Some patients experience the opposite, noticing dryness or increased thirst. Testosterone Replacement Therapy, or TRT, has become one of the most discussed treatments in men’s health. Our goal is to promote long term wellness to maximize a long and healthy lifestyle.
Importantly, the creatine supplementation protocol appeared to be well tolerated and did not adversely affect laboratory markers of kidney function, oxidative stress, and bone health 81–83. From a clinical perspective, creatine supplementation has been found to potentially offer health benefits with minimal adverse effects in younger populations. More recently, in a comprehensive review examining the safety of creatine supplementation in adolescents, Jagim et al. summarized several studies that examined the efficacy of creatine supplementation among various adolescent athlete populations and found no evidence of adverse effects. In five of these studies 67–71, free testosterone, which the body uses to produce DHT, was also measured and no increases were found.
If symptoms of low testosterone are interfering with your quality of life, know that you don’t have to just grin and bear it. For all these reasons, your healthcare provider will carefully consider if TRT is safe for you based on your unique characteristics. Research has also studied the increased risk of venous thromboembolism, and the results are mixed. If you don’t have these health concerns, TRT is generally safe. This is why healthcare providers do extensive evaluations and tests before approving the use of TRT. Certain existing health conditions make TRT unsafe, like prostate cancer, breast cancer and heart failure.
Sleep, particularly deep sleep, is where growth hormone pulses, testosterone secretion, and muscle repair are most active. Some men exploring oxandrolone are already in the world of medically supervised testosterone replacement therapy, and that context matters. You can stay on testosterone replacement therapy for as long as it’s benefiting your symptoms and not causing health issues. This includes monitoring your testosterone level and getting other blood tests to make sure TRT isn’t harming your health.
In a review of creatine supplementation studies, Persky and Rawson found no increase in serum creatinine in 12 studies, 8 studies showed an increase that remained within the normal range, and only 2 studies showed an increase above normal limits (although not different from the control group in one study). Both blood and urinary creatinine may be increased by ingestion of creatine supplementation and creatine containing foods, such as meat. However, the amount of creatinine in the blood is related to muscle mass (i.e. males have higher blood creatinine than females) and both dietary creatine and creatinine intake . As a result, creatine supplementation may not lead to water retention.
Creatine monohydrate remains one of the most well-studied and effective legal supplements for strength and lean mass, with a safety profile that is genuinely favorable over long-term use. Protein intake sufficient to support muscle protein synthesis is the nutritional cornerstone, and most men who are not seeing results are under-eating protein rather than lacking a pharmaceutical edge. It requires a clinician who can review labs, understand personal health history, and make individualized decisions. What works well for one man, in terms of body composition benefit and side effect tolerance, may be entirely inappropriate for another.
Short-term loading with creatine monohydrate (e.g., consuming 5 g, 4 times daily for 5-7 days) has been reported to increase intramuscular creatine stores by 20–40% and exercise performance capacity by 5–10% 2, 125. Creatine monohydrate was used in early studies to assess bioavailability, determine proper dosages, and assess the impact of oral ingestion of creatine on blood creatine and intramuscular creatine stores 35, 60, 182. In summary, there is accumulating evidence that creatine supplementation has the potential to be a multifactorial therapeutic intervention across the lifespan in females, with little to no side effects. For example, postmenopausal females who supplemented daily with 0.1 g/kg/day of creatine during 52-weeks of supervised whole-body resistance training experienced an attenuation in the rate of bone mineral loss at the femoral neck (hip), compared to females on placebo during training .
Pioneering research in the early 1900’s using animal models showed that creatine supplementation could augment creatine content by 70% 101, 102. There was no significant difference in absolute fat mass loss; however, the creatine group lost ~0.5 kg more fat mass compared to those on placebo. Participants supplementing with creatine had a greater reduction in body fat percentage. In contrast, the children who did not consume creatine gained fat mass . There was an increase over time for lean tissue and strength with a decrease in fat mass. Study participants were randomized to supplement with creatine or placebo before or after resistance training (3 days per week).
TRT suppresses the body’s natural testosterone and sperm production. A thorough medical evaluation, including comprehensive lab work and health history review, is essential before starting TRT. Lowering the dose or switching to more frequent, smaller injections often resolves acne, fluid retention, and mood issues without sacrificing benefits. Regular complete blood count (CBC) monitoring is essential, and therapeutic phlebotomy may be required if levels climb too high. Elevated hematocrit from TRT can increase blood viscosity, raising the risk of deep vein thrombosis (DVT), pulmonary embolism, or stroke. Testosterone can promote sodium and water retention, causing mild swelling in the ankles, hands, or face.

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