Cornelissen VA, Defoor JG, Stevens A, Schepers D, Hespel P, Decramer M, Mortelmans L, Dobbels F, Vanhaecke J, Fagard RH, Vanhees L. Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. Clin Rehabil. 2010;24:988–999. doi: 10.1177/0269215510367995. [PubMed] [CrossRef]
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
In otherwise healthy adults subject to leg immobilization for two weeks while taking 20g creatine daily during immobilization and then 5g daily during eight weeks of rehabilitation, it was noted that the creatine group failed to reduce atrophy during the immobilization (10% reduction in cross sectional area and 22-25% reduction in force output) despite preventing a decrease in phosphocreatine, yet experienced a significantly enhanced rate of regrowth and power recovery. A similarly structured and dosed study has also noted greater expression of skeletal muscle, GLUT4 expression, and a 12% increase in muscle phosphocreatine content.
In a pilot study on youth with cystic fibrosis, supplementation of creatine at 12g for a week and 6g for eleven weeks afterward was associated with a time-dependent increase in maximal isometric strength reaching 14.3%, which was maintained after 12-24 weeks of supplement cessation (18.2% higher than baseline). This study noted that more patients reported an increase in wellbeing (9 subjects, 50%) rather than a decrease (3, 17%) or nothing (6, 33%) and that there was no influence on chest or lung symptoms.
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:
Another supplement that’s ideal to take pre-workout is protein. Depending on your goals and your workout time, taking protein before your workout can help you keep your energy levels elevated while working out. Make sure you give yourself at least an hour between the time you take your protein and your workout time so that your body has time to digest.
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Creatine supplementation may also be of benefit to injured athletes. Op’t Eijnde et al  noted that the expected decline in GLUT4 content after being observed during a immobilization period can be offset by a common loading creatine (20g/d) supplementation protocol. In addition, combining CM 15g/d for 3 weeks following 5 g/d for the following 7 weeks positively enhances GLUT4 content, glycogen, and total muscle creatine storage .
1. Are you tracking calories? Doesn't have to be religiously but one should have a general idea of where they're at if the goal is mass gain and things have stalled. I'm not talking about weighing every gram of food you put in your mouth and meticulously logging your life on MyFitnessPal. As long as you're aware (within 100-200 calories) of what's going in, you should have an idea of what to adjust.
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, yet a later trial trying to replicate the obsevations using 150mg/kg daily for five weeks noted the opposite, that creatine supplementation exacerbated symptoms.