Creatine use for muscle bulk

I remember in the 90's a competitive cyclist told me he was using creatine for his work outs and noted the when he was on it, bulk was thick, without it, training was same but doesn't think he got as "beefy".  At that time the information out there was it caused kidney failure if taken during times of dehydration.  It was theorized that benefits only came to endurance sports.   No great reproducible studies, only one or two case reports.   The amount of creatine used (during loading phase) is equal to about 5 steaks, I remember some friends from the 80's on Temple University's Power lifting Team that would get close to 3-4 steaks during competitive season.  I wonder if they went onto healthy futures with the Temple Hospital bypass team.  So if you could get the effects of creatine without any side effects of too much red meat, why not enhance your exercise?  According to Jay Hoffman (one of the profs from UCF where I was team physician) the idea is to use creatine to enhance training response.  Creatine helps to rephosphorylate ADP to ATP.  The more ATP in the muscle cell, the stronger the actin/myosin pulls, the stronger the muscle works to move, pull, push, contract.  With an effective training response, followed by good repair time and a healthy diet, the stronger the muscle is to endure the next exercise routine.  Note to beginners, if you are not fine tuned with an existing exercise routine, do that first to establish muscle fitness, cardio and proper body mechanics.  If you start out of the gate with expensive supplementation and a new exercise program (designed by someone trained in the exercise arena-personal trainer, certified instructor, exercise physiologist, physical therapist, sports medicine physician) no doubt my average patient usually gets muscle soreness and joint pain and really waste the dose of creatine.  For it to be effective, most studies suggest:
1-loading dose of 20-25grams daily for 5 days
2-maintenance of 2-5grams daily for 10 weeks (depending on size of athlete)
3-wash out period for 3 weeks (no creatine) it takes about 3-4 weeks of abstinence to have muscle levels return to baseline
Wash out suggested since there have been no reproducible studies on the long term effects of creatine on the bodies own production.  Yes, the body produces it, in fact those with high endogenous creatine will have poor to no results when ingesting the supplement.  Side effects are gastric bloating, and discomfort with the loading phase.  Muscle cramping also a smaller listed side-effect although when I used it at the above suggestions, during a post workout abdominal stretch, I suffered one of the most excruciating spasms to the rectus abdominis.  This causes 10/10 pain and locks the body into a forward fold until the muscle fatigues in a few minutes.....oh..it also cuts back inspiration so I couldn't breath.  Good thing I was in forward fold with my head down or I would have passed out. 

The wash out phase should be coordinated with the "max out" concept of muscle fatigue.  If your exercise routine is challenging, your "coach" will always design a progress/overload schedule over several weeks.  Care in designing this on your own as either we are too complacent and stick with no overload thus loose stimulation of muscle growth or too aggressive and push/crash (I took this term from my exercise physiologist Aimee Weber). 

Care in using creatine with exercise stimulants like "Amino Shooters", Redline or other pre workout energy drinks as they may have more ingredients than are written on the label.  (The FDA "asks" that companies watch-dog themselves and be honest in labeling ingredients....kinda like asking your teenagers to "be good" on a date).  These are great for enhancing reaction time, focus, training response but could also cause insomnia, high blood pressure, agitation (similar to caffeine overdose). 

Finally if there is pre existing kidney disease, you are on a blood pressure medicine (diuretic) or a diabetic, avoid this stuff and seek out another way to get you past your exercise plateau.

(A study in the UK was performed hoping creatine in pulmonary rehab patients would be able to gain muscle mass during therapy for lung disease.  No great results were found but more info necessary-I believe it was due to the participants did not hit their plateaus in fitness and were just tested during ordinary exercise endeavors) 

Creatine Use Video