Athletic performance and recovery: Evidence-Based Supplement Guide

Athletic performance is the second most common reason people in Avelor take a supplement: 33 of 72 people with a saved stack hold something for training, across 40 saved items. It is also the area where the evidence is unusually good, which is rare enough to say plainly. **Creatine monohydrate is the best-evidenced supplement in this guide and one of the best-evidenced in the product.** It has been examined in systematic reviews and meta-analyses for training performance (PMID 30935142, 27328852, 25946994) and for recovery and adaptation (PMID 37432300, 39074168, 24576864). This is not a case where the research is thin and the marketing is loud. The research is substantial and consistent. **Protein adequacy is the other thing with real evidence behind it**, and it is about total daily intake rather than a product. A widely cited systematic review and meta-analysis examined protein supplementation and resistance-training adaptations (PMID 28698222), with further reviews covering distribution and adequacy (PMID 29462923, 38039960, 35689750, 40647175). The finding people usually miss is that the benefit attaches to reaching an adequate total, not to the powder that delivers it. **Caffeine has good evidence for acute performance** across several reviews and trials (PMID 36615805, 29876876, 39408319, 40431449, 35239468). It is the clearest example in Avelor of a supplement whose effect is real, short-lived and dose-timing dependent, which is why it appears in both this guide and the sleep guide for opposite reasons.

1. **Reach an adequate daily protein total first.** The evidence attaches to the total (PMID 28698222), not to any particular product. 2. **Consider creatine monohydrate**, the most examined option here (PMID 30935142, 37432300). 3. **Treat caffeine as a timing decision, not just a dose one.** It works acutely (PMID 36615805) and the same property costs you sleep later (see the sleep guide). 4. **Tell whoever prescribes your medicines** what you are taking, particularly if you take lithium or a stimulant.

Creatine trials commonly run **four weeks or longer** for performance and body-composition outcomes (PMID 30935142, 24576864). Caffeine's performance effect is measured **within hours** of intake (PMID 36615805). Protein adequacy is a **daily habit** rather than a course with an endpoint, which is why the reviews report training-period outcomes rather than a duration.

- **Populations vary and are mostly narrow.** Several trials here are in specific athlete groups, soccer players (PMID 30935142) and volleyball players (PMID 40431449), which does not generalise to an untrained reader. One creatine trial is specifically in **older adults** (PMID 24576864), so this is not uniformly a young-male literature, and neither claim should be made about it as a whole. - **"Performance" is many different outcomes.** Strength, power, endurance and body composition are measured separately and do not move together. A review reporting a benefit for one is not evidence for the others. - **Caffeine's effect is acute and habituates.** Regular use changes the size of the effect, and the trials mostly test a single occasion. - **No dose appears in this guide.** Dosing is a clinical decision and is held for clinician review. - **This guide has not been reviewed by a clinician.** `reviewStatus` above says so.

- **Caffeine and lithium interact in the direction most people get backwards.** Caffeine increases lithium clearance, so *reducing* caffeine can raise serum lithium. Raise any planned change with **the prescriber who manages your lithium** (PMID 38621222, 3338980). - **Caffeine raises exposure to some medicines** through the same liver enzyme, including ciprofloxacin and clozapine. Tell **the prescriber who manages those** that you take caffeine (PMID 2729942, 33849480). - **Creatine draws water into muscle.** Anyone with kidney disease, or taking a medicine that affects the kidneys, should raise it with **the clinician managing that condition** before starting. - **Sudden large increases in protein intake** are worth raising with **a doctor or a dietitian** if you have reduced kidney function.

| Entity ID | Name | | --- | --- | | `avelor:sup:creatine` | Creatine | | `avelor:sup:protein` | Protein (whey or plant) | | `avelor:sup:whey-protein` | Whey Protein | | `avelor:sup:beetroot` | Beetroot (nitrate) | | `avelor:sup:electrolytes` | Electrolytes | | `avelor:sup:taurine` | Taurine | | `avelor:sup:coffee` | Coffee | **Named and not linkable.** **Caffeine** has no canonical entity of its own; `coffee` is the nearest and is not the same thing, because a pre-workout powder is not coffee. **Beta-alanine** and **BCAAs** appear in live user stacks and have no entity at all. Recorded here rather than linked to an invented ID. **Resolving is not the same as being checkable.** The interaction catalogue keys on a collapsed name string rather than an entity id. Of the seven entities above, five carry a catalogue key and two do not: `beetroot` and `taurine` display as recognised ingredients and are checked against nothing.

| PMID | Title | | --- | --- | | 30935142 | "Effects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis" | | 27328852 | "Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis" | | 25946994 | "Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses" | | 37432300 | "The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy: A Systematic Review with Meta-Analysis" | | 39074168 | "The Effect of Creatine Supplementation on Resistance Training-Based Changes to Body Composition: A Systematic Review and Meta-analysis" | | 24576864 | "Creatine supplementation during resistance training in older adults-a meta-analysis" | | 28698222 | "A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults" | | 29462923 | "The Effect of Whey Protein Supplementation on the Temporal Recovery of Muscle Function Following Resistance Training: A Systematic Review and Meta-Analysis" | | 38039960 | "Effects of Timing and Types of Protein Supplementation on Improving Muscle Mass, Strength, and Physical Performance in Adults Undergoing Resistance Training: A Network Meta-Analysis" | | 35689750 | "Effects of Protein Supplementation Associated with Resistance Training on Body Composition and Muscle Strength in Older Adults: A Systematic Review of Systematic Reviews with Meta-analyses" | | 40647175 | "Does Protein Ingestion Timing Affect Exercise-Induced Adaptations? A Systematic Review with Meta-Analysis" | | 36615805 | "Effects of Caffeine Intake on Endurance Running Performance and Time to Exhaustion: A Systematic Review and Meta-Analysis" | | 29876876 | "The Effect of Acute Caffeine Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis" | | 39408319 | "Effect of Caffeine and Nitrates Combination on Exercise Performance, Heart Rate and Oxygen Uptake: A Systematic Review and Meta-Analysis" | | 40431449 | "Effects of Caffeine Supplementation on Exercise Performance in Volleyball Players: A Systematic Review and Meta-Analysis" | | 35239468 | "Effects of caffeine chewing gum supplementation on exercise performance: A systematic review and meta-analysis" | | 38621222 | "Sudden Reduction in Caffeine Intake Increases Serum Lithium Concentration to Supratherapeutic Level: A Case Report" | | 3338980 | "Lithium tremor and caffeine intake: two cases of drinking less and shaking more" | | 2729942 | "Interaction between oral ciprofloxacin and caffeine in normal volunteers" | | 33849480 | "Caffeine-clozapine interaction associated with severe toxicity and multiorgan system failure: a case report" |