Small but significant is good. It’s especially helpful during short periods of extremely powerful physical activity, particularly if those short bursts of activity are repeated, as in weightlifting, sprinting or football, for example. The study also says that creatine supplementation is associated with enhanced strength gains in strength training programs, which could be related to the greater volume and intensity of training that you can achieve when you’re taking creatine supplements. Plus, according to the study, there’s no evidence of gastrointestinal, renal or muscle cramping complications – more good news.
If you want to take creatine as a supplement for bigger and stronger muscles, then the standard protocol is to have a “loading period” where you significantly increase your creatine intake for a few days or weeks. “This can prime your muscles to increase the amount of creatine that they ‘hold,’” explains Bates. “During the loading period, you generally take 5 g of creatine four times per day. After the loading period, you decrease the amount of creatine you take to a ‘maintenance’ level of 3 to 5 g per day.” (That’s also the recommendation from the International Society of Sports Nutrition.) (5)
Without supplementation, approximately 14.6mmol (2g) of creatinine, creatine’s urinary metabolite, is lost on a daily basis in a standard 70kg male ages 20-39. The value is slightly lower in females and the elderly due to a presence of less muscle mass.[35] This amount is considered necessary to obtain in either food or supplemental form to avoid creatine deficiency. Requirements may be increased in people with higher than normal lean mass.[35][198] Creatine excretion rates on a daily basis are correlated with muscle mass, and the value of 2g a day is derived from the aforementioned male population with about 120g creatine storage capacity.[35] Specifically, the rate of daily creatine losses is about 1.6%[199]-1.7%,[25] and mean losses for women are approximately 80% that of men due to less average lean mass.[35] For weight-matched elderly men (70kg, 70-79 years of age) the rate of loss of 7.8mmol/day,[49] or about half (53%) that of younger men.
It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
3) Relatively low cholesterol. This is one nutrition category that many people overlook with these supplements, but it's arguable one of the most important. Remember, if you're going to be downing 2 of these a day, you DON'T want to be maxing out your cholesterol intake. Luckily, this whey keeps it down to 30mg per scoop (which is about 10% of your daily intake). I've seen worse and ... full review
Eat healthy fats. That's right—not only does it make food taste good, fat is good for you, as long as you are eating the right kinds and amounts of fat! Saturated fats—the fat you'll find in a stick of butter, a bag of chips, or bacon—should be limited to about 20g or less. That's the bad news. The good news is that unsaturated fats are actually beneficial, even necessary. Fat is necessary for the proper distribution of vitamins A, D, E, and K, helps promote better eyesight, and healthy skin. Fats are also important for the synthesis of hormones, so maintaining an adequate intake of them will speed up muscle-building and recovery.
Multivitamin: A bodybuilder’s regime is strict and consuming the essential nutrients is an integral part of the process. The entire process can take a very nasty turn if one is not careful with the amount and type of food intake. The intake of multi vitamins can, therefore, have a good impact on a body builder. These multivitamins are used so that essential vitamins and minerals are supplied to the body, to promote good health and also allow a constant flow of energy.
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
In vitro, creatine (0.125mM or higher) can reduce excitotoxicity from glutamate, which is thought to be secondary to preserving intracellular creatine phosphate levels.[209] Glutamate-induced excitotoxicity is caused by excessive intracellular calcium levels resulting from ATP depletion. Since high levels of calcium inside the cell are toxic, ATP preserves membrane integrity,[210] in part by promoting calcium homeostasis. When ATP is depleted, the sodium-potassium ATPase pump (Na+,K+-ATPase) stops working, leading to sodium accumulation in the cell. This reduces the activity of the sodium-calcium exchange pump, which, alongside a lack of ATP, reduces calcium efflux through the Na+,K+-ATPase. Thus, ATP depletion leads to intracellular calcium overload, loss of membrane potential, and excitotoxic cell death. Therefore, by helping preserve ATP levels, creatine is protective against excitotoxicity. This protective effect was noted after either creatine preloading or addition up to 2 hours after excitotoxicity.[209] Protection from glutamate-induced toxicity also extends to glial cells[211] and is additive with COX2 inhibition.[212]
More specifically, you can expect to end up in the upper half of these ranges ONLY if you are a beginner, younger, and/or have amazing genetics. You can expect to end up in the lower half of these ranges if you are an intermediate or advanced trainee, older, and/or have poor genetics. The average person can expect to end up somewhere in the middle. Additional details here: How Much Muscle Can You Gain?

It is prudent to note that creatine supplementation has been shown to reduce the body’s endogenous production of creatine, however levels return to normal after a brief period of time when supplementation ceases [1,6]. Despite this creatine supplementation has not been studied/supplemented with for a relatively long period. Due to this, long term effects are unknown, therefore safety cannot be guaranteed. Whilst the long term effects of creatine supplementation remain unclear, no definitive certainty of either a negative or a positive effect upon the body has been determined for many health professionals and national agencies [19,78]. For example the French Sanitary Agency has banned the buying of creatine due to the unproven allegation that a potential effect of creatine supplementation could be that of mutagenicity and carcinogenicity from the production of heterocyclic amines [78]. Long term and epidemiological data should continue to be produced and collected to determine the safety of creatine in all healthy individuals under all conditions [78].
Safety. Iron overload may cause a disease called hemochromatosis in some susceptible people. Iron supplements should only be prescribed by a doctor, and for athletes or those who train heavily, a sports physician combined with a sports dietitian may be preferable. Be sure to take care with this because iron supplements should not be taken casually. Iron supplements may cause constipation and gastric upset in some people.
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.

Even if your focus is on a particular body part, say getting flat abs or losing fat around the hips, it's important to work all your muscle groups. Spot reduction doesn't work, so doing crunches for your abs or leg lifts for your thighs isn't going to help you achieve your goal. What does work is building more lean muscle tissue and burning more calories.
How to Take It: If you decide you want to take BCAAs as one of your weight lifting supplements, you can easily get them and take them much like you would protein powders. One scoop provides 2.5g of leucine, 1.25g of isoleucine and 1.25g of valine. Take it before a workout, during or after. As with all supplementation, the aim is to reach your overall daily needs and goals.

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]


A: If your goal is the largest accrual of muscle mass possible then there may be some benefit to ingesting nutrients with a period of 30-60 minutes after your workout. Does this have to be a protein shake? No, but ideally it should be a meal lower in fat to enhance the digest rate of nutrients within the gastrointestinal tract. However, if you have just eaten a mixed macronutrient meal pre-workout then you should keep in mind that that meal is still likely digesting so there’s no need to throw down the weights after your last set and rush to your locker to slam a protein shake.
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.
Every gym has a guy shaped like a lightbulb. He's the one who neglects his lower body. If you don't want to be that guy, work your major leg muscles on the leg press machine. Place your feet on the plate with knees bent at 90 degrees. Grasp the handles and slowly push the plate out until your knees are straight but not locked. Pause and slowly return to the starting spot.
Contrary to certain rumors that animal-based protein is more suitable to trigger muscle growth than plant-based protein, a study by Mangano et al. (2017) could not provide any evidence for this. In contrast, if combined properly, plant-based protein can even have a higher biological quality. A combination of one part wheat protein (e.g. seitan) and two parts soy protein (e.g. tofu) has thus been favored by many bodybuilders. Some bodybuilders, such as Patrik Baboumian and Robert Cheeke, follow a strict vegan diet.[37]
Don’t get us wrong—cardio is important for keeping your body fat down and keeping your heart health in check. (Bonus points if you run or bike, since outdoor exercise is linked to better energy and improved mental health.) But when it comes to building muscle, hitting the treadmill won't help you much. “Every component of exercise, minus cardio, can help with muscle hypertrophy,” which is the scientific term for muscle building, says Michelle Lovitt, an exercise physiologist and trainer in Los Angeles. “Cardio tends to burn calories and puts your body in a deficit, which is great for leaning out, but not building mass.”
Vegetarians and other people who have lower total creatine levels when they start taking creatine supplements seem to get more benefit than people who start with a higher level of creatine. Skeletal muscle will only hold a certain amount of creatine; adding more won't raise levels any more. This "saturation point" is usually reached within the first few days of taking a "loading dose."
The structure of cyclocreatine is fairly flat (planar), which aids in passive diffusion across membranes. It has been used with success in an animal study, where mice suffered from a SLC6A8 (creatine transporter at the blood brain barrier) deficiency, which is not responsive to standard creatine supplementation.[97] This study failed to report increases in creatine stores in the brain, but noted a reduction of mental retardation associated with increased cyclocreatine and phosphorylated cyclocreatine storages.[97] As demonstrated by this animal study and previous ones, cyclocreatine is bioactive after oral ingestion[97][98] and may merely be a creatine mimetic, able to phosphorylate ADP via the creatine kinase system.[97]

It is regularly reported that creatine supplementation, when combined with heavy resistance training leads to enhanced physical performance, fat free mass, and muscle morphology [18-22]. A 2003 meta analysis [8] showed individuals ingesting creatine, combined with resistance training, obtain on average +8% and +14% more performance on maximum (1RM) or endurance strength (maximal repetitions at a given percent of 1RM) respectively than the placebo groups. However, contradicting studies have reported no effects of creatine supplementation on strength performance. Jakobi et al [23] found no effects of a short term creatine loading protocol upon isometric elbow flexion force, muscle activation, and recovery process. However, this study did not clearly state if creatine supplementation was administered concurrent with resistance training. Bemben et al [24] have shown no additional benefits of creatine alone or combined with whey protein for improving strength and muscle mass after a progressive 14 weeks (3 days per week) resistance training program in older men. These conflicting results can be explained by the possibility that the supplemented groups were formed by a greater amount of non-responders or even because creatine supplementation was administered on the training days only (3 times a week). This strategy has not been adequately tested as effective in middle aged and older men for maintaining post loading elevated creatine stores [5].

Weight training also requires the use of 'good form', performing the movements with the appropriate muscle group, and not transferring the weight to different body parts in order to move greater weight (called 'cheating'). Failure to use good form during a training set can result in injury or a failure to meet training goals; since the desired muscle group is not challenged sufficiently, the threshold of overload is never reached and the muscle does not gain in strength. At a particularly advanced level; however, "cheating" can be used to break through strength plateaus and encourage neurological and muscular adaptation.
3) Relatively low cholesterol. This is one nutrition category that many people overlook with these supplements, but it's arguable one of the most important. Remember, if you're going to be downing 2 of these a day, you DON'T want to be maxing out your cholesterol intake. Luckily, this whey keeps it down to 30mg per scoop (which is about 10% of your daily intake). I've seen worse and ... full review
In fact, in one new study comparing the effects of aerobic exercise versus resistance training on the psychological health of obese adolescents, researchers found that people in the resistance group experienced significantly greater self-esteem and perceived strength over four weeks. But what’s most interesting is that the feeling of getting stronger — rather than any measurable gains — was all it took to give them a boost.
A dose of 5g daily has strong evidence supporting it not causing any adverse side effects[605] and 10g has been used daily for 310 days in older adults (aged 57+/-11.1) with no significant differences from placebo.[519] Such a dose has also been demonstrated for long-term safety for people with Parkinson’s disease,[606] and at least one small retrospective study in athletes (surverying people taking creatine for up to or over a year) failed to find any significant differences in a battery of serum health parameters.[502] Other studies measuring serum parameters have also failed to find abnormalities outside the normal range.[607]

Creatine helps create essential adenosine triphosphate (ATP). This is the energy source of muscle contractions. By upping your levels, you can increase the amount of energy available to your muscles, boosting your performance. Because your muscle strength and size increases when you add weight and reps, improving your performance can be a game changer in terms of increasing your muscle mass. If you’re able to lift longer and harder, your muscles will grow. Creatine is certainly a winner among muscle building supplements.
Previous investigations have shown that a single dose of CM (8 grams) increased the number of repetitions performed during an upper-body resistance training protocol and reduced soreness at 24 and 48 hours post-exercise (compared to a placebo).7 Recently, researchers from Mississippi State University found that a single dose of CM (8 grams) significantly increased the number of lower-body repetitions compared to a placebo group.[8]
Need the motivation to push past your comfort zone and squeeze out one more push-up or bicep curl? Sure, it helps to remember that you’ll get stronger, rock more toned muscles and rev your metabolism, thanks to all that added muscle mass. But if that wasn’t enough, now comes news that all that pump-itude (yes, that’s an SNL reference) has psychological benefits, too.
Most of us have lives, or jobs, or school, or family, or whatever else that puts some kind of limit on when and how often we can work out. For example, are there certain days that you are able to work out on, and certain days you aren’t? Are you able to train 5 days per week, or would 3-4 be more ideal? Choosing a split that suits your personal schedule and is as convenient for you as possible will be crucial for adherence, and without adherence, nothing is going to work.
Research shows that strength training is especially effective at raising EPOC. That’s because, generally speaking, strength-training sessions cause more physiological stress to the body compared to cardiovascular exercise, even higher-intensity cardio intervals. However, it’s worth noting that overall exercise intensity is what makes the biggest impact on EPOC. So squats, deadlifts, and bench presses with heavy weights are going to be much more effective at raising EPOC compared to bicep curls and triceps extensions with light weights.
Increasing creatine levels in skeletal muscle to 687% of baseline (0.5mM creatine, thought to be equivalent to 5g creatine[135]) doesn’t seem to per se increase glucose uptake, but increases glucose oxidation (140% of baseline)[341] which is due to a two-fold increase in the activity of α1 and α2 subunits of AMPK, a potency comparable to 1mM of the reference drug AICAR.[341] Glucose uptake associated with AMPK has indeed been noted in diabetic people who are undergoing physical exercise[342] and in contracting skeletal muscle cells,[153][330] but according to rat[343][344][345] and in vitro studies of cells not being contracted,[341] this is not a per se effect of non-exercising tissue but an augmentation of exercise-induced glucose uptake.

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.”


On top of this, you’ll need to consume more calories than you’re burning. Burning more calories each day than you eat is a great way to lose weight, but if your goal is to put on muscle mass, this can make the process much harder. Your body requires calories to build new muscle tissue, but this can’t occur if all the body’s energy is being used up for daily processes. Because of this, some bodybuilding supplements include weight gainers to help you get more healthy calories in your diet.
Entry into neural tissues in general is mediated by the secondary creatine transporter (CrT-2) known as SLC6A10,[186] which is the same transporter that is active in a male’s testicles.[145] CrT-2 belongs to the family of SLC6 transporters that act to move solutes across the membrane by coupling transport with sodium and chloride.[187][188] Genetic deletions in the 16p11.2 region, which encodes both SLC6A8[189] and SLC6A10[186] can result in severe mental retardation in humans and is one of the causes of “Creatine Deficiency Syndrome.” Creatine Deficiency Syndrome is not only caused by lack creatine transporter expression, however, as creatine synthesis is also critical for neural function.[190].[189] Retardation caused by defective creatine synthesis[31] can be reversed with creatine supplementation and dietary changes.[191]
What kind of exercises? Work all major muscle groups, starting with the larger muscles. Always include exercises for opposing muscles: for example, work the biceps and triceps of your arms, and the quadriceps and hamstrings of your thighs. Avoid above-the-shoulder exercises if you have arthritis in your upper body, and talk to your doctor before using leg press machines if you have arthritis in your knees or hips.

Over time, we naturally lose muscle mass in a process called sarcopenia. On average, men lose about 30% of their muscle mass during their lives. Usually, this begins in your 30s and progresses slowly as you age. But, don’t despair. You can rebuild and maintain muscle mass even as you age. Often, diet and exercise are enough. But, sometimes, if the above hormones play a role, your doctor may recommend medications and additional treatments (4).
AAKG β-hydroxy β-methylbutyrate Carnitine Chondroitin sulfate Cod liver oil Copper gluconate Creatine/Creatine supplements Dietary fiber Echinacea Elemental calcium Ephedra Fish oil Folic acid Ginseng Glucosamine Glutamine Grape seed extract Guarana Iron supplements Japanese Honeysuckle Krill oil Lingzhi Linseed oil Lipoic acid Milk thistle Melatonin Red yeast rice Royal jelly Saw palmetto Spirulina St John's wort Taurine Wheatgrass Wolfberry Yohimbine Zinc gluconate

While it'’s okay to chow down on the occasional fast-food choice for convenience, a mass-gain program isn'’t an excuse to gorge on pizza and chocolate sundaes. “"Rebuilding muscle tissue broken down by training requires energy -— in other words, calories,"” says bodybuilding nutritional guru Chris Aceto. "“But many people, including many nutritionists, overestimate the energy needs for gaining mass, encouraging extreme high-calorie intakes. This often leads to an increase in bodyfat, making you bigger, for sure, but also leaving you fat." In general, aim for 300-500 more calories every day than your body burns through exercise and normal functioning (multiply bodyweight by 17). And that'’s divided among six meals a day.

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


Parameters of lung function (main cause of death in ALS is declining respiratory function) have not benefited after creatine supplementation, and when quality of life is measured, there is no benefit either. Despite one study failing to find any significant differences in mortality risk, two other studies have suggested that creatine may reduce the risk. The results were nonsignificant, but due to all treatments being well tolerated it is thought that creatine may still play a role as an adjuvant.
A good way to determine how much fat in grams you should be taking in is to multiply your calorie intake by 0.001 for maximum trans-fats; by 0.008 for maximum saturated fats; and by 0.03 for the "good fats". For example, for a 2,500-calorie diet, you would limit trans-fats to 3g or less, saturated fats to 20g or less, and up to 75g of mono- and polyunsaturated fats.
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]

Despite the fact that BCAAs may offer some benefits, you should keep in mind that these three amino acids are also present in any quality whey protein that you purchase. You can also get these essential amino acids from food sources. Basically, as long as you’re meeting your daily protein intake goals, you’re probably getting enough of these essential amino acids. Research supports this approach. So, why spend more on another supplement?
Syndromes caused by problems metabolizing creatine. Some people have a disorder that prevents their body from making creatine. This can lead to low levels of creatine in the brain. Low levels of creatine in the brain can lead to decreased mental function, seizures, autism, and movement problems. Taking creating by mouth daily for up to 3 years can increase creatine levels in the brain in children and young adults with a disorder of creatine production called guanidinoacetate methyltransferase (GAMT) deficiency. This can help improve movement and reduce seizures. But it doesn't improve mental ability. Arginine-glycine amidinotransferase (AGAT) deficiency is another disorder that prevents the body from making creatine. In children with this condition, taking creatine for up to 8 years seems to improve attention, language, and mental performance. But taking creatine does not seem to improve brain creatine levels, movement, or mental function in children who have a disorder in which creatine isn't transported properly.
Small but significant is good. It’s especially helpful during short periods of extremely powerful physical activity, particularly if those short bursts of activity are repeated, as in weightlifting, sprinting or football, for example. The study also says that creatine supplementation is associated with enhanced strength gains in strength training programs, which could be related to the greater volume and intensity of training that you can achieve when you’re taking creatine supplements. Plus, according to the study, there’s no evidence of gastrointestinal, renal or muscle cramping complications – more good news.
Nephrotoxic drugs. Because taking high doses of creatine might harm your kidneys, there is concern about combining creatine with drugs that might damage the kidneys (nephrotoxic drugs). Potentially nephrotoxic drugs include nonsteroidal anti-inflammatory drug (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), cyclosporine (Neoral, Sandimmune) and others.
In today's extra-large society, we tend to focus on the admirable guys who train hard and switch up their diet to transform their bodies by losing weight. We highlight their quests to lead healthier lives every chance we get — but there's another side of the wellness scale that can be just as difficult, depending on your body's makeup: Gaining mass and muscle.
In standard dosages (5-10g creatine monohydrate) the bioavailability of creatine in humans is approximately 99%,[68][83] although this value is subject to change with different conjugates (forms) of creatine and dosages.[83] Coingestion of cyclocreatine (an analogue) can reduce uptake by about half[131] and coincubation of taurine, choline, glycine, or beta-alanine had minimal attenuation of absorption, which is likely not practically relevant.[131] The inhibition noted with cyclocreatine may be due to receptor saturation.

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.

Due to the growing concerns of the high cost, health consequences, and illegal nature of some steroids, many organizations have formed in response and have deemed themselves "natural" bodybuilding competitions. In addition to the concerns noted, many promoters of bodybuilding have sought to shed the "freakish" perception that the general public has of bodybuilding and have successfully introduced a more mainstream audience to the sport of bodybuilding by including competitors whose physiques appear much more attainable and realistic.
The general sentiment among nutrition experts is that creatine monohydrate is, for most people, the best bet. It’s the cheapest form and more importantly, it’s the most well-researched. Hundreds of studies have been performed on creatine monohydrate and there’s no evidence of ill effects, whereas many of the more novel forms of creatine have one or sometimes no studies supporting them.
Other areas of research include therapeutic uses of creatine to help patients with muscle wasting caused by disease states such as muscular dystrophy and amyotrophic lateral sclerosis (ALS). Small-scale preliminary studies show some gains in strength may be possible for these patients, which could improve their quality of life. One study of 81 patients with various neurologic diseases found that giving 10 g/day of creatine for five days, followed by 5 grams for another week, increases their muscle strength by about 10% [20]. Large-scale studies should be done before recommendations are made to such patients.

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.

Bodybuilders do cardio training such as running and using a StairMaster StepMill to burn fat and make their muscles more visible. “Do cardio throughout the year at least three days a week for at least 30-40 minutes, whether it be first thing in the morning on an empty stomach or after a post-workout protein shake,” says Heath. “Cardio won’t kill your gains as much as you think, you’ll see how much muscle you really have.” Break a sweat to stay lean ’round the clock.
The incidence of liver damage from herbal and dietary supplements is about 16–20% of all supplement products causing injury, with the occurrence growing globally over the early 21st century.[2] The most common liver injuries from weight loss and bodybuilding supplements involve hepatocellular damage with resulting jaundice, and the most common supplement ingredients attributed to these injuries are catechins from green tea, anabolic steroids, and the herbal extract, aegeline.[2]
It’s true—your genes can play a role when it comes to building muscle. In general, there are two types of muscle fibers: Type I, which are slow twitch, and Type II, which are fast twitch. Depending on which you have more of, you may have an easier or harder time gaining muscle. “Fast twitch muscle fibers are two times as thick as slow twitch muscle fibers, lending to the overall thickness of the muscle without any activity,” explains Lovitt. “Those people with a genetic predisposition of a high percentage of these fibers can increase muscle size very easily while the people with a higher percentage of slow twitch muscle fibers have to work really hard to put on mass.” It’s the reason why a world-class sprinter genetically has more fast twitch muscle fibers than a world-class marathoner—it comes down to what we’re born with.
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]
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