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Nevin Morrison, Steven Russell, and Clayton Anderson
Knes 4900
November 8, 1999
For: Dr. Neil Little


Studies on the increase of skeletal muscle mass have become a popular area in the field of kinesiology and sport sciences in recent years.  Science is continually trying to push the human body to reach its maximum potential.  Athletes and coaches are continually searching for new ways in which they can gain an edge over their competition.  The effects in this field of study go beyond the sport and science realms as society pushes its cultural values of the “skinny woman and the strong man” This field of study is also becoming popular for the elderly as they attempt to maintain muscle mass while aging in an attempt to prolong their healthy active life.
The scientific basis of increasing skeletal muscle mass
The following paper will provide an overview of the scientific basis of increasing skeletal muscle mass.  It will also, include four major areas which relate to this increase in skeletal muscle mass.  These areas will be the training principles of muscle gain, nutrition and its effects on muscle gain, supplements and their ability to help increase muscle mass, and hormone muscle enhancing drugs and how they help to increase skeletal muscle growth.  
The first area that will be addressed is the training principles behind increasing skeletal muscle mass.  This will include a scientific overview of the physiology behind increasing muscle mass.  We will also explore the most popular theories behind muscular growth. The energy systems that aid anaerobic muscular contraction will also be looked at in this section.  The training curve will be thoroughly explained along with it’s relation to a proper program for increasing skeletal muscle mass. We will then explain different types of skeletal muscle contractions and how they can be used as a stimulus for muscular growth.  In this same area we will explain the importance of the intensity and type of physical stress required to increase skeletal muscle mass.  We will also highlight different training techniques designed for optimal muscular growth, while considering rest and recovery periods between workouts.  The effects of genetics and gender on muscular growth will conclude the training principles section of our paper.
The next section will examine nutrition and health implications involved with increasing muscle mass.  It will include an outline of the six essential nutrients necessary for proper body function and the quantities of each which are necessary for increasing skeletal muscle mass.  This section will also explore the principles of calorie intake versus expenditure and their effects on increasing body mass or more specifically skeletal muscle mass. 
  The third topic of our paper will explore the use of creatine one of the most popular supplements on the market today used to aid in the increase of skeletal muscle mass. Our group will show to you through the physiology of increasing skeletal muscle mass, how exactly this supplement may aid in the muscular growth.   
 Finally the last section of our paper will look at the popular use of hormone muscle enhancing drugs (more specifically steroids) and their effects on muscular growth as discussed in scientific literature such as “The World Anabolic Review 1996”(Grunding, 1995).  Furthermore we will look at the effects of anabolic/androgenic steroids and how they help to increase muscle mass.  This section will also address the detrimental side effects and risks of using these drugs.
            In order for muscular hypertrophy to occur certain physiological principles have to be in place.  The first concept that must be understood is the principle of “specificity.” When training to reach any type of outcome you must train specifically to reach that outcome. (Adams, 1993).  This principle can be applied to any type of training including training to increase skeletal muscle mass. 
            The second element that must be present in a training program is the appropriate stimulus.  The stimulus must be placed on the muscle repeatedly over a minimum period of eight weeks in order for noticeable muscular hypertrophy to occur (Adams).  In the first eight weeks strength gains will be due to an increased efficiency in neuromuscular function.  However after this initial period further increases in strength will be more the result of muscular hypertrophy.  To maximize muscular hypertrophy this stimulus should be from 60 to 90 percent of the individuals 1RM (the weight that an individual can lift only one time), but more importantly the weight should be such that muscular failure is reached somewhere between eight and twelve repetitions.  The recommended number of sets of repetitions to be done varies from one to four sets per exercise.  It is also necessary to have forty five to ninety seconds rest between sets.
            There are several types of muscle contractions that can provide the appropriate stimulus which will stimulate muscle growth.  The first is an isometric contraction.  This is a static contraction of the muscle against an immovable force.  The next type is a concentric contraction.  This type of contraction is when the muscle shortens with contraction.  The third type is an eccentric contraction this type of contraction is when the muscle is lengthens while still contracting.  The last type of contraction is an isokinetic contraction; it “is a maximal contraction of a muscle group at a constant velocity through the entire range of motion of the joint”(Heyward, 1997).  Isokinetic contractions maintain the same velocity no matter the force that is applied to them.
            The next training principle that I will discuss is the principle of “overload.”  In order for muscle to continue to increase in size there must also be a continual increase in the stimulus.  “This can be accomplished via lifting more weight, lifting the same weight faster, or lifting it for a longer period of time during a single work session”(Heyward).  For the purpose of increasing muscle mass the individual must increase the number of sets, increase the weight or increase the number of repetitions.   The key to this concept is that the stimulus should always be such that muscular fatigue still occurs between eight and twelve repetitions.  In order to apply this principle the individual should start by working with a weight that he/she can only lift eight to ten times before fatigue.  Over time he/she will be able to increase the number of repetitions he/she can do with this weight.  When the individual can do more than twelve repetitions he/she should then increase the weight to a weight that the individual can only do eight to ten repetitions with again. 
            The third guideline for training to increase skeletal muscle mass is the principle of “rest and recovery.”  In order for skeletal muscle to grow, it must first be damaged.  This damage is provided by the stimulus.  After the muscle is damaged it needs approximately forty eight to seventy two hours to heal and grow before it should receive another stimulus.  If a sufficient stimulus is received before the end of this recovery time it is possible that the individual will over train.  If appropriate recovery time is given the muscle should return to and actually surpass its original performance level.  If this pattern is continued over time, continual increases in muscular hypertrophy should occur.
            The next section will show why hypertrophy occurs at the physiological level.  “Exercise-induced hypertrophy occurs through hormonal mechanisms.  Anabolic (protein building) hormones such as testosterone, growth hormone and insulin like growth hormone (IGH) increase in response to heavy resistance exercise and interact to produce protein synthesis” (Heyward).  The amount of these hormones released is directly related to “the size of the muscle groups that are being used, exercise intensity (%1RM), and length of rest between sets”(Heyward).  Higher levels of testosterone, growth hormone and catecholamines are produced dependent on these factors.  “During weight lifting, your muscles are exercised at greater than normal workloads, producing microscopic tears in the muscle cells and connective tissues.  Your body responds by producing new muscle proteins.  This causes muscle growth and increased strength.”(Heyward, p.  139).  One would think that muscular hypertrophy may be due to an increase in the number of fast twitch muscle fibers (the muscle fibers generally used in anaerobic activities such as weight lifting), but this is not the case.  Muscle hypertrophy is actually due to an increase in the size and diameter of these muscle cells.  This increase in diameter is due to  “the enlargement of myofibrils via the production of actin and myosin filaments. The greater diameter of the muscle increases because of greater amounts of actin, myosin, and other intercellular proteins in myofibrils.”  (Adams, 1993)  Actin and myosin are the active intercellular structures that produce muscle contraction (Adams).  By increasing the size of the myofibrils the muscle gains more contractile power.
Other factors that may help produce the appearance of an increase in skeletal muscle mass are increases in the size of connective tissue, tendons and the number of capillararies in and around the muscle.    Increases in the size of the connective tissues provide support for the enlarged skeletal muscle while an increase in the number of capillaries help to provide an increased blood supply to the muscles allowing them to more quickly recover from exercise  (Davis et al).
            All though this paper deals primarily with increasing skeletal muscle mass, it is also important to understand some of the other physiological effects that work together with the increase in skeletal muscle mass to produce increased performance.  First, along with an increase in muscle mass there is also an increase in neuromuscular function.  In the first few weeks of training, most increases in performance are due to an increase in neuromuscular function as your body adapts to new movements and learns how to recruit the necessary muscle groups to perform the task.
            Other physiological changes that occur with weight training are increases in supporting tissues.  Connective tissues and ligaments around the muscles increase in size and strength and bone density also increases in strength in response to the stress of weight training.  These physiological effects are important because if only the muscle itself was increased the supporting tissues would be subject to injury because of the new force that could be generated do to the hypertrophy.
            Another adaptive response to strength training is an increase in the efficiency of the energy systems within the body, which fuel the skeletal muscle.  The two main energy systems involved in strength training for the purpose of increasing skeletal muscle mass are the ATP-PC system and the lactic anaerobic energy system. These systems are involved in fueling the fast twitch muscle fibers which increase in diameter with strength training.   In the ATP-PC energy system, “If exercise requiring large amounts of instant energy lasting less than ten seconds are repeated, with full recovery between repetitions, then the stores of ATP and PC within muscle cell sarcoplasm are increased, therefore enabling more energy to be available”  (Davis et al.  1991).  This will create a higher training threshold for the individual which will enable them to maintain the same intensity for longer periods of time (Davis et al., 1991).
The lactic anaerobic energy system can also be enhanced through strength training.  “It is found that glycogen stores in muscle are enhanced (possibly by virtue of an increase in size and number of fast twitch muscle fibers/cells which preferentially and more rapidly store glycogen) and are more effectively utilized (through the increase in the amount of glycogen converting enzymes found in muscle cells in mitochondria ---the cells themselves being increased in size and number.)”(Davis et al., 1991).
The importance of the increase in efficiency of these energy systems and there effects on muscle hypertrophy are easily seen.  With increased muscular performance due to more efficient energy systems, more stress can be placed on the muscle providing a stronger stimulus for muscular growth. 

Fig. 1
Increased Efficiency  = Increases Performance = Increased Stimulus = Increased Hypertrophy


            A person’s natural genetic make-up also plays a major role in their ability to increase skeletal muscle size.  Every person has his or her own genetically predetermined ratio of fast and slow twitch fibers.  “The enzymatic characteristics of muscle fibers govern several aspects of human muscle performance, namely, contractile speed, strength, and fatigue ability.  An important muscle characteristic in this regard is the relative proportions of constituent muscle fibers (fast vs. slow)” (Bouchard, 1992).  The effects of this ratio on one’s ability to increase skeletal muscle size are obvious as the muscle fibers which increase in diameter with strength training are fast twitch muscle fibers.  Therefore individuals with a larger percentage of fast twitch muscle fibers will be able to increase skeletal muscle size more effectively than individuals with lower percentage of fast twitch muscle fibers. 
Body type differences may also be a factor in increasing skeletal muscle mass as certain body types are more structurally capable of producing and supporting muscular hypertrophy.
            Another genetically predetermined characteristic that effects one’s ability to increase skeletal muscle mass is gender.  A person’s gender, male or female, also effects their ability to increase skeletal muscle mass.  Males produce testosterone, which is a very important hormone in producing the different sex characteristics.  One of these characteristics is an average increase in skeletal muscle mass.  Males are also more receptive to the stimulus of testosterone.  This makes it easier for males to increase skeletal muscle mass.  Although there are differences between the ability of males and females in their ability to produce muscular hypertrophy, the differences are not as great as once thought. (Heyward, 1997).
            Age has very important effects on a person’s ability to increase skeletal muscle mass.  The greatest increases in skeletal muscle mass can be made typically between the ages of twenty five and thirty five years of age. However, with proper weight training programs the maintenance of muscle mass can be possible until much later stages of life.  It was once thought that increases in muscle mass were impossible for elderly individuals, but recent studies have shown that it is possible for muscle to hypertrophy as one ages.  As for children increasing muscle mass, becomes a much more difficult feat because of their high metabolisms.  Furthermore because, heavy weights are not recommended for children as damage can be done to growth plates with improper lifting of heavy weights.  It is recommended that lower weights with higher repetitions be used for children.  The weight can be increased after adolescence after the growth plates have closed.   
In order to understand how muscle hypertrophies one must first understand how it contracts.  As discussed earlier the main energy supplied to the muscle for contraction for weight lifting purposes comes from the ATP-PC system and the Lactic Aerobic Systems.  These energy systems provide energy to the muscle cells quickly but, only for short periods of time. 
The first stage of muscle contraction begins when the nervous impulse reaches the muscle cell.  This initiates the release of calcium ions from the “T” cells in the sarcoplasmic reticulum.  The calcium ions then stimulate the contraction of muscle by exposing the active sites on the actin filaments. (Davis, 1991).  After the breakdown of ATP into ADP the heads of the myosin filaments become active.  These active myosin heads attach to the actin filaments, forming actin-myosin bonds or cross bridges.  The myosin heads pull the actin filaments over them and continue to attach, pull and reattach. (Davis, 1991).  “The whole effect is to pull the actin filaments past the myosin filaments so that they form a bigger overlap (than in the resting state) and therefore shorten the sacromere.”(Davis, 1991).  “With many thousands of thin filaments pulling past thick filaments in a single cell and many thousands of muscle cells contracting, ……skeletal muscle can quickly respond to the demands of ballistic activity …”The strength of muscular contraction is proportional to the number of cross-bridges in harness.”(pg.  41).  By increasing the number of actin and myosin filaments through weight training you can also increase the strength of the muscle’s contraction.
There are many different types of training methods that can be used to maximize muscular hypertrophy.  One of the first principles called a “split routine” is used by bodybuilders to work different muscle groups on different days (Allesen, 1996).  For example bodybuilders would work lower body one day and the upper body the next.  By repeating cycle it enables the athlete to work out everyday while still allowing the body to recover.  Another principle of increasing skeletal muscle mass is to use exercise that require compound movements and require many muscle groups to perform.  This allows for stress not only to be placed on prime moving muscle groups but also on support muscles.  The use of free weights are great for these types of exercises. (Cormier, 1995).  Another important principle used by professional bodybuilders is to concentrate on the areas of the physique which need the most improvement.  The weakest areas of your body will be able to improve performance and hypertrophy easier than the areas that are already strong.  (Cormier, 1995).
In addition the use of weight lifting aids such as straps, chalk and gloves can also be effective increasing the stimulus placed on muscle.  These aids help take the stresses off of weaker muscle groups such as the forearms which allow one to put more stress on stronger muscle groups such as the bicep muscles, for example.
Other techniques that may be used to increase the stress placed on muscles is exercises which require spotters. The spotter functions to aid the bodybuilder at the weakest points of the exercise allowing him/her to lift more weight to achieve muscular fatigue. These type of repetitions are called “forced reps”(Allesen, 1996). There are available some isokinetic machines which have a similar effect as the spotter technique (Allesen, p.  11).  Another technique used to increase blood flow to the muscle groups is called “burns.”  Burns consist of very rapid half-contractions to the point of muscular fatigue  (Allesen, p. 131).  These contractions by increasing the blood flow to the muscles are thought to bring important nutrients to the muscle.  Research supporting the effectiveness of this method is limited.  Burns are usually used near the end of the work out.

            Nutrition is an essential aspect of increasing muscle mass that is frequently overlooked by resistance trainers. Many people follow a disciplined training schedule, using all the right steps toward making size gains, and receive limited results. Nutrition is often the roadblock that prevents them from making these substantial size gains. There are aspects of nutrition that must be followed, such as quantity, quality, and balance within the diet, if gains are to be made in size. Sacrificing one or more of these components in order to fulfill one of the other components often occurs, and inhibits muscular growth more than it encourages it.
The Six Essential Nutrients

            The six essential nutrients all play an important role in the diet of an individual attempting to increase skeletal muscle mass. These six essential nutrients are vitamins, minerals, water, protein, fat, and carbohydrates.
            Vitamins are organic compounds that act as catalysts in the transformation of other organic compounds into energy (Adams, 1991). They aid resistance trainers by helping supply energy to the body during workouts, therefore allowing maximum muscle exertion. Many believe that an increase in physical activity increases the proportion of vitamins needed in the diet, however increased physical activity only increases the need for vitamins in direct proportion with the rest of the needs of the diet. Excess intake of fat-soluble vitamins (A, D, E, and K) can be toxic as they are stored in body tissues and primarily the liver (Adams, 1991). However, excess intake of water-soluble vitamins (B complex and C) has not been proven to be harmful to our health as the kidney excretes them from the body.
            Minerals are inorganic elements that are vital to life through their roles in bone formation, heart, muscle, and nerve function, and regulation of cellular metabolism. Adequate intake of minerals can be achieved through a balanced diet, and there is currently no evidence of performance enhancement through mineral supplementation of already well- nourished individuals. Without proper mineral balance however, muscular performance will suffer, detracting from potential mass gains.
            Ingestion of water before and during exercise can significantly increase performance time before exhaustion sets in (Adams, 1991). Glycogen is a fuel that the body uses to produce energy in the absence of carbohydrates, and is essential to energy metabolism. Intense exercise can deplete glycogen stores within a short period of time, and ingestion of water helps to impede the depletion of glycogen stores. REFERENCE?  Water also plays an important role in regulating our body temperature during exercise. Consuming water before, during, and also after a workout helps to prevent dehydration. For this reason, two cups of water should be consumed for every pound sweated off during a workout. Water also increases sweating during exercise, and helps the body adjust core temperature. The goal of a resistance trainer should be to consume three to six ounces of water for every twenty minutes spent working out.
            Carbohydrates provide us with a readily available source of energy for intense activities, and should comprise sixty to seventy percent of a resistance trainer’s diet. Adenosine triphosphate (ATP) and creatine phosphate (PC) reserves are the body’s first resource for energy, but will burn off within fifteen seconds. After this, the majority of energy liberated during muscle work is derived from carbohydrates and fats (Brouns, 1993). At higher intensity, the body will use more and more carbohydrates, making them the most important fuel in resistance training exercises. They also play an essential role in “protein sparing”, which we will look at in our section on nutrition and over training.
             Fats also provide us with energy, and are recommended to comprise twenty to thirty percent of resistance trainer’s diets. As mentioned earlier, fat is the second main energy source for the exercising individual. Fat serves as a back up to carbohydrates, and becomes the major energy source after carbohydrate stores are used up. However, some amounts of carbohydrates will still be needed to aid in the citric acid cycle. This need will constitute the body to produce glucose from other substrates, in order to provide the needed carbohydrates (Brouns, 1993).
            Protein is known as the building block of muscle, forming the basis for growth and development of organs and tissues. Unlike carbohydrates and fats, the body has no reserve or storage of protein in it. A common misconception of coaches and athletes is that protein is an energy source for muscles. Protein is a source of amino acids needed to build or repair muscle, but muscles do not use protein for fuel. Any protein that is consumed cannot be stored as protein and will be broken down so that the nitrogen in it will be excreted in urine and the rest will either be immediately used for exercise or stored as glycogen or fat. Our body undoubtedly needs protein in order to increase levels of skeletal muscle, but just how much we need is not agreed upon. A general recommendation for protein intake is ten to fifteen percent of an individual’s diet, resulting in fifty to one hundred and ten grams of protein being consumed daily. Brouns (1993) suggests that increased caloric intake for physically active people is alone enough to meet protein requirements if ten to fifteen percent of the diet is still comprised of protein.
Nutrition and Overtraining
            Overtraining is commonly cited as one of the major roadblocks in making significant increases in skeletal muscle mass. Some of the major indicators of over training are sudden weight loss, an increase of five or more beats per minute in resting heart rate, loss of appetite, and performance plateaus. Such factors as not enough rest time in between workouts, long-term high intensity training, and inconsistent sleeping patterns have all been frequently named as facilitators of over training. However, Phillips (1997) contends that most over trained states stem from inadequate diet, not from too much exercise. He makesthe comparison that if a long distance runner was to train every day without eating a sufficient diet, they would obviously not have the energy to perform at their top level. The same applies to weight trainers, as without adequate nutritional support for an individual’s muscles, the chances of muscular growth are slim.
            One dietary factor, which causes weight trainers to be more susceptible to over training, is insufficient protein intake. Protein is the most important nutrient for bodybuilders, as it allows us to retain muscle and provides amino acids to the amino acid pool within our body (Phillips, 1997). If protein intake is insufficient, recuperation will be affected. This causes people to believe that their weight training habits, not their diet is the cause of over training.
            A little known fact about water is that the less you drink, the more likely you are to become over trained. As you sweat during workouts, you dehydrate and lose substantial amounts of body water. Muscle is comprised of seventy percent water, and a higher protein intake requires more water (Phillips, 1997). Water is also an essential transport mechanism for many nutrients such as vitamins, minerals, and carbohydrates. It plays an important role in cellular activity, meaning that if your water intake is too low, transportation will decrease and toxins such as ammonia, uric acid, and urea will begin to accumulate in your body. As this “junk” accumulates, the body is not capable of pushing water into the muscle because too much is pulled out to handle the demands and stresses being placed on it (Phillips, 1997).
            As mentioned earlier, carbohydrates provide us with a “protein sparing” effect. Protein plays a vital role in the maintenance, repair, and growth of body tissues, and it is important that we have adequate levels at all times. When carbohydrate reserves are reduced, the body will convert protein into glucose for energy in a process called “glyconeogenesis”, thus reducing protein levels and depleting muscle from the body.
Caloric Intake. Vs. Expenditure

            In order to give our body the opportunity to increase muscle mass, we must have a higher caloric intake than what we expend in a day. This can be achieved through calorie counting and energy expenditure awareness. Knowing how many calories we expend in an average day can help us to determine how many calories we require exceeding our expenditure, and taking a positive step toward gaining muscle. This can be obtained through adding our basal metabolism (minimum number of calories burned in a twenty four hour period) and our physical activity expenditures for each day. Peterson (1996) suggests that caloric intake should exceed our caloric expenditures by 500 to 1000 kcal per day, equating into a diet of 3500 to 5000 kcals per day. However, consuming this large amount of calories is much more difficult than it sounds. A steady diet must be followed, aided by the use of calorie counting. Calorie counting is simply keeping track of all the calories that we ingest in a day. This can be accomplished through reading the labels of the products we consume, as the majority of product labels now tell us the basic nutritional facts of the product. Experts have advised eating smaller, more frequent meals comprised of caloric dense foods throughout the day. The body works continuously throughout the day, and should be fueled as the need arises. Protein must be present forincrease lean muscle mass, and in order to avoid protein usage for energy, sufficient carbohydrates and fat must be present at all times. These nutrients can be used more efficiently if a moderate amount is ingested on a frequent basis, versus a few large meals per day (Peterson, 1996). It is recommended that weight lifters consume 3-5 meals per day complimented by 3-4 healthy snacks in between meals. Meal replacement shakes or bars can be an excellent way to aid in calorie consumption. Often a feeling of pain or illness can accompany high calorie consumption, and these supplements are highly concentrated (40 calories/oz.) to make the calorie consumption less painful.
            To ensure that weight gain is lean body mass and not extra fat, Peterson (1996) suggests that the rate of gain should be no more than 2 pounds (.90 KG) per week. If an individual is having troubles gaining weight, their caloric intake should be increased by 500kcals/day, until weight gain is achieved. Weekly visits to a dietician will be advantageous so that the diet can be monitored and adjusted as necessary. Also, skin fold measurements should be performed on a monthly basis in order to assure of the desired lean muscle mass increase, versus an increase in body fat.                                        
            Lifestyle is also an important issue in promoting the growth of lean muscle mass. Consistency is perhaps the major obstacle to increasing lean muscle mass, as workout programs and diets are often erratic. One option to increase consistency of workouts is having a committed workout partner. Having someone rely on them to show up will encourage the regularity of an individual’s workouts, therefore increasing the opportunity for growth. As mentioned earlier, diet is also a difficult aspect to consistently maintain. The constant effort of eating on schedule and being aware of what you eat can be exhausting, and methods may be necessary to aid an individual in maintaining a high calorie diet. These can be methods such as planning what an individual will consume each day and writing it down on paper, or carrying an alarm set for every couple of hours reminding them it’s time to eat. Basically, whatever works for an individual to maintain the necessary diet should be utilized.
            Sleep is an essential contributor to muscular development, and is often overlooked or abused by a weight trainer’s lifestyle. It is recommended that nine to ten hours of sleep are obtained each night in order to allow for muscular regeneration and repair.
Tips for Improving Nutrition
            There are many aspects needed if an individual’s diet is going to promote the growth and development of lean muscle mass. The absence of one or more of these aspects can significantly decrease a resistance trainer’s chances of making positive gains in skeletal muscle mass. Outlined here are some tips forsound nutritional habits:
            - Eat more frequent, smaller meals in order to increase caloric intake
-Avoid caffeine products, as they dehydrate the body
            -Meal replacement shakes serve as quick, effective snacks if time is limited
            -Ensure that you are consuming caloric dense foods
-Read labels of products before you buy them, to ensure they contain the desired amounts of various nutrients
-Employ calorie counting throughout the day, to ensure you are consuming enough calories
            -Avoid consuming large quantities of alcohol, as this dehydrates the body
Society has undoubtedly instilled in athletes the mentality that success means being the best. In order to achieve this high level of success, many athletes looking for the competitive edge have turned to dietary supplements.  Dietary supplement is a catch all term that indicates substances that the FDA does not consider drugs and that also do not fall into the categories of normal foods or food additives (Baeckle, 1994). There are thousands of different supplements on the market today, but for the purpose of gaining muscle mass and this paper, we are going to look specifically at creatine and amino acids.
Creatine monohydrate is a compound that’s naturally made in our bodies to supply energy to our muscles. Chemically, it is called “methylguandio-acetic acid” (Phillips, 1997 pg. 49). Creatine is formed from the amino acids arginine, methionine, and glycine. It is manufactured in the liver and may also be produced in the pancreas and kidneys. Creatine is transported in the blood and taken up by muscle cells, where it is converted to creatine phosphate (CP). This CP is best known as small reserves of readily available and rapidly released energy- the alactic anaerobic system. Typically, the average person metabolizes about two grams of creatine per day, and the body normally synthesizes that same amount. Thus there is generally a creatine balance in the body.  The purpose of taking creatine is that it “helps build lean body mass, which allows greater force to be used when weightlifting; provides energy so duration of exercise or workcan be lengthened; and it helps speed recovery so exercise frequency can be increased” (Philips, 1997). A study done by Brannon et al., showed that creatine supplementation provided an ergogenic aid to high intensity exercise, especially that of a repetitive nature. Also creatine supplementation enhances muscular performance during repeated sets of bench press and jump squat exercises (Volek et al. 1997). All of the effects of using creatine would definitely help someone gain more muscular mass compared to someone who is not using it.
In most cases, almost everyone connects the word “steroids” with anabolic steroids, which to the layman is better known under the name of “anabolics”. It is often forgotten, however, that the name “steroids” is only the generic term for various steroid hormones. Their representatives are the suprarenal cortical hormones (gluco- and mineralcorticoids), the female sex hormones (estrogen and gestagen), as well as the male sex hormones (androgens) (Grunding and Bachmann). For the purpose of increasing skeletal muscle mass, we are going to look at the last version of the hormones of which testosterone is the most important representative.
            Hanrahan states that testosterone is the basis of almost all anabolic/androgenic steroids known to man and is the most important representative of the male sex hormones, also called androgens. The body uses cholesterol as a basis for the development of this hormone group (Cohen, Hartford and Rogers, 1994. Pg.371). The Leydig’s cells in the male gonads (testes) produce the androgens. The final product is testosterone, which fulfills three functions in the human body. 1) Testosterone promotes the development of secondary male sex characteristics (increased growth of body hair, beard growth, deepening of voice, increased production of sebaceous glands, development of the penis, aggressiveness, sexual libido, etc.) and the maturation of sperm. These aspects are also called the androgenic functions of testosterone. Men distinguish themselves from women by the amount of testosterone produced daily. Men produce between 4 and 10 mg of testosterone daily while women produce only 0.15 – 0.4 mg/day. 2) Testosterone also helps in the promotion of the protein biosynthesis: Responsible for this process are the highly anabolic characteristics of testosterone. Accelerated muscle buildup, increased formation of red blood cells, faster regeneration, and a shorter recovery time after injuries or illness are achieved. The entire metabolism is stimulated, and the burning of body fat is activated. 3) Lastly, testosterone also inhibits the gonadal regulating cycle: This includes the hypothalamohypophysial testicular axis, which regulates the amount of testosterone produced in the body (Grunding and Bachmann, 1996. Pg.12). If the testosterone concentrations in the blood are high, the testes will signal the hypothalamus to release less LHRH (leutenizing hormone releasing hormone). Thus the hypophysis releases less gonadotropin LH (leutenizing hormone) and FSH (folic stimulating hormone). Consequently, the Leydig’s cells in the testes reduce the production of testosterone.
            Anabolic/androgenic steroids are synthetically manufactured compounds which are similar to the natural male androgen, testosterone. They are therefore defined as synthetic derivatives of testosterone. Bridge states that the main reason for their original development was the intention to produce a product which would include the highly anabolic effect of testosterone while, at the same time, exclude the negative aspects of the pronounced androgenic components. Great efforts were made to develop a pure anabolic steroid without androgenic side effects, but complete separation of anabolic and androgenic effect has not been achieved. To attempt this goal, various changes to the steroid molecule were made. The newly developed steroids distinguished themselves through both a decreased effect with a weaker anabolic and androgenic effect or with an increased effectiveness, after both the anabolic and androgenic components had been increased. Structural changes in some steroids resulted in an even higher androgyny but reduced the anabolic activity. A so-called anabolic steroid, therefore, also has a certain androgenic effect and, correspondingly, an androgenic steroid also has anabolic characteristics. One would therefore assume that for fast buildup of strength and muscle mass a predominately anabolic steroid with only minimal androgyny should be selected. Unfortunately not, because the name “anabolic steroid” does not tell us about the strength of the anabolic effect. Instead it only indicates that the anabolic/androgenic relationship in the original steroid testosterone was shifted. In order to determine this relationship and thus be able to classify a steroid as an anabolic or an androgenic, testosterone serves as a parameter. Steroids which are less androgenic are called anabolic steroids, while steroids which are equally or even more androgenic, are called androgenic steroids. An athlete wishing to gain the most muscle mass has a problem, since the androgenic steroids are not only more effective but unfortunately also more harmful. From this we can derive a certain rule: the more effective a steroid, the more androgenic its substance and the more harmful it is for the body. The first anabolic/androgenic steroids were officially available during the 1950’s (Hanrahan, 1994. Pg. 16). Only a decade later, most of today’s available compounds were already on the market. In the meantime, only a few new steroid compounds have been developed. Many steroids have been removed from the market; some were reintroduced in other countries under a generic name. Nevertheless steroids are still the most effective method of improving muscular mass and strength (Lenehan, Bellis, and McVeigh, 1996. Pg. 65).
            The physiology of anabolic/androgenic steroids is a very complex subject. It is almost impossible to give exact configurations of all biochemical processes that take place in the body during the intake of steroids. Steroids are either injected intramuscularly or taken orally. When injected, the substance directly enters the bloodstream while tablets, taken orally, reach the liver through the gastrointestinal tract. Here the substance is either completely or partially destroyed or sent into the bloodstream in its original form. The administered steroid is now present in the blood in the form of numerous steroid molecules that, through blood circulation, move around the entire body. Each steroid molecule contains a certain message or information that it tries to transmit to specific body cells. The cells designated for this purpose possess various receptor types on their membranes. One of these is the steroid receptor that, for example, is present in large amounts at the muscle cell. The form and size of these steroid receptors match those of the steroid molecules. Receptor and molecule show a high affinity, comparable to a key that fits the right lock. The steroid receptor absorbs the matching molecules while rejecting thousands of other molecules, which do not fit in size and shape. Only when the steroid receptor and the steroid molecule have formed a complex can the molecule transmit its message to the muscle cell. In the bloodstream usually close to 98% of the steroid molecules in the blood are bonded with binding proteins, while only 2% of the steroid molecules are present in a free unbonded state (Keith, et al.1996. pg. 250). The formed steroid receptor complex now travels to the cell nucleus where it bonds to certain sequences on the nucleic acid sections of DNA (desoxy ribonuclein acid). Now a transcription takes place, where a template of the DNA is made. The resulting MRNA (messenger ribonuclein acid) leaves the cell nucleus and bonds with the RNA in the cytoplasm where, through translation, an increased protein synthesis takes place. When combined with an intense weightlifting workout, an increase in the diameter of the muscle cell occurs (muscular hypertrophy). After the steroid complex has done its job in the cell nucleus, the steroid molecule returns to the blood stream and can either be reused briefly for the some purpose of changed into a weaker, ineffective molecule, which is then excreted through the urine. Not all-steroid molecules end up doing their job. Some are metabolized and eliminated by the body, while others can be converted into the female sex hormone estrogen. 
Although the increased protein synthesis is considered to be the most important effect of steroids on the muscle cell, the steroid molecules also forward other information important to the bodybuilder. There is increased evidence that steroids have a high anticatabolic effect. Thus, the rate at which protein in the muscle cell is broken down is reduce (Grunding and Bachmann, 1996). The steroid molecule also occupies the cortisone receptors on the membrane of the muscle cell and blocks them. Therefore, the cortisone produced by the body, a highly catabolic (reducing) hormone, cannot become effective and the muscle cell does not release protein (Grunding and Bachmann, 1996. Pg. 16). Another advantage of steroids is that they increase the phosphocreatine synthesis (CP) in the muscle cell. As stated earlier in the paper, CP is of crucial importance during the restoration of ATP (adenosine triphosphate). The more ATP available to the muscle means the muscle has the ability to become stronger. Another factor, which benefits the athlete, is that steroids store more carbohydrates in the muscle cell in the form of glycogen. This process, together with a higher liquid retention, which takes place simultaneously, results in a higher muscle volume, improved endurance, and more strength (Phillips, 1997).  Steroids also reduce the release of endogenous insulin since the steroid allows the muscle cell to absorb nutrients (carbohydrates in the form of glucose and protein in the form of amino acids) by depending less on the insulin. This helps the athlete in lowering the body fat and hardening the muscles since insulin helps in stimulating the growth of fat cells. The last benefit that steroids have on gaining muscle mass is the pump effect that occurs from working out. The reason for this is that steroids increase the blood volume and amount of red blood cells in the body. The muscle has a larger appearance and becomes more vascular. In addition to these advantages, the increased blood flow allows for a greater transport of nutrients to the muscle cells (Grunding and Bachmann, 1996).
In general, steroids are frowned upon by society because of ethical and moral doubts, and because of the potential negative side effects that occur from using them. Brower, Blow and Hill stated that the potential effects upon the liver are most apparent in steroid users. These can manifest themselves in various dysfunctions of the liver such as cholastasis (bile obstruction in the liver), a peliosis hepatis (blood-filled cavities in the liver tissue, cysts), or liver cancer. Other side effects of taking steroids are the inhibition of the gonad cycle, water and salt retention, feminization (gynocomastia, A.K.A.bitch tits), changes in skin, psychological changes, gastrointestinal symptoms, baldness, cardiovascular defects, virilization, growth deficit, prostate hypertrophy, high blood pressure, cardiac hypertrophy, and kidney damage (Evans, 1997. Pg. 350).
Steroids are not a wonder drug since their effectiveness depends on external factors such as workout, nutrition, attitude, and the genetic predisposition of the individual. This last point, in particular, will determine how the individual responds to the intake of anabolic/androgenic steroids and how he/she copes with their side effects. The fact that it is illegal in America to use steroids other than for medicinal reasons has not stop bodybuilders from using and abusing the drugs. For an individual wishing to gain outrageous amounts of muscle mass over the shortest period of time there is no denying the fact that steroids are the most effective compounds for this purpose, regardless of their side effects.

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The Scientific Basis of Increasing Skeletal Muscle Mass

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