stronger and feeling empowered that you’re navigating your own success.”
Some ingredients found in dietary supplements marketed for bodybuilding or performance enhancement—such as whey protein, creatine, and caffeine—generally aren’t associated with any serious safety concerns (when used appropriately). However, they still have the potential for side effects. Before you take any dietary supplement, talk to your healthcare provider. You also can read the articles below about some of these ingredients:
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. 

Antioxidants in the diet protect against natural and synthetic chemical fragments called free radicals that are a part of daily living. Lifestyle challenges may increase your requirements for antioxidants. Vitamin C and E are the main antioxidants in the normal diet although many other plant nutrients contribute to this effect. Pollution, stress, smoking, strenuous exercise, and illness may increase your requirements for antioxidant protection.
If you'’re looking to add muscle mass to your frame, hitting the weights hard is a given. Quality time in the gym begins a cascade of changes that will stimulate your muscles to grow bigger in response to the challenges you throw their way. It'’s tempting to think that'’s all it takes to add muscle to your body. After all, you can actually feel your biceps growing after an intense set of curls.

If you have been diagnosed with a certain testosterone deficiency, ask your doctor and/or pharmacist to see if TestoFuel could be beneficial for you. Aside from balancing your testosterone, you may experience increased muscle strength while using this supplement during your intense exercise routine. Here are certain instances where TestoFuel could help correct your testosterone problems:


Finally, starvation (nutrient deprivation for four days) appears to increase activity of the creatine transporter secondary to decreasing serine phosphorylation (SGK target)[173] with no influence on tyrosine phosphorylation (c-Src target).[173] Starvation-induced increases in creatine influx do not necessarily mean more phosphocreatine, however, due to a depleted cellular energy state.[173]
The right amount of workout: It is highly possible that the protein powder you are taking doesn’t work on your body. Supplements should only be taken if you have a rigorous workout schedule or else, it will turn out to be of no value. Most people just purchase a box of supplements without really doing the math, which is very important. Unless you find out the dosage that suits you, the amount of time you should dedicate for the workout and so on, you must not expect daydream the results. 

In regard to bioenergetics, phosphorylated cyclocreatine appears to have less affinity for the creatine kinase enzyme than phosphorylated creatine in terms of donating the high energy phosphate group (about 160-fold less affinity) despite the process of receiving phosphorylation being similar.[104][105] When fed to chickens, phosphorylated cyclocreatine can accumulate up to 60mM in skeletal muscle,[106] which suggests a sequestering of phosphate groups before equilibrium is reached.[105] Cyclocreatine still has the capacity to donate phosphate, however, as beta-adrenergic stimulated skeletal muscle (which depletes ATP and glycogen) exhibits an attenuation of glycogen depletion (indicative of preservation of ATP) with phosphocreatine.[102]
In your body, you can only store enough ATP for about 10 seconds of maximum exercise, this means that after those storages are depleted, it is up to your body to produce ATP to reach the demand your body is placing. [5] Creatine helps in the body by increasing stores of phosphocreatine which is the main ingredient used to create new ATP during intense exercise. By just supplementing creatine for 6 days, you can double your levels of creatine in your muscle storages, resulting in a higher capacity to create energy. [5]
McArdle’s disease is a myopathy associated with impaired glucose release from glycogen and impairments in muscle function at times when glucose would be the primary energy substrate. Creatine is thought to be therapeutic, but has shown differing effects in the two trials so far (both benefit and worsening of symptoms) for currently unknown reasons.
After your standard whey protein powder, creatine may be the most popular sports supplement on Earth, and with good reason. A lot of supplements out there have a few promising studies suggesting they may improve some aspect of performance. Creatine has hundreds of them, and study after study has shown that among most people (a small percentage of are non-responders) it can have a significant effect on several areas of performance.
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.
Taking high doses of creatine might harm the kidneys. Some medications can also harm the kidneys. Taking creatine with medications that can harm the kidneys might increase the chance of kidney damage.

Some of these medications that can harm the kidneys include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.

Ancient Greek sculptures also depict lifting feats. The weights were generally stones, but later gave way to dumbbells. The dumbbell was joined by the barbell in the later half of the 19th century. Early barbells had hollow globes that could be filled with sand or lead shot, but by the end of the century these were replaced by the plate-loading barbell commonly used today.[3]
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.

Activation of NMDA receptors is known to stimulate Na+,K+-ATPase activity[218] secondary to calcineurin,[219] which which has been confirmed with creatine in hippocampal cells (0.1-1mM trended, but 10mM was significant). This is blocked by NMDA antagonists.[220] This increase in Na+,K+-ATPase activity is also attenauted with activation of either PKC or PKA,[220] which are antagonistic with calcineurin.[219][221]
In regard to practical interventions, concurrent glycogen loading has been noted to increase creatine stores by 37-46% regardless of whether the tissue was exercised prior to loading phase.[176] It is important to note, however, that creatine levels in response to the creatine loading protocol were compared in one glycogen-depleted leg to the contralateral control leg, which was not exercised.[176] This does not rule out a possible systemic exercise-driven increase in creatine uptake, and the increase in creatine noted above[176] was larger than typically seen with a loading protocol (usually in the 20-25% range). Consistent with an exercise-effect, others have reported that exercise itself increases creatine uptake into muscle, reporting 68% greater creatine uptake in an exercised limb, relative to 14% without exercise.[153]
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]
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.
You've got your equipment ready, now it's time to choose about eight to 10 exercises, which comes out to about one exercise per muscle group. Use the list below to choose at least one exercise per muscle group to start. For the larger muscles, like the chest, back, and legs, you can usually do more than one exercise. These involve a variety of equipment, so you can choose based on what you have available. 

How much weight? Start with a pair of light dumbbell hand weights (2 to 3 pounds for women and 5 to 8 pounds for men). If you can’t do 12 repetitions (or reps are the number of times you do the exercise) the weight is too heavy. If your muscles don’t feel tired after 12 reps, it’s too light. Adjustable weights that can be strapped to wrists or ankles may be convenient if you have arthritis in your hands. You can also use home or gym weight machines, or resistance bands.

Escolar, D. M., Buyse, G., Henricson, E., Leshner, R., Florence, J., Mayhew, J., Tesi-Rocha, C., Gorni, K., Pasquali, L., Patel, K. M., McCarter, R., Huang, J., Mayhew, T., Bertorini, T., Carlo, J., Connolly, A. M., Clemens, P. R., Goemans, N., Iannaccone, S. T., Igarashi, M., Nevo, Y., Pestronk, A., Subramony, S. H., Vedanarayanan, V. V., and Wessel, H. CINRG randomized controlled trial of creatine and glutamine in Duchenne muscular dystrophy. Ann Neurol 2005;58(1):151-155. View abstract.
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.
These effects were noted before in a preliminary study of depressed adolescents (with no placebo group) showing a 55% reduction in depressive symptoms at 4g daily when brain phosphocreatine levels increased.[231] Other prelimnary human studies suggest creatine might lessen unipolar depression[256] and one study on Post-Traumatic Stress Disorder (PTSD) noted improved mood as assessed by the Hamilton Depression Rating Scale.[232]
Peirano, R. I., Achterberg, V., Dusing, H. J., Akhiani, M., Koop, U., Jaspers, S., Kruger, A., Schwengler, H., Hamann, T., Wenck, H., Stab, F., Gallinat, S., and Blatt, T. Dermal penetration of creatine from a face-care formulation containing creatine, guarana and glycerol is linked to effective antiwrinkle and antisagging efficacy in male subjects. J.Cosmet.Dermatol. 2011;10(4):273-281. View abstract.
Creatine is old school and definitely hit a pop culture zenith, but that doesn’t make it out-dated or irrelevant today. Creatine supplementation gets results. For starters, one study from Medicine and Science in Sports and Exercise confirms that creatine supplementation can enhance physical performance, claiming that it “exhibits small but significant physiological and performance changes.”
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. 

Based on the limited data on performance and safety, some authors have not identified any conclusions and do not recommend its consumption in regards to creatine supplementation in children and adolescents [52,54]. Conversely, according to the view of the ISSN [5], younger athletes should consider a creatine supplement under certain conditions: puberty is past and he/she is involved in serious competitive training; the athlete is eating a well-balanced caloric adequate diet; he/she as well as the parents approve and understand the truth concerning the effects of creatine supplementation; supplement protocols are supervised by qualified professionals; recommended doses must not be exceeded; quality supplements are administered.

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
It’s important to remember that since everybody is different, these estimates are just that. How the numbers work out for each person will definitely vary. So many factors—like genetics, hormones, sleep, and diet—can change the rate at which our bodies burn calories. And some people may have a harder time than others when it comes losing fat or gaining muscle—again, there are so many factors at play and our body chemistries are all different. Strength training is important for many, many, many other reasons (more on that later), but if you’re looking to increase your metabolism, it’s important to have realistic expectations and know that strength training can make a difference, but probably won’t drastically affect how many calories you burn from one day to the next.
Beach muscles and Olympic lifts draw more attention. But the many little stabilizer muscles around your shoulders, hips, and midsection — collectively the core — provide a strong foundation. Challenging the stability and mobility of these key muscles with medicine balls, physioballs, mini-bands, and rotational movements (lifting, chopping) pays huge dividends.
Carducci, C., Birarelli, M., Leuzzi, V., Carducci, C., Battini, R., Cioni, G., and Antonozzi, I. Guanidinoacetate and creatine plus creatinine assessment in physiologic fluids: an effective diagnostic tool for the biochemical diagnosis of arginine:glycine amidinotransferase and guanidinoacetate methyltransferase deficiencies. Clin Chem 2002;48(10):1772-1778. View abstract.

Stand on one foot with the arch and heel hanging off of the edge of a step or platform. Hold onto something if you need help balancing. Drop your heel all the way down below the step, and then rise all the way up on your toes. Hold dumbbells to make it harder. If you can balance without holding on to something, you’ll work your core muscles, too. You'll also build more stable joints in the other leg.
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
These protective effects are similar to those seen with trimethylglycine, since they both cause an increase in liver concentrations of phosphatidylcholine (PC, causing an increase in vLDL production and efflux of triglycerides from the liver).[497] Both TMG and creatine are thought to work indirectly by preserving SAMe concentrations,[125][498] since PC synthesis requires SAMe as well (via PEMT[499]) and genes involved in fatty acid metabolism in the liver that were not affected by the diet (VLCAD and CD36) were unaffected by creatine.[125]
The failure of creatine to improve physical performance in these conditions is thought to be related to the myopathies in general, which are known to result in less phosphocreatine in skeletal muscle,[568] associated with reduced expression of the creatine transporter.[569] As creatine has once been noted to not accumulate in the skeletal muscle of people with DM1 given supplementation,[566] it is thought that the subjects did not respond to therapy.

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]
Without a doubt, you can add muscle simply by eating right and lifting weights. But to truly maximize your growth potential, supplements are a requirement. Hence, we've compiled a rundown of the 11 best mass-gain supplements on which to spend your hard-earned cash. They're listed in order of priority, from the absolute most critical, can't-do-without supplements to the less crucial yet still highly effective ingredients for packing on size. The point is to help those on a tight budget decide which supplements to buy. If money is no object, then by all means knock yourself out and use them all as directed. Because after all, as far as we're concerned, you can never have too much muscle.
If you’ve been training longer than 6–12 months, you can split your workouts into upper- and lower-body days. The most common setup is to train upper body one day and lower the next so that each area gets trained twice in one week. If you train four days per week, you can train upper body on Monday, lower Tuesday, rest Wednesday, and then do upper body again on Thursday, lower body on Friday, and then rest on the weekend.
Getting comfortable with a steady running routine is definitely something to be proud of, but when you're on that cardio grind day-in and day-out, you might be ready to change things up and take on a new challenge. Time to throw some strength training into the mix. It can be a little intimidating at first if you don't know where the hell to start, but understanding the basics can help you feel confident in your refreshed fitness routine.
The high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[24] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[25]
Tough workouts drive muscle growth, but they generally cause a lot of damage to your muscles to do so. This damage often results in soreness for several days, which can make it tough to get to the gym or sometimes even move. Many bodybuilding supplements contain ingredients that work to reduce the breakdown of muscle during workouts, making the recovery process easier on the body.
In people with COPD given either glucose placebo (40.7g) or creatine supplementation (5.7g creatine with 35g glucose) thrice daily for two weeks followed by a single dose for ten weeks, supplementation was associated with improvements in muscular strength and endurance, but not cardiovascular exercise potential.[579] A later trial of larger power using a loading phase of 22g creatine with a maintenance phase of 3.76g during rehabilitative exercise failed to replicate the improvements in skeletal muscle performance despite increased body weight seen with creatine,[580] and the failure to improve cardiovascular performance during aerobic exercise seen in both aforementioned studies has been replicated elsewhere after eight weeks supplementation, during which muscular performance was, again, unaffected.[581]
If you are somebody that is tired of not getting results, wants to avoid trial-and-error, or you just want to be told exactly what to do to reach your goals, check out our popular 1-on-1 coaching program. You’ll work with our certified NF instructors who will get to know you better than you know yourself and program your workouts and nutrition strategy for you.
When looking for a whey protein powder to purchase, seek out powders that offer at least 20 g of protein per serving (one scoop) and are low in carbohydrates (aim for 5 g per serving or less). You may run into whey protein isolate, which looks attractive because it’s a higher concentration of protein. However, avoid this one as in the extreme processing, proteins are denatured that can render them less effective. In addition, these formulas are also often chock full of artificial sweeteners. Instead, look for powders from grass-fed cows that aren’t pumped with hormones.
Weight training also provides functional benefits. Stronger muscles improve posture, provide better support for joints, and reduce the risk of injury from everyday activities. Older people who take up weight training can prevent some of the loss of muscle tissue that normally accompanies aging—and even regain some functional strength—and by doing so, become less frail.[33] They may be able to avoid some types of physical disability. Weight-bearing exercise also helps to prevent osteoporosis.[34] The benefits of weight training for older people have been confirmed by studies of people who began engaging in it even in their eighties and nineties.
Because I don’t want you to have to waste all the years and money that I did (not to mention the surgeon’s bills), I came up with a method of training and eating specifically for skinny-fat, injury-prone hard-gainers: guys who historically can’t gain muscle doing the workouts they find in magazines or on blogs. It’s also perfect for all guys over age 35 who need to be smarter with their training as they age.
Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lagging.[54] This is known as "fluffing".[55][56] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[55] It is not restricted, and many brands are available on the Internet.[57] The use of injected oil to enhance muscle appearance is common among bodybuilders,[58][59] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[60] stroke,[55] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[59][61][62] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[63]
One pilot study using 150mg/kg creatine monohydrate for a five day loading phase followed by maintenance (60mg/kg) for the remainder of the five weeks noted that supplementation was associated with fewer muscle symptoms and complaints alongside improved muscular function,[572] yet a later trial trying to replicate the obsevations using 150mg/kg daily for five weeks noted the opposite, that creatine supplementation exacerbated symptoms.[573] 
Beach muscles and Olympic lifts draw more attention. But the many little stabilizer muscles around your shoulders, hips, and midsection — collectively the core — provide a strong foundation. Challenging the stability and mobility of these key muscles with medicine balls, physioballs, mini-bands, and rotational movements (lifting, chopping) pays huge dividends.
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]
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