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Han:SPRD‐cy rats (human polycystic kidney disease model[514][515]) have pre-existing renal damage, which is accelerated upon ingestion of creatine supplementation at 0.3% of the diet for five days and 0.03-0.05% for the next 35 days (equivalent to human loading and maintenance).[516] During this particular disease state, renal water content and size progressively increases.[514][515] Since creatine supplementation furthered the increase by an additional 2.1%, it was thought that this property of creatine explained the 23% increased cyst scores seen relative to control.[516]
An exercise should be halted if marked or sudden pain is felt, to prevent further injury. However, not all discomfort indicates injury. Weight training exercises are brief but very intense, and many people are unaccustomed to this level of effort. The expression "no pain, no gain" refers to working through the discomfort expected from such vigorous effort, rather than to willfully ignore extreme pain, which may indicate serious soft tissue injuries. The focus must be proper form, not the amount of weight lifted.[23]

Myotonic Dystrophy type I (DM1) is an inhereted muscular disorder caused by an expanded CTG repeat in the DMPK gene on chromosome 19q13.3 (genetic cause of the disorder[561]) resulting in muscular degeneration and myotonia. The related myopathy, Myotonic Dystrophy type II (DM2) which is also known as proximal myotonic myopathy (PROMM) is due to a CCTG repeat on 3q,[562] and is less affected by myotonia and more by muscular pain and weakness. There is no cure for either because they are genetic disorders, so current therapies are aimed at reducing side-effects. Therapies include modafinil for the somnolence[563] and perhaps creatine for the reduction in strength and functionality.[548]

Recently, studies are coming out that show a general decline in testosterone levels of men in the United States and around the world. The trend is across the board and doesn’t appear to be caused simply by a decline in health, aging or an increase in obesity rates. It could be caused because of chemicals or environmental factors. In any case, low levels of testosterone can affect many areas of your health, including your ability to build muscle. If you suspect that you have low testosterone levels, you can ask your doctor to test you for it. In addition to traditional hormone therapies, there are also many natural ways to boost your levels including through supplements, some of which will be discussed later in this article.
Synthesis primarily takes place in the kidney and liver, with creatine then being transported to the muscles via the blood. The majority of the human body's total creatine and phosphocreatine stores is located in skeletal muscle, while the remainder is distributed in the blood, brain, and other tissues.[17][18][20] Typically, creatine is produced endogenously at an estimated rate of about 8.3 mmol or 1 gram per day in young adults.[16][17] Creatine is also obtained through the diet at a rate of about 1 gram per day from an omnivorous diet.[17][18] Some small studies suggest that total muscle creatine is significantly lower in vegetarians than non-vegetarians, as expected since foods of animal origin are the primary source of creatine. However, subjects happened to show the same levels after using supplements.[21]
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