One case study on a subject with a methylentetrahydrofolate reductase (MTHFR) 677TT homozygote, a relatively common genetic mutation known as “mild MTHFR deficiency,” which causes mild homocysteinemia,[310] has seen benefits due to creatine supplementation where homocysteine was approximately halved (49% reduction) while CT heterozygotes and CC homozygotes (n=9) were unaffected.[311] Additionally, one rat study suggested a possible role for creatine in reducing homocysteine levels in a model of high uric acid levels (model for end stage renal disease[312]) but this was not replicated when investigated in humans.[313]
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.

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]
Despite a possible decreasing creatine content in the muscles when maintenance is deemed suboptimal, the overall retention of weight and lean mass is merely additive over time. This is thought to be due to increases in skeletal muscle production (increase in body weight) compensating for the progressive declines in water and glycogen content (decreases in body weight).
Peirano, R. I., Achterberg, V., Dusing, H. J., Akhiani, M., Koop, U., Jaspers, S., Kruger, A., Schwengler, H., Hamann, T., Wenck, H., Stab, F., Gallinat, S., and Blatt, T. Dermal penetration of creatine from a face-care formulation containing creatine, guarana and glycerol is linked to effective antiwrinkle and antisagging efficacy in male subjects. J.Cosmet.Dermatol. 2011;10(4):273-281. View abstract.
Hip flexor “crescent” lunge — Kneel down on one knee, with the front knee bent and thigh parallel to the ground. Lift your hands overhead and form a straight line between your head, spine and pelvis. Alternate about five times between straightening your front leg and bringing your hands down to frame the front foot, then bending your front knee again and lifting your arms back up. Hold each position for about 10 seconds at a time.

Stand with your feet slightly wider than shoulder width with a kettlebell about a foot in front of you. With your weight in your heels, hinge at your hips while lowering your hands to the kettlebell handle. Grab the kettlebell with an overhand grip,  “Hike” the kettlebell back between your legs, catching the force of the moving kettlebell with your hips. Exhale as you swing the kettlebell forward by thrusting your hips, straightening your legs, and squeezing your glutes and abs. Once the kettlebell reaches chest height, inhale as you allow it to fall, and guide it back to the “hiked” position.
Testosterone replacement therapy is currently only FDA approved for men who have been diagnosed with hypogonadism, but it’s also prescribed off-label for older men who take it in hopes that it will improve their libido. The use of testosterone therapy is increasingly common in the United States, with more than 2 million men receiving the therapy. Not every man benefits from taking testosterone supplements. Testosterone is available in different forms, including topicals such as gels, creams, and patches; injections; and pellets that are surgically placed directly beneath the skin. (7)
Prison food isn’t as bad as people think. Prisoners often get three meals a day. Meals need to meet a certain amount of calories. You don’t need that much protein to build muscle, but prisoners can buy protein powder (and also extra food like oatmeal). Prisoners aren’t underfed in most western countries. The diet may not be optimal, but it’s sufficient to build muscle.
Creatine is classified as a "dietary supplement" under the 1994 Dietary Supplement Health and Education Act and is available without a prescription. Creatine is not subjected to FDA testing, and the purity and hygienic condition of commercial creatine products may be questionable [21]. A 1998 FDA report lists 32 adverse creatine-associated events that had been reported to FDA. These include seizure, vomiting, diarrhea, anxiety, myopathy, cardiac arrhythmia, deep vein thromboses and death. However, there is no certainty that a reported adverse event can be attributed to a particular product [22]. A recent survey of 28 male baseball players and 24 male football players, ages 18 to 23, found that 16 (31%) experienced diarrhea, 13 (25%) experienced muscle cramps, 7 (13%) reported unwanted weight gain, 7 (13%) reported dehydration, and 12 reported various other adverse effects [23].
The function of the gluteus maximus is primarily upper leg (thigh) extension, such as moving the upper leg backward—think rising from a squat position. Another way of thinking about this is bringing the torso upright after being hinged forward. Think of a kettlebell swing and you’ll get a good visual for the major action of the gluteus maximus muscle.

In males, testosterone is synthesized primarily in Leydig cells. The number of Leydig cells in turn is regulated by luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In addition, the amount of testosterone produced by existing Leydig cells is under the control of LH, which regulates the expression of 17β-hydroxysteroid dehydrogenase.[132]
The main storage area of creatine in the human body is the skeletal (contractile) muscle, which holds true for other animals. Therefore, consumption of skeletal muscle (meat products) is the main human dietary source of creatine. Since vegetarians and vegans lack the main source of dietary creatine intake, which has been estimated to supply half of the daily requirements of creatine in normal people, both vegetarians and vegans have been reported to have lower levels of creatine.[58][59] This also applies to other meat-exclusive nutrients, such as L-Carnitine.[58]
Protein powder is a popular go-to supplement. Though the first protein powders to hit the market tasted like chalk, today’s powders are cheap and delicious. They’re as good as or better than other protein sources for bioavailability and amino acid balance, which makes them very useful when you want to eat chocolate with the nutritional profile of chicken. Whey and casein protein are processed from milk, and can be essentially treated as dehydrated foodstuff. And they’re high in calcium.
It doesn’t get more natural than getting a good night’s sleep. Research published in the Journal of the American Medical Association showed that lack of sleep can greatly reduce a healthy young man’s testosterone levels. That effect is clear after only one week of reduced sleep. Testosterone levels were particularly low between 2 and 10 p.m. on sleep-restricted days. Study participants also reported a decreased sense of wellbeing as their blood testosterone levels dropped.