The major controversies regarding creatine are its side effects and the best form to use. Nearly all side effects attributed to creatine, such as muscle cramps, kidney disease and gastrointestinal disturbances, haven't proved significant under controlled scientific scrutiny. Although various claims are made for a variety of creatine supplements, creatine monohydrate, which is 99 percent absorbed, is the best form to use.
The other component of that study is that the subjects ate much less saturated fat. Saturated fats are common in meat, butter, and coconut products, and they’re crucial for your body to function. Saturated fats keep the integrity of your cell membranes, and if you limit carbs and/or do Bulletproof Intermittent Fasting, saturated fats become a phenomenal source of energy for your brain.
When assessing the antioxidant effects of creatine, it does not appear to sequester superoxide and may not be a direct antioxidant.[241] Additionally, creatine failed to protect neurons from H2O2 incubation to induce cell death via pro-oxidative means.[241] These results are in contrast to previously recorded results suggesting creatine acts as a direct anti-oxidant.[242]
Do a single set of repetitions. Theories on the best way to approach weight training abound, including countless repetitions and hours at the gym. But research shows that a single set of exercise with a weight that fatigues your muscle after about 12 to 15 repetitions can build muscle efficiently in most people and can be as effective as three sets of the same exercise.
Creatine is known to increase skeletal muscle cellular volume alongside increases in water weight gain.[346] Since glycogen itself also increases the osmolytic balance of a cell (draws in water)[347][348] and preliminary evidence shows a strong trend of creatine augmenting glycogen loading,[153] creatine is thought to be related to an increase in cell volume, which is known to promote glycogen synthesis.[112]
However, a much more accurate determination of how much fluid is necessary can be made by performing appropriate weight measurements before and after a typical exercise session, to determine how much fluid is lost during the workout. The greatest source of fluid loss during exercise is through perspiration, but as long as your fluid intake is roughly equivalent to your rate of perspiration, hydration levels will be maintained.[14]

That pump is tangible, real-time biofeedback to let you know that blood is flowing to your muscle cells, beginning a chain of events that stimulates protein synthesis. Maybe that'’s why it's easy to overlook how important good nutrition is in the mass-building equation. When you choose to eat, say, chicken instead of ice cream, there'’s no immediate muscle gratification -- no pump to keep you motivated.
It can be hard to know where to start when beginning strength training. There are countless exercises you can do, some of which work some muscles, but not others. There are safety concerns to beware of, a wide variety of sometimes confusing equipment to help you in your efforts, and so on. With some familiarity of the basics of getting started with strength training, actually doing so can become far less daunting, and you can begin to craft a routine that is targeted toward helping you achieve your personal goals.

Competitive and professional bodybuilders, however, can often build up to two to three pounds of muscle per month during dedicated bulking periods. "But they are living and breathing muscle growth. They aren't just in and out of the gym like most people," Simpson says, noting that under extreme conditions, hyperplasia, or the growth in the number of muscle cells in a given muscle tissue, may actually occur, further adding to muscle growth results.
Early infancy androgen effects are the least understood. In the first weeks of life for male infants, testosterone levels rise. The levels remain in a pubertal range for a few months, but usually reach the barely detectable levels of childhood by 4–7 months of age.[15][16] The function of this rise in humans is unknown. It has been theorized that brain masculinization is occurring since no significant changes have been identified in other parts of the body.[17] The male brain is masculinized by the aromatization of testosterone into estrogen, which crosses the blood–brain barrier and enters the male brain, whereas female fetuses have α-fetoprotein, which binds the estrogen so that female brains are not affected.[18]
Longer rest periods are more ideal for making progressive tension overload happen, and shorter rest periods are more ideal for generating metabolic fatigue. So, if you’re doing an exercise that is better suited for progressive overload (i.e. primary compound exercises), you’re going to want to rest longer between sets to maximize strength output. And if you’re doing an exercise that is better suited for metabolic fatigue (i.e. isolation exercises), you’re going to want to rest less between sets to make that happen. And if you’re doing an exercise that is suited equally for a combination of the two (i.e. secondary compound exercises), you’re usually going to want a moderate rest period somewhere in between.
It has been argued that purposely overtraining for a brief period can be beneficial. One article published by Muscle & Fitness magazine stated that you can "Overtrain for Big Gains". It suggested that if one is planning a restful holiday and does not wish to inhibit their bodybuilding lifestyle too much, they should overtrain before taking the holiday, so the body can recuperate and grow during the prolonged rest period. Overtraining can be used advantageously, as when a bodybuilder is purposely overtrained for a brief period of time to super compensate during a regeneration phase. These are known as "shock micro-cycles" and were a key training technique used by Soviet athletes.[53]
If you touch your phone between exercise sets, it better be to set its timer to 30 to 90 seconds. When lifting for hypertrophy, rest periods of 30 to 90 seconds encourage a quick release in muscle-building hormones (including testosterone and human growth hormone) while also making sure that you really, truly fatigue your muscles, according to Fitzgerald.
Eat healthy fats. That's right—not only does it make food taste good, fat is good for you, as long as you are eating the right kinds and amounts of fat! Saturated fats—the fat you'll find in a stick of butter, a bag of chips, or bacon—should be limited to about 20g or less. That's the bad news. The good news is that unsaturated fats are actually beneficial, even necessary. Fat is necessary for the proper distribution of vitamins A, D, E, and K, helps promote better eyesight, and healthy skin. Fats are also important for the synthesis of hormones, so maintaining an adequate intake of them will speed up muscle-building and recovery.
Stand lunge-length in front of a bench making sure your knee does not extend past your toes. Hold a dumbbell in each hand and rest the top of your left foot on the bench behind you. Lower your body until your rear knee nearly touches the floor and your front thigh is parallel to the floor. Then push through the heel of your front foot to return to standing, keeping the back foot on the bench. Repeat for required reps then switch legs.
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.
Our bodies store creatine in our muscles so that we have quick access to it for fast, high-intensity movements, like sprinting or powerlifting, explains Autumn Bates, a certified clinical nutritionist and sports nutritionist in private practice in Manhattan Beach, California. “It's a nonessential amino acid, meaning your body creates it and you don't need to primarily get it from food.”
A loading phase of 10g creatine monohydrate for two weeks and 4g for the final week in subjects with MELAS (Mitochondrial Encephalomyopathy Lactic Acidosis and Stroke-like episodes) has been noted to increase physical strength relative to baseline, although the poor VO2 max seen in these subjects was not affected.[549] A case study exists in which a patient with a relatively novel mutation in their mitochondrial function (affecting cytochrome B) experienced benefits from creatine at 10g daily.[550] Researchers examining another case of MELAS found both cognitive and physical benefits with 5g creatine supplementation,[551] while four controlled case studies of 100-200mg/kg daily in children with myopathies found improved muscular endurance (30-57%) and muscular power (8-17%) after 100-200mg/kg daily for at least three months.[552] 

If you are somebody that is tired of not getting results, wants to avoid trial-and-error, or you just want to be told exactly what to do to reach your goals, check out our popular 1-on-1 coaching program. You’ll work with our certified NF instructors who will get to know you better than you know yourself and program your workouts and nutrition strategy for you.
Testosterone is necessary for normal sperm development. It activates genes in Sertoli cells, which promote differentiation of spermatogonia. It regulates acute HPA (hypothalamic–pituitary–adrenal axis) response under dominance challenge.[22] Androgen including testosterone enhances muscle growth. Testosterone also regulates the population of thromboxane A2 receptors on megakaryocytes and platelets and hence platelet aggregation in humans.[23][24]
Creatine has been found to increase skeletal muscle glycogen when given to sedentary adults for a loading and maintenance phase for 37 days at 2g (13.5% after five days of loading, but returning to baseline at the end of the trial). Exercise was not enforced in this study.[207] This study also noted that, despite a normalization of glycogen after the trial, total creatine and ATP was still higher than placebo,[207] and a loading protocol appears to have failed elsewhere in increasing glycogen stores in sedentary people subject to an aerobic exercise test before and after the loading phase.[349]

There have been a few reported renal health disorders associated with creatine supplementation [73,74]. These are isolated reports in which recommended dosages are not followed or there is a history of previous health complaints, such as renal disease or those taking nephrotoxic medication aggravated by creatine supplementation [73]. Specific studies into creatine supplementation, renal function and/or safety conclude that although creatine does slightly raise creatinine levels there is no progressive effect to cause negative consequences to renal function and health in already healthy individuals when proper dosage recommendations are followed [73-77]. Urinary methylamine and formaldehyde have been shown to increase due to creatine supplementation of 20 g/d; this however did not bring the production outside of normal healthy range and did not impact on kidney function [56,78]. It has been advised that further research be carried out into the effects of creatine supplementation and health in the elderly and adolescent [73,75]. More recently, a randomized, double blind, 6 month resistance exercise and supplementation intervention [79] was performed on elderly men and women (age >65 years) in which subjects were assigned to either a supplement or placebo group. The supplement group was given 5 g CM, 2 g dextrose and 6 g conjugated linoleic acid/d, whilst the placebo group consumed 7 g dextrose and 6 g safflower oil/d. CM administration showed significantly greater effects to improve muscular endurance, isokinetic knee extension strength, fat free mass and to reduce fat mass compared to placebo. Furthermore the supplement group had an increase in serum creatinine but not creatinine clearance suggesting no negative effect on renal function.


Recommended Dose: In Shannon Clark's article, "6 Ways To Get More Energized For Your Workouts", Dr. Chris Lockwood recommends between 1.36 and 2.5 milligrams of caffeine per pound of bodyweight. That would be 200-375 milligrams for a 150-pound person. If that leaves you jittery, try less. Determine your tolerance and find the dose that works best for you.

Heath suggests incorporating dropsets into your training routine by immediately decreasing the weight and repping out again to failure. “Dropsets overload the muscle with shorter rest periods and increasing volume which you need to grow,” says Heath. “That overload improves your body’s abilities to utilize more nutrients, natural growth hormone, and natural testosterone into those areas and makes the supplements you take more effective.” Heath’s favorite way to do dropsets is on a pin-loaded machine since it’s faster to switch weights.

Creatine synthesis primarily occurs in the liver and kidneys.[2][16] On average, it is produced endogenously at an estimated rate of about 8.3 mmol or 1 gram per day in young adults.[16][17] Creatine is also obtained through the diet at a rate of about 1 gram per day from an omnivorous diet.[16][18] Most of the human body's total creatine and phosphocreatine stores are found in skeletal muscle, while the remainder is distributed in the blood, brain, and other tissues.[17][18]


Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., … Lopez, H. (2017, June 13). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(18). Retrieved from https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z

Generally, you should consume about 20 grams of protein with some carbs shortly after a workout. During the post-workout anabolic window, you’ll also want to limit fats, which can slow the absorption of protein. While there is some recent research that suggests the window may actually extend up to several hours following exercise, there’s no harm in getting nutrients in early as long as you’re sticking to your overall caloric and macronutrient goals.
Sugar is to testosterone what kryptonite is to Superman. Eliminating sugar is probably the single most powerful way to increase your performance, in part because sugar absolutely devastates your testosterone levels (but all carbs do not, especially under heavy training.) In one study of 74 men, a 75g dose of sugar – about the equivalent of a bottle of soda – decreased serum testosterone by 25% in under an hour, and levels stayed low for at least 2 hours [7]. On top of that, 15% of the men who started with normal testosterone dipped into the hypogonadal range after they ate sugar – that’s the range in which doctors diagnose men’s testes and women’s ovaries as failing. When you do eat carbs, stick to Bulletproof ones like sweet potatoes and squash. My recommendations for types of carbs and how often to eat them are here.
Second, strength training has a much greater level of excess post-exercise oxygen consumption than aerobic exercise.  What does this mean?  When you finish a workout, your body needs to do a lot of work to replenish itself in order to bring itself back to a normal state (the way it was before you worked out).  This takes a lot of energy, and some studies have shown that it can boost your metabolism for up to 38 hours after you finish your workout.

Studies that use a dosage range typical of creatine supplementation (in the range of 5g a day following an acute loading period) note increases to total body water of 6.2% (3.74lbs) over 9 weeks and[608] 1.1kg over 42 days.[609] Interestingly, some studies comparing creatine paired with training against training itself fail to find a significant difference in percentage of water gained (which is inherently to activity) with standard oral doses of creatine[609][607][610] (although low dose creatine supplementation of 0.03g/kg or 2.3g daily doesn’t appear to increase water retention[611]) despite more overall water weight being gained, due to an equal gain of dry mass in muscles. One study has quantified the percentage increase in mass of muscle cells to be 55% water, suggesting the two groups are fairly equal.[609]
Trouble walking, running or doing other activities — Any physical movement that involves stability, flexibility and strength in the legs and hips can be compromised. For example, yoga, dancing, horseback riding, cycling, hiking, burst training, sprinting, plyometrics or tabata workouts, and other activities will be more difficult with underdeveloped glutes.
The glutes, what most people think of as the “butt muscles,” are located behind the pelvis region, attaching to fascia tissue of the lumbar region (the lower back). (3) They sit below the gluteus medius (the top of the buttocks) and above the biceps femoris (the muscles in the back of the thighs). They also connect to the sacrum, sacrotuberous ligament and coccyx bones (the tailbone).
Creatine is only taken up by its transporter, and changes in the activity level of this transporter are wholly causative of changes in creatine uptake. The transporter is regulated by mostly cytosolic factors as well as some external factors that affect creatine transport activity, [143] including extracellular creatine.[140] Agents affecting creatine transport are further divided into positive regulators (those that increase activity of the transporter) and negative regulators (those that suppress activity).
A loading phase of 10g creatine monohydrate for two weeks and 4g for the final week in subjects with MELAS (Mitochondrial Encephalomyopathy Lactic Acidosis and Stroke-like episodes) has been noted to increase physical strength relative to baseline, although the poor VO2 max seen in these subjects was not affected.[549] A case study exists in which a patient with a relatively novel mutation in their mitochondrial function (affecting cytochrome B) experienced benefits from creatine at 10g daily.[550] Researchers examining another case of MELAS found both cognitive and physical benefits with 5g creatine supplementation,[551] while four controlled case studies of 100-200mg/kg daily in children with myopathies found improved muscular endurance (30-57%) and muscular power (8-17%) after 100-200mg/kg daily for at least three months.[552]
How to Take It: So, you want to give it a go? How much should you take and what should you look for in a supplement? Definitely opt for creatine monohydrate, as it performs better in studies than other varieties, as mentioned above. A standard dose is about 5 grams a day. You can try taking this muscle builder for about 4 weeks to boost your levels. Following this time, you can either cut out creatine or lower to a maintenance dose of 3-5 grams per day. However, you’ll notice if you read the fine print that subjects in studies often have a loading phase of five days where the dosage is upped to 20 g per day, prior to adopting a standard dose (7, 8).
Lie on your back on the floor and bend one knee so that your foot is flat on the floor. Keeping your opposite leg straight, push your foot into the floor, raising your hips until both thighs are in line with each other. Reverse the motion to return to the starting position. That’s one rep. Complete all your reps on one leg, and then switch legs and repeat.
Beta-alanine is a naturally occurring non-essential amino acid that comes into the body through foods that are rich in protein. The performance-enhancing aspect of beta-alanine (BA) is due to its ability to increase intra-muscular levels of carnosine. Increasing beta-alanine through supplementation may raise carnosine levels by over 60 percent in as quickly as four weeks.[6]

In males, the majority of testosterone is secreted from the testes, hence the term “testosterone”. The hormone is also produced in small amounts by the adrenal gland. The production of this hormone is controlled by the hypothalamus and pituitary gland in the brain. The pituitary gland receives instructions from the hypothalamus on how much testosterone needs producing and passes this information onto the testicles via chemicals and hormones circulating in the bloodstream.
These effects are secondary to creatine being a source of phosphate groups and acting as an energy reserve. The longer a cell has energy, the longer it can preserve the integrity of the cell membrane by preserving integrity of the Na+/K+-ATPase and Ca2+-ATPase enzymes.[241][235][236] Preserving ATP allows creatine to act via a nongenomic response (not requiring the nuclear DNA to transcribe anything), and appears to work secondary to MAPK and PI3K pathways.[226]
Increasing creatine levels in skeletal muscle to 687% of baseline (0.5mM creatine, thought to be equivalent to 5g creatine[135]) doesn’t seem to per se increase glucose uptake, but increases glucose oxidation (140% of baseline)[341] which is due to a two-fold increase in the activity of α1 and α2 subunits of AMPK, a potency comparable to 1mM of the reference drug AICAR.[341] Glucose uptake associated with AMPK has indeed been noted in diabetic people who are undergoing physical exercise[342] and in contracting skeletal muscle cells,[153][330] but according to rat[343][344][345] and in vitro studies of cells not being contracted,[341] this is not a per se effect of non-exercising tissue but an augmentation of exercise-induced glucose uptake.
For many people, appearance is the top priority when it comes to their posterior. But yoga practitioners also know that the glute muscles can do so much more than look great in jeans: They’re the primary players in many of the movements that make it possible to do yoga. The gluteus maximus, medius, and minimus—along with many other smaller, supporting muscles—act as a base of support for the pelvis and hips. What’s more, these hard-working muscles stabilize your femur (thighbone) in your hip socket, rotate your femur internally and externally, and draw your leg back. And yes, all of these actions also help us stand and walk, and even support us when we sit.
Diet – To boost your body’s testosterone levels, you need to reduce your intake of foods that promote an increase in your belly fat. Increase in belly fat promotes the activity of an enzyme called aromatase which converts testosterone to the female sex hormone, estrogen. Therefore, the greater the amount of belly fat you have, the more your level of testosterone reduces. In addition, increase your intake of heart-healthy foods such as fiber from whole grains, lean white meat, fresh fruits, and vegetables and reduce your intake of red meat and animal fat.

Studies that use a dosage range typical of creatine supplementation (in the range of 5g a day following an acute loading period) note increases to total body water of 6.2% (3.74lbs) over 9 weeks and[608] 1.1kg over 42 days.[609] Interestingly, some studies comparing creatine paired with training against training itself fail to find a significant difference in percentage of water gained (which is inherently to activity) with standard oral doses of creatine[609][607][610] (although low dose creatine supplementation of 0.03g/kg or 2.3g daily doesn’t appear to increase water retention[611]) despite more overall water weight being gained, due to an equal gain of dry mass in muscles. One study has quantified the percentage increase in mass of muscle cells to be 55% water, suggesting the two groups are fairly equal.[609]


In the modern bodybuilding industry, the term "professional" generally means a bodybuilder who has won qualifying competitions as an amateur and has earned a "pro card" from their respective organization. Professionals earn the right to compete in competitions that include monetary prizes. A pro card also prohibits the athlete from competing in federations other than the one from which they have received the pro card.[12] Depending on the level of success, these bodybuilders may receive monetary compensation from sponsors, much like athletes in other sports.

Consuming sufficient high-quality protein is essential for building muscle. Current recommendations are to consume a minimum of 0.8g of protein for each kg of body weight, however, this is really only applicable to the average sedentary individual. Current evidence shows that to support muscle development, protein intake is the key, therefore the recommended 0.8g per kg should be increased to 1.5-2.0g of protein per kg of body weight. For an 80 kg individual, that would equate to 120-160 grams of protein per day.
The neuroprotective effects of creatine appear to exist in regard to dopamine biosynthesis, and the suppression of dopamine synthesis seen with some neurological toxins appears to be partially attenuated with dietary intake of creatine. The protective effect is weak to moderate in animal research, but appears to be additive with anti-inflammatories.

Creatine is used and researched in a clinical setting to investigate various pathologies or disorders such as myopathies [3,4] and is also used as an ergogenic aid for improving health and sports performance in athletes [5]. As an oral supplement, the most widely used and researched form is creatine monohydrate (CM). When orally ingested, CM has shown to improve exercise performance and increase fat free mass [5-9].
Miscellaneous: Sleep: (REM sleep) increases nocturnal testosterone levels.[146] Behavior: Dominance challenges can, in some cases, stimulate increased testosterone release in men.[147] Drugs: Natural or man-made antiandrogens including spearmint tea reduce testosterone levels.[148][149][150] Licorice can decrease the production of testosterone and this effect is greater in females.[151]
There is some research that suggests that creatine can help people with type 2 diabetes by improving insulin sensitivity, glucose uptake into the cells, and glycemic control. This has led many people with T2 to start supplementing their diets with pure creatine to try and reap the benefits. At this time there has been no conclusive research done into the effectiveness of creatine for type 1 diabetics.
A testosterone test is done if your doctor suspects that your depressive symptoms may be a result of testosterone deficiency. This test is usually done at a particular time of the day –usually in the morning between 7:00 a.m. and 10:00 a.m. This is because testosterone levels in the body vary with the time of the day, being highest in the morning. Before this test is scheduled, however, your doctor will ask you to discontinue certain medications which may affect the accuracy of the test.
Taking creatine can also cause 5-10 lbs of water-weight gain. The stress from extra water causes muscle cells to grow faster. This is one reason why creatine supplementation increases muscle growth over the long term. Novice weightlifters see more benefits with creatine than seasoned athletes, since they have more muscle to gain. (That doesn’t mean athletes shouldn’t take creatine though.)
I’m telling you all of this because no matter who you are, keeping your testosterone levels balanced is more important now than ever before. Modern living has not been kind to our hormones. In American men, serum testosterone levels have declined by about 1% each year for the past 30 years [5], and you can make a few educated guesses about why. Hormone-disrupting chemicals are more prevalent than ever before, physical activity is less and less common, veganism is popular (I was a raw vegan for a while), and many doctors insist on pushing a low-fat, low-cholesterol diet for health (by the way, the concept of a low-fat diet began in the mid-70s, shortly before the nationwide testosterone decline. It could be a coincidence, but I doubt it).
Weight training also requires the use of 'good form', performing the movements with the appropriate muscle group, and not transferring the weight to different body parts in order to move greater weight (called 'cheating'). Failure to use good form during a training set can result in injury or a failure to meet training goals; since the desired muscle group is not challenged sufficiently, the threshold of overload is never reached and the muscle does not gain in strength. At a particularly advanced level; however, "cheating" can be used to break through strength plateaus and encourage neurological and muscular adaptation.

Expert tip: “Optimum form and range of motion for the squat is very dependent on your physicality, structure, joint integrity, limb length, strength, flexibility, and current condition,” Reames says. Your range of motion is 90° max at the knee. Some guys will be able to go lower than this, but not everyone will squat to parallel, he says. And that’s totally okay. “Stick to form and the appropriate resistance levels for you; the squat is still one of the best and simplest moves for overall strength, building lower-body muscle, core strength, and athletic performance. 
The other interesting thing about the study: men’s testosterone levels were lowest in March (at the end of winter) and highest in August (at the end of summer). Sunlight affects your vitamin D production, so you have seasonal dips and peaks. Get a blood test to check your levels, and if you’re low, take a high-quality vitamin D3 supplement. If you’re going to take D3, take vitamin K2 and vitamin A with it. The three work in sync, so you want them all to be balanced. Here are my dosage recommendations.

How long and how often? Two or three weekly 20- to 30-minute, weight-training sessions are sufficient to start reaping noticeable benefits within four to 12 weeks, such as improved energy and muscle tone. Within six months, most people increase their strength 40 percent or more. Give your body at least one recovery day between sessions (although some people may need more, especially in the beginning).


Total levels of testosterone in the body are 264 to 916 ng/dL in men age 19 to 39 years,[169] while mean testosterone levels in adult men have been reported as 630 ng/dL.[170] Levels of testosterone in men decline with age.[169] In women, mean levels of total testosterone have been reported to be 32.6 ng/dL.[171][172] In women with hyperandrogenism, mean levels of total testosterone have been reported to be 62.1 ng/dL.[171][172]
A typical creatine supplementation protocol of either a loading phase of 20 to 25 g CM/d or 0.3 g CM/kg/d split into 4 to 5 daily intakes of 5 g each have been recommended to quickly saturate creatine stores in the skeletal muscle. However a more moderate protocol where several smaller doses of creatine are ingested along the day (20 intakes of 1 g every 30 min) could be a better approach to get a maximal saturation of the intramuscular creatine store. In order to keep the maximal saturation of body creatine, the loading phase must be followed by a maintenance period of 3-5 g CM/d or 0.03 g CM/kg/d. These strategies appear to be the most efficient way of saturating the muscles and benefitting from CM supplementation. However more recent research has shown CM supplementation at doses of 0.1 g/kg body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Creatine retention by the body from supplementation appears to be promoted by about 25% from the simultaneous ingestion of carbohydrate and/or protein mediated through an increase in insulin secretion. This combination would produce a faster saturation rate but has not been shown to have a greater effect on performance.
Anti-depressive effects have been noted in woman with major depressive disorder when 5g of creatine monohydrate was supplemented daily for 8 weeks in combination with an SSRI. Benefits were seen at week two and were maintained until the end of the 8-week trial.[253] The improvement in depressive symptoms was associated with significantly increased prefrontal cortex levels of N-acetylaspartate, a marker of neuronal integrity,[254] and rich club connections, which refers to the ability of nerons to make connections to one another.[255]
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…
Back in the 1970s, scientists discovered that taking creatine in supplement form might enhance physical performance. In the 1990s, athletes started to catch on, and creatine became a popular sports supplement. The supplement is particularly popular among high school, college, and professional athletes, especially football and hockey players, wrestlers, and gymnasts. 
^ The effect of HMB on skeletal muscle damage has been assessed in studies using four different biomarkers of muscle damage or protein breakdown: serum creatine kinase, serum lactate dehydrogenase, urinary urea nitrogen, and urinary 3-methylhistidine.[38][41][42] When exercise intensity and volume are sufficient to cause skeletal muscle damage, such as during long-distance running or progressive overload, HMB supplementation has been demonstrated to attenuate the rise in these biomarkers by 20–60%.[38][42]
In well-trained endurance runners, creatine (with glycerol for hyperhydration) caused a relatively large increase in body weight gain (0.90+/-0.40kg) and water weight (0.71+/-0.42L) but failed to negatively influence performance over 30 minutes in the heat.[3] This failure to improve physical performance in the heat with creatine loading (despite water retention) has been noted elsewhere.[346] 
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