The Optimal Creatine Protocol for Strength, Brain, and Longevity | Darren Candow, PhD

and how is it going to benefit you is it going to improve your training volume is it going to make you stronger all the above I'm one of the big proponents of taken a lot more than probably what's recommended but when it comes to set two three and four that's where creatine really comes to the rescue and they measured it for 21 hours of sleep deprivation and it really improved memory cognition and it increased brain creatine content today I'm joined by Dr Darren kandow who is a leading researcher in the creatine field and muscle aging he's published over 140 papers on nutrition and exercise performance how it affects muscle muscle Health Muscle aging uh Darren I'm super excited to have you here today to have this conversation with you to go deep into the science of creatine yeah no thanks for having me I'm really excited as well absolutely yeah I've I've read several of your studies I'm a huge fan a lot of really important and interesting research to talk about okay uh maybe we could start start where it's most most I mean a lot of people think about creatine in its role in in exercise performance however um there's been a lot of emerging research in other areas maybe you could give people just a quick snapshot and yeah like it's really evolved over the last 40 years it's gone from athletes getting bigger stronger faster now we're looking at potential benefits on bone health uh brain health cardiovascular health um even in children and during pregnancy so it's evolved from just the young male athlete to pretty much anybody on the planet is now considering creatine either in their diet or supplementation so for the next few hours super excited to talk about all aspects of creatine and the evidence-based research behind it well let's talk about the the resistance training and improving performance muscle health I mean why why are people why is it so popular well it because it works from a a muscle performance perspective so it really it basically increases the ability to produce ATP or maintain it during uh an exercise session so for example when you're doing you know uh a squat or leg press or even running you're doing muscle contractions and fossil creatine which is what we're going to be talking about today from creatine supplementation it really maintains ATP or adenine D triphosphate so if you have more ATP longer you can exercise at a higher capacity a higher intensity and that delays the utilization of other energy systems that might be a bit slower um so anybody involved in high explosive anerobic type of Sports weightlifting high intensity interval training for example um probably would experience some benefits from creatin supplementation and how is it going to benefit you is it going to improve your training volume is it going to make you stronger all the above so it definitely seems to increase training volume so that's either the load by the Reps by the set or Exercise capacity from a cardiov vaster perspective um it definitely if you were to choose one thing why creatine has been so effective it's improving muscle strength um you could also Encompass that with endurance and power it also improves lean body mass so here's a big dis uh discrepancy that a lot of the viewers might not know when we measure lean body mass in the labs we're we're technically measuring blood connective tissue soft tissue um so we're not directly measuring muscle mass we need to do a lot more research on that um but in general about 50% of the value of lean body mass we consider muscle so it has some small favorable effects there's been some studies with qct as well as ultrasound but you can get an increase in lean body mass Regional muscle thickness muscle performance but probably the area that most people don't realize is the recovery aspects it really seems to have some anti-catabolic effects um potentially anti-inflammatory uh effects and that's interesting because it's from the aerobic Community for the longest time we never thought creatin was for endurance or aerobic type athletes and the best lines of evidence from a recovery aspect uh come from long duration aerobic exercise a marathon ultramarathon a triathlon it seems to reduce cyto so those are markers of inflammation um so there's a whole gamut of mechanisms there's about 10 what we consider anabolic uh factors and then there's probably just as many as an anti-catabolic effect so uh it has a plethora of benefits which I'm sure we'll talk more about in detail today yeah so you okay to to go back you just gave it total information dump it which is awesome um let's go back for to the explosive power you were talking about it seems to really help benefit in that explosive power like you're talking about doing doing a squat yes or I don't know maybe the first few seconds of a interval um something where you're going you know using all that power yeah um is is it is creatine benefiting benefiting is that how it's benefiting increasing the training volume or is there something else that's happening yeah in two ways so it really seems to um maximize either the recruitment or the ability of type two muscle fibers uh and when we talk about aging unfortunately those are the ones we're losing as we get older but it really seems to work in the second third and fourth set so for example if you were to do four sets of leg press compared to bbo you may not notice any difference in the first set because we think we have enough ATP or fossil creatine storage in our muscle but when it comes to set two three and four that's where creatine really comes to the rescue the individual or group can do more uh repetitions and then over time they can do a greater volume we think with weeks of training if you're doing more volume you can actually get greater physiological adaptations so when we look at all the meta analysis when you compare creatine and weight training to creatine Placebo and weight training there is a greater increase in lean body mass uh muscle size as well as muscle performance so creatine there is something there from a mechanistic standpoint to allow that uh and we think muscle fiber recruitment primarily type two muscle fibers is one of the main reasons does it affect the recovery time in between sets excellent question it does it really speeds it up so on average if you were to totally wipe out your normal creatine stores it takes about 3 to five minutes for your mitochondria to recover that uh however creatine really really speeds up that recovery which is great for the average person they don't have a lot of time to work out they can't wait around for 3 to five minutes in between a really intense set so it really speeds up the recovery not only does it speed up the recovery after every set but in between contractions as well so over time the individual could probably have a really intense great workout in less time total and get actually more favorable effects and I think what this is really important we're talking about here I mean we were talking about squats you know these explosive types of um Power types of training um and and this is a really important field because you know you often hear about people talking about the loss of muscle mass as we age you talked about losing type two types of muscle fibers more readily than the type one so these are the types of muscle fibers involved in that explosive type of um Power type you know exercise and um you know people don't think about how power decreases with age how you strength decreases with age and how that affects our quality of life how it affects our physical Independence our fall risk right right and so I think just focusing on this type of training I mean the creatine is the icing on the cake right but just focusing on doing these types of multi-joint compound types of Li which is something that I in the past I would say year a good year now a solid year of doing CrossFit type of training where I'm doing strength training I'm doing resistance training strength training and high intens inner training that's including you know the types of stuff that I'm used to doing um biking and and Rowing but also adding in you know doing doing some drop sets with with you know front squats with the barbell and things like that it's super important so this velocity or powertrain or or variety training first we got to get people to move and then allowing them to give some type of benefit to their training program so creatine is probably the one that will be number one when people selected even probably more than caffeine nowadays uh from an exercise training capacity uh so it should be considered um it can have a lot of substantial beneficial effects and as we get older after about the fourth decade unfortunately we start to lose these type two muscle fibers and so exercise has to be foundational uh and if anything else can be beneficial protein creatin um I'm all for it and I think most people hopefully will be as well yeah so the the improvements in in the muscle strength presumably are coming because you're increasing your training volume right is that or is there a direct effect on strain yeah there's actually a neurophysiological recruitment so now creatine has been touted as a new neurot transmitter so this is quite interesting it actually seems to release a lot of things from a neuromuscular uh uh uh perspective effective but the biggest thing is the ability to recruit not only type one but these type two muscle fibers as well um and then of course if we're having greater muscle or motor unit recruitment we can potentially lift longer heavier and and over time get uh uh sort of more an increase in strength the other big thing from a cellular perspective is that creatine causes calcium to come back in a little vesicle in our muscles if you're taking high school biology or university uh this will be your nightmare but I remember everybody talking about the cop plasma reticulum and it's an area that just releases calcium to allow our muscles to contract and and creatine speeds up the uptake of calcium so some of the evidence out to Europe has shown that it increases relaxation time or the ability of the the proteins in your muscle to grab hold of each other to contract so there's a cellular aspect there explaining why we think we get an increase in muscle performance I say strength but endurance and power are all lumped in there as well so endurance is the ability to perform repetitions to fatigue or power move an object as fast as you can they're all vitally important but we think strength is overall from a Global Perspective uh number one it's probably the main reason a lot of older adults are plac in long-term care facilities if they have a reduction in strength they can't live independently so that's why again resistance training or weightbearing exercise as you mentioned CrossFit whichever it is foundational I'm from Canada so shoveling the driveway in the winter counts because anything that's a load against you is is really beneficial to the body I think people underestimate the benefits of moving um and then if anything can be taken in in this form creatine it'd be very very uh beneficial yeah you you mentioned some of the anti-inflammatory effects of creatine particularly in the context of more endurance type of training people that are perhaps running marathons or just clocking in a lot of hours of running or cycling per week right um is that so I think that that that goes in to some respect in the recovery sort of Bin right and um I'm wondering if that also plays a in recovering from doing your resistance training or strength training like on a recovery day so I mean do you think it plays a role just broadly in recovery yeah it does now this is interesting and I probably would have been the most surprised when we wrote the paper on this that we don't think traditional weight training um where you're doing a set you're resting maybe a minute to two it seems like it's not catabolic or intense enough now most people will say shake their head say hey when I'm in the gym I'm really putting a lot of effort in I think from a mechanistic standpoint when you're doing running or long distance continuous muscle contractions it causes this large catabolic effect to the body um so that really heightens the inflammatory response weight training is acute 10 seconds of work 3 minutes of rest 10 seconds of work three minutes of rest or whichever it is and we just don't see creatine having a lot of superior effects from a resistance Trin and Recovery aspect probably because the rest intervals for the average person are there but from a long distance event you're running hour hours uh you're swimming whichever it is the best lines of Defense come from Triathlon and Marathon running where the increase in these markers called cytic kinds were elevated uh but creatine sort of attenuate that rise could allow the individual to recover and get back on the the the track or whichever it is quicker um but I've talked to some good colleagues in Canada and it just seems like weight training is is too intermittent um now when you mention CrossFit that's different I'm thinking of the three sets of 10 you move from machine to machine you rest you have a CrossFit or something that's really continuous would probably uh fall in line here of the um necessity for creatine so that would be a very good study to look at the effects of creatine on the recovery aspects of something like high-intensity interval training or uh CrossFit for example our military type of training that's really endurance and and resistance training so you just gave me another idea to to run with but it it's logical the more intense the more demanding I think that's where creatine's anti-inflammatory properties would come into play yeah so when people hear catabolic or you know they'll think they'll think of muscle breakdown right and certainly you know there's there's a big component to sarcopenia inflammation in sarcopenia which is age related muscle breakdown is there is there a role for creatine in in preventing the breakdown of muscle there is it's very mix so we don't have a lot of data um first off creating doesn't directly increase protein Sy synthesis which might be a surprise for a lot of reviewers it sort of works in in a magical other way which we can talk about but from a a muscle breakdown perspective it seems to reduce something called Lucine oxidation primarily in young males and that's an indicator of whole body uh breakdown we've also shown in our lab it reduces thre methylene which is another indicator of whole body breakdown but nothing is directly shown in the muscle itself uh and for some reason females don't experience this we've looked at it in Young and older females we don't see the same effect the only logical explanation is it could have something to do with progesterone or estrogen we just don't know that um and from an anti-catabolic effect uh decreasing some of these tissue repair mechanisms there's not a lot of research out there but unfortunately we're not seeing any evidence that creatine increases protein synthesis so unlike protein which it does creatine seems to help increase muscle size in other ways satellite cells grow factors things like that but it does decreased protein breakdown primarily though in males uh and we still don't know exactly why but we think estrogen or the other sex hormones might be involved does creatine have a general anti-inflammatory effect in in both males and females it does in young and older individuals but here's an important distinction the more stressed the body is it seems to come to the rescue more so if you're a young individual adequate sleep proper nutrition you're probably not going to notice any anti-inflammatory effects it's when the body is under times of extensive exercise or trauma hypoxia um I'm sure we'll talk about the brain and sleep deprivation so whenever the body is more stressed or under more attack that's when creatine seems to come to the rescue and getting getting um circling back to you know people that are supplementing with creatine and it improves their training volume improves their strength um what why do people have to supplement with creatine well uh they don't actually so little a bit of clarity so we naturally are producing creatine in two main areas in the liver and in the brain and on average we're producing uh about 1 to two grams then we're also consuming in the diet anywhere between 1 to three grams or none so a vegan is not getting any dietary creatine uh those that are on a carnivore diet might be all all the way up to about three grams and we excrete uh through the urine a product called creatin and about two so when you do the math we're in a net Surplus anywhere between 1 to two gam a day we know it's not essential because vegans can live a long healthy successful life but we consider it conditionally essential because when we see all the evidence I think there's over a thousand peer review papers when we take in a little bit more there is some substantial beneficial effects across the whole board not just muscle we're now looking at bone brain and the immune system you so from from a perspective of a vegan who is not getting a any almost amount of dietary cre they're relying on their liver to make it um what what's going on in their brain you mentioned the brain makes creatine yeah it's very interesting so on average vegans have substantially less muscle creatine compared to an omnivore or carnivore diet but an elegant study out of Brazil about four years ago uh they Ed sort of an MRI for the brain and they showed that vegans and omnivores had the same amount of brain creatine store so that's really substantiating that the brain makes its own creatine it probably makes enough for the nonstressed individual but during times of metabolic stress the question is will vegans or omnivores need more and it's likely that it that's true yeah during development is the developing brain making its own creatine like it is y just like our liver is making its own creatine it's using and it's probably an accelerated rate for brain development cognitive development uh again our brain is small but it uses 20% of our daily energy and of course during uh development that's when is very very precious as well yeah so creatine is most found in animal Foods Meats poultry fish yes um none in plants at all Trace Amounts you'd have you'd have to eat the entire Orchard of whatever plant you're thinking and same with uh milk you'd have to drink all the milk from a Jersey cow to get any significant amount so that's why it's unrealistic you so so if we're having if we're producing between you know 1 to two grams at best just in in our liver correct um and that presumably then is being transported to muscle that's the whole 95% we can't forget about the bone uh and brain or the main areas yep okay and then if let's say let's say you're getting I think I was reading some enhan study where on average people get younger adults not older adults get anywhere between um 1 to two grams a day from their diet right but older adults are getting on that lower end even not even necessarily at even at one gram so so older adults are getting even even less yes but um then you know is there is there is there more to be consumed by the muscle or does it get spread around yeah that's an excellent question so the thought is as we get older we have R reduced fossil creatine stores in our body so they might need more um and the hope is about 95% Is Res is housed in our our skeletal muscle but now with the emergence of research the rest is in bone and brain specifically so the hope is if we take in more our muscles will be full which is great but now hopefully we're going to have some trickling into our bone which is even just as important and I think most people would argue from the neck out that's really important from a Global Perspective with all the neurological diseases depression anxiety so I'm one of the big proponents of taking a lot more than probably what's recommended based on uh the evidence-based research to sort of disperse throughout the whole body not just skeletal muscle well let's let's talk a little bit about that so in some of these let's you know the strength training resistance training studies what's the common do that's taken and maybe we can talk a little bit about I mean there's the loading phase which I've never done so I actually take five grams a day Y and um although I might start taking more after this podcast so I I'd love to know like what what is the average dose that's taken to improve you know your strength training your resistance training your training volume and then um we can go from there yeah so I mean in 1992 uh Roger Harris came up with a seminal uh um um protocol where you just mentioned this loading phase it's the most viable rapid way to really saturate your skeletal muscle this has nothing to do with the bone or the brain and so that's 20 grams a day for about 7 days is usually what's recommended uh a bit of new information you only need to do that for two days and then your muscles are saturated so the loading phase was designed for athletes to really rapidly uh sort of fill up the room if you will from a skeletal muscle perspective after that you can reduce it as little as 2 gram a day so again that's a half a salmon steak that would a half a chicken breast or whichever so it's very viable they call that the maintenance phase the only problem with the loading phase is it's so rapid it does cause water to enter a lot of our cells and a lot of individuals do not like this potential net water retention or GI track irritation we don't usually use that in our labs for that reason um but for the Athletes World Championship coming up the loading phase followed by a maintenance phase is a very viable Rapid Way young females hate it because of that water retention and and weight gain the good news is you can take as little as 2 to three gram a day no loading phase and take that on a day daily basis probably for the rest of your life and that will definitely accumulate and fill up your muscles in about 30 days we don't know if that low dose will get into the bone or brain on a long period of time uh what we've done is look at a relative dose so that means everybody uh has a certain weight we put them on scale and we use 0.1 G all the way up to 0.14 G per kilog um so for example if you're 70 kg you're taking 7 g a day all the way up to about 9 g a day uh you can take that in one bis dose or split it up into smaller dose eaches throughout the day I wouldn't go any less than one gram one gram doesn't seem to get in the blood as rapidly as we need um so that's something for your viewers if they're micro doing no less than one gram um but you can split it up 2 and half gram 5 gram whichever are you want I take a lot more than that um based on our new clinical data I'm 48 years of age I know the effects of aging and from a bone and brain perspective but really all this dosing came from muscle and we have all these new areas that's why I think the emergence of new dosing strategies has really come to light you I and I I definitely want to get into some of these you know potentially negative effects of the of the high high dose um but but let's talk a little bit about your your new emerging data on bone health so you're talking about so I mentioned five grams a day and well maybe before we get to that um how long does if if I'm taking like someone's taking 5 grams a day and you know how long does it take to to to get your muscle stores saturated and then let's say your resistance training right so you're working let's say your resistance training and endurance training I mean you're working out five to six hours a week I'm just talking about my schedule here and then and and I'm and I'm doing five grams a day right is am I just constantly saturating my stores even though I'm you know pulling down from them as I'm working out or how does that work perfect cuz five is the average global recommendation and that's a fantastic dose uh overall we think to start especially from a muscle perspective so it'll take you 21 days to fully saturate your skel muscles so after that you're going to have some being excreted in your urine or let's pray here hopefully some is now being uptaken into your bone because the muscle is pulling on bone your bone is a very metabolically active tissue which no one actually sees in the mirror and then hopefully some is trickling more into your brain so the thought is okay 5 grams is very viable easily 21 days your muscles will be full taking five grams a day thereafter some would probably go in the form of creatinin but hopefully and we don't know this maybe some is going into your bone being used by your immune system your GI tract your gut health and your brain so five is a great dose I'd like it to be higher just because of some of the new data to suggest every day we get out of bed we're a day older there's some good evidence to suggest bone needs a bit more and of course the brain we still don't know but I have some lines of thinking about when we're really metabolically stressed um how much to take but if you're taking five rest assured you're doing exceptionally well yeah well let's talk about bone so one of the best things you can do for bone health is weightbearing exercise these compound lifts the things that we were talking about with improving your your explosive power and your strength right right um how is creatine adding to that by two ways a direct and indirect so let's go with the boring direct it sort of increases osteoblast cells these are these are cells that sort of create uh or the formation of our our bone cells so in rodents osteoblast cells have been energized in the presence of creatine so it was logical to think in humans maybe our osteoblast cells the cells that are responsible for increasing bone size and strength might have more fuel and these cells do use creatine just like our muscles do for fuel um and potentially increase bone density and if that's true we've just cured osteoporosis basically um the other line of thinking which is surprising going back to this anti-catabolic uh phenomenon is the best lines of evidence with bone are from an anti-catabolic perspective it seems to resemble abys phosphinate so a lot of reviewers are maybe taking abys phosphinate it sort of preserves your skeleton I know my mom is taking that as well um so creatine reduces something called the osteoclast activity or bone resorption so for for some reason it really inhibits these osteoclasts from sort of chopping down our bone and increasing blood calcium levels when not needed and then of course if it sort of increases osteoblast potential maybe the recycling a bone gets stronger it's kind of like laying a foundation of a house the bricks are stronger you're sort of putting the bricks together a little bit faster and then inclement weather is not chopping away the bricks or the cement so that's how we theorize it was working and there's been about 15 studies now showing that it has a lot of anti-resorptive effects so think of anti-catabolic to the Bone uh we have not shown in a single study an increased bone mineral density so this is really crucial we are not saying that creatine and weight training increases bone mineral density but it certainly decreases bone mineral density loss and really specifically around the hip region which is crucially important for a lot of older adults because when they fall if they if they land on their hip they could be more susceptible to fracture so there's a lot of anti-catabolic effects and we've just shown in a long-term clinical trial and improved bone strength so picture a pen or pencil you can't crack it as much there I think weight training is the main driver when it comes to Bone um the more muscle you have from an indirect perspective there's more muscle pulling on bone so that's very beneficial look at gymnast they have phenomenal bone mineral density and muscle mass there so there's a lot of potential there um it's not uh overwhelmingly convincing I think cuz bone takes a long time to turn over but this is is interesting the lowest dose ever been shown to be effective is 8 G of monohydrate a day now as we just talked about 3 to 5 gam it's great for muscle but now you're getting into bone what needs to happen is a dosing study could five grams over maybe two years be equivalent to 8 grams over two years or even higher uh that is very expensive to do um but it's been in the back of my mind I would just speculate that 5 gr over time will still benefit your skeleton but you need such a large sample size to get these small effects either from a dexa or CT scan and that's probably why we haven't seen it yet but in all our clinical trials eight grams but the Brazilian group have looked at 1 to three grams for two straight years and not a single Improvement so weight training is there and I think that's the Big Driver from any of the muscle bone perspectives yeah so you so you think um just supplementing with creatine by itself even if you're doing 8 G isn't isn't really going to necessarily affect your bone health if you're not doing any weightbearing exercise even even considering the you know preventing the the breakdown I mean preventing the activation of these Osteo class that are breaking down the bone I would be very surprised I think you need that mechanical loading from weight training or weightbearing exercise Plyometrics that cause the bone to turn over and then maybe creatine doesn't increase the resorptive or it increases osal blast a little bit more um the cool thing with osal blast it it releases the cyto called osteoprotegerin which acts as a decoy and that's been shown in in in vitro studies there so there is some cellular data uh which is a bit surprising when it comes to the the skeleton not just Imaging um but if I was to take eight grams would I tell my parents to take eight grams and not work out if I did I don't think they'd expect anything on the bone the bone is really stubborn it's just like our brain and creatine it's really really stubborn I think the main Force is is the driver of weight training out what about someone who is let's say a postmenopausal woman who who experiencing some perhaps osteopenia yes do you think before trying some of these other standard of care treatments like bis phosphates for example you mentioned doing the weightbearing training and the creatine perhaps 8 grams or 10 gram a day would be a good first line of defense to try before trying some of these other drugs that do have negative side effect so if there's if you're in line for Abyss phosphinate there's no way that creatine or weight training will come close so a drug effect will always be superior the the effects we're seeing even from a significant perspective with creatine are so small we don't even get to a clinical perspective but let's talk about weight training I 100% agree if I had to choose one for bone it's weight training or Plyometrics or anything that you feel to the body and then consider creatine in your treatment program creatine would never replace a pharmaceutical intervention from a a bone perspective um and the effects we're seeing are so small or even over 2 years at best it's preserving now this begs the question maybe the adults we chose were too healthy none had diagnosed osteoporosis or osteopenia or Frailty what if we took a population with severe osteoporosis maybe creatine could come to the rescue there that's another thing we're starting to hopefully get governmental funding for down the road um but a lot of young females a lot of young males and of course older females even postmenopausal their skeleton is still very uh beneficial and strong they may not have incidents as osteopenia or fracture uh uh risk um but until we do a study and diagnosed osteoporotic uh males and females uh we just don't know if it's the disease or maybe they were just healthy enough yeah well prevention is obviously I think the key right if we can encourage people before they're experiencing Mass breakdown of their bone or osteoporosis osteopenia to you know engage in in resistance training and not and not the single joint exercises where you're making your biceps bigger right I mean like you need to you need to be doing these multi-joint compound lips rows you know presses anything that's multi-joint um and then perhaps in combination with creatine if it's it's really if it's preserving bone that does really suggest a preventative role right yeah and and that's 100% correct like the movement is is got to be there um and I think most people are aware of the benefits of exercise and then if creatine or protein or whatever it is you're eating can give you a small beneficial effect I'm all forward and I think a lot of people would be there as well so creatine definitely has the potential it's kind of has a lot of potential for a lot of things um but without protein um you know those two need to be there um we don't think creatine could rescue a hypocaloric diet especially low in protein um but we just don't know I argue that creatine Falls in line with protein with this aging anabolic resistance as we get older my guess is where we have lower creatine in in some of our muscles as we get older we need more so now there's a young versus older uh stereotype just like protein younger individuals may respond from 20 to 25 grams all the way up to older adults so I think creatine is definitely part of my day um and I try to promote the the evidence-based research especially from an older adult population if anything we can do to offset chronic disease or getting chronic disease uh that's beneficial and we're starting to really focus on young females exercise is so important adequate uh protein and then creatine it's not just for males we're seeing a plethora of benefits for young biological females which is really important it is you you know when you when you hear the word creatine you think about like the Jim bro right like I mean it's like you're taking the creatine trying to get you know their muscles bigger and um the reality is is that you know women women are also very I me they suble to you know losing muscle mass and strength but bone is a big one yeah and when we look at all the data females get an improvement in muscle performance primarily strength that's the population we've seen the best bone benefits now they were postmenopausal but uh reduction in bone mineral density bone strength uh and then we're seeing from a a sports perspective agility balance so uh for the females watching uh don't shy away from creatine it's extremely potentially beneficial in combination with exercise and if you're worried about weight gain or or whichever do not do the loading phase it's not needed you can start as little as 2 to three grams a day divide that up even so I'll tell a lot of our clients or or participants you can take one and a half grams in the morning wait till the evening to take one and a half grams uh that really decreases the chance of water retention um but if you're eating red meat or seafood you're getting a little bit amount for the vegans watching keep in mind you're not getting any and that's why supplementation uh third party tested they are vegan based could be considered yeah I mean it seems like it'd be very important for that population of people in particular yeah we we've done some really fascinating studies with vegans and vegetarians and they respond exceptionally well uh because we're doubling the amount of creatine which is the high energy compound in our muscle so they those individuals can do more repetitions higher volume quicker recovery so it really has favorable effects for male and female uh vegans and vegetarians and again those emphasizing a plant-based diet with everything going on in the world nowadays A lot of people are are uh look into more plant-based diets for health uh reasons or whichever um and then they might need to consider a supplement so usually we're not in the market of of talking about supplements but this one is the one that seems to come to mind where it might be difficult to get the amount needed in your diet um from Financial cost ethical treatment of animals whatever your own habitual preference is uh and if they're third party tested it's the safest most effective ergogenic Aid out there right now the the safety profile is exceptional especially at the do each as we're talking about like when we talk about protein we're talking hundreds of grams at most we're talking maybe 10 20 grams for the athletes which is basically two teaspoons in in the Run of a day so it's not a lot but there is a lot of uh evidence-based research behind it yeah yeah and I let's we'll definitely dive a little more into the supplementation but um I'm interested in the brain and we've gone from we've gone from the the role of creatine it seems to have multiple roles um anti-inflammatory anti-catabolic right um it's obviously important for producing ATP regen you know regenerating the ATP um what about the brain what super exciting like this is such an emerging area so from the neck up I think the next 20 to 30 years we'll be focused almost entirely on this so um our liver produces creatine and our brain actually is unique it also produces creatine but the brain is very resistant we have the bloodb brain barrier for a really important reason um and the Brain says you know what circulation we don't need creatine in the blood we're making our own so an individual getting adequate sleep no chronic disease no metabolic diseases no neurogenerative diseases is producing adequate amounts of brain creatine it could be as as little as 1 to three grams um now our brain is small from stature but it uses 20% of our daily energy and of course as we all know when you're really tired sleep deprivation running around chasing your children most people that I know are really U metabolically stress primarily from a cognition perspective and that's where creatin seems to have the best lines of evidence sleep deprivation hypoxia I jet leg I was up at 3:00 this morning and flew down so I'll be taking a really high dose today to hopefully offset the the chance of inflammation or uh cognitive decline um so when we look at the totality of emerging evidence it's split some studies don't see any effect but the ones that do is in a population where they're either mentally fatigued sleep deprivation or during times of aging and that's where memory comes into play and the common denominator seems to be the more that the brain is stressed the more creatine seems to come to the rescue same analogy from a muscle and bone perspective so uh we can talk for hours just on the brain and uh it's a very exciting area for sure yeah so the brain is stress so so brain aging brain older adults that's that's that's aging is a stress on the brain it is so supplementing with how much creatine can improve cognition in let's say older adults yeah as little as about five grams has been shown to have some potential but this is interesting I just you know 20 minutes ago said that the loading phase wasn't needed for muscle the best studies for the brain look at 20 grams a day for at least a week so now you're in a conundrum I'm looking at muscle bone and brain and the theory here is that since the blood brain barrier is very resistant to creatine and unfortunately we have this really important G cell called astrocytes which are the most the biggest in in our uh central nervous system it sort of acts as a filter from our blood into our cells and it really determine what gets in and it says Hey foreign pathogens no you're not getting into the the neuron or the cell uh so unfortunately they don't have the creatine transporter or doorway so that's why uptake into the brain is very blunted so the thought is to get an improvement in brain creatine stores you need longer duration of supplementation or higher dosages so the best lines of evidence using mrss have shown that higher 20 gam a day seem to be the most viable there's been a single study looking at about four gram a day but it took three months to accumulate in the brain uh unlike our muscle which acts as like a vacuum it sucks in all the creatine from our blood our brain says no no no I'm only going to take what's in our blood I.E supplementation when need be so that's why sleep deprivation seems to have the best lines of evidence or mental fatiguing challenges yeah okay so let's if you're if you're someone like myself who supplementing with 5 a day for a year that's enough time for it to eventually accumulate into the brain presumably yeah like that low dose remember you need about two to three grams now I'm not sure about your diet but you're going to need that just to maintain your muscle and then comes down to your genetics what's more in Jeopardy is it your bones or brain so again the 5% that's remaining throughout the body is in your testes heart uh uh bone uh and brain so for me as a biological male it's going to different areas compared to you as a biological female but my hope is wait a minute let's go a bit higher so we're sort of sort of uh checking off all the boxes my guess is five grams you'd have a small increase in brain creatine content um but if you have a really nonstressful life the brain says no go to the Bone or we'll excrete it down the toilet but if you're metabolically stressed it's begging for more I'd like you to be probably higher than five but I think it'd be interesting to look at some prepost uh mrss scans and um it's viable it could be there the study that did for grams was in Long COV these individuals brain fog fatigue headaches things like that so the brain was really begging for Recovery out okay so you just mentioned the best studies showing any Improvement in and when we're talking about Improvement we're talking about cognition we're talking about like memory memory okay you said 20 G right which is definitely what I don't want the the swelling part of that um which happens around 20 Gams yes so have there been studies looking at 10 grams is that like a sweet spot the seminal study was out of Germany and they did four two versus four versus 10 and this is where I personally take at least 10 and they use mrss studies and they only they showed that about 10 double the percent increase in brain creatine content but they also measured it in the gray matter the matter and I believe the phalus and it all improved by about 10% now it was a small sample size because the run on mrss is super expensive so statistically it wasn't there but the percent improvements were were a lot higher and when you look at all the other data 10 gam seems to be a very viable dose to not only check off the Box definitely for muscle we're now checking off the box for brain and now we're or sorry bone and then we're also checking off the the box for uh brain as well so I personally take about 10 gram a day on average but during times of metabolic stress sleep deprivation or uh um jet lag I'll increase it to 20 so today I will take 20 grams because I flew down from Canada I'll take 20 grams again tomorrow but when I get back home I'll decrease it back down to 10 if any is being excreted down the toilet I'm totally fine with that creatine is very cost effective but I want to make sure I'm maximizing all my abilities and the immune system especially in Canadian Winters is really heightened and uh activated and and I really have found in the last few years I'm I'm not getting flu like symptoms hopefully that's from exercise or Diet but uh who knows maybe creatine is helping because there is some anti-inflammatory effects you um you you went to another area that I definitely want to talk about but like before that so 20 grams then you're saying acutely when you're in this sleep deprived State jet lag you know let's say fill in the blank type of you know extreme stress um is that immediate so let's say like you you miss you're like up late you had you're up late one night you have some to do the next morning or the next day you have to be like on your game if you take that 20 G either at night would you take it at night like before you go to sleep or in the morning or does it matter and will it have an effect immediately yeah and I love learning and this is just so 20 GS mighton be too low it's surprisingly to your viewers so another study came out of Germany they did is very elegant design it was a crossover and they gave 0.35 grams per kilogram so even if you're only 70 kg that's 25 G in a bowl of do and they measured it for 21 hours of sleep deprivation and it really improve memory cognition and it increase brain creatine content so that higher dose not only does it get into your plasma or blood really quickly probably in about 3 hours it's peing when your brain is stressed it's being taken in quite readily so during times of metabolic stress it seems to work now the argument is how do I know I'm going to be stressed tomorrow how do I know I'm going to have a bad night sleep you don't so that's why I think taking a higher daily dose might be a safety but the day you're like oh I didn't sleep at all and I have a big presentation later or me as a professor teaching four classes a term I've really increased the amount I would say I might be the most saturated person on the planet because I've been taking creatine for decades uh there's no reason to stop uh we can talk about cycling or or continuous um but I'm even taking more in hope that it's getting into my brain again 20 years ago it was just muscle then we've evolved into the bone and now we're getting into the brain and I think a University students midterm week it finally examed staying up all night cramming maybe creatine could really improve their ability to score better on tests and when you look at the mental fatiguing uh studies that's when creatine seems to work after you've done a whole bunch of fatiguing exercises or sorry taken creatine before it really speeds up your ability to maintain memory and cognition and uh we can talk about neurofilament um things in the brain or bdnf and and that's some of the mechanisms primarily in Roden so there is some mechanisms showing that creatine is decreasing oxidative stress are really having some uh potential for neuronal health which now you think of Alzheimer's dementia neurogen diseases so I'm super excited to see where this is going for the next 20 or 30 years yeah I wonder if there's any effect uh just because sort of a triaging of like it's it's helping with the energy and so it's like freeing up other energy you know for like other you know taking care of O oxidation and probably the best overall Segway so it increases brain bioenergetics and if and one of the common Den numbers with depression or concussion is that they have reduced brain creatine stores and bioenergetics compared to a healthy control on average and so maybe creatine is bringing those values up or even slightly more and now the brain has more energy capacity to do and deal with all the daily stressors of of society yeah absolutely so TBI I mean traumatic brain injury it I I the way I think of it is like real time brain aging yes it's just it's like all of a sudden you just get a a knock to your head and it's like accelerated aging so what would be a protocol for someone that you know let's say they take a Blow To The Head or they get hit with the ball soccer ball or you know whatever the football whatever sport that they're doing um would it be like they should be taking high dose immediately yeah so I'm now in the camp and I think a lot of other researchers and a lot of the works come coming from here in the United States but if you're in contact Sports creatine should be taken on a daily basis because unfortunately if you do get hit in the Roden model when because you can't do this as in humans but when they've actually forced concussion in rodents taking creatine beforehand the recovery symptoms are really accelerated and in the only single human study was in children as soon as these people in Scotland got head trauma they put them on 0.4 grams of creatine per kilogram so about 20 these are just children immediately and over six months these children that were taking creatine had substantial improvements in self-care and efficacy no blood bile markers were taken but at least it showed the Improvement in recovery so instead of waiting till you get hit why not take the preventative role and that's why again I think for me and again it's it's it's opinion but we've seen some data to suggest that 10 grams might be a good viable dose um more or even a little bit less depending on why you're taking it but I personally take it from a whole body perspective I don't play any contact Sports um now but who knows I could go and skate and fall and hit my head or skiing or whichever and maybe that would help accelerate recovery um I'm taking it just for any chance to have some potential brain benefits but the big area it does increase the recovery aspects of concussion so NFL NCAA especially down here United States trillion dollar industry I got to believe these players are taking creating in anticipation I know the quarterback for the Dolphins I think he's had third three concussions this year so his brain is so compromised right now massive inflammation hopefully his medical team is at least considering high dose with his other treatment program to get there so yeah and they should be taking it for the the benefits on on muscle you know AB you know explosive power ex those you know high intensity moments um you mentioned earlier about 0.1 gram per kilogram body weight so how would you adjust let's say you know you're taking 10 grams of creatine per day and you're wanting the effects of the benefits of muscle bone brain as do I however I do not weigh as much as you so would you is there a scalable amount per kilogram body weight you think would be something that or is it hard that's an excellent question and the answer would probably be no because when we go on the scale we don't consider the head even when we do dexa scans as headless so you know if I'm 80 kog I'm taking about there's the The Sweet Spot about you know 9 to 10 grams a day uh taking it from a weight perspective to the correlate to the brain is almost impossible because we need to measure the the weight and where it's a hard tissue it's a little bit soft but it's usually hard tissue um I think overall body weight um very similar how people do protein based on lean mass or uh a total body structure so you can take creatine based on lean body mass but it's very difficult you would have to have some type of Imaging uh apparatus so we just usually recommended on body U Mass they hit the all the aspects that makes sense and it really does seem like there's this sort of triaging where it's like okay the muscles consuming it it's like the greedy one and then whatever's left over maybe the bone but if the brain stress Maybe you know it's funny how the body can figure that out like you know the brain needs it um so you know there was another there's some interesting research that you also published kind of um in the in the brain area is sleep right and um I'd love for you to talk about that study I thought it was so interesting these resistance training females and you gave them creatine and it really seemed to help improve their sleep on training days yeah it was uh colleagues at University of Oto and brown and CJ brush and they looked at young healthy uh individuals biological females and we gave a pretty high dose here five grams plus we add a five grams of PBO so 10 grams a day versus a 10 gr Placebo and this was done for 6 weeks and they resistance train um with a tonal home gym for um two days a week and the interesting thing is Total Sleep duration on the days they trained was substantially higher I think it was about almost an hour compared to Placebo and again these are young um university age students that were taking creatine about five grams a day the nice thing is it also improved strength there was no big fluctuations in weight gain which was very very uh interesting no adverse effects um now there was no mechanisms assessed but the logic was that on the days these individuals are training um maybe they put in more effort so creatine helped recover the body a little bit more allowed that body to be in repair mechanism a little bit more and they slept more for about an hour on average more we still don't know the exact reason but it is interesting that it improves sleep duration yeah and it's almost kind of the opposite of what we were just talking about we were talking about if you're in this context where you're jetlagged or sleep deprived and you take the creatine and it kind of helps you get over that brain fog that like right you know you just you're not quite you know on your game yeah it goes against most the uh the comments I get where when people take highd do creatine some people say they feel like insomnia or intermittent sleep and the theory there from a rodent model at Belgium is that maybe the brain is recovering quicker that it doesn't need to sleep as long so we still need a lot of work to do we need to look at different stages of sleep we I'd really like to look at some blood biomarkers indication of what's Happening from an inflammation perspective uh so there's a lot of work in that area to go yeah you know the other thing I was thinking about Darren was I mean when so a dennine yes MH is there is there a role because I mean it's Downstream of ATP right so I'm wondering if there's any role because a Denine is something that does make sleepy yeah yeah I always think of caffeine the Adine and yeah no it's possibly there um there's been a lot of speculation they thought also glycine is implicated and where glycine is involved in the in the synthesis of creatine so there's a lot there um I think we'll talk maybe about homosysteine a little bit later in the methyl so God there's a lot of areas to look at and I think we thought we knew everything about creatine and now it's taken on a new life its own and again I'll have a jaw for maybe 20 or 30 more years looking at this so yeah before we continue I just want to mention something important if you're finding these episodes valuable please consider subscribing to the channel and clicking the notification Bell it's the only way to ensure you'll be notified when a new episode goes live many people assume they'll be alerted automatically but unless the Bell is clicked they won't be we cover a lot of detailed evidence-based content here and I want to make sure that you don't miss any of it now back to the episode well let's talk let's go back to the brain and talk about another so we talked about brain aging you know traumatic brain injury which is stress we talked about lack of sleep you know and things that's stressing the brain I guess you know neurod degenerative disease is a very stressful thing on the brain as well it would be interesting to see uh if creatine can help in that regard although again prevention is always it's always better right if you can yeah we've looked at the totality of limited evidence and we're not seeing a lot of effects yet um there's benefits on young boys with muscular distrophy but that's a little bit different but when we look at ALS Parkinson's Huntington multiple sclerosis um all those dementia and Alzheimer's we're not seeing a lot of problems there's been a few small scale studies to show benefits but when you look at a properly sample sized study there was a big one five years in Germany didn't see any greater effects um so again maybe the dose was too when I look at the dose they use it was very small compared to now our our body of evidence suggesting higher dose big sample size and then of course what about the the effects of the disease can creatine really rescue the effects to give a significant effect we don't know preventing would be the number one thing but uh we're starting to do a study in Northern Iowa to look at the effects of creatine now in individuals with cognitive decline um and I believe there's a study out to Kansas that are actually looking at people with diagnosed Alzheimer so super excited to see these results if it can have any effect even help one person um even regardless of a statistical effect if it can have individual results I think it's something we need to consider you okay well what I was going to get to was the other um part of you know brain disorders you have Neuropsychiatric disorders you have depression anxiety um those are those are also unfortunately very common um nowadays even in in younger adults and Adolescence so there's been some interesting research with creatine and depression yes there has it's an emerging area primarily to Utah there a great Psychiatry group there and uh as a cavea no study has ever looked at creatine without anti-depressant medication so they're always as adjunct so we're not creatin could ever replace anxiety or anti-depressive medications but in these sub populations primarily females with clinical depression it's really starting to have some um speed up recovery and decrease some of the symptoms the mechanisms are starting to emerge it's starting to have a role primarily from RADS and this is implicated in depression where uh they have reduced brain creatine stores so maybe creatin supplementation can bring those levels up uh there's potential to increase bdnf so that has been implicated there as well and there's another thing called neurofilament um or light chain it's an indication of neuronal damage uh and one gram of creatin in your diet has been shown to reduce that so there's potential there but the overarching thing with uh anti-depression is it increases brain bioenergetics as you as you mentioned and decreases again here we go mitochondrial Health uh decreases reactive oxidative species all these are implicated in all the brain and cognitive decline and primarily depression so I'm really excited in that area big RCT needs to be done though um because it's always being added to either cognitive behavior therapy or ssris yeah for sure and there's also a big um inflammatory component in depression there's like inflammation in fact there have been studies just in healthy young individuals where they induce inflammation through like LPS it can cause depressive symptoms yeah yeah and 100% so the anti-inflammatory role comes back there as well so you'll start to hear these two words anti-catabolic and anti-inflammatory people think of Advil or Tylenol from an anti-inflammatory but creatin seems to work some very similar in the Cox inhibitors as well and um but it seems to decrease cyto kindes um so it could be something there to consider you well what's interesting is you know activated lymphocytes te- cells consume just enormous amounts of energy you know and and to to basically become active and fight off pathogens right and so I'm wondering if creatine is taken up by you know these immune cells and it maybe helps in some way I mean you're saying it reduces cyto kindes I mean a lot of these t- cells are you know producing cyto kindes to fight off things but um who knows if they have if they have that energetic boost yes um how that could affect you know just I would say like the broader like not having this huge kind of war going on right yeah there's been some cellular data around the immune system cells around creatine specifically around tea cells or macroasia uh that's where the anti-cancer idea came in from creatine specifically like regarding lymphoma leukemia um so uh that's more inv vitro there's a lot of work needs to be done but there's a lot of studies now looking at the anti-cancer potential of creatines primarily from the anti uh or the en heightened immune system response you I wonder if there's any um has anyone ever looked at you know creatine's role in helping prevent infectious you know disease or respiratory illness fighting off pathogens like just anecdotally uh I supplement with glutamine my 5 grams of it's about 5.6 grams of glutamine I take a day and with creatine five grams of creatine and it has made a insanely big difference in my susceptibility to respiratory illness which I have a I have a little seven-year-old who brings home everything okay yeah it's like a vector um and and it's it's made a really big difference and glutamine also is just it's consumed by activated tea cells take a lot of work on use for cancer yeah and treatment sepsis and things like that yeah so I it it would be interesting if but just at creatine as I know glutamine been shown in endurance athletes like who are very prone to respiratory illness like these marathon runners really like they're they're really just getting getting to the catabolic state right yeah it's interesting because I was the first to do glutamine fa high do in weight training based on the premise that you know if it did have anti catabolic effects for cancer long duration and and and that was my master thesis and we didn't see any effect probably going back to our initial start where resistance might not be stressful or catabolic enough in continuous duration compared to long duration um events so that's very interesting are you familiar with any of that work of the of the long-distance Runners and glutamine there's like a few studies showing that these these um marathoners and stuff they they don't get as much as many respiratory illnesses if they're taking glutamine yeah no I'm very familiar I had to do the whole literature search and uh um it was a higher dose and they also looked at for sepsis but the immune system response T4 and T8 I don't think were nearly High um and that was from long duration and a young healthy individual they probably might not notice any effect um but again that was the idea the premise behind it was more of an anticatabolic um and why it didn't work for me it was a non-essential amino acid and of course the protein synthesis you need all the essentials so it was uh a trying moment when I was doing my masters but it works out and understanding it yeah well there certainly doesn't seem to be any shortage of interesting things to study with creatine and it's like you know there's the field is exploding so maybe someone out there be looking at that at some point um another really interesting area is the the vascular health and I mean there's just like we were just chatting about a recent study coming out um endothelial cells have Transporters for creatine they do right next to the asites which don't so the endoc cells at the blood brain barrier especially but around all the um smooth muscle they do have the transporter so that was one of the theories Mike Orby just put out a study in Eric rosson just recently in older adults uh and that makes sense because you look at a population that might get some benefits and they show some very small favorable effects from creatine supplementation uh either a week long or for up to four weeks I believe it was a loading phase and then down to about five grams a day um so it has some favorable effects for in I think it was macro and microvascular function so that might have potential down the road for cardiac rehab or individuals with cardiovascular disease or even subsets of that like type 2 diabetes or metabolic syndrome so that's an area to stay tuned for as well as emerging um and um same with type 2 diabetes there's potential there as well uh potentially improving GL glucose disposal again if there's more muscle activation you have more glute four doorways maybe more glucose gets in so the Brazilian group is leading the way there so it's gone from just athletes to now looking at the health aspects for a lot of different uh conditions and interesting chronic diseases has come to the Forefront which is very exciting yeah I I've also come across some other like cardi metabolic health benefits so glucose but also triglycerides and with cholesterol in there too can you talk about that is that maybe some mixed data I'm not sure if if if everything is sh the same it's totally mixed um some show decrease in triglycerides LDL um um and then others don't see the effect and again I think it comes back when you look at those studies with the population if they're compromised as we get older there're probably going to be more of an effect and then the question is was it dietary change that did it or was it the creatine itself so that's one of the big issues when we give a creatine supplement if you don't consider what they're already consuming or now they've initiated exercise compared to a true Placebo um there is potential the mechanisms seem to be from a a triglyceride perspective it seems to increase energy expenditure some thermogenic potentially effect that might explain why creatin decreases body fat in individuals 18 and above uh but from the cholesterol perspective we don't really know the mechanism there um and that's an area I'm sure that'll be exploding down the road yeah so creatine decreases body fat in combination with resistance training compared to resistance training alone correct yeah now small about 1% or about .5 kg uh there's some potential mechanisms there but the thought is maybe increase in lean tissue Mass increase energy expenditure so a lot of people are very cautious they don't want to take creatine because they think it's going to increase fat Mass what the research is suggesting is increasing lean body mass Mass potentially decreasing fat Mass so usually the number on the scale barely changes after you do an intervention yeah well going going back to this loading phase and this higher dose I mean when I say higher I mean 20 grams um all these studies doing that I mean barring the brain stuff is it is it really just to like kind of get their stores saturated quickly because the study is you're not going to wait 30 days so it's really you know all these other people trying to do this loading stuff just kind of following the studies but really they don't have to do that unless they like tomorrow when I hit the gym and have that explosive power benefit or if you need a really quick effect like Rehabilitation from an injury ACL surgery something where you need to rehabilitate the muscle quickly or you're an athlete the loading phase to me is not needed from a muscle perspective now because we've talked about bone and brain might need a bit more so now maybe the new daily loading phase is maybe you know 5 10 grams a day or a little bit more but that athlete 20 g a day for 7 Days followed by the maintenance that is only ever been shown to have beneficial effects to muscle there's been a few studies that have looked at it now from a brain but again that's from a different perspective you just um brought up a point that I was thinking of and that is surgery and and like you know like or injury um how does how does create because that's a stressful situation we're talking about you know really creatine shining in that background of of some sort of stress whether it's training or you know sleep deprivation but also you know you can have something like an injury or a surgery where you're planning a stressful event yeah it's multifactorial the studies that looked at from a rehabilitation perspective creatin seem the increase these things called myogenic transcription factors so without boring your audience these are little guys that sort of tell DNA to sort of increase proteins in a quicker way so these myogenic regulatory factors went up during Rehabilitation uh and then we did a study when we got individuals to put on a cast volunteer and creatine seem to maintain strength going back to the mechanism it probably has to do that reduction in protein breakdown or the anti-catabolic anti-inflammatory effect again we don't think it has anything from a synthetic perspective because creatine doesn't but it does it has been shown increase satellite cells which are needed for um recovery and Rehabilitation growth factors igf-1 and decreases my Statin the one that increases protein breakdown so all of these factors come into play it's like the caramel secret there's a whole bunch of things that go into that chocolate bar creatine seems to work in a very variety of ways and then again on the other side it's certainly been shown to decrease reactive oxidative species so it seems to have more of a preservation to the cell effect um but from an injury perspective um it seems to speed up recovery do we know would it speed up recovery if you took it before surgery uh the jury's out on that we'd have to do ACL surgery or studies on that long-term clinical trials we see a bit of Promise in osteoarthritis um but not a lot of other ones and because basically the studies haven't been done yeah and what are the do what's the dose on on some of those these are usually the loading phase with a slight maintenance phase or if they're looking at it from a cellular perspective it's usually just the loading phase seven days prepost they'll do biopsies or cellular data so the 20 20 G A Day loading phase and then the maintenance phase being about five okay and if someone's already taking let's say five or 10 grams a day and then they're going to have a surgery do they still need to do the loading or should they just continue on I would just continue on or even slightly a bit more because when the tissue is is under trauma you get heighten inflammation reactive oxidative species or stress and then protein breakdown so maybe could help speed up your ability to recover quicker um we don't know any of the effects of creating on Cross education where if someone has an immobilized limb and they train the opposite limb we don't think there's any effect it's a great study to do um and that could have huge applications for professional athletes or individuals that have are waiting for ACL surgery instead of sitting around all day go to the gym and train the the healthy limb and maybe creatine could potentially increase more drive there uh it's a study I've always wanted to do we just haven't done it yet yeah okay so it sounds like you know in most cases you you know the creatine plus the the the training resistance training endurance training um is is the key but in in some some situations when there's just a massive amount of stress from you know perhaps an injury or surgery or sleep deprivation creatine can can shine on its own is that correct yeah there's actually a small body of search in healthy individuals young and old that say creatine without exercise actually improves muscle performance so uh those that I think of uh disuse bed rest immobilization uh sedentary individuals um maybe they have functional uh mobility issues um or people that don't know or have access to weight training um creating by itself has been shown to improve muscle performance improve strength endurance uh their ability to perform repetitions to fatigue primarily in older adults but there's been studies in younger individuals and that's sort of where uh creating research Blossom all the initial studies were very acute 7 Days the loading phase and then we saw improvements over time uh on muscle performance and that sort of paved the way to lifelong um interventions which include exercise is the main thing yeah for sure yeah exercise is is definitely the most important thing but I know I'm going to ask you to speculate a little bit here but let's say let's say you do have an older adult who is sedentary and um you know just just getting up out of a chair is is hard it's Challen it can be challenging uh do you think that even supplementing with creatine in that regard maybe help them a little bit more two meta analysis has been performed both in Canada we were fortunate to do one St Phillips I know has been a guest I think for you and um uh we've done two meta analysis and then when you look at creatine in older adults with resistance training though it did improve tasks of functionality sit to stand so getting out out of the bed off the toilet getting out of a chair again that was with exercise without um exercise uh nothing has been there so um I would love to say Yes um but again the movement of exercise but the nice thing is for those willing to do you know is it resistance bands anything that you feel mechanical stress creatine will give you a slightly greater benefit but for those that are in Jeopardy of chronic disease I think you should consider it uh absolutely yeah so another question of mine um you talking about where creatine Transporters are where it synthesiz you mentioned it's created in the liver and the Brain but you mentioned it it goes to the testes there's a little bit down to the testes so any organ that only has the um enzymes to make it so since it's made in the liver and brain it'll be dispersed to other areas so the interesting thing is the area that it's created it goes through circulation to different transports so male fertility has become a big issue and there was a thought that oh creatine since sperm Rel it's a FAL so since sperm are relying for movement um on creating so much maybe it's downregulating sperm production and my good colleague out of Norway sir joak who's one of the world's best secreting researchers has looked at this in many forms and not showing any effect of anything it improves the vitality and mobility of sperm so that could have huge implications for male fertility um so yeah it's an area that you probably would never think of uh but it's an area that has shown some evidence-based research behind it yeah and that's that was going to be my question is it affecting fertility it's going it's going it seems improves it so again that could applications for uh individuals trying to start a family or or male male fertility issues we don't see any down regulation there's a thought of taking in supplementation maybe that'll give your brain and liver a bit of a break and there's evidence to suggest that maybe if you're taking creatine on a daily basis those organs don't need to make as much because you're you're offsetting that um but again when you stop supplementation it goes back to baseline or it doesn't disrupt any of that and and the good thing is from a fertility perspective there's no evidence to suggest it downregulates sperm motility Health uh we can talk about hair follicle loss and thinning the same idea if you if the viewers were looking at me but that was the same idea maybe creatine was causing baldness so maybe it must be doing the same thing to sperm it must be killing off the cell and we just don't see any of that research you so well good yeah well let's get into those myths but before we get into those I kind of wanted to to we've talked a lot about adults we've talked about older adults the effect of creatine on many different tissues in those populations but at the start of this podcast you said something that caught my attention and that was you said children and you said pregnancy and um you know I'm a mother of a seven-year-old who's quite active you know plays soccer and tennis and and I often wondered um you know C can children take creatine I mean obviously weight adjusted but is there any has there been any you know evidence in children has anyone looked at children besides the TBI study yeah not there has CH Chad gersi and and ragum at the mail Clinic here in the United States are the two most profound research in that area and they've looked at study after study in children uh young children adolescence and there's no adverse effects and why would there be if our body doesn't like it we just excrete it and there's a big push right now in some states trying to uh ban creatine and younger individuals and they're just not looking at the evidence-based research so overall there's no adverse effects we still need to do a little bit of blood work but it improves Health agility coordination muscle mass there's no reason and so that's why I'm one of the big proponents I argue including the fetus why someone couldn't take creatine if we're already producing it it's not like caffeine a drug effect we're already producing it that's like telling people you can't take protein in your food or supplement that's just nonsensical so I'm one of the big people say anybody can take creatine um even if you have chronic kidney disease there's some benefits because it'll help the kidneys absorb creatine and so right now there's uh potential benefits for children for pregnancy Stacy olivy in Australia is the leading researcher there in Abby Smith Ry in UNCC and so they're actually looking at fetal development having more brain bioenergetics for the female uh we now know that the transporter from breast milk is is there uh and then when you look at habitual diet uh again Serge o has looked at an ha's data and for those children taking less than one gram it leads to a lot of potential detriments later on cognition impairments lean body mass bone mineral so I mean a serving a salmon is about 3 to four grams of creatine um a hamburger would even have that so again in habitual diet unless the child is vegan um they're probably getting a little bit of them out and the dose two to three grams or you can even do 0.1 gram because they're so much smaller so if I had a child I just have animals a dog um I would give my children creatine for sure as early as possible cuz I'm looking at brain development bone development muscle immune system it has all those benefits and keep in mind if our body didn't like it we just make expensive urine like we just excrete it um people see this when they go for their blood requisition they see creatinin on this Blood requisition form and that's all it is a byproduct so it it's very safe um the safety profile is exceptional yeah wow I mean so a few things here so so um with respect to the the dose with children so you said two to three grams or1 gr per kilogram body weight or or is that is that applicable to wellsely I mean if you want to do five grams or more I don't see any reason why not do they need to be taking the 10 and 20 grams we just don't have the data to support that but a low dose two to three five grams is is totally viable and and vegan kids probably even more so right and then pregnancy um has there actually been any human data looking at women supplementing with creatine being safe just subjective questionnaire how they're feeling things like that it's too dangerous in a sense cuz we just don't know yet U and to get ethics board approval at a a research institution is very difficult even for uh teenagers and adults um under the age of 18 so I know Stacy is in our big myths paper is concluded that we need more randomized control trials a big trial uh because we definitely want to get this one right make sure it's 100% safe not just for the unborn child but also for the mother um so there's going to be a lot more data to come out but overall there's no reason to suggest there's any issues whatsoever you yeah and and all again coming to the back to the vegans that comes to mind you're talking about women who are pregnant who are um only relying on their their liver you know ability to make to make Crea team right so um that would be phenomenal to get a study like that done but do you think it'll be approved I think down the road when they look at the hypoxic environment of of fetal growth I think it probably will get approved but we're going to need a lot more clinical data to suggest it's safe and uh um maybe a polot study in that the issue pilot studies they're usually low sample size so then from a feasibility perspective it might be have it actually I can see it in a multi country to get a lot of people in different countries to come together and make the sample size that high so that's something to look out forward uh forward to as well especially and and in addition to the neurogen diseases yeah um I know I'm jumping all over the place here but um going back to the kids you mentioned the creatine supplementation was shown to improve agility it now why is that is that because of the type two muscle fact or motor unit recruitment or maybe muscle Activation so there's a whole plethora of ideas from a a balance agility uh um coordination perspective it could be that they're able to exercise at a higher capacity sort of sort of almost hyper accelerate muscle development um those are all the things that are in its infancy to to look at again there hasn't been a study to look at blood biomarkers for like liver and kidney enzymes but I would be very surprised if a lowd dose study was done and there was any issues yeah okay um well getting into some of the supplementation you know questions and I think we've been we kind of you touched on quite a few but I want to kind of dive a little bit deeper um you first mentioned of course I think a lot of people that are in familiar with the creatine field know creatine monohydrate creatine monohydrate is that still the gold standard for supplementing with creatine if so why yeah it's the only standard so when I say creatine today it's monohydrate and the reason being it's is based on its safety and efficacy so monohydrate means that creatine is linked to water so when it comes to your GI tract the water diffuses in the hydrochloric acid of your stomach so that molecule it's very unique it can actually get through our small intestine intact unlike protein which gets degraded creatine is very unique it it's because the acidity of our stomach is actually too acidic it doesn't like it so much uh so it gets through and then when it gets in our blood the creatine that you're taking from supplementation monohydrate is identical to what's being synthesize in the liver so that's likely why the safety profile is so exceptional now there's probably 50 different other Market forms of creatine out there first it has to be creatine when it gets into your blood so whatever Market form you want to try make sure it is creatine getting into the blood or it's useless second no other creatine has ever gotten into the cell and had Superior effects there has been a few studies to look at crean hydrochloride and with the Ester bond to get sort of through the phospholipid Bayer of yourselves quicker but no study has ever showed it to be safer or more effective so I know monohydrated has been boring it's been around since the 1990s but in my opinion why mess with a good thing and probably because the efficacy and safety behind it well why do people turn to these other forms um is it is it because of GI distress that can be experienced with monohydrate is it is it seems as though like I get mixed reviews I'll talk to like like almost like 50% of people say hey like I get GI like stomach stomach distress GI problems if I take creatin Mony R um some people have to go to another form or they have to lower their dose why does that happen are there any ways around that is there like any any tricks to improving you know the ability of your stomach to digest I think 99% of it is marketing I think people get conned into buying something that's more expensive or flashy um and maybe they're making some errors with the monohydrate they're taking and probably from the loading phase so creatine monohydrate has been shown to increase intracellular water so it's based on the doorway it sort of brings water with it and some people get GI tra irritation or some weight gain and other forms of creatine are marketed to not do that um I argue if it doesn't do that it's probably not creatine in other words creatine is osmotic if you're taking a form of creatine that doesn't increase intracellular water a little bit I would question the validity of that type of creatine um so I'm in the camp of 100% monohydrate based on the mechanisms the structure of the molecule and the efficacy behind it um do you need to spend more on a fancy type of creatine if it works for you I'm all for it but at the end of it I don't think you need to well the question is like getting back to what you said um if if it's not increasing intracellular water then it may not be doing what it's supposed to do and ultimately that's the whole point so the you know the question is if you're taking creatin HCL or you know there there's liposomal liposomal creatine or there's there's a GNC brand that's like it's a creatine HCL so it's like you know at the end of the day the bulk of the research is done using monohydrate and 99% of all the thousands of papers and the one I I hear a lot is there's a better bioavailable form than monohydrate I'm like wait a minute creatin monohydrates bioavailability is near 100% there might be a little bit extracted from the gut so how can you get more than 100% And then if it even got into the cell I've never seen a study just show that it increased protein synthesis or had any of the effect on satellite cells or whichever I'm only aware that it increased creatin content so the good thing there is in those cells I think it was hydrochloride that means it is a form of creatine but did it lead to Performance benefits better than monohydrate I've never seen it so I just caution people just don't get um con into a lot of these marketing forms really exp expensive forms when monohydrate is is the one true Ines I'm going to Germany and we're going to be talking for four straight days and two weeks a monohydrate why because that's what all the evidence-based researchers need to talk about because it's the only form that seems to be very viable yeah well aside from the marketing I think some people I know some people personally that even taking like a five gram dose of creatine monohydrate experience like stomach issues yeah so um what what can those individuals do yeah so I recommend to these people and it happens quite often um the sort of micro dose so I would say if you're taking 5 gram take about 2 and a half grams in the morning weight at least SS and 2 and 1 half grams later uh also take it with food so I put I have for breakfast I'm sort of boring but I take Greek yogurt collagen protein whey protein blueberries and I usually put 10 grams of creatine in my yogurt um but some people can't so if you want you want to put 2 and a half grams there but if you want to start as low as 3 gram 1 and 1/ half in the morning 1 and 1/ half in the evening or you could do one and 1/2 in the morning another one and half with lunch with food seems to increase the absorption because the insulin from carbohydrates Andor some of the the effects of fat uh the most times is when people just drink it with water I find that's where they get the GI tra irritation just because it's going through the GI track quickly uh taking water with it but with food whenever we tell people that they say it all went away yeah so that would be an interesting experiment for someone to try that's experienced um GI problems to try taking it with food and carbohydrates seems Seems like it might be good really good okay so um and then the other thing is you're talking about like lower dose micro doing and spreading it out does that is that something you'd have to do like forever or is that like to to kind of get your gut used to it or is it kind of both it's almost from a a um a consistency perspective but there was a study done in 2003 where they showed smaller more frequent does were better than a super large 20 G Bolis dose so it's almost like this retention idea um but taking you know multiple 1.5 gam dosages or whatever it might not be feasible on a daily basis but you know a quar of a teaspoon 2 and 1/2 gram whichever that would get your body used to then slowly titrate up so the best way I usually tell people is start with 3 gram one and a half morning and evening then move it up to five 2 and a half then move it up to nine but then I say three three and three then eventually you're sort of getting tolerated it's like caffeine starting with a small coffee and working up to a large your body gets used to it and then there's more in circulation you know well you you said um the these smaller doses were uh more effective at what at the idea was that it would get into the blood maintain Peak or platum plasma levels since hopefully you can retain more than some being excreted as creatinin the thought was a super mega bolao so maybe 20 G um now there's new evidence that can get in the brain but there's logic like some of that would be cleared from the kidneys and because the muscle may not be able to take that in all at once you know okay so dosing studies need to be really done yeah well this kind of this kind of goes to a another question I had which was we talk we've been talking a lot about dose but it's also about you know if if like if you're taking um the cycling of it so you know some people like to slam their protein shake right after a workout is there any reason to worry about that with creatine because you're talking about repl like saturating the stores it seems like it's a okay well it's like you're trying to saturate the stores I don't know that's cycling around that's going to do anything yeah so that's a two-part answer I think from a timing perspective and cycling so from a timing perspective unlike caffeine we don't think the timing really plays a major role there is one area that I would just recommend it's post exercise or pre-exercise and the reason for that is that we think blood flow or transport kinetics is turned on with muscle contraction so if you want to take creatine within an hour before you work out or I drink five grams during my workout or right after that seems like a very viable time but for the viewers the timing seems to be irrelevant but that begs the question what about cycling so if you've been taking creatine for maybe two months 3 months it's very likely your muscle stores are so saturated that when you're consuming the extra creatine um that you would just be excreting it so some people say hey I don't want to do that I don't want to waste my money I'm going to cycle it I now argue you should take it on a daily basis because of the emergence of like okay I'm okay with the muscle being full if someone's going down the toilet in urination that's okay but now I'm hoping our bone is taking in some our brain is taking in some so we used to be in the camp where you just need creatin on the days you work out now I say take it every day and hope some is going to go to your brain and muscle or sorry bone uh because on the days you're not working out your muscle is not sucking it in as as fast maybe those other tissues are getting replenished so do you think it's better to take um creatine like you taking it in the morning if you're going to work out in the morning but what if you work out in the evening do you want to take it in the evening yeah I would take it any in close proximity exercise I would take it so if you work out twice a day you're taking creatine twice a day um but if you take it in the morning and then work out later in the night that's totally fine we're not seeing any big differences but I'm a big advantageous proponent of taking close proximity to exercise and that's when in an hour pre and post okay so some of the other questions are interaction with other supplements other compounds um for a very very very very long time I put creatine in my my coffee I put everything in my coffee cuz it just masks everything and I just didn't do it in one I've never really had GI problems with creatine supplementation myself so um but I'm not sure that I'm supposed to be doing that yes so I'm one of the rare people and most people argue against me I don't do it either um so there's two ways to look at this the phoc kinetics of creatine and uh caffeine do not oppose each other but from a cellular perspective they certainly do so remember when I talked about the cop plasma reticulum caffeine likes to release calcium but likes to take it in and some really good research out of Europe have shown that they the two molecules oppose each other from a muscle relaxation time but the dose of caffeine seems to be the most important factor if the dose is over 250 milligrams or even higher that's when it seems to have the interference effect if the dose is lower it doesn't seem to have an interference effect so the average large black coffee from Starbucks might be 3 400 milligram of caffeine so if you were to put your of creatine in there and sip on it for hours you probably won't notice an interference effect in a few few times but if you did that every day for months you might notice a blunting effect um if you did it a onetime shot uh you know you you were doing an experimental trial you might not notice it so I never combine the two I always have coffee early in the morning I love coffee and then I wait at least two hours before I take my first thing of creatine in anticipation of those cellular interference but other people other big time creatine researchers say no they I take it together if it works for you great but there's something there that makes me a little cautious and we've done the only training study it was underpowered but they did interfere with each other you yeah okay is is creatine heat sensitive it is it denatures a little bit so if you warm up the um solution some people don't like the grittiness um so when the temperature rises it will decrease the uh or increase the solubility if you will it will not degrade at the creatinin unless it's super heated for a long long period of time so if you are putting it in your coffee the heat is not the act it seems like the caffeine molecule might be the one that might interfere with it okay so you don't have to worry so much about it being in like a hot liquid like tea or no but if you had like a normal K cup is 80 milligrams there should be no interference effect you could have two of those but if you get up to like a large coffee so a normal cup of coffee here in the United States maybe 80 to 100 milligrams should be totally fine yeah yeah okay um well this is all really good information I think addressing some of these the the the myths and you know questions the misconceptions I mean all those things because you've published a couple of meta analysis or review articles I guess or review articles on this and so um you talked about let's let's talk about the the the fat gain right so that was kind of one you touched on a little bit I mean especially women women it's is it really just because of the lean mass increase yeah we there has been some cellular uh or animal data to show it increases thermogenesis um but overall the decrease in body fat is there but it's very low so don't run out and buy creatine I think you're going to lose 20 or 30 pounds we're seeing at best about a 1% decrease in body fat and about 0.5 kilogram reduction over time in combination with weight training now that could have implications for obesity type 2 diabetes or chronic uh diseases down the road but the nice thing is a lot of people had a myth creatin increased body fat we don't see any evidence uh to that okay so doing the opposite um the hydration myth so what about you hear I've heard some people talk about um cramps it causes cramps or dehydration it's opposite it super hydrates the muscle so it could be from the sodium potassium pump or disruption from dehydration but if you're metabolically dehydrated creatine is not the cause if anything creatine is trapping water into the cell it also has been shown to increase in uh extracellular water and total body water in some studies um so from a cramping or dehydration perspective it's actually opposite so for those exercising upcoming summer months uh NFL football players uh 2day practices in July creatine might actually help hydrate the muscle and decrease the chance of uh muscle cramping or dehydration oh that's super super interesting um has anyone directly looked at that I think Rick cder's done some studies with that when he looked at NCAA uh players um but a lot of people don't take it the myth was that it was dehydrating and we just don't see where did that myth come from I think what happened was in the Inception of creatine research a lot of people were not drinking water or going through some practices like wrestling wearing rubber suits extreme hydration they happen to be taking creatine and then they said well I'm not creatine uh since it traps water therefore my cells must be exploding or muscles and therefore was causing cramping and we just don't see any evidence behind that yet okay so it was like a correlation thing where UNT was the opposite and sort of with you um okay we've talked a lot about the kidneys and you're talking about creatinin and I'd love to talk that that's that's one that I hear a lot um that it can it's bad for the kidneys it's bad for the liver can can you address that it's probably the biggest concern um so we've looked at study after study and rest assured from a clinical perspective uh creatin does not adversely affect renal liver or cardiovascular uh cells uh and we've given 11 grams a day in post-menopausal females to a population where their organs are under a little bit more stress and no adverse effects the theory here was that when creatine enters your muscle when it gets metabolized it's non-enzymatically metabolizes something called creatinin and those watching say oh wait a minute I just saw that my doctor checked that off and and the reason they do that is creatinin is a byproduct it's supposed to be filtered by the kidneys so if you have high blood creatinin that means your filtration rate in the kidneys is not working properly think of your Brit of water filter it's clogged up so unfortunately when lot of people go to their doctor they don't say hey to the nephologist or GP I'm on creatine supplements because it's logical that if you're taking creatine your creatin might be acutely raised and then that causes a false positive your uh uh estimated filtration rate is low so your doctor says whatever you're taking stop it's killing your kidneys we know that's not the case because when they do stop their kidney function just comes back so it's just the metabolism of the molecule okay well this is really important I've had um a few people reach out to me and tell me that they're was elevated and I don't think they told their their GP that they were taking Crea creatine and so so the so the idea here is that it's it's the metabolism of the creatine to creatinin that's being excreted through urine that's right so creatine and fossil creatine don't leave the muscle it gets left in the muscle as creatinin creatinin can also be raised with a very very high protein diet excessive exercise or dehydration um but make sure if you're on creatin supplement tell your doctor because it's logical that your creatinin in the blood will be elevated that's just from the metabolism of the supplement now if your liver enzymes are through the roof that could be an infection so again make sure you go and get medical uh um uh screening and and guidance but every time we hear this it's usually a false positive I see false positive okay so it's really good to talk to your physician about that um baldness that's one that's one it was that it was that rugby was it rugby players that yeah yeah yeah um I was going bald way before I started taking creatine so a lot of people say oh well obviously um and it's interesting it was a great study in a sense that they looked at a novel concept so they had Elite rugby players do a crossover design and a crossover design is really powerful that means the group gets both Placebo and creatine so it really controls for diet genetics hormones things like that and when they took 20 g a day um might have been even 25 gram a day for 7 Days uh during the cre supplementation phase they increase the hormone dihydroxy testosterone or DHT and most people say oh I think I've seen commercials about this it's a surr of testosterone but it's been highly linked to hair follicle loss and thinning from a cellular perspective they measured it in the blood so the correlation uh you know it's just a a surrogate but when they went up I think it went up by about 57% but it was still within the physiological range and what I mean by that is when you go to your doctor and they measure your blood glucose and it comes back and the doctor said no it's within the normal range cholesterol is in the normal range even increasing by 57% I think that was the number uh it was still within the normal range when they were on Bo increased by about 40% so everybody says Whoa hormone went up correlation causation everybody was freaking out that this hormone went up they did not measure hair follicle loss thinning cross-sectional area no dermatologist was involved but a lot of people have run with this and to this day they cite this single study um that even didn't look at free testosterone there was no increase so just because DHT went up a little bit and they started lower so there was more room to improve people think it causes baldness I've assessed easily over a thousand people males and females not a single person that said hey whatever you're giving to me BL double blind is causing my hair to fall and I I got to believe a participant would say I'm not taking this anymore my hair's falling out um and I do know I can't talk about it because I'm not sure but I do know that there's been a paper submitted that have looked directly at hair follicle loss and thinning with creatine supplementation and I that was going to be my next question I mean has first of all has anyone replicated this study it sounds like no no um and has second has anyone you know directly looked at hair follicle it's in it's in review right now um but if I had to have a magical guess it doesn't affect hair follicle La oring so if people are watching me they're like oh and then they look at other creat researchers I can blame my parents and primarily my mother for that for the maternal DNA um but then there's other people with full heads of hair so it can't be a cure it's like carbohydrates cause obesity that's nonsensical it's it's everybody's different um but I still get this on a daily basis both from males and females they don't want to take it or their hair is thinning and um I'm really glad that this study is coming out because the way we should have answered this is we don't know until the study emphatically says no we didn't see any of the effects um we would to say we don't have any evidence to suggest it does and we don't have any evidence to suggest it doesn't and even when the study gets published we'll probably have to do multiple but um it just has never been done and no rodent studies no rodent studies nothing I think it's an area that people said no one cared about and then all of a sudden everybody cared about it yeah that's so is there is there any other uh really I think prevalent misconceptions or myths that you want to talk about or je there's so many I think the the big one um that the big one we're getting a lot is does it increase hypertension or blood pressure because if it increases water into the body could that have any effects and we're not seeing any adverse effects there um the other one is we do not see any evidence it disrupts sleep although we talked about the the study earlier doesn't have any negative effects there um and then cancer so this is an area that is difficult to answer or talk about um because we just don't have a lot of human cellular data from the inv vitro data um we're not seeing any in humans at least from recommended dosages any uh malignant growth or any uh cancer promotion if anything we're seeing anti-cancer properties uh from improving inflamm or anti-inflammatory responses there and in our latest paper of the Miss and misconceptions part two uh one of the world's best uh creatine researchers and medical doctor Mark tarnopolski WR really good section on that um so if anybody's interested read that and it seems to have some potential for cancer Rehabilitation when you're looking at uh tissue loss caia seems to have some beneficial effects there and um I'm with Kieran Fairman in University of South Carolina looking at uh prostate and breast cancer Rehabilitation so I think you're going to start to see some medical applications growing more than just young healthy individuals again the common denominators all these um are sort of asking something for help so either Rehabilitation or prevention and that's where I think creatine is really uh changed it used to be for just young individuals who are healthy and now it seems to have some of these Health aspects so very exciting times to be talking about it yeah are are you familiar with any of the research of uh Dr krie Kier out of University Alberta yeah so cancer there I don't think he's ever looked at creating but he does a lot of Community Based yet I just had him on the podcast and he was you know he does a lot of um ex the role of exercise in cancer treatment and you know not just not just aerobic but resistance training so um that would be interesting for you guys to have a discussion um the other thing that came to my mind that I now remember I've I've heard a lot of people talk about is creatine supplementation increasing their urination um particularly during sleep like like having to go urinate more frequently I just answered this question on Instagram so an individual because I I said I take a pre-sleep sometimes and they oh that'll keep me out peeing all night and I said oh actually that's interesting so in this Miss misconception paper as well uh there's a section there that uh the creatine molecule whichever does not increase um urinary output people thought since it's creating creatinin you need to filter it we think it's the increase in fluid ingestion that you're probably taking either with exercise or what is usually recommended with creatine that's actually a myth as well you don't need to increase tons of water consumption but the molecule doesn't cause an increase in urination it's not a diuretic or it doesn't increase uh urinary uh flow that way I do hear that a lot my logical guess is you're probably putting the creatine in 8 ounces of water and you're probably drinking more water or exercising and that's one of the things but there's no evidence to suggest the molecule itself stimulat urination yeah okay well that's good to know um I think we've covered a lot there's one area I did want to talk about and we talked about kind of saving at the end because there's more speculation here and this is um just an an interest of mine I remember several years ago a former colleague of mine Mark shanaga um was talking to me about you know creatine production in the liver being one of the biggest B biggest um sort of syns for methyl as aprod you Hine and so um he was talking about some at the time I think it was pretty preliminary but some evidence showing that if you did supplement with creatine that the the enzymes in the liver that do produce creatine were there was a feedback and they they sensed that and they they didn't use so much of the the methyl groups were being shunted to other meth Pathways and so um I was just wondering if you've come across any evidence looking at creatine supplementation and homosysteine levels for example yeah the most studies don't support it and that's where we got to the point where oh if it doesn't decrease homosysteine levels then maybe exogenous creatine doesn't reduce our natural creatine synthesis the the studies that show it does are in animals and I believe there was one human trial uh but the Mo majority shows it doesn't have any effect now that could be the dose there but you're totally right methionine is donating I think it's 40% of our our methyl groups to creatine synthesis so if I'm taking more dietary creatine or or supplementation why use that why why not decrease the amount being synthesized because that has huge implications on enthal health and cardiovascular health um but ironically the it's not even equivocal the majority suggests it doesn't decrease maybe the studies are not long enough or maybe they're not populations that needed as much yeah right so the question is like maybe you need to start with a population that has elevated homoy correct yeah vegans yeah yeah yeah yeah because it's hard it's hard to detect small changes when you already have it's easy to do you just look at some of these blood biomarkers uh but there's not a lot of there's probably less than 10 majority in rodents um few in human and I think last time I checked it was probably seven against three supported it so it's there's a lot of methodology issues there well maybe someone will look at it I ABS especially as we start to get into vascular health for sure that's a huge area so I would be shocked if more studies don't come out in vascularity health or uh angio Genesis or anything like that potentially looking at homocysteine as a surate marker for potentially explaining some of the effects yeah because if homosysteine comes down you would speculate endothal Health would go up and some of those things yeah right well if you talk to any researchers doing doing uh vascular Health be great um so I think we've covered pretty much just a lot interesting did we there's anything you wanted to discuss jeez um no you hit the caffeine one I knew that was an important one for people are there any other interactions with other you know let's go back to the carbohydrate one because I think people uh hear this um the best way to augment creatine into the muscle is with muscle contraction which is great but the dose of carbohydrates shown to sort of increase it is almost over 75 G and I think most people are not going to consume that protein is a great one to add creatine too because it's insulin genic as well um so combining creatine and protein will probably give you a superior effect and there's been two studies that show you get a greater increase in in muscle performance and lean body mass when you combine creatine with protein in this protein case it was whey protein it was only about 30 grams so now when you're looking at your post exercise meal pre-exercise meal I think creatine and protein are good friends uh consider them as something that you may want to consider um especially in your post exercise meal or like I take at least 50 grams of protein with breakfast I put my creatine in there I don't need to worry about it until later on and then I usually drink it or have it with a meal um most creatine is tasteless you can put it in food um that's fine you can you know the heat would denature it a little bit but it's something to consider yeah I'm glad you brought this up because um it to clarify maybe some people were confused when we were talking about this earlier um the taking the the timing of the creatine around exercise it was to improve the uptake of creatine into muscle and that can be done before or after like close proximity to the exercise yeah and if you don't want to work out keep in mind it still accumulates maybe just not as quick so the study in 1992 was very elegant they had one leg exercise and that increased creatine uptake by about 37% and in the other leg that didn't exercise is still improved by 25% so at the end of the day the person you know at home watching TV taking creatine whatever for some time they're still accumulating but exercise unlocks a lot of the doorways so to speak that sort of get it in there more so it might give you a little bit extra benefit and that's why I say appr proximity exercise is a very viable time to take it you but if you're looking for the benefit in terms of improving or increasing your training volume and you know that explosive power the strength um that it doesn't necessarily have to be timed around the exercise right just take it like if you don't want to take it all at once take it in small dosages I think consistency I I now recommend take it every day uh just get it like a multivitamin whatever you're doing but just keep in mind it it's giving you not only exercise benefits but I'm really happy to see the emergence of the health benefits and I think in today's society we could all use a little bit of help yeah it sounds it sounds like there's no reason not to take it I mean it's there's a lot of benefits the the muscle the bone the brain very very convincing um third party testing you can look for companies that have been vetted that are that are you know reliable Brands and and that's always like a yeah that's a big thing that we didn't talk about so if you are considering supplementation again you don't necessarily need it if you're getting it through your diet uh but make sure third party tested I would really focus on monohydrate um based on the evidence-based research uh monohydrate has grass status creapure is from Germany it's it's more scrutinized it has less purities um that's an excellent form of creatine hydrate I make sure it's pharmaceutical grade so all these things that you would do by putting something in your body just do a little bit of homework but if you're not seeing certified safe or third party test it um that's something to be a little cautious and the other thing is when you're buying a compound or ingredient with a whole bunch of ingredients in there um we don't know if the creatine is going to be effective or not in these pre-workouts things like that there's no reason to suggest not but when I've been talking about creatine in our experimental studies we're giving 100% pure Crea we're not giving it with 10 or or 12 other compounds that you got at a grocery store things like that um but again so there's a little bit more work that needs to be done if you're considering a multi-ingredient compound yeah yeah and that's a good um point because you're we were talking about taking you know 10 10 grams a day which is your your sort of goto and now soon will be mine um you don't want to take 10 grams a day of some you know mixture of things right you want it to be just creatine now you mentioned cre cre creatine Pure or cre cre pure monohydrate y that's very pure it's very pure from Germany it's third party tested now as as a disclosure I'm on The Advisory board for Crea pure so full disclosure um and that's helped sponsoring the creating conference in Germany in in a few weeks but it has grass status um and when you look at the independent lab results it's 100% pure uh there has been some issues out of Asia with transportation and not being third party tested so I think the consumer just needs to do a little bit of work most companies nowadays if you're on the shelves of a product um are very reputable um and again if it has third partyy test it safe just look at the ingredients it should say monohydrate or if you're entertaining another form of creatine that should be the only ingredient or at least the most important ingredient on the product yeah what about micro ionized yeah that's a new form to get away from some of the things you mentioned on GI track irritation so that's just being continually processed it's very fluffy I've noticed uh um some of the new products it it dissolves exceptionally well uh get away from that grittin that the creatine can cause in in uh solution so these are just coming up with new Alternative forms to help please a lot of individuals make it more attractive um but it's another form that can just uh sort of be um sort of solubility is very high yeah is there any reason to believe it wouldn't work it's because it's it's monohydrate right so it should do the same thing 100% it's just a different way to get it into your body uh if you like it really really micronized um so it's purefine um I just take normal cre and if there's a little bit of grittiness at the bottom I that doesn't bother me but some people they do yeah okay well excellent we've just covered so much wonderful information and thank you so much for taking time to talk about all this research with me today and thank you for doing all this research I mean really um you've just done an amazing job covering so much important you know ground in terms of uh the effects of creatine on human health right oh thank you so much for having me had a great time thank you me too thanks thanks thank you to Dr Darren k for coming on the podcast after this episode was recorded a new stud was published suggesting that creatine supplementation was not effective for increasing muscle mass but that study is not what most people think it is Dr kandal Who was actually one of the co-authors of the paper joined me to break down what the study actually showed what the data support what they don't and how to interpret the findings in context you can watch that full breakdown on the found my fitness Clips YouTube channel and if you found this podcast valuable please consider sharing it with friends with family colleagues anyone who might think benefit from this information I think a direct link goes a long way thank you so much for listening and I'll talk to you guys soon