What medications or supplements are effective for building lean muscle mass?

From the Guidelines

For building lean muscle, the most effective and safe supplements are whey protein powder and creatine monohydrate, as supported by the most recent and highest quality study 1.

Key Recommendations:

• Take 20-25 grams of whey protein within 30 minutes after workouts or as a snack between meals.
• For creatine, start with a loading phase of 20 grams per day for 5-7 days, divided into 4 doses, then maintain with 3-5 grams daily.

Rationale:

These supplements work by providing essential amino acids for muscle repair and increasing energy for high-intensity workouts. While not a medication, testosterone replacement therapy under medical supervision can help build muscle in men with clinically low testosterone levels, as noted in 1 and 1. However, the foundation for muscle growth is a proper diet high in protein (1.6-2.2 grams per kg of body weight daily) and a consistent resistance training program, as emphasized in 1 and 1. Supplements can enhance results but cannot replace proper nutrition and exercise.

Important Considerations:

• Be aware that creatine may cause water retention, and excessive protein intake can strain kidneys in some individuals, as mentioned in 1 and 1.
• Always consult with a healthcare provider before starting any new supplement regimen, especially if considering testosterone therapy.

Additional Guidance:

• A daily vitamin D supplement of 15 μg, as recommended in 1, can also support overall health and muscle function.
• Adequate amounts of fluids, with women needing at least 1.6 l and men needing at least 2 l of drinks per day, are essential for overall health and muscle recovery, as noted in 1.

From the Research

Effective Medications and Supplements for Building Lean Muscle Mass

• Protein supplements: Consuming supplemental protein may promote muscle hypertrophy and enhance gains in muscle strength in both untrained and trained individuals, particularly when the training stimulus is adequate 2.
• Creatine monohydrate: This supplement appears to have beneficial effects relevant to contest preparation and can increase muscle mass, especially in combination with resistance exercise 3, 4.
• Beta-alanine: This supplement may also have beneficial effects relevant to contest preparation 3.
• Caffeine: Caffeine appears to have beneficial effects relevant to contest preparation 3.
• Amino acids: Stimulation of muscle protein synthesis (MPS) from amino acids can contribute to an increase in net muscle protein balance (NBAL), leading to accretion of muscle proteins 4.
• Carbohydrates: Attenuation of muscle protein breakdown (MPB) by carbohydrates can also contribute to an increase in NBAL 4.
• Testosterone: This hormone is a potent anabolic stimulus primarily through improvement in re-utilization of amino acids from MPB 4.

Nutrition Recommendations

• Caloric intake: Should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention 3.
• Protein intake: Most bodybuilders will respond best to consuming 2.3-3.1 g/kg of lean body mass per day of protein 3.
• Fat intake: 15-30% of calories should come from fat 3.
• Carbohydrate intake: The remainder of calories should come from carbohydrate 3.
• Meal frequency: Eating three to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior and subsequent to resistance training may maximize any theoretical benefits of nutrient timing and frequency 3.