How To Take Creatine

Creatine Practical Guide.

Creatine: A practical guide evolved from the thousands of questions asked by professional and amateur athletes from around the globe. Learn How To Most Effectively Combine Exercise, Nutrition And Smart Creatine Use For Explosive Muscle Growth And Improved Overall Health. Here is just a small sampling of the many questions addressed by this e-book How long can I keep creatine on the shelf? Will I lose muscle after I stop supplementing? Not all creatine brands recommend the same amount. What gives? Is mixing creatine with protein powder a bad idea? Why do so many creatine brands contain so much dextrose? Is loading really necessary? Im currently taking Accutane for nodular acne. Is it safe for me to supplement? Will creatine stunt my growth? Im training twice as much these days and Im still not making any gains! Why? If creatine isnt a steroid, then how come it gave me a positive doping result? Will creatine shrink my package?! Read more...

Creatine Practical Guide Summary

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Creatine Kinase CK Creatine Phosphokinase CPK

Creatine kinase (CK), also called creatine phosphokinase (CPK), is an enzyme that is found primarily in heart and skeletal muscles, and to a lesser extent in the brain. It is the main cardiac enzyme studied in patients with heart disease. Creatine kinase can be divided into three chemically distinct forms called isoenzymes CK-BB (CK,), CK-MB (CK2), and CK-MM (CK3). The isoenzymes are associated with specific organs, organ damage, and diagnoses. CK-BB is linked to brain tissue and the gastrointestinal and genitourinary tracts CK-MB is primarily associated with cardiac muscle and cardiac cells and CK-MM is predominant in skeletal muscle. Measuring total CK levels and identifying specific isoenzyme levels provide the clinician with valuable diagnostic information about heart, skeletal muscle, and central nervous system disorders.

Clinical Presentation

The patient's history of chest pain may provide clues to the duration of the infarction. However, it is important to keep in mind that the duration of the pain does not always correlate with the age of the infarction. For example, a patient who has had chest pain for 10 hours could have had unstable angina (i.e., subtotal occlusion) for eight of those hours, and therefore still be a candidate for reperfusion therapy despite the prolonged history of chest pain. That this is the case would be suggested by ECG findings of significant ST-segment elevation and lack of Q-wave development, accompanied by minimal (or no) increase in creatine kinase (CK) enzyme level. On the other hand, the patient who presents with an eight-hour history of chest pain and deep Q waves, minimal ST-segment elevation and marked CK enzyme elevation is likely to have had infarction longer (probably at the onset of his or her pain).

Materials see Note 1

10X Run-on buffer. 1.5MNaCl, 25 mMMgCl2, 50 mMMg acetate, 10 mM MnCl2, 20 mM DTT, 1 25 mM EDTA, 5 mM ATP (Pharmacia, Uppsala, Sweden), 5 mM GTP (Pharmacia), 5 mM CTP (Pharmacia), 20 mM creatine phosphate, 30 U mL creatine phosphokinase (Boehringer Mannheim, Mannheim, Germany), and 5 mg mL heparin.

Soft Tissue Infections

GAS may invade the epidermis and subcutaneous tissues, resulting in local swelling, erythema, and pain.17 The skin becomes indurated and, in contrast to erysipelas, is a pinkish color. Patients with lymphedema secondary to lymphoma, filariasis, or surgical node dissection (mastectomy, carcinoma of the prostate, etc.) are predisposed to development of GAS cellulitis, as are those with chronic venous stasis and superficial dermatophyte infection of the toes. Saphenous vein donor site cellulitis may be due to group A, C, or G streptococci. Cellulitis associated with a primary focus (e.g., an abscess or boil) is more likely caused by S. aureus. Aspiration of the leading-edge and punch biopsy yield a causative organism in 15 and 40 of cases, respectively. Patients respond quickly to penicillin, though in some cases where staphylococcus is of concern, nafcillin or oxacillin may be a better choice, or one may need cover for methicillin-resistant S. aureus (MRSA) infection (discussed later in...

Plant Based Mixed Diet Diet

Creatine and its application as an ergogenic aid. Int. J. Sport Nutr., 5 S100, 1995. 67. Mujika, I. and Padilla, S. Creatine supplementation as an ergogenic aid for sports performance in highly trained athletes a critical review. Int J. Sports Med., 18 491, 1997. 68. Hultman, E., Soderlund, K., Timmons, J.A., Cederblad, G., and Greenhaff, P.L. Muscle creatine loading in men. J. Appl. Physiol., 81 232, 1996. 69. Clarys, P.M., Zinzen, E.M., Hebbelinck, M., and Verlinden, M. The effect of oral creatine supplementation on torque production in a vegetarian and a non-vegetarian population a double blind study. Veg. Nutr Int. J, 1 100, 1997. 70. Burke, L.M., Pyne, D.B., and Telford, R.D. Effect of oral creatine supplementation on single-effort sprint performance in elite swimmers. Int. J. Sport Nutr, 6 222, 1996. 71. Williams, M.H. and Branch, J.D. Creatine supplementation and exercise performance an update. J. Am. Coll. Nutr, 17 216, 1998.

Assessment of Apoptosis in Fractionated Extract

Subcutaneous Lymph Sac Frog

5 mg mL Creatine kinase. 3. 5 mg mL Creatine kinase. 11. Add 1 10 dilution of 0.2 M phosphocreatine (20 mM final) and 1 100 of 0.5 mg mL creatine kinase (50 g mL final) and 0.2 M ATP (20 M final) to create an ATP-regenerating system and sperm nuclei to a concentration of 1000 L (1 100 dilution). Incubate this extract at room temperature for 4 to 8 h. The onset of apoptosis can be assayed in this system by observing the morphology of sperm nuclei stained with Hoechst 33528 (Subheading 3.2.4.), measuring cytochrome c release (Subheading 3.2.2.) or assessing caspase activity (Subheading 3.2.3.).

Magnetic Resonance Spectroscopy Quantification of Ectopic

Schick et al. (118) were the first to identify two compartments of triglycerides in muscle that have resonant frequencies separated by 0.02 ppm. The two compartments were identified to represent the lipid located inside (IMCL) and outside (EMCL) the muscle cell. IMCL droplets are spherical with a relatively homogenous distribution, and as such, are independent of muscle orientation relative to the magnetic field (115-117,119). On the other hand, EMCL lies outside the muscle fiber, and appears in plate-like structures (115-117,120) that have a highly variable distribution throughout the muscle. Due to the varying orientations and patterns of EMCL, misalignment of the muscle fibers relative to the magnetic field will cause the EMCL line to broaden, and potentially overlap the IMCL resonance peak (117). Further, Boesch et al. demonstrated that IMCL, and not EMCL, signals scale linearly with voxel size, water, and creatine signals, which are used to quantify and scale the IMCL spectra...

Assay of Apoptosis Using Fractionated Interphase Egg Extracts

Add ATP-regenerating mix (1 10 dilution of 0.2 Mphosphocreatine and 1 100 of 0.5 mg mL creatine kinase and 0.2 M ATP ) to 170 L of cytosolic extract. 1. Thaw 50 to 100 L cytosolic egg extract and add ATP-regenerating mix (1 10 dilution of 0.2 M phosphocreatine, 1 100 dilution of 0.5 mg mL creatine kinase, and 1 100 dilution of 0.2 M ATP).

Special Concerns For Athletes On Vegetarian Diets

Protein and Creatine Creatine supplementation has been urged as an ergogenic aid for athletes who engage in repeated bouts of short-term, high-intensity exer-cise.66,67 Creatine is found in large quantities in skeletal muscle and binds a significant amount of phosphate, providing an immediate source of energy in muscle cells (adenosine triphosphate or ATP). The intent of consuming supplemental creatine is to increase the skeletal muscle's creatine content, in the hope that some of the extra creatine binds phosphate, increasing muscle phosphocreatine content. During repeated bouts of high intensity exercise (for example, five 30-second bouts of sprinting or cycling exercise separated by 1-4 minutes of rest), the increased availability of phosphocreatine may improve resynthesis and degradation rates, leading to greater anaerobic ATP turnover and highpower exercise performance.66 The estimated daily requirement for creatine is about 2 grams. Non-vegetarians typically get about 1 gram...

Streptococcal Toxic Shock Syndrome

Evidence of renal involvement was apparent at the time of admission by the presence of hemoglobinuria and elevated serum creatinine level. The serum albumin level was moderately low (3.3 g dL) on admission and dropped further (2.3 g dL) by 48 hours. Hypocalcemia, including ionized hypocalcemia, was detectable early in the hospital course. The serum creatine phosphokinase (CPK) level is a useful test to detect deeper soft tissue infections, such as necrotizing fasciitis or myositis.

Commentary

There are only a few studies that have evaluated the beneficial effects of perioperative statin use in reducing perioperative cardiac complications 16-18 . Poldermans et al. 16 , using a case-control study design in 2816 patients who underwent major vascular surgery, showed that controls more often were statin users than cases, which resulted in a fourfold reduction in all-cause mortality within 30 days after surgery. This finding was consistent in subgroups of patients according to type of vascular surgery, cardiac risk factors and beta-blocker use. Q2 D Similar to these findings, Durazzo et al. 17 also reported a significantly reduced incidence of cardiovascular events within 6 months of vascular surgery in patients who were randomly assigned to atorvastatin compared with placebo (atorvastatin vs. placebo, 8.3 vs. 26.0 ). Finally, the study results of Lindenauer et al. 18 indicated that statin use was associated with 28 percent relative risk reduction of in-hospital mortality...

Creatinine

Creatinine is a waste product of creatine phosphate, a substance used in skeletal muscle contraction. Production of both creatine phosphate and creatinine is a function of muscle mass and is not affected by diet, age, gender, or exercise. Since creatinine is excreted solely by the kidney, plasma creatinine levels provide diagnostically significant information about kidney excretory function.

Enzyme Tests

For example, creatine kinase (CK), aspartate aminotransferase (AST), and lactic acid dehydrogenase (LDH) are enzymes that are associated with cardiac function and disease, specifically myocardial infarction. Figure 3-1 displays blood levels of these enzymes in the days following myocardial infarction.

Conclusion

The available evidence does not support either a beneficial or detrimental effect of a vegetarian diet upon physical performance capacity, especially when carbohydrate intake is controlled. Concerns have been raised that an emphasis on plant foods to enhance carbohydrate intake to optimize body glycogen stores may increase dietary fiber and phytic acid intake to levels that reduce the bioavailability of several nutrients, including zinc, iron, and some other trace minerals. There are no convincing data, however, that vegetarian athletes suffer impaired nutrient status from the interactive effect of their heavy exertion and plant-food-based dietary practices, at least enough to impair performance or health. Although there has been some concern about protein intake for vegetarian athletes, data indicate that all essential and nonessential amino acids can be supplied by plant food sources alone, as long as a variety of foods is consumed and the energy intake is adequate to meet needs....

The Vascular Patient

- Renal disease (5-25 ) Renal damage due to hypertension, congestive cardiac failure and involvement of the renal arteries in atherosclerotic, and aneurysmal disease will lead to a degree of renal failure reflected in increased pre-operative plasma concentrations of urea and creatine. Vascular surgery may be associated with sudden haemorrhage and temporary mechanical occlusion of renal vessels. This causes acute tubular necrosis and renal failure.

Serum lipids

Before starting statin therapy, baseline measurements should include a lipid profile, and creatine kinase (CK), alanine transferase (ALT), and aspartate transferase (AST) levels. Elevations of less than three times normal are not contraindications to starting, continuing, or increasing doses of these drugs, but these patients should be monitored carefully.17,25 Statins should be discontinued if CK levels are more than ten times normal in a patient with muscle tenderness or pain.25 If a patient has symptoms and a modest or no CK elevation (three to ten times normal), then the patient's symptoms and CK levels should be followed weekly until the trajectory of the problem is clear. If symptoms progress and CK levels rise, it is best to stop the agent. For routine use, ALT and AST should be rechecked after the patient has been on treatment for 12 weeks and then checked annually thereafter, unless symptoms arise.25

Block

The answer is c. (Fauci, 14 e, pp 1352-1353, 1361, 1374.) Myocardial infarction occurs when an atherosclerotic plaque ruptures or ulcerates. Patients having myocardial infarctions are typically anxious, restless, and uncomfortable secondary to the extreme pain. They may demonstrate the Levine sign (clenching of the fist to demonstrate the severity of the pain). Risk factors for this patient include male gender, positive family history, hypertension, diabetes mellitus, tobacco use, and hyperlipidemia. Electrocardiogram (ECG) will show ST elevations, and cardiac isoenzymes troponin, creatine phosphokinase (CPK)-MB fraction, and lactate dehydrogenase (LDH) will be elevated. Patients with Prinzmetal's angina have recurrent attacks of chest pain at rest or while asleep (unstable angina) due to a focal spasm of an epicardial coronary artery. The diagnosis is confirmed by detecting the spasm after provocation during coronary arteriog-raphy. Cardiogenic shock is a form of severe left...

Uncoupling Protein

UCP-3 is abundantly expressed in skeletal muscle, an important tissue for thermogen-esis (53). Phenotypes of mice in which UCP-3 genes have been inactivated do not indicate that these homologs have a function in regulating either body temperature or body weight (134-137). In one study in which UCP-3 was overexpressed in skeletal muscle of transgenic mice, mice showed a resistance to diet-induced obesity and an improvement in insulin sensitivity (138). As the amount of UCP-3 in the muscle of the transgenic mice was at a level that had been shown previously, by the same group of investigators, to be toxic to the mitochondria of mammalian cells, it is possible that the mitochondria of the transgenic mice were leaky owing to toxicity from the high levels of UCP-3 (139). Consequently, the effects of the UCP-3 transgene expression were not indicative of normal physiological function. A recent study, in which UCP-3 was induced in human muscle by a high-fat diet and then the rate of recovery...

Brown Spiders

Vital signs should be checked, looking for any evidence of systemic toxicity (tachycardia, tachypnea, hypotension, fever). Laboratory workup should include a complete blood count, platelet count, and urinalysis. If there is evidence of DIC, hemolysis, or hemoglobinuria, further studies should be obtained, including coagulation studies, electrolytes, blood urea nitrogen, serum creatine, blood sugar, liver function tests, and serum haptoglobin, and blood should be typed and screened. The white blood cell count may be elevated and the hemoglobin may drop dramatically in systemic loxoscelism.71,90

Myocarditis

Erythrocyte sedimentation rate, creatine kinase, and lactate dehydrogenase may all be elevated. Serum viral titers are helpful only if positive. Polymerase chain reaction can identify specific viruses. Chest radiograph shows a large heart and pulmonary edema. ECG shows sinus tachycardia, reduced QRS complex, and abnormal S and ST waves. Echocardiography shows poor ventricular function and possible pericardial effusions, as well as absence of congenital heart disease and of coronary involvement. Endomyocardial biopsy confirms the diagnosis of myocarditis.

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