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]
Hopefully I didn’t put a big damper on your Captain-America fueled dreams! I just want to set proper expectations so you don’t get discouraged with slow progress, and instead get SUPER encouraged with any progress. Getting strong should be freakin’ fun! Weirdly enough, once I stopped trying to get there quickly is when I started to actually make permanent progress.
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]

In the following article I will outline the supplements that have helped me to add a massive 10 kilograms (22lbs) of solid muscle to my physique over the past year—taking my body weight from 80 kilograms (176lbs) to 90 kilograms (198lbs)—and explain how these have helped me to improve my performance and enhance my size as a natural bodybuilder, aged 35.


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;58:151-155. View abstract.
Those 5-pound dumbbells were a great place to start as a beginner, but if you've been lifting weights for a while, it's time to bump up the weight. “You can use both exercise machines and free weights,” explains Michele Olson, PhD, exercise physiologist, professor of exercise science at Auburn University Montgomery, “but, if you are not lifting heavy enough weight, it doesn’t matter if you are primarily using free weights or machines.” In order to build muscle, you must break down muscle tissue using a weight that is challenging enough to cause micro-tears, which when repaired, form denser, stronger fibers.
This post can absolutely change your life, and probably help you avoid some pitfalls. Like shrunken balls. (I am not an expert in the synthetic anabolic testosterone drugs used by bodybuilders — they carry lots of risks but pack a big punch if you want to get swole. Bulletproof is all about having massive clean energy, looking good, and living a very long time…so anabolic steroids aren’t on my roadmap.)
If you have low testosterone, your functional medicine or anti-aging physician will help you diagnose it. There are several different hormones your physician should measure, but the most important two are your free testosterone and estrogen levels, because converting too much testosterone to estrogen is a problem that’s different from not making enough testosterone in the first place. In my case, I wasn’t making very much testosterone, and what I was making my body converted to estrogen way too effectively.
Creatine is a natural source of energy for muscle contraction. The body produces creatine in the liver, kidneys, and pancreas. People can also get creatine by eating meat or fish. (Vegetarians may have lower amounts of creatine in their bodies.) Most of the creatine in the body is stored in skeletal muscle and used during physical activity. The rest is used in the heart, brain, and other tissues.
In the following article I will outline the supplements that have helped me to add a massive 10 kilograms (22lbs) of solid muscle to my physique over the past year—taking my body weight from 80 kilograms (176lbs) to 90 kilograms (198lbs)—and explain how these have helped me to improve my performance and enhance my size as a natural bodybuilder, aged 35.
A great analogy that I like is that the balance between training and recovery is like digging a hole. Each time you lift, you dig yourself deeper and make it harder to climb out of the hole. To get back out again, you have to fill in the hole to return to ground level, and the only way to fill it is with food and rest. If you overdo it in the gym by pushing too hard, you won’t be able to train as often or at a high capacity. Eventually, you’ll get injured.
Tongkat Ali, biologically called Eurycoma longifolia, is a herb found in Southeast Asia which is primarily used to boost male fertility. However, it is also known to boost testosterone levels significantly. Tongkat Ali has a low side-effect profile, been found to be generally safe and well-tolerated. A common side effect reported by users is trouble falling asleep which you can avoid by taking the supplement in the morning, preferably with breakfast.
Incubation of a β-cell with additional creatine (5-10mM), even at saturated concentrations of glucose, is able to further increase insulin secretion in response to glucose, specifically as the leucine metabolite 2-ketoisocaproic acid, potassium, and a potassium channel blocker were all ineffective.[494] This has been found to occur in rats given 2% of the diet as creatine[345] but has since failed in humans given 5g of creatine.[351]
Testosterone is the principle sex hormone responsible for the development of reproductive function in male vertebrates. Testosterone is one of the hormones referred to as androgens, which are also known of as anabolic steroids. As a steroid hormone, testosterone is derived from cholesterol and the structure of this hormone is similar across all mammals, reptiles, birds and fish.
But when a premenopausal woman’s testosterone levels are too high, it can lead to polycystic ovary syndrome (PCOS), a condition that increases the risk of irregular or absent menstrual cycles, infertility, excess hair growth, skin problems, and miscarriage. High levels of testosterone in women, whether caused by PCOS or by another condition, can cause serious health conditions such as insulin resistance, diabetes, high cholesterol, high blood pressure, and heart disease. (12)
The Branched-Chain Amino Acids, BCAAs for short, are leucine, valine and isoleucine.  Essentially, its a form of protein powder for muscle gain or other uses. These essential amino acids are not made by the body but are found in foods such as meats, dairy products and legumes. In medicine, BCAAs are used for a number of conditions, however, for many uses, further research is necessary to determine whether or not treatment is effective.
On January 16, 1904, the first large-scale bodybuilding competition in America took place at Madison Square Garden in New York City. The competition was promoted by Bernarr Macfadden, the father of physical culture and publisher of original bodybuilding magazines such as Health & Strength. The winner was Al Treloar, who was declared "The Most Perfectly Developed Man in the World".[5] Treloar won a $1,000 cash prize, a substantial sum at that time. Two weeks later, Thomas Edison made a film of Treloar's posing routine. Edison had also made two films of Sandow a few years before. Those were the first three motion pictures featuring a bodybuilder. In the early 20th century, Macfadden and Charles Atlas continued to promote bodybuilding across the world. Alois P. Swoboda was an early pioneer in America.
Creatine is produced endogenously at an amount of about 1 g/d. Synthesis predominately occurs in the liver, kidneys, and to a lesser extent in the pancreas. The remainder of the creatine available to the body is obtained through the diet at about 1 g/d for an omnivorous diet. 95% of the bodies creatine stores are found in the skeletal muscle and the remaining 5% is distributed in the brain, liver, kidney, and testes [1]. As creatine is predominately present in the diet from meats, vegetarians have lower resting creatine concentrations [2].

Discomfort can arise from other factors. Individuals who perform large numbers of repetitions, sets, and exercises for each muscle group may experience a burning sensation in their muscles. These individuals may also experience a swelling sensation in their muscles from increased blood flow (the "pump"). True muscle fatigue is experienced as a marked and uncontrollable loss of strength in a muscle, arising from the nervous system (motor unit) rather than from the muscle fibers themselves. Extreme neural fatigue can be experienced as temporary muscle failure. Some weight training programs, such as Metabolic Resistance Training, actively seek temporary muscle failure; evidence to support this type of training is mixed at best.[24] Irrespective of their program, however, most athletes engaged in high-intensity weight training will experience muscle failure during their regimens.
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.
Conflicting results have been obtained concerning the importance of testosterone in maintaining cardiovascular health.[29][30] Nevertheless, maintaining normal testosterone levels in elderly men has been shown to improve many parameters that are thought to reduce cardiovascular disease risk, such as increased lean body mass, decreased visceral fat mass, decreased total cholesterol, and glycemic control.[31]
This copyrighted, evidence-based medicine resource is provided by Natural Medicines Comprehensive Database Consumer Version. Natural Medicines Comprehensive Database disclaims any responsibility related to consequences of using any product. This monograph should not replace advice from a healthcare professional and should not be used for the diagnosis or treatment of any medical condition.
"Some say it's just a part of aging, but that's a misconception," says Jason Hedges, MD, PhD, a urologist at Oregon Health and Science University in Portland. A gradual decline in testosterone can't explain a near-total lack of interest in sex, for example. And for Hedges' patients who are in their 20s, 30s, and early 40s and having erectile problems, other health problems may be a bigger issue than aging.

You've figured out the exercises you should be doing, but what about the number of sets and repetitions? Your decision should be based on your goals. The American College of Sports Medicine recommends 4 to 6 reps for strength and hypertrophy, 8 to 12 reps for muscular strength and 10 to 15 reps for muscular endurance. They also recommend at least one set of each exercise to fatigue although you'll find that most people perform about 2 to 3 sets of each exercise. In general:
Having a spotter nearby is particularly important when using free weights. Even someone in great shape sometimes just can't make that last rep. It's no big deal if you're doing biceps curls; all you'll have to do is drop the weight onto the floor. But if you're in the middle of a bench press — a chest exercise where you're lying on a bench and pushing a loaded barbell away from your chest — it's easy to get hurt if you drop the weight. A spotter can keep you from dropping the barbell onto your chest.
At the time, low-potency creatine supplements were available in Britain, but creatine supplements designed for strength enhancement were not commercially available until 1993 when a company called Experimental and Applied Sciences (EAS) introduced the compound to the sports nutrition market under the name Phosphagen.[14] Research performed thereafter demonstrated that the consumption of high glycemic carbohydrates in conjunction with creatine increases creatine muscle stores.[15]
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.
In October 1994, the Dietary Supplement Health and Education Act (DSHEA) was signed into law in the USA. Under DSHEA, responsibility for determining the safety of the dietary supplements changed from government to the manufacturer and supplements no longer required approval from the U.S. Food and Drug Administration (FDA) before distributing product. Since that time manufacturers did not have to provide FDA with the evidence to substantiate safety or effectiveness unless a new dietary ingredient was added. It is widely believed that the 1994 DSHEA further consolidated the position of the supplement industry and lead to additional product sales.[6]
Bodybuilding supplements are dietary supplements commonly used by those involved in bodybuilding, weightlifting, mixed martial arts, and athletics for the purpose of facilitating an increase in lean body mass. The intent is to increase muscle, increase body weight, improve athletic performance, and for some sports, to simultaneously decrease percent body fat so as to create better muscle definition. Among the most widely used are high protein drinks, branched-chain amino acids (BCAA), glutamine, arginine, essential fatty acids, creatine, HMB,[1] and weight loss products.[2] Supplements are sold either as single ingredient preparations or in the form of "stacks" – proprietary blends of various supplements marketed as offering synergistic advantages. While many bodybuilding supplements are also consumed by the general public the frequency of use will differ when used specifically by bodybuilders. One meta-analysis concluded that for athletes participating in resistance exercise training and consuming protein supplements for an average of 13 weeks, total protein intake up to 1.6 g/kg of body weight per day would result in an increase in strength and fat-free mass, i.e. muscle, but that higher intakes would not further contribute.[3] The muscle mass increase was statistically significant but modest - averaging 0.3 kg for all trials and 1.0–2.0 kg, for protein intake ≥1.6 g/kg/day.[3]
Nitrate-rich foods like beets, radishes, and pomegranates are a great way to boost the production of nitric oxide (NO). Although there's very limited research examining the effects of beet root juice and pomegranate extract on resistance training, these ingredients have previously been shown to increase skeletal muscle blood flow and lead to reduced soreness, which may ultimately lead to improvements in strength and performance.[9,10]
If testosterone deficiency occurs during fetal development, then male characteristics may not completely develop. If testosterone deficiency occurs during puberty, a boy’s growth may slow and no growth spurt will be seen. The child may have reduced development of pubic hair, growth of the penis and testes, and deepening of the voice. Around the time of puberty, boys with too little testosterone may also have less than normal strength and endurance, and their arms and legs may continue to grow out of proportion with the rest of their body.

Rheumatoid arthritis. Early research shows that taking creatine by mouth daily increases lean muscle mass and may improve muscle strength, but does not improve physical functioning in adults with rheumatoid arthritis. In children, taking a specific supplement containing creatine and fatty acids twice daily for 30 days might reduce pain and swelling. But the effects of creatine alone are not clear.
How to do it: Sit comfortably into the leg press machine, pressing your back against the seat and your feet firmly planted to the platform. Lift off and press, straightening your legs so your knees assume a neutral position (not straight or severely bent). Continue lowering the platform until your knees create 90° angles, then return to the neutral starting position and repeat. 
^ Jump up to: a b c d Luckose F, Pandey MC, Radhakrishna K (2015). "Effects of amino acid derivatives on physical, mental, and physiological activities". Crit. Rev. Food Sci. Nutr. 55 (13): 1793–1807. doi:10.1080/10408398.2012.708368. PMID 24279396. HMB, a derivative of leucine, prevents muscle damage and increases muscle strength by reducing exercise-induced proteolysis in muscles and also helps in increasing lean body mass. ... The meta analysis studies and the individual studies conducted support the use of HMB as an effective aid to increase body strength, body composition, and to prevent muscle damage during resistance training.
D-aspartic acid can also help to reduce cortisol levels. Cortisol is known as the “stress” hormone because its production increases during stressful situations. High cortisol levels can have many negative side effects, such as weight gain, muscle tissue breakdown, or increased blood sugar. Taking a supplement that includes cortisol can reduce stress and prevent excess fat storage or muscle loss.
Creatine retention (assessed by urinary analysis) tends to be very high on the first loading dose (65±11%) and declines throughout the loading phase (23±27%).[203] This is likely due to increased muscular uptake when creatine stores are relatively low, which has been noted in vegetarians. So, creatine absorption is very high initially, but decreases througout the loading phase, as muscle creatine stores increase.[204]
Chin-Ups. The chin-up is the easiest way to determine someone’s relative strength. If you can knock out sets of bench with your bodyweight but can’t perform at least 5 bodyweight chin-ups then it’s time to re-evaluate your priorities. Chin-ups are an excellent mass builder for the lats, biceps, and upper back so they should take the place of machine variations like lat pulldowns whenever possible.
Creatine (/ˈkriːətiːn/ or /ˈkriːətɪn/[1] is an organic compound with the nominal formula (H2N)(HN)CN(CH3)CH2CO2H. This species exists in various modifications (tautomers) in solution. Creatine is found in vertebrates where it facilitates recycling of adenosine triphosphate (ATP), the energy currency of the cell, primarily in muscle and brain tissue. Recycling is achieved by converting adenosine diphosphate (ADP) back to ATP via donation of phosphate groups. Creatine also acts as a buffer.[2]
While the number of reps you do per set is important, of equal importance is the total number of reps you do per muscle group. The National Strength and Conditioning Association has determined that, to maximize growth, you need approximately 20–70 total reps per muscle group. Depending on which end of a rep range you’re working, this can be done in one session or over a few days (a training week, for instance), but that’s the spread you need to cover to see gains. 

Guanidoacetate (made by AGAT) then receives a methyl donation from S-adenosyl methionine via the enzyme guanidinoacetate methyltransferase (GAMT), which produces S-adenosylhomocysteine (as a byproduct) and creatine. Deficiencies in GAMT are more severe (although equally rare) relative to AGAT, resulting in severe mental retardation and autism-like symptoms.[31]
Furthermore, because creatine can help restore ATP levels, increasing energy, it can lead to reduced amounts of heart muscle stress. More energy in your life will result in less pain, stress, and boost morale in everyday life which has a significant role in improving heart health. The increased capacity to exercise is also crucial in maintaining and improving heart health.
Neurological and cognitive function has also been shown to be improved by creatine supplementation [47,48]. Rawson and Venezia [49] review the effects of creatine supplementation on cognitive function highlighting that higher brain creatine has been associated with improved neuropsychological performance. Creatine supplementation protocols have been shown to increase brain creatine and phosphocreatine contents. Cognitive processing hindered due to sleep deprivation and natural impairment due to aging can be improved by creatine supplementation. This review also highlights other possible benefits of creatine ingestion to older adults, such as improvements in: fatigue resistance, strength, muscle mass, bone mineral density, and performance of activities of daily living. Some of these benefits occur without concurrent exercise. The authors inform that discrepancies between studies do exist and are hard to explain but may be possibly due to differences in diet, race and/or supplementation protocols. However, the ideal dose of creatine to maximize brain uptake is not known. Patients have been supplemented with 40 g while in healthy adults positive results have been reported with around 20 g per day [49]. 

Furthermore, because creatine can help restore ATP levels, increasing energy, it can lead to reduced amounts of heart muscle stress. More energy in your life will result in less pain, stress, and boost morale in everyday life which has a significant role in improving heart health. The increased capacity to exercise is also crucial in maintaining and improving heart health.
This claim has not been demonstrated at this time, and a recent comparative study of buffered creatine against basic creatine monohydrate found no significant differences between the two in 36 resistance trained individuals, in regard to the effects or the accumulation of creatine in muscle tissue.[71] There also were no significant differences in the amount of adverse side-effects reported.
Creatine is used up as energy during high intensity exercise. Due to this usage, the amount of glucose required from glycogen is decreased a bit. This both preserves glycogen concentrations in skeletal muscle and reduces lactate production, which is produced when glucose is oxidized for energy. There do not appear to be any alterations in the bioenergetic status of muscle cells during low to moderate intensity exercise.
Put simply, "strength training means using resistance to create work for your muscles," says Hannah Davis, C.S.C.S. and author of Operation Bikini Body. So even if your mind jumps straight to those hardcore machines and massive weights, there are a lot of ways to create this resistance that require minimal equipment (or none at all). Bodyweight workouts can be an incredibly effective way to strength train. Squats and push-ups FTW. You can also use tools like dumbbells, medicine balls, TRX bands, resistance bands, kettlebells, and slider disks, to help get the job done, explains Davis. But if that sounds like gibberish don't worry about it. Keep it simple and focus on equipment-free routines first. No matter what you do, the most important thing is to find something that challenges you, says Davis.

Unfortunately, it’s hard to significantly increase levels through food alone. That’s where supplementation comes in. For instance, in one 12-week study of resistance-trained individuals, taking HMB in tandem with a high-intensity lifting routine significantly improved muscle strength and size compared to lifting alone. Plus, in the off-chance that you push yourself too hard, HMB helps prevent the effects of overtraining—including muscle loss.
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