The most well known explanation for the performance enhancing effect of creatine monohydrate is that it allows improvements in energy metabolism by causing accumulation of creatine in skeletal muscle, which increases the buffering capacity for ATP. However, there may be other mechanisms by which creates can improve exercise performance. In particular, creatine monohydrate supplements may stimulate muscle protein synthesis. In one study, creatine caused an increase in muscle fibre size of around 35 % with resistance training, but the training alone caused an increase in fibre size of only 15 %. It is possible that this effect stems from an anti catabolic effect as creatine has been shown to prevent leucine oxidation in skeletal muscle. Some authors have suggested that as creatine is an end product of contraction, it may be possible that creatine is a stimulus for protein synthesis. In fact creatine can stimulate action and myosin fibres in animal models. Some evidence therefore suggests that creatine may cause muscle growth.
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