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]
In people with COPD given either glucose placebo (40.7g) or creatine supplementation (5.7g creatine with 35g glucose) thrice daily for two weeks followed by a single dose for ten weeks, supplementation was associated with improvements in muscular strength and endurance, but not cardiovascular exercise potential.[579] A later trial of larger power using a loading phase of 22g creatine with a maintenance phase of 3.76g during rehabilitative exercise failed to replicate the improvements in skeletal muscle performance despite increased body weight seen with creatine,[580] and the failure to improve cardiovascular performance during aerobic exercise seen in both aforementioned studies has been replicated elsewhere after eight weeks supplementation, during which muscular performance was, again, unaffected.[581]
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].
There is a nuclear receptor known as TIS1 (orphan receptor, since there are no known endogeouns targets at this time) which positively influences transcription of new creatine transporters[171] and, in C2C12 myotubes, seems to be responsive to cAMP or adenyl cyclase stimulation from forskolin (from Coleus Forskohlii) with peak activation at 20µM.[171][172] 

Mitochondrial myopathies are a subgroup of mitochondrial cytopathies in which the skeletal muscle is negatively influenced. They are characterized by weaknesses in muscular function and energy metabolism.[547] These particular myopathies are thought to benefit from creatine supplementation, since creatine can help with some of the dysregulated energy production.[548]


This basic form of creatine comes in two forms, one of which involves the removal of the monohydrate (which results in creatine anhydrous) that converts to creatine monohydrate in an aqueous environment,[66][67] but due to the exclusion of the monohydrate it is 100% creatine by weight despite creatine monohydrate being 88% creatine by weight, as the monohydrate is 12%. This allows more creatine to be present in a concentrated formula, like capsules.[68]
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]
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.
For many people in rehabilitation or with an acquired disability, such as following stroke or orthopaedic surgery, strength training for weak muscles is a key factor to optimise recovery.[35] For people with such a health condition, their strength training is likely to need to be designed by an appropriate health professional, such as a physiotherapist.

JAK2 (Janus-Activating Kinase 2) is a novel protein that has been shown to suppress the activity of the creatine transporter CrT in vitro. The effects of JAK2 on CrT are not well-understood in vivo, however. Given that growth hormone activates both c-src (increases CrT activity) and JAK2- which has been found to decrease CrT activity, it is plausible that JAK2 may function as a negative-feedback regulator of creatine uptake. Future research is needed to better understand the role of JAK2 on CrT activity in vivo.

The bodybuilding community has been the source of many weight training principles, techniques, vocabulary, and customs. Weight training does allow tremendous flexibility in exercises and weights which can allow bodybuilders to target specific muscles and muscle groups, as well as attain specific goals. Not all bodybuilding is undertaken to compete in bodybuilding contests and, in fact, the vast majority of bodybuilders never compete, but bodybuild for their own personal reasons.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
Many other important bodybuilders in the early history of bodybuilding prior to 1930 include: Earle Liederman (writer of some of bodybuilding's earliest books), Zishe Breitbart, Georg Hackenschmidt, Emy Nkemena, George F. Jowett, Finn Hateral (a pioneer in the art of posing), Frank Saldo, Monte Saldo, William Bankier, Launceston Elliot, Sig Klein, Sgt. Alfred Moss, Joe Nordquist, Lionel Strongfort ("Strongfortism"),[6] Gustav Frištenský, Ralph Parcaut (a champion wrestler who also authored an early book on "physical culture"), and Alan P. Mead (who became an impressive muscle champion despite the fact that he lost a leg in World War I). Actor Francis X. Bushman, who was a disciple of Sandow, started his career as a bodybuilder and sculptor's model before beginning his famous silent movie career.
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]
McArdle’s disease is a myopathy associated with impaired glucose release from glycogen and impairments in muscle function at times when glucose would be the primary energy substrate. Creatine is thought to be therapeutic, but has shown differing effects in the two trials so far (both benefit and worsening of symptoms) for currently unknown reasons.

The amount of testosterone synthesized is regulated by the hypothalamic–pituitary–testicular axis (see figure to the right).[133] When testosterone levels are low, gonadotropin-releasing hormone (GnRH) is released by the hypothalamus, which in turn stimulates the pituitary gland to release FSH and LH. These latter two hormones stimulate the testis to synthesize testosterone. Finally, increasing levels of testosterone through a negative feedback loop act on the hypothalamus and pituitary to inhibit the release of GnRH and FSH/LH, respectively.
Multivitamin: A bodybuilder’s regime is strict and consuming the essential nutrients is an integral part of the process. The entire process can take a very nasty turn if one is not careful with the amount and type of food intake. The intake of multi vitamins can, therefore, have a good impact on a body builder. These multivitamins are used so that essential vitamins and minerals are supplied to the body, to promote good health and also allow a constant flow of energy.
The structure of cyclocreatine is fairly flat (planar), which aids in passive diffusion across membranes. It has been used with success in an animal study, where mice suffered from a SLC6A8 (creatine transporter at the blood brain barrier) deficiency, which is not responsive to standard creatine supplementation.[97] This study failed to report increases in creatine stores in the brain, but noted a reduction of mental retardation associated with increased cyclocreatine and phosphorylated cyclocreatine storages.[97] As demonstrated by this animal study and previous ones, cyclocreatine is bioactive after oral ingestion[97][98] and may merely be a creatine mimetic, able to phosphorylate ADP via the creatine kinase system.[97]
Below (in no particular order) are the top glute exercises to incorporate into your fitness regimen. You can mix and match these in multiple combinations for awesome glute and overall lower body work. Sets and reps for each exercise depends on your particular needs, goals, and current abilities. But, 2-5 sets of 8-15 reps is Reames’ general recommendation. 

Creatine supplementation often causes weight gain that can be mistaken for increase in muscle mass. Increasing intracellular creatine may cause an osmotic influx of water into the cell because creatine is an osmotically active substance [10]. It is possible that the weight gained is water retention and not increased muscle. The retention of water may be connected to reports of muscle cramps, dehydration, and heat intolerance when taking creatine supplements. It would be prudent to encourage proper hydration for creatine users. Further research is needed to investigate these and other possible side effects.


Due to a combination of its neuroprotective effects and dopaminergic modulatory effects, creatine has been hypothesized in at least one review article to be of benefit to drug rehabilitation.[266] This study used parallels between drug abuse (usually methamphetamines) and traumatic brain injury[267][268] and made note of creatine being able to reduce symptoms of brain trauma, such as headaches, fatigue, and dizziness in clinical settings in two pilot studies.[269][270] No studies currently exist that examine creatine supplementation and drug rehabilitation.

However, not all proteins are created equal in the muscle building stakes. Always remember the better the quality (biological value) of protein consumed, the more of it will be used for muscle building. To maximise muscle growth, stick to high-quality proteins, such as whey, milk, eggs, fish or lean meats. However, combining lower quality or incomplete protein from plant-based sources, such as nuts and beans, can still be a valuable protein source for muscle building.

Cornelissen et al [80] analyzed the effects of 1 week loading protocol (3 X 5 g/d CM) followed by a 3 month maintenance period (5 g/d) on cardiac patients involved in an endurance and resistance training program. Although CM supplementation did not significantly enhance performance, markers of renal and liver function were within normal ranges indicating the safety of the applied creatine supplementation protocol.

Creatine is cheap, healthy, and provides a variety of benefits (as it is essentially cellular energy, it has been linked to benefits to overall health). Not everyone responds positively to creatine, meaning some people don’t see any benefits from creatine supplementation. Athletic people are more likely to respond to creatine, compared to sedentary people.


"Your glutes are made up of three different muscles, the gluteus maximus, medius, and minimus," says Lefkowith. "They externally rotate your hip, abduct your hip, extend your hip, and even posteriorly tilt your pelvis." Because of this, it is important that you not only work one or two of these muscles, but rather, focus on showing all of them some love. "If you were only to do moves in one plane of motion, say a front lunge or squat, you wouldn't work your glutes to strengthen all of the joint actions they can perform."

If you have hit a plateau, a good supplement could be all you need to pull yourself out of a slump and make the progress you want to be making. Creatine is widely known as the most effective sports supplement. Scientific studies have proven that creatine maximizes ATP production which is responsible for energy in your body. Essentially, creatine will give you more energy to allow you to do the things that will make you stronger.


Bodybuilders also train small muscles with a similar volume, frequency and intensity of their larger muscles. Strength athletes laugh at this. “Curls are a waste of time” is a common phrase you will hear hurled at a bodybuilder. This is SILLY. Although big compound movements should be most people’s resistance training priority, smaller muscle group focus work has some benefits for every athlete. Bicep tears are quite common among strength athletes, especially strong men and powerlifters. This happens because these competitors will lift tremendous weights with their backs, but their biceps are the weak link. Many of these injuries could be prevented with some good old-fashioned bodybuilder type isolation work. If you are only as strong as your weak link, doesn’t it make sense to make those weak links strong ones?
I’ve previously written about Bacopa Monnieri and cocoa, two nootropics with strong studies showing their benefits in humans. Well, creatine is up there too. (In case you’re interested in specifics, on days each week when I need to be especially sharp I consume 350 mg Bacopa Monnieri, 75 g cocoa, and 5 g creatine monohydrate. It’s my favorite combination to date.)
A meta-analysis of 16 studies conducted on creatine and its influence on power and strength,[368][369] (with or without exercise in all age groups above 16, but placebo controlled and without crossover[368]) compiled studies utilizing a 5-7 day loading period with continued maintenance thereafter and studies assessing 1-3 rep bench press strength in trained young men. Seven studies (four of which are online[370][371][372][373]) totaling 70 people using creatine and 73 people in placebo showed a 6.85kg increase in strength relative to placebo, the benefits of which peaked at 8 weeks.[368] This meta-analysis also quantified a significant increase in squat strength (9.76kg) yet failed to find a significant influence on peak bicep contraction power, which may have been influenced by the two null studies[374][375] being in elderly people while the positive study[376] was statistically outweighed, but noted an 1.8-fold increase in power associated with creatine over placebo. The other meta-analysis conducted the following year[369] calculated effect sizes for creatine supplementation and noted no significant differences between genders or when comparing trained and untrained individuals. The mean effect size of exercises lasting below 30s (those that use the creatine-phosphate system) was 0.24+/-0.02 and performed significantly better than placebo, where exercise increased performance by 4.2+/-0.6% while the addition of creatine enhanced this effect to 7.5+/-0.7%.[369]
Taking creatine supplements may increase the amount of creatine in the muscles. Muscles may be able to generate more energy or generate energy at a faster rate. Some people think that taking creatine supplements along with training will improve performance by providing quick bursts of intense energy for activities such as sprinting and weightlifting.
The amount of testosterone synthesized is regulated by the hypothalamic–pituitary–testicular axis (see figure to the right).[133] When testosterone levels are low, gonadotropin-releasing hormone (GnRH) is released by the hypothalamus, which in turn stimulates the pituitary gland to release FSH and LH. These latter two hormones stimulate the testis to synthesize testosterone. Finally, increasing levels of testosterone through a negative feedback loop act on the hypothalamus and pituitary to inhibit the release of GnRH and FSH/LH, respectively.
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.
Men who produce more testosterone are more likely to engage in extramarital sex.[55] Testosterone levels do not rely on physical presence of a partner; testosterone levels of men engaging in same-city and long-distance relationships are similar.[54] Physical presence may be required for women who are in relationships for the testosterone–partner interaction, where same-city partnered women have lower testosterone levels than long-distance partnered women.[59] 
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