Older women with knee osteoarthritis given supplemental creatine at 20g for five days followed by 5g for the rest of the twelve week trial experienced improvements in stiffness (52% reduction), pain (45%), and physical function (41%) as assessed by WOMAC, despite no improvements in physical power output relative to placebo.[425] This study paired supplementation and placebo with a mild exercise regimen.[425]
Testosterone is used as a medication for the treatment of males with too little or no natural testosterone production, certain forms of breast cancer,[10] and gender dysphoria in transgender men. This is known as hormone replacement therapy (HRT) or testosterone replacement therapy (TRT), which maintains serum testosterone levels in the normal range. Decline of testosterone production with age has led to interest in androgen replacement therapy.[109] It is unclear if the use of testosterone for low levels due to aging is beneficial or harmful.[110]

Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[42][43][44] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.


Studies with animal and cellular models demonstrated positive effect of creatine ingestion on neurodegenerative diseases. These effects have been attributed to improved overall cellular bioenergetics due to an expansion of the phosphocreatine pool [50]. Creatine deficiency syndromes, due to deficiency of glycine amidinotransferase and guanidinoacetate methyltransferase, can cause decreases or complete absence of creatine in the central nervous system. Syndromes of this nature have the possibility to be improved by supplementing orally with creatine. Brain creatine deficiency resulting from ineffective crea T1 has been shown not to be effectively treated with oral creatine supplementation [51]. Additionally, oral creatine administration in patients with myopathies has shown conflicting results depending on the type of myopathy and creatine transport systems disorders [4].
You see, there is only so much muscle that the human body is capable of building in a given period of time. So, if you supply your body with MORE calories than it’s actually capable of putting towards the process of building new muscle… it’s not going to magically lead to additional muscle being built. It’s just going to lead to additional fat being gained.
Safety. In general health terms, most medical opinion is that up to three cups of coffee a day are not harmful, and may even have some benefits, although some people respond to the stimulant properties with more problems than others. Heart palpitations and restlessness are experienced by some caffeine drinkers. In pregnancy, one or two cups each day are thought to be without harm to the fetus.
Kornblum, C., Schroder, R., Muller, K., Vorgerd, M., Eggers, J., Bogdanow, M., Papassotiropoulos, A., Fabian, K., Klockgether, T., and Zange, J. Creatine has no beneficial effect on skeletal muscle energy metabolism in patients with single mitochondrial DNA deletions: a placebo-controlled, double-blind 31P-MRS crossover study. Eur J Neurol 2005;12:300-309. View abstract.
That soreness you feel post-strength session may seem like a setback. Yet over time, you’ll come to acknowledge that it signifies you’re getting stronger. “You think, ‘I’ve done something worthwhile. My body is telling me I’ve had a workout.’ You look forward to the fatigue and interpret it in a positive way,” says John Spence, PhD, professor of physical education and recreation at the University of Alberta in Canada, who wrote a review on the effect of exercise on self-esteem. (Wondering how sore is too sore to work out? Here’s your answer.)
HMB supplementation is claimed to build muscle size and strength and promote fat loss in conjunction with a strength program. Studies of HMB have shown some benefit to strength athletes in building muscle bulk but the benefits are relatively small and the cost of HMB is high. The effective dose seems to be 3 grams/day divided into 1 gram three times a day. Probably not worth taking. Beta-alanine is the new guy on the block and has not been evaluated sufficiently in my view. It may provide some advantage in high-intensity sports like weight training but it’s much too early to know that it does. Some early studies are flawed. Save your money or try creatine instead.

Aging (senescence, specifically) is characterized by deterioration in many biological processes, including energy supply and regulation of oxidative stress. Therefore, there are good reasons to believe that creatine may improve numerous variables that often worsen with age, including physical function and quality of life in people with osteoarthritis, blood lipids, blood sugar regulation in type 2 diabetes, and cognition. Speaking of which…

Creatine is a hydrophilic polar molecule that consists of a negatively charged carboxyl group and a positively charged functional group [64]. The hydrophilic nature of creatine limits its bioavailability [65]. In an attempt to increase creatines bioavailability creatine has been esterified to reduce the hydrophilicity; this product is known as creatine ethyl ester. Manufacturers of creatine ethyl ester promote their product as being able to by-pass the creatine transporter due to improved sarcolemmal permeability toward creatine [65]. Spillane et al [65] analyzed the effects of a 5 days loading protocol (0.30 g/kg lean mass) followed by a 42 days maintenance phase (0.075 g/kg lean mass) of CM or ethyl ester both combined with a resistance training program in 30 novice males with no previous resistance training experience. The results of this study [65] showed that ethyl ester was not as effective as CM to enhance serum and muscle creatine stores. Furthermore creatine ethyl ester offered no additional benefit for improving body composition, muscle mass, strength, and power. This research did not support the claims of the creatine ethyl ester manufacturers.

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.
A proper warm-up is an important part of an effective strength workout. Start by foam rolling your muscles to wake 'em up. "Foam rolling loosens up tight muscles so that they work the way they're designed to," says Davis. A dynamic warm-up is another important part of your pre-workout routine, it preps your muscles for the work they're about to do and helps increase your range of motion. Increasing your range of motion allows you to go deeper into those squats and fully extend those bicep curls, which means more muscle recruitment and better results. "These two combined reduce your risk of injury and allow you to push harder during your workout," says Davis. Get started with this five-minute warm-up.

Laying down on your back, bend your knees and bring them parallel while hip distance apart. Push off the bottom of your feet and drive through with your heels, extending your hips vertically up as you round your back. You should feel your core engaged and weight supported by your glutes, thighs, back and heels. Extend while you keep your chin tucked to your chest and core engaged, then reverse to lower your hips down. You can also increase the difficulty by raising one leg in the air at a time as you hold your hips up, or using a barbell held over your hips.
de Salles Painelli V, Alves VT, Ugrinowitsch C, et al. Creatine supplementation prevents acute strength loss induced by concurrent exercise. Eur J Appl Physiol 2014;114(8):1749-55.del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids 2012;42(6):2299-305. View abstract.
Children: Creatine is POSSIBLY SAFE in children when taken by mouth appropriately. Creatine 3-5 grams daily for 2-6 months has been taken safely in children 5-18 years of age. Creatine 2 grams daily for 6 months has been taken safely in children 2-5 years of age. Additionally, creatine 0.1-0.4 grams/kg daily for up to 6 months has been taken safely in both infants and children.
There are many potential reasons, but I am going to keep it simple and give you just two. The first and most common reason people suffer from underactive glutes or “glute amnesia” is due to lifestyle. Even when people train hard every day, if they spend the majority of the remainder of the day sitting down, then they are simply not using their glutes. And remember the old saying - if you don’t use it, you lose it. Unfortunately, this is just what happens with your glutes.
In competitive bodybuilding, bodybuilders aspire to develop and maintain an aesthetically pleasing body and balanced physique.[16][17] In prejudging, competitors do a series of mandatory poses: the front lat spread, rear lat spread, front double biceps, back double biceps, side chest, side triceps, Most Muscular (men only), abdominals and thighs. Each competitor also performs a personal choregraphed routine to display their physique. A posedown is usually held at the end of a posing round, while judges are finishing their scoring. Bodybuilders usually spend a lot of time practising their posing in front of mirrors or under the guidance of their coach.
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).

In addition to the proper amount of sleep, do not overdo your training regimen. While you might be tempted to think that "more is better," in fact the opposite is true. You can reach a point known as "over-training", in which you'll lose the ability to "pump" (engorge the muscles with oxygen-rich blood) your muscles, and this can even lead to muscle wasting—exactly the opposite of what you are trying to achieve. Here are some symptoms to be aware of if you think you may be falling into the over-training zone:


Citrulline Malate is an amino acid also known as L-Citrulline and is taken for many different medical conditions. There is some research that shows that the amino acid may help improve performance while exercising by reducing fatigue. What does that mean for you? In your muscle building efforts, you can use this supplement to help you make it through longer, harder workouts. This will spur more muscle building in response to the trauma your muscles experience in a tough workout. Not only that, but Citrulline Malate can also help reduce soreness after a workout. Who doesn’t want to avoid feeling sore? Reduced soreness means you can get back to the gym the next day with renewed enthusiasm.

Creatine is most commonly used for improving exercise performance and increasing muscle mass in athletes and older adults. There is some science supporting the use of creatine in improving the athletic performance of young, healthy people during brief high-intensity activity such as sprinting. Because of this, creatine is often used as a dietary supplement to improve muscle strength and athletic performance. In the U.S., a majority of sports nutrition supplements, which total $2.7 billion in annual sales, contain creatine.


Testosterone was first used as a clinical drug as early as 1937, but with little understanding of its mechanisms. The hormone is now widely prescribed to men whose bodies naturally produce low levels. But the levels at which testosterone deficiency become medically relevant still aren’t well understood. Normal testosterone production varies widely in men, so it’s difficult to know what levels have medical significance. The hormone’s mechanisms of action are also unclear.
The body's pool of creatine can be replenished either from food (or supplements) or through synthesis from precursor amino acids. Dietary sources include beef, tuna, cod, salmon, herring, and pork [2]. The normal dietary intake of creatine is 1-2 g/day, although vegetarians may consume less [3,4]. Dietary creatine is absorbed from the intestines into the bloodstream. If the dietary supply is limited, creatine can be synthesized from the body stores of the amino acids glycine, arginine, and methionine. The kidneys use glycine and arginine to make guanidinoacetate, which the liver methylates to form creatine [1], which is transported to the muscle cells for storage. It is also stored in the kidneys, sperm cells, and brain tissue [5].
Creatine ethyl ester increases muscle levels of creatine to a lesser degree than creatine monohydrate.[72] It may also result in higher serum creatinine levels[73] due to creatine ethyl ester being converted into creatinine via non-enzymatic means in an environment similar to the digestive tract.[74][75] 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).[76] 

Sculthorpe et al (2010) has shown that a 5 day (25g/d) loading protocol of creatine supplementation followed by a further 3 days of 5 g/d negatively influence both active ankle dorsiflexion and shoulder abduction and extension range of movement (ROM) in young men. There are two possible theories to explain these effects: 1) Creatine supplementation increases intracellular water content resulting in increased muscle stiffness and resistance to stretch; 2) Neural outflow from the muscle spindles is affected due to an increased volume of the muscle cell. The authors highlight that the active ROM measures were taken immediately after the loading phase and the reduced active ROM may not be seen after several weeks of maintenance phase [45]. Hile et al [46] observed an increase in compartment pressure in the anterior compartment of the lower leg, which may also have been responsible for a reduced active ROM.
In people who are fairly active, the glutes are usually one of the strongest muscle groups in the entire body, due to the need to support the sacrum and femur, areas of the lower and mid body where the glute muscles attach to. Together the glute muscles help with exercises or activities such as: lifting and lowering when sitting, thrusting, climbing stairs, jumping, and balancing the lower body. For the overall most functional lower body strength, the glutes are exercised in proportion to other muscles of the legs, including the quadriceps and calves.
show that total testosterone levels increase after exercising, especially after resistance training. Low testosterone levels can affect your sex drive and your mood. The good news is that exercise improves mood and stimulates brain chemicals to help you feel happier and more confident. Exercise also boosts energy and endurance, and helps you to sleep better. Fitness experts recommend 30 minutes of exercise every day.
In regard to practical interventions, concurrent glycogen loading has been noted to increase creatine stores by 37-46% regardless of whether the tissue was exercised prior to loading phase.[176] It is important to note, however, that creatine levels in response to the creatine loading protocol were compared in one glycogen-depleted leg to the contralateral control leg, which was not exercised.[176] This does not rule out a possible systemic exercise-driven increase in creatine uptake, and the increase in creatine noted above[176] was larger than typically seen with a loading protocol (usually in the 20-25% range). Consistent with an exercise-effect, others have reported that exercise itself increases creatine uptake into muscle, reporting 68% greater creatine uptake in an exercised limb, relative to 14% without exercise.[153]
It is prudent to note that creatine supplementation has been shown to reduce the body’s endogenous production of creatine, however levels return to normal after a brief period of time when supplementation ceases [1,6]. Despite this creatine supplementation has not been studied/supplemented with for a relatively long period. Due to this, long term effects are unknown, therefore safety cannot be guaranteed. Whilst the long term effects of creatine supplementation remain unclear, no definitive certainty of either a negative or a positive effect upon the body has been determined for many health professionals and national agencies [19,78]. For example the French Sanitary Agency has banned the buying of creatine due to the unproven allegation that a potential effect of creatine supplementation could be that of mutagenicity and carcinogenicity from the production of heterocyclic amines [78]. Long term and epidemiological data should continue to be produced and collected to determine the safety of creatine in all healthy individuals under all conditions [78].
For several years, research studies have shown that adolescents concerned with both athletics and appearance are taking performance-enhancing supplements. A study by the American Academy of Pediatrics of middle-school and high-school students ages 10 to 18 years found creatine use in all grades 6 through 12. About 5.6% of the study participants and 44% of high-school senior athletes admitted taking creatine.
Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis.[26] Insulin has steroid-like effects in terms of muscle gains.[27] It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass.[28] Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.[29]
In males, the testosterone test can help find the reason for sexual problems, like reduced sex drive or erectile dysfunction. If you’re having a hard time getting your partner pregnant, the test can tell if your blood testosterone level is low. It can also screen for problems with the hypothalamus or pituitary gland. This controls how much testosterone your body makes.

Co-ingesting creatine with caffeine partially negated the benefits of creatine supplementation (at 5mg/kg bodyweight) during the loading phase in one study.[590] The exact mechanism responsible for this effect is not known, but might be related to opposing actions on muscle contraction time.[591] However, another study in trained men found that co-ingestion of 300mg caffeine per day during creatine loading at 20g per day (split into 4 doses) had no effect on bench press 1RM, time to fatigue, or sprinting ability.[592] However, this study also found that creatine alone or when combined with caffeine had no effect on any of these parameters over placebo, either. Thus, the study may have been underpowered or done in too short a time frame (the test was done after only 5 days of loading) to observe any possible effects.[592]
^ Southren AL, Gordon GG, Tochimoto S, Pinzon G, Lane DR, Stypulkowski W (May 1967). "Mean plasma concentration, metabolic clearance and basal plasma production rates of testosterone in normal young men and women using a constant infusion procedure: effect of time of day and plasma concentration on the metabolic clearance rate of testosterone". The Journal of Clinical Endocrinology and Metabolism. 27 (5): 686–94. doi:10.1210/jcem-27-5-686. PMID 6025472.
If you want to take creatine as a supplement for bigger and stronger muscles, then the standard protocol is to have a “loading period” where you significantly increase your creatine intake for a few days or weeks. “This can prime your muscles to increase the amount of creatine that they ‘hold,’” explains Bates. “During the loading period, you generally take 5 g of creatine four times per day. After the loading period, you decrease the amount of creatine you take to a ‘maintenance’ level of 3 to 5 g per day.” (That’s also the recommendation from the International Society of Sports Nutrition.) (5)

The United States Army is about to undertake a dramatic and unprecedented overhaul to the way it tests, and promotes, military fitness. The man who headed the research into the new standards talks with us about how and why, as well as the future of Army nutrition and how the Army plans to circulate 80,000 kettlebells to bases around the globe. January 22, 2019 • 43 min read

Make no mistake: Eating for muscle is just as important as lifting for muscle. The foods you grab in the morning on the way to work, the meals you pack for lunch and mid-afternoon, what you put into your body immediately following your workout, and your final meal of the day impact your results as much as, if not more than, the number of reps you squeeze out at the end of a set. But in reality, it can be tough to stick to a "“clean"” diet when you'’re busy. We know that adding another layer of complexity to life in the form of reading food labels and studying ingredient lists just isn'’t an option for most of us. Not to mention actually preparing all those healthy meals.


For example, say you are pursuing a muscle power objective in which you have decided to perform 3 sets of 8 repetitions each. You'll want to make sure you don't add too much weight so that you are able to perform all 8 repetitions before your muscles are too tired to finish the set. Conversely you'll want to make sure you add enough weight so that you are not simply breezing past the repetitions and finish your sets of plenty of energy still left in the tank. While it may take a few workout sessions to find the right combination, once you'll do it'll be easy to monitor and increase weight as you progress.
In the stomach, creatine can degrade by about 13% due to the digestive hormone pepsin, as assessed by simulated digestion.[127] Although creatinine is a known byproduct of creatine degradation, simulated gastric digestion did not increase creatinine levels, indicating that other breakdown products were formed. However, creatinine was noted to increase in the presence of pancreatin, a mixture of pancreatic enzymes.[127] 
A retrospective study [81], that examined the effects of long lasting (0.8 to 4 years) CM supplementation on health markers and prescribed training benefits, suggested that there is no negative health effects (including muscle cramp or injuries) caused by long term CM consumption. In addition, despite many anecdotal claims, it appears that creatine supplementation would have positive influences on muscle cramps and dehydration [82]. Creatine was found to increase total body water possibly by decreasing the risk of dehydration, reducing sweat rate, lowering core body temperature and exercising heart rate. Furthermore, creatine supplementation does not increase symptoms nor negatively affect hydration or thermoregulation status of athletes exercising in the heat [83,84]. Additionally, CM ingestion has been shown to reduce the rate of perceived exertion when training in the heat [85].
The right amount of workout: It is highly possible that the protein powder you are taking doesn’t work on your body. Supplements should only be taken if you have a rigorous workout schedule or else, it will turn out to be of no value. Most people just purchase a box of supplements without really doing the math, which is very important. Unless you find out the dosage that suits you, the amount of time you should dedicate for the workout and so on, you must not expect daydream the results. 
These effects were noted before in a preliminary study of depressed adolescents (with no placebo group) showing a 55% reduction in depressive symptoms at 4g daily when brain phosphocreatine levels increased.[231] Other prelimnary human studies suggest creatine might lessen unipolar depression[256] and one study on Post-Traumatic Stress Disorder (PTSD) noted improved mood as assessed by the Hamilton Depression Rating Scale.[232]
Some of the most common minor side effects include stomach discomfort, nausea, and increased bowel movements. Other potential side effects may include headaches, bloating, and increased thirst. There is always the chance that a supplement could cause an allergic reaction. This can result in rashes, swelling, or difficulty breathing, depending on the severity of the reaction. This is another reason why starting out with lower doses of new products is advisable.
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