In natural contests, the testing protocol ranges among organizations from lie detectors to urinalysis. Penalties also range from organization to organization from suspensions to strict bans from competition. It is also important to note that natural organizations also have their own list of banned substances and it is important to refer to each organization's website for more information about which substances are banned from competition. There are many natural bodybuilding organizations; some of the larger ones include: MuscleMania, Ultimate Fitness Events (UFE), INBF/WNBF, and INBA/PNBA. These organizations either have an American or worldwide presence and are not limited to the country in which they are headquartered.
Creatine ethyl ester increases muscle levels of creatine to a lesser degree than creatine monohydrate. It may also result in higher serum creatinine levels due to creatine ethyl ester being converted into creatinine via non-enzymatic means in an environment similar to the digestive tract. At equal doses to creatine monohydrate, ethyl ester has failed to increase water weight after 28 days of administration (indicative of muscle deposition rates of creatine, which are seemingly absent with ethyl ester).