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You drink more and piss more, some people also notice stomach discomfort immediatly after consuming it.
Creatine is something found naturally in meats and your own body, it's all natural. By taking it as a suppliment, you merely increase levels of things that you normally consume without problem, and therefor it's more effective.
However, long term effects arn't known as the suppliment has only been on markets a relativly short amount of time.
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