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

0:00 and how is it going to benefit you is it

0:02 going to improve your training volume is it going to make

0:05 you stronger all the above I'm one of the big

0:08 proponents of taken a lot more than probably what's recommended

0:12 but when it comes to set two three and four

0:14 that's where creatine really comes to the rescue and they measured

0:17 it for 21 hours of sleep deprivation and it really improved

0:21 memory cognition and it increased brain creatine content today I'm joined

0:24 by Dr Darren kandow who is a leading researcher

0:28 in the creatine field and muscle aging he's published over 140 papers

0:33 on nutrition and exercise performance how it affects muscle muscle Health

0:38 Muscle aging uh Darren I'm super excited to have you here

0:42 today to have this conversation with you to go deep

0:45 into the science of creatine yeah no thanks for having me

0:47 I'm really excited as well absolutely yeah I've I've read several

0:50 of your studies I'm a huge fan a lot of really

0:53 important and interesting research to talk about okay uh maybe

0:57 we could start start where it's most most I mean

1:00 a lot of people think about creatine in its role

1:05 in in exercise performance however um there's been a lot of emerging

1:10 research in other areas maybe you could give people just

1:12 a quick snapshot and yeah like it's really evolved over the last

1:15 40 years it's gone from athletes getting bigger stronger faster

1:18 now we're looking at potential benefits on bone health uh brain

1:22 health cardiovascular health um even in children and during pregnancy

1:26 so it's evolved from just the young male athlete to pretty

1:30 much anybody on the planet is now considering creatine either

1:33 in their diet or supplementation so for the next few hours

1:36 super excited to talk about all aspects of creatine and the evidence-based

1:40 research behind it well let's talk about the the resistance

1:43 training and improving performance muscle health I mean why why

1:48 are people why is it so popular well it because it

1:51 works from a a muscle performance perspective so it really

1:55 it basically increases the ability to produce ATP or maintain it

1:59 during uh an exercise session so for example when you're

2:01 doing you know uh a squat or leg press or even

2:04 running you're doing muscle contractions and fossil creatine which is

2:08 what we're going to be talking about today from creatine supplementation

2:11 it really maintains ATP or adenine D triphosphate so if

2:16 you have more ATP longer you can exercise at a higher

2:19 capacity a higher intensity and that delays the utilization of other

2:23 energy systems that might be a bit slower um so

2:26 anybody involved in high explosive anerobic type of Sports weightlifting

2:31 high intensity interval training for example um probably would experience some

2:34 benefits from creatin supplementation and how is it going to benefit

2:38 you is it going to improve your training volume is

2:42 it going to make you stronger all the above so it

2:45 definitely seems to increase training volume so that's either the load

2:49 by the Reps by the set or Exercise capacity

2:51 from a cardiov vaster perspective um it definitely if you were

2:55 to choose one thing why creatine has been so effective it's

2:58 improving muscle strength um you could also Encompass that with endurance

3:02 and power it also improves lean body mass so here's

3:05 a big dis uh discrepancy that a lot of the viewers

3:08 might not know when we measure lean body mass in the labs

3:11 we're we're technically measuring blood connective tissue soft tissue um

3:17 so we're not directly measuring muscle mass we need to do

3:19 a lot more research on that um but in general

3:22 about 50% of the value of lean body mass we consider

3:26 muscle so it has some small favorable effects there's been some

3:29 studies with qct as well as ultrasound but you can

3:33 get an increase in lean body mass Regional muscle thickness muscle

3:36 performance but probably the area that most people don't realize is

3:40 the recovery aspects it really seems to have some anti-catabolic effects

3:45 um potentially anti-inflammatory uh effects and that's interesting because it's

3:49 from the aerobic Community for the longest time we never thought

3:52 creatin was for endurance or aerobic type athletes and the best

3:56 lines of evidence from a recovery aspect uh come from long

3:59 duration aerobic exercise a marathon ultramarathon a triathlon it seems

4:04 to reduce cyto so those are markers of inflammation um so

4:08 there's a whole gamut of mechanisms there's about 10 what we

4:12 consider anabolic uh factors and then there's probably just as many

4:16 as an anti-catabolic effect so uh it has a plethora

4:20 of benefits which I'm sure we'll talk more about in detail

4:22 today yeah so you okay to to go back you

4:25 just gave it total information dump it which is awesome um

4:29 let's go back for to the explosive power you were

4:31 talking about it seems to really help benefit in that explosive

4:35 power like you're talking about doing doing a squat yes

4:38 or I don't know maybe the first few seconds of a interval

4:42 um something where you're going you know using all that power

4:45 yeah um is is it is creatine benefiting benefiting is

4:49 that how it's benefiting increasing the training volume or is

4:54 there something else that's happening yeah in two ways so it

4:57 really seems to um maximize either the recruitment or the ability

5:01 of type two muscle fibers uh and when we talk

5:04 about aging unfortunately those are the ones we're losing as we

5:06 get older but it really seems to work in the second

5:09 third and fourth set so for example if you were

5:11 to do four sets of leg press compared to bbo

5:14 you may not notice any difference in the first set

5:16 because we think we have enough ATP or fossil creatine storage

5:19 in our muscle but when it comes to set two

5:21 three and four that's where creatine really comes to the rescue

5:25 the individual or group can do more uh repetitions and then

5:28 over time they can do a greater volume we think with weeks

5:32 of training if you're doing more volume you can actually get

5:34 greater physiological adaptations so when we look at all the meta

5:38 analysis when you compare creatine and weight training to creatine

5:42 Placebo and weight training there is a greater increase in lean

5:45 body mass uh muscle size as well as muscle performance

5:49 so creatine there is something there from a mechanistic standpoint

5:52 to allow that uh and we think muscle fiber recruitment primarily

5:56 type two muscle fibers is one of the main reasons does

5:59 it affect the recovery time in between sets excellent question

6:04 it does it really speeds it up so on average if

6:08 you were to totally wipe out your normal creatine stores it

6:10 takes about 3 to five minutes for your mitochondria to recover

6:13 that uh however creatine really really speeds up that recovery

6:17 which is great for the average person they don't have

6:19 a lot of time to work out they can't wait around

6:21 for 3 to five minutes in between a really intense set

6:24 so it really speeds up the recovery not only does

6:26 it speed up the recovery after every set but in between

6:29 contractions as well so over time the individual could probably have

6:33 a really intense great workout in less time total and get

6:37 actually more favorable effects and I think what this is

6:40 really important we're talking about here I mean we were talking

6:42 about squats you know these explosive types of um Power

6:47 types of training um and and this is a really important

6:51 field because you know you often hear about people talking

6:55 about the loss of muscle mass as we age you talked

6:57 about losing type two types of muscle fibers more readily

7:01 than the type one so these are the types of muscle

7:03 fibers involved in that explosive type of um Power type

7:07 you know exercise and um you know people don't think about

7:11 how power decreases with age how you strength decreases with age

7:14 and how that affects our quality of life how it affects

7:17 our physical Independence our fall risk right right and so

7:20 I think just focusing on this type of training I mean

7:23 the creatine is the icing on the cake right but just

7:26 focusing on doing these types of multi-joint compound types of Li

7:29 which is something that I in the past I would

7:31 say year a good year now a solid year of doing

7:35 CrossFit type of training where I'm doing strength training I'm

7:38 doing resistance training strength training

7:40 and high intens inner training that's

7:42 including you know the types of stuff that I'm used

7:45 to doing um biking and and Rowing but also adding

7:49 in you know doing doing some drop sets with with you

7:52 know front squats with the barbell and things like that it's

7:55 super important so this velocity or powertrain or or variety

7:59 training first we got to get people to move and then

8:02 allowing them to give some type of benefit to their training

8:05 program so creatine is probably the one that will be number

8:09 one when people selected even probably more than caffeine nowadays

8:13 uh from an exercise training capacity uh so it should be

8:16 considered um it can have a lot of substantial beneficial

8:19 effects and as we get older after about the fourth decade

8:23 unfortunately we start to lose these type two muscle fibers

8:26 and so exercise has to be foundational uh and if anything

8:29 else can be beneficial protein creatin um I'm all for it

8:33 and I think most people hopefully will be as well yeah

8:36 so the the improvements in in the muscle strength presumably are

8:41 coming because you're increasing your training volume right is that or is

8:46 there a direct effect on strain yeah there's actually a neurophysiological

8:49 recruitment so now creatine has been touted as a new

8:52 neurot transmitter so this is quite interesting it actually seems

8:56 to release a lot of things from a neuromuscular uh uh

8:58 uh perspective effective but the biggest thing is the ability

9:01 to recruit not only type one but these type two muscle

9:04 fibers as well um and then of course if we're having

9:06 greater muscle or motor unit recruitment we can potentially lift longer

9:10 heavier and and over time get uh uh sort of more

9:14 an increase in strength the other big thing from a cellular

9:17 perspective is that creatine causes calcium to come back

9:20 in a little vesicle in our muscles if you're taking high school

9:23 biology or university uh this will be your nightmare but I

9:26 remember everybody talking about the cop plasma reticulum and it's

9:29 an area that just releases calcium to allow our muscles

9:32 to contract and and creatine speeds up the uptake of calcium

9:36 so some of the evidence out to Europe has shown

9:38 that it increases relaxation time or the ability of the the proteins

9:42 in your muscle to grab hold of each other to contract

9:44 so there's a cellular aspect there explaining why we think

9:48 we get an increase in muscle performance I say strength

9:51 but endurance and power are all lumped in there as well

9:53 so endurance is the ability to perform repetitions to fatigue

9:56 or power move an object as fast as you can they're

9:59 all vitally important but we think strength is overall

10:02 from a Global Perspective uh number one it's probably the main reason

10:06 a lot of older adults are plac in long-term care

10:08 facilities if they have a reduction in strength they can't live

10:11 independently so that's why again resistance training or weightbearing exercise

10:16 as you mentioned CrossFit whichever it is foundational I'm from Canada so

10:20 shoveling the driveway in the winter counts because anything that's

10:22 a load against you is is really beneficial to the body

10:26 I think people underestimate the benefits of moving um and then

10:29 if anything can be taken in in this form creatine

10:32 it'd be very very uh beneficial yeah you you mentioned

10:35 some of the anti-inflammatory effects of creatine particularly in the context

10:39 of more endurance type of training people that are perhaps running

10:43 marathons or just clocking in a lot of hours of running

10:46 or cycling per week right um is that so I think

10:52 that that that goes in to some respect in the recovery

10:55 sort of Bin right and um I'm wondering if

10:58 that also plays a in recovering from doing your resistance training

11:01 or strength training like on a recovery day so I mean

11:04 do you think it plays a role just broadly in recovery

11:07 yeah it does now this is interesting and I probably

11:09 would have been the most surprised when we wrote the paper

11:12 on this that we don't think traditional weight training um

11:16 where you're doing a set you're resting maybe a minute

11:19 to two it seems like it's not catabolic or intense enough

11:23 now most people will say shake their head say hey when

11:25 I'm in the gym I'm really putting a lot of effort

11:27 in I think from a mechanistic standpoint when you're doing

11:31 running or long distance continuous muscle contractions it causes this large

11:36 catabolic effect to the body um so that really heightens

11:39 the inflammatory response weight training is acute 10 seconds of work

11:43 3 minutes of rest 10 seconds of work three minutes

11:46 of rest or whichever it is and we just don't

11:48 see creatine having a lot of superior effects from a resistance

11:51 Trin and Recovery aspect probably because the rest intervals

11:54 for the average person are there but from a long distance event

11:58 you're running hour hours uh you're swimming whichever it is

12:01 the best lines of Defense come from Triathlon and Marathon running where

12:05 the increase in these markers called cytic kinds were elevated uh

12:08 but creatine sort of attenuate that rise could allow the individual

12:12 to recover and get back on the the the track

12:14 or whichever it is quicker um but I've talked to some

12:17 good colleagues in Canada and it just seems like weight

12:19 training is is too intermittent um now when you mention CrossFit

12:24 that's different I'm thinking of the three sets of 10 you

12:26 move from machine to machine you rest you have a CrossFit

12:30 or something that's really continuous would probably uh fall in line

12:34 here of the um necessity for creatine so that would

12:38 be a very good study to look at the effects

12:40 of creatine on the recovery aspects of something like high-intensity interval

12:43 training or uh CrossFit for example our military type of training

12:47 that's really endurance and and resistance training so you just

12:51 gave me another idea to to run with but it it's

12:54 logical the more intense the more demanding I think that's where

12:57 creatine's anti-inflammatory properties would come into play yeah so when

13:01 people hear catabolic or you know they'll think they'll think

13:04 of muscle breakdown right and certainly you know there's there's

13:08 a big component to sarcopenia inflammation in sarcopenia which is age related

13:14 muscle breakdown is there is there a role for creatine

13:18 in in preventing the breakdown of muscle there is it's very

13:23 mix so we don't have a lot of data um first

13:26 off creating doesn't directly increase protein Sy synthesis which might be

13:30 a surprise for a lot of reviewers it sort of works

13:32 in in a magical other way which we can talk

13:35 about but from a a muscle breakdown perspective it seems

13:38 to reduce something called Lucine oxidation primarily in young males and that's

13:43 an indicator of whole body uh breakdown we've also shown

13:46 in our lab it reduces thre methylene which is another indicator

13:49 of whole body breakdown but nothing is directly shown

13:52 in the muscle itself uh and for some reason females don't experience

13:57 this we've looked at it in Young and older females

14:00 we don't see the same effect the only logical explanation is

14:03 it could have something to do with progesterone or estrogen we

14:06 just don't know that um and from an anti-catabolic effect uh

14:10 decreasing some of these tissue repair mechanisms there's not a lot

14:14 of research out there but unfortunately we're not seeing any

14:17 evidence that creatine increases protein synthesis so unlike protein which it

14:21 does creatine seems to help increase muscle size in other ways

14:26 satellite cells grow factors things like that but it does

14:29 decreased protein breakdown primarily though in males uh and we still

14:33 don't know exactly why but we think estrogen or the other

14:36 sex hormones might be involved does creatine have a general

14:40 anti-inflammatory effect in in both males and females it does

14:44 in young and older individuals but here's an important distinction the more

14:48 stressed the body is it seems to come to the rescue

14:51 more so if you're a young individual adequate sleep proper

14:54 nutrition you're probably not going to notice any anti-inflammatory effects it's

14:58 when the body is under times of extensive exercise or trauma

15:03 hypoxia um I'm sure we'll talk about the brain and sleep

15:05 deprivation so whenever the body is more stressed or under

15:09 more attack that's when creatine seems to come to the rescue

15:12 and getting getting um circling back to you know people

15:15 that are supplementing with creatine and it improves their training volume

15:20 improves their strength um what why do people have to supplement

15:24 with creatine well uh they don't actually so little a bit

15:29 of clarity so we naturally are producing creatine in two

15:31 main areas in the liver and in the brain

15:34 and on average we're producing uh about 1 to two grams then

15:38 we're also consuming in the diet anywhere between 1 to three

15:41 grams or none so a vegan is not getting any

15:43 dietary creatine uh those that are on a carnivore diet

15:46 might be all all the way up to about three grams

15:49 and we excrete uh through the urine a product called

15:52 creatin and about two so when you do the math we're

15:55 in a net Surplus anywhere between 1 to two gam

15:58 a day we know it's not essential because vegans can live

16:02 a long healthy successful life but we consider it conditionally essential

16:07 because when we see all the evidence I think there's over

16:10 a thousand peer review papers when we take in a little

16:12 bit more there is some substantial beneficial effects across the whole

16:16 board not just muscle we're now looking at bone brain

16:19 and the immune system you so from from a perspective

16:22 of a vegan who is not getting a any almost amount

16:28 of dietary cre they're relying on their liver to make it

16:32 um what what's going on in their brain you mentioned

16:34 the brain makes creatine yeah it's very interesting so on average

16:38 vegans have substantially less muscle creatine compared to an omnivore

16:41 or carnivore diet but an elegant study out of Brazil about four

16:44 years ago uh they Ed sort of an MRI

16:46 for the brain and they showed that vegans and omnivores had

16:50 the same amount of brain creatine store so that's really substantiating

16:54 that the brain makes its own creatine it probably makes enough

16:57 for the nonstressed individual but during times of metabolic stress

17:01 the question is will vegans or omnivores need more and it's

17:04 likely that it that's true yeah during development is the developing

17:09 brain making its own creatine like it is y just like

17:13 our liver is making its own creatine it's using and it's

17:16 probably an accelerated rate for brain development cognitive development uh

17:19 again our brain is small but it uses 20%

17:22 of our daily energy and of course during uh development that's when

17:25 is very very precious as well yeah so creatine is

17:28 most found in animal Foods Meats poultry fish yes um none

17:34 in plants at all Trace Amounts you'd have you'd have

17:37 to eat the entire Orchard of whatever plant you're thinking and same

17:40 with uh milk you'd have to drink all the milk

17:43 from a Jersey cow to get any significant amount so that's

17:45 why it's unrealistic you so so if we're having if

17:48 we're producing between you know 1 to two grams at best

17:53 just in in our liver correct um and that presumably

17:57 then is being transported to muscle that's the whole 95% we

18:01 can't forget about the bone uh and brain or the main

18:04 areas yep okay and then if let's say let's say you're

18:07 getting I think I was reading some enhan study where

18:11 on average people get younger adults not older adults get anywhere

18:15 between um 1 to two grams a day from their diet

18:18 right but older adults are getting on that lower end

18:21 even not even necessarily at even at one gram so

18:25 so older adults are getting even even less yes but um

18:29 then you know is there is there is there more

18:31 to be consumed by the muscle or does it get spread around

18:35 yeah that's an excellent question so the thought is

18:38 as we get older we have R reduced fossil creatine stores

18:41 in our body so they might need more um and the hope

18:44 is about 95% Is Res is housed in our our skeletal

18:48 muscle but now with the emergence of research the rest

18:50 is in bone and brain specifically so the hope is if

18:54 we take in more our muscles will be full which

18:57 is great but now hopefully we're going to have some trickling

19:00 into our bone which is even just as important and I

19:04 think most people would argue from the neck out that's

19:06 really important from a Global Perspective with all the neurological diseases

19:10 depression anxiety so I'm one of the big proponents of taking

19:14 a lot more than probably what's recommended based on uh

19:18 the evidence-based research to sort of disperse throughout the whole body

19:22 not just skeletal muscle well let's let's talk a little

19:24 bit about that so in some of these let's you know

19:27 the strength training resistance training studies what's the common do

19:31 that's taken and maybe we can talk a little bit about

19:33 I mean there's the loading phase which I've never done

19:36 so I actually take five grams a day Y and um

19:39 although I might start taking more after this podcast so

19:43 I I'd love to know like what what is the average

19:45 dose that's taken to improve you know your strength training

19:48 your resistance training your training volume and then um we can go

19:52 from there yeah so I mean in 1992 uh Roger

19:55 Harris came up with a seminal uh um um protocol where

19:58 you just mentioned this loading phase it's the most viable

20:01 rapid way to really saturate your skeletal muscle this has nothing

20:04 to do with the bone or the brain and so

20:06 that's 20 grams a day for about 7 days is usually

20:09 what's recommended uh a bit of new information you only need

20:13 to do that for two days and then your muscles are

20:14 saturated so the loading phase was designed for athletes to really

20:19 rapidly uh sort of fill up the room if you

20:21 will from a skeletal muscle perspective after that you can reduce

20:24 it as little as 2 gram a day so again that's

20:26 a half a salmon steak that would a half

20:29 a chicken breast or whichever so it's very viable they call

20:31 that the maintenance phase the only problem with the loading phase

20:35 is it's so rapid it does cause water to enter a lot

20:39 of our cells and a lot of individuals do not

20:41 like this potential net water retention or GI track irritation we

20:45 don't usually use that in our labs for that reason

20:49 um but for the Athletes World Championship coming up the loading

20:52 phase followed by a maintenance phase is a very viable

20:54 Rapid Way young females hate it because of that water retention

20:58 and and weight gain the good news is you can take

21:01 as little as 2 to three gram a day no loading

21:04 phase and take that on a day daily basis probably

21:07 for the rest of your life and that will definitely accumulate

21:10 and fill up your muscles in about 30 days we

21:13 don't know if that low dose will get into the bone

21:15 or brain on a long period of time uh what

21:18 we've done is look at a relative dose so that means

21:21 everybody uh has a certain weight we put them on scale

21:24 and we use 0.1 G all the way up to 0.14

21:27 G per kilog um so for example if you're 70

21:30 kg you're taking 7 g a day all the way up to about 9 g a day uh you can take

21:35 that in one bis dose or split it up into smaller

21:38 dose eaches throughout the day I wouldn't go any less than

21:40 one gram one gram doesn't seem to get in the blood

21:43 as rapidly as we need um so that's something

21:45 for your viewers if they're micro doing no less than one gram

21:49 um but you can split it up 2 and half

21:50 gram 5 gram whichever are you want I take a lot

21:53 more than that um based on our new clinical data

21:56 I'm 48 years of age I know the effects of aging

22:00 and from a bone and brain perspective but really all

22:03 this dosing came from muscle and we have all these new

22:06 areas that's why I think the emergence of new dosing strategies

22:10 has really come to light you I and I I definitely

22:13 want to get into some of these you know potentially

22:16 negative effects of the of the high high dose um

22:19 but but let's talk a little bit about your your new

22:23 emerging data on bone health so you're talking about so I

22:27 mentioned five grams a day and well maybe before we

22:30 get to that um how long does if if I'm taking

22:33 like someone's taking 5 grams a day and you know how

22:37 long does it take to to to get your muscle stores

22:40 saturated and then let's say your resistance training right so

22:43 you're working let's say your resistance training and endurance training I

22:46 mean you're working out five to six hours a week I'm

22:48 just talking about my schedule here and then and and I'm

22:52 and I'm doing five grams a day right is am

22:54 I just constantly saturating my stores even though I'm you know

22:58 pulling down from them as I'm working out or how

23:00 does that work perfect cuz five is the average global recommendation

23:04 and that's a fantastic dose uh overall we think

23:07 to start especially from a muscle perspective so it'll take you

23:10 21 days to fully saturate your skel muscles so after

23:13 that you're going to have some being excreted in your urine

23:17 or let's pray here hopefully some is now being uptaken

23:20 into your bone because the muscle is pulling on bone your bone

23:23 is a very metabolically active tissue which no one actually

23:26 sees in the mirror and then hopefully some is trickling more

23:29 into your brain so the thought is okay 5 grams is

23:32 very viable easily 21 days your muscles will be full taking

23:37 five grams a day thereafter some would probably go in the form

23:40 of creatinin but hopefully and we don't know this maybe

23:43 some is going into your bone being used by your immune

23:45 system your GI tract your gut health and your brain

23:48 so five is a great dose I'd like it to be

23:52 higher just because of some of the new data to suggest

23:55 every day we get out of bed we're a day

23:56 older there's some good evidence to suggest bone needs a bit

23:59 more and of course the brain we still don't know

24:02 but I have some lines of thinking about when we're really metabolically

24:05 stressed um how much to take but if you're taking

24:08 five rest assured you're doing exceptionally well yeah well let's talk

24:12 about bone so one of the best things you can do

24:14 for bone health is weightbearing exercise these compound lifts the things

24:20 that we were talking about with improving your your explosive

24:23 power and your strength right right um how is creatine adding

24:27 to that by two ways a direct and indirect so

24:30 let's go with the boring direct it sort of increases osteoblast

24:34 cells these are these are cells that sort of create uh

24:37 or the formation of our our bone cells so in rodents

24:40 osteoblast cells have been energized in the presence of creatine

24:44 so it was logical to think in humans maybe our osteoblast

24:47 cells the cells that are responsible for increasing bone size

24:50 and strength might have more fuel and these cells do use

24:54 creatine just like our muscles do for fuel um and potentially

24:58 increase bone density and if that's true we've just cured

25:01 osteoporosis basically um the other line of thinking which is

25:05 surprising going back to this anti-catabolic uh phenomenon is the best

25:09 lines of evidence with bone are from an anti-catabolic perspective

25:13 it seems to resemble abys phosphinate so a lot of reviewers

25:16 are maybe taking abys phosphinate it sort of preserves your skeleton

25:20 I know my mom is taking that as well um

25:22 so creatine reduces something called the osteoclast activity or bone

25:26 resorption so for for some reason it really inhibits these osteoclasts

25:31 from sort of chopping down our bone and increasing blood

25:33 calcium levels when not needed and then of course if it

25:37 sort of increases osteoblast potential maybe the recycling a bone gets

25:41 stronger it's kind of like laying a foundation of a house

25:44 the bricks are stronger you're sort of putting the bricks

25:47 together a little bit faster and then inclement weather is not

25:50 chopping away the bricks or the cement so that's how we

25:53 theorize it was working and there's been about 15 studies now

25:57 showing that it has a lot of anti-resorptive effects so

26:00 think of anti-catabolic to the Bone uh we have not shown

26:04 in a single study an increased bone mineral density so

26:07 this is really crucial we are not saying that creatine and weight

26:10 training increases bone mineral density but it certainly decreases bone

26:15 mineral density loss and really specifically around the hip region which

26:19 is crucially important for a lot of older adults because

26:21 when they fall if they if they land on their hip

26:24 they could be more susceptible to fracture so there's a lot

26:27 of anti-catabolic effects and we've just shown in a long-term

26:30 clinical trial and improved bone strength so picture a pen

26:33 or pencil you can't crack it as much there I think weight

26:37 training is the main driver when it comes to Bone

26:40 um the more muscle you have from an indirect perspective there's

26:42 more muscle pulling on bone so that's very beneficial look

26:45 at gymnast they have phenomenal bone mineral density and muscle mass there

26:49 so there's a lot of potential there um it's not

26:53 uh overwhelmingly convincing I think cuz bone takes a long time

26:56 to turn over but this is is interesting the lowest dose

27:00 ever been shown to be effective is 8 G of monohydrate

27:03 a day now as we just talked about 3

27:05 to 5 gam it's great for muscle but now you're getting

27:07 into bone what needs to happen is a dosing study could

27:12 five grams over maybe two years be equivalent to 8 grams

27:15 over two years or even higher uh that is very

27:18 expensive to do um but it's been in the back

27:21 of my mind I would just speculate that 5 gr over

27:25 time will still benefit your skeleton but you need such a large

27:28 sample size to get these small effects either from a dexa

27:31 or CT scan and that's probably why we haven't seen

27:34 it yet but in all our clinical trials eight grams

27:37 but the Brazilian group have looked at 1 to three grams

27:39 for two straight years and not a single Improvement so

27:42 weight training is there and I think that's the Big Driver

27:45 from any of the muscle bone perspectives yeah so you so

27:49 you think um just supplementing with creatine by itself even if

27:53 you're doing 8 G isn't isn't really going to necessarily

27:56 affect your bone health if you're not doing any weightbearing exercise

28:00 even even considering the you know preventing the the breakdown

28:04 I mean preventing the activation of these Osteo class that are

28:07 breaking down the bone I would be very surprised I

28:10 think you need that mechanical loading from weight training or weightbearing

28:14 exercise Plyometrics that cause the bone to turn over and then

28:18 maybe creatine doesn't increase the resorptive or it increases osal blast

28:23 a little bit more um the cool thing with osal

28:26 blast it it releases the cyto called osteoprotegerin which acts

28:29 as a decoy and that's been shown in in in vitro

28:32 studies there so there is some cellular data uh which is

28:36 a bit surprising when it comes to the the skeleton

28:38 not just Imaging um but if I was to take eight

28:41 grams would I tell my parents to take eight grams

28:43 and not work out if I did I don't think they'd expect

28:46 anything on the bone the bone is really stubborn it's

28:49 just like our brain and creatine it's really really stubborn I

28:52 think the main Force is is the driver of weight

28:54 training out what about someone who is let's say a postmenopausal

28:58 woman who who experiencing some perhaps osteopenia yes do you

29:05 think before trying some of these other standard of care treatments

29:10 like bis phosphates for example you mentioned doing the weightbearing training

29:15 and the creatine perhaps 8 grams or 10 gram a day

29:20 would be a good first line of defense to try

29:24 before trying some of these other drugs that do have negative

29:27 side effect so if there's if you're in line for Abyss

29:31 phosphinate there's no way that creatine or weight training will

29:34 come close so a drug effect will always be superior

29:37 the the effects we're seeing even from a significant perspective with creatine

29:40 are so small we don't even get to a clinical

29:43 perspective but let's talk about weight training I 100% agree if

29:47 I had to choose one for bone it's weight training

29:49 or Plyometrics or anything that you feel to the body

29:53 and then consider creatine in your treatment program creatine would

29:57 never replace a pharmaceutical intervention from a a bone perspective um

30:02 and the effects we're seeing are so small or even over

30:05 2 years at best it's preserving now this begs the question

30:10 maybe the adults we chose were too healthy none had diagnosed

30:14 osteoporosis or osteopenia or Frailty what if we took a population

30:17 with severe osteoporosis maybe creatine could come to the rescue

30:21 there that's another thing we're starting to hopefully get governmental funding

30:25 for down the road um but a lot of young

30:27 females a lot of young males and of course older females

30:30 even postmenopausal their skeleton is still very uh beneficial and strong

30:35 they may not have incidents as osteopenia or fracture uh

30:38 uh risk um but until we do a study and diagnosed

30:42 osteoporotic uh males and females uh we just don't know if

30:46 it's the disease or maybe they were just healthy enough

30:49 yeah well prevention is obviously I think the key right if

30:53 we can encourage people before they're experiencing Mass breakdown of their bone

30:58 or osteoporosis osteopenia to you know engage in in resistance

31:04 training and not and not the single joint exercises where

31:06 you're making your biceps bigger right I mean like you need

31:09 to you need to be doing these multi-joint compound lips

31:12 rows you know presses anything that's multi-joint um and then perhaps

31:17 in combination with creatine if it's it's really if it's

31:20 preserving bone that does really suggest a preventative role right yeah

31:25 and and that's 100% correct like the movement is is

31:28 got to be there um and I think most people are

31:30 aware of the benefits of exercise and then if creatine

31:33 or protein or whatever it is you're eating can give you

31:36 a small beneficial effect I'm all forward and I think

31:39 a lot of people would be there as well so creatine definitely

31:42 has the potential it's kind of has a lot of potential

31:45 for a lot of things um but without protein um

31:49 you know those two need to be there um we don't

31:52 think creatine could rescue a hypocaloric diet especially low in protein

31:56 um but we just don't know I argue that creatine Falls

32:00 in line with protein with this aging anabolic resistance as we

32:03 get older my guess is where we have lower creatine

32:06 in in some of our muscles as we get older we

32:07 need more so now there's a young versus older uh stereotype

32:12 just like protein younger individuals may respond from 20 to 25

32:15 grams all the way up to older adults so I

32:18 think creatine is definitely part of my day um and I

32:21 try to promote the the evidence-based research especially from an older

32:24 adult population if anything we can do to offset chronic

32:28 disease or getting chronic disease uh that's beneficial and we're

32:32 starting to really focus on young females exercise is so important

32:35 adequate uh protein and then creatine it's not just for males

32:39 we're seeing a plethora of benefits for young biological females

32:42 which is really important it is you you know when

32:44 you when you hear the word creatine you think about like

32:47 the Jim bro right like I mean it's like you're

32:50 taking the creatine trying to get you know their muscles bigger

32:52 and um the reality is is that you know women women

32:56 are also very I me they suble to you know losing

33:00 muscle mass and strength but bone is a big one

33:04 yeah and when we look at all the data females get

33:06 an improvement in muscle performance

33:08 primarily strength that's the population we've

33:10 seen the best bone benefits now they were postmenopausal but uh

33:13 reduction in bone mineral density bone strength uh and then

33:16 we're seeing from a a sports perspective agility balance so uh

33:21 for the females watching uh don't shy away from creatine

33:24 it's extremely potentially beneficial in combination with exercise and if you're

33:29 worried about weight gain or or whichever do not do

33:31 the loading phase it's not needed you can start as little

33:34 as 2 to three grams a day divide that up even

33:37 so I'll tell a lot of our clients or or participants

33:40 you can take one and a half grams in the morning

33:41 wait till the evening to take one and a half

33:43 grams uh that really decreases the chance of water retention

33:47 um but if you're eating red meat or seafood you're getting

33:49 a little bit amount for the vegans watching keep in mind

33:52 you're not getting any and that's why supplementation uh third

33:55 party tested they are vegan based could be considered yeah I

33:59 mean it seems like it'd be very important for that population

34:01 of people in particular yeah we we've done some really

34:04 fascinating studies with vegans and vegetarians

34:06 and they respond exceptionally well

34:09 uh because we're doubling the amount of creatine which is

34:11 the high energy compound in our muscle so they those individuals

34:14 can do more repetitions higher volume quicker recovery so it

34:18 really has favorable effects for male and female uh vegans

34:21 and vegetarians and again those emphasizing a plant-based diet with everything

34:24 going on in the world nowadays A lot of people are

34:26 are uh look into more plant-based diets for health uh

34:29 reasons or whichever um and then they might need to consider

34:33 a supplement so usually we're not in the market of of talking

34:35 about supplements but this one is the one that seems

34:38 to come to mind where it might be difficult to get

34:40 the amount needed in your diet um from Financial cost

34:44 ethical treatment of animals whatever your own habitual preference is uh

34:48 and if they're third party tested it's the safest most effective

34:51 ergogenic Aid out there right now the the safety profile

34:54 is exceptional especially at the do each as we're talking about

34:57 like when we talk about protein we're talking hundreds of grams

35:00 at most we're talking maybe 10 20 grams for the athletes

35:04 which is basically two teaspoons in in the Run

35:06 of a day so it's not a lot but there is

35:08 a lot of uh evidence-based research behind it yeah yeah

35:11 and I let's we'll definitely dive a little more into the supplementation

35:14 but um I'm interested in the brain and we've gone

35:17 from we've gone from the the role of creatine it seems to have multiple roles um

35:23 anti-inflammatory anti-catabolic right um it's obviously

35:26 important for producing ATP regen you know regenerating the ATP um

35:32 what about the brain what super exciting like this is

35:36 such an emerging area so from the neck up I think

35:39 the next 20 to 30 years we'll be focused almost entirely

35:42 on this so um our liver produces creatine and our brain

35:47 actually is unique it also produces creatine but the brain

35:51 is very resistant we have the bloodb brain barrier

35:53 for a really important reason um and the Brain says you

35:56 know what circulation we don't need creatine in the blood we're

36:00 making our own so an individual getting adequate sleep no

36:04 chronic disease no metabolic diseases

36:06 no neurogenerative diseases is producing adequate

36:09 amounts of brain creatine it could be as as little

36:12 as 1 to three grams um now our brain is small

36:15 from stature but it uses 20% of our daily energy

36:18 and of course as we all know when you're really tired

36:20 sleep deprivation running around chasing your children most people that I

36:25 know are really U metabolically stress primarily from a cognition perspective

36:30 and that's where creatin seems to have the best lines

36:33 of evidence sleep deprivation hypoxia I jet leg I was up

36:36 at 3:00 this morning and flew down so I'll be taking

36:39 a really high dose today to hopefully offset the the chance

36:42 of inflammation or uh cognitive decline um so when we

36:46 look at the totality of emerging evidence it's split some studies

36:51 don't see any effect but the ones that do is

36:54 in a population where they're either

36:56 mentally fatigued sleep deprivation or during

37:00 times of aging and that's where memory comes into play

37:04 and the common denominator seems to be the more that the brain

37:07 is stressed the more creatine seems to come to the rescue

37:11 same analogy from a muscle and bone perspective so

37:14 uh we can talk for hours just on the brain

37:17 and uh it's a very exciting area for sure yeah so

37:19 the brain is stress so so brain aging brain older adults

37:23 that's that's that's aging is a stress on the brain it

37:26 is so supplementing with how much creatine can improve cognition

37:29 in let's say older adults yeah as little as about

37:32 five grams has been shown to have some potential

37:36 but this is interesting I just you know 20 minutes ago said

37:39 that the loading phase wasn't needed for muscle the best

37:42 studies for the brain look at 20 grams a day

37:44 for at least a week so now you're in a conundrum

37:47 I'm looking at muscle bone and brain and the theory here is

37:51 that since the blood brain barrier is very resistant to creatine

37:54 and unfortunately we have this really important G cell called

37:57 astrocytes which are the most the biggest in in our uh

38:01 central nervous system it sort of acts as a filter

38:03 from our blood into our cells and it really determine what

38:05 gets in and it says Hey foreign pathogens no you're not

38:08 getting into the the neuron or the cell uh so unfortunately

38:12 they don't have the creatine transporter or doorway so that's why

38:16 uptake into the brain is very blunted so the thought

38:19 is to get an improvement in brain creatine stores you need

38:22 longer duration of supplementation or higher dosages so the best

38:27 lines of evidence using mrss have shown that higher 20 gam

38:30 a day seem to be the most viable there's been

38:32 a single study looking at about four gram a day

38:35 but it took three months to accumulate in the brain uh

38:39 unlike our muscle which acts as like a vacuum it sucks

38:41 in all the creatine from our blood our brain says no

38:43 no no I'm only going to take what's in our blood

38:45 I.E supplementation when need be so that's why sleep deprivation

38:50 seems to have the best lines of evidence or mental fatiguing

38:53 challenges yeah okay so let's if you're if you're someone

38:57 like myself who supplementing with 5 a day for a year

39:02 that's enough time for it to eventually accumulate into the brain

39:06 presumably yeah like that low dose remember you need about two

39:10 to three grams now I'm not sure about your diet

39:12 but you're going to need that just to maintain your muscle

39:15 and then comes down to your genetics what's more in Jeopardy

39:18 is it your bones or brain so again the 5%

39:22 that's remaining throughout the body is in your testes heart uh

39:25 uh bone uh and brain so for me as a biological

39:28 male it's going to different areas compared to you

39:30 as a biological female but my hope is wait a minute let's

39:34 go a bit higher so we're sort of sort of uh

39:36 checking off all the boxes my guess is five grams

39:40 you'd have a small increase in brain creatine content um

39:45 but if you have a really nonstressful life the brain says

39:50 no go to the Bone or we'll excrete it down

39:52 the toilet but if you're metabolically stressed it's begging for more

39:56 I'd like you to be probably higher than five but I

40:00 think it'd be interesting to look at some prepost uh mrss

40:04 scans and um it's viable it could be there the study

40:08 that did for grams was in Long COV these individuals

40:11 brain fog fatigue headaches things like that so the brain

40:14 was really begging for Recovery out okay so you just mentioned

40:17 the best studies showing any Improvement in and when we're

40:20 talking about Improvement we're talking about cognition we're talking about like

40:25 memory memory okay you said 20 G right which is definitely

40:29 what I don't want the the swelling part of that um

40:34 which happens around 20 Gams yes so have there been

40:37 studies looking at 10 grams is that like a sweet spot

40:40 the seminal study was out of Germany and they did four

40:44 two versus four versus 10 and this is where I personally

40:47 take at least 10 and they use mrss studies and they

40:50 only they showed that about 10 double the percent increase

40:53 in brain creatine content but they also measured it in the gray

40:56 matter the matter and I believe the phalus and it

41:00 all improved by about 10% now it was a small

41:03 sample size because the run on mrss is super expensive so

41:06 statistically it wasn't there but the percent improvements were were

41:09 a lot higher and when you look at all the other

41:12 data 10 gam seems to be a very viable dose

41:16 to not only check off the Box definitely for muscle we're

41:19 now checking off the box for brain and now we're

41:21 or sorry bone and then we're also checking off the the box

41:23 for uh brain as well so I personally take about

41:26 10 gram a day on average but during times of metabolic

41:30 stress sleep deprivation or uh um jet lag I'll increase it

41:34 to 20 so today I will take 20 grams because I

41:37 flew down from Canada I'll take 20 grams again tomorrow

41:40 but when I get back home I'll decrease it back down

41:41 to 10 if any is being excreted down the toilet I'm

41:44 totally fine with that creatine is very cost effective but I

41:48 want to make sure I'm maximizing all my abilities

41:51 and the immune system especially in Canadian Winters is really heightened

41:55 and uh activated and and I really have found in the last

41:58 few years I'm I'm not getting flu like symptoms hopefully

42:01 that's from exercise or Diet but uh who knows maybe

42:04 creatine is helping because there is some anti-inflammatory effects you um

42:08 you you went to another area that I definitely want

42:09 to talk about but like before that so 20 grams then you're

42:13 saying acutely when you're in this sleep deprived State jet

42:15 lag you know let's say fill in the blank type

42:18 of you know extreme stress um is that immediate so let's

42:23 say like you you miss you're like up late you had

42:25 you're up late one night you have some to do

42:27 the next morning or the next day you have to be

42:29 like on your game if you take that 20 G either

42:33 at night would you take it at night like before you

42:36 go to sleep or in the morning or does it

42:38 matter and will it have an effect immediately yeah and I

42:40 love learning and this is just so 20 GS mighton

42:42 be too low it's surprisingly to your viewers so another study

42:44 came out of Germany they did is very elegant design

42:47 it was a crossover and they gave 0.35 grams per kilogram

42:51 so even if you're only 70 kg that's 25 G

42:54 in a bowl of do and they measured it for 21 hours

42:57 of sleep deprivation and it really improve memory cognition and it

43:01 increase brain creatine content so that higher dose not only

43:05 does it get into your plasma or blood really quickly

43:07 probably in about 3 hours it's peing when your brain is

43:10 stressed it's being taken in quite readily so during times

43:14 of metabolic stress it seems to work now the argument is

43:18 how do I know I'm going to be stressed tomorrow how

43:20 do I know I'm going to have a bad night sleep

43:21 you don't so that's why I think taking a higher

43:24 daily dose might be a safety but the day you're like

43:27 oh I didn't sleep at all and I have a big

43:29 presentation later or me as a professor teaching four classes

43:32 a term I've really increased the amount I would say

43:36 I might be the most saturated person on the planet because

43:38 I've been taking creatine for decades uh there's no reason

43:41 to stop uh we can talk about cycling or or continuous um

43:45 but I'm even taking more in hope that it's getting

43:47 into my brain again 20 years ago it was just muscle

43:50 then we've evolved into the bone and now we're getting

43:53 into the brain and I think a University students midterm week it

43:56 finally examed staying up all night cramming maybe creatine could

44:00 really improve their ability to score better on tests and when

44:03 you look at the mental fatiguing uh studies that's when creatine

44:07 seems to work after you've done a whole bunch of fatiguing

44:09 exercises or sorry taken creatine before it really speeds up

44:13 your ability to maintain memory and cognition and uh we can

44:16 talk about neurofilament um things in the brain or bdnf

44:19 and and that's some of the mechanisms primarily in Roden so

44:22 there is some mechanisms showing that creatine is decreasing oxidative

44:26 stress are really having some uh potential for neuronal health which

44:30 now you think of Alzheimer's dementia neurogen diseases so I'm

44:34 super excited to see where this is going for the next

44:36 20 or 30 years yeah I wonder if there's any

44:38 effect uh just because sort of a triaging of like it's

44:42 it's helping with the energy and so it's like freeing

44:45 up other energy you know for like other you know taking

44:49 care of O oxidation and probably the best overall Segway so

44:54 it increases brain bioenergetics and if and one of the common

44:58 Den numbers with depression or concussion is that they have

45:00 reduced brain creatine stores and bioenergetics compared to a healthy control

45:04 on average and so maybe creatine is bringing those values

45:07 up or even slightly more and now the brain has more

45:10 energy capacity to do and deal with all the daily

45:13 stressors of of society yeah absolutely so TBI I mean traumatic

45:17 brain injury it I I the way I think of it

45:20 is like real time brain aging yes it's just it's

45:23 like all of a sudden you just get a a knock

45:26 to your head and it's like accelerated aging so what would

45:31 be a protocol for someone that you know let's say

45:34 they take a Blow To The Head or they get hit

45:35 with the ball soccer ball or you know whatever the football

45:38 whatever sport that they're doing um would it be like they

45:41 should be taking high dose immediately yeah so I'm now

45:44 in the camp and I think a lot of other researchers

45:46 and a lot of the works come coming from here

45:48 in the United States but if you're in contact Sports creatine should

45:51 be taken on a daily basis because unfortunately if you

45:55 do get hit in the Roden model when because you can't

45:58 do this as in humans but when they've actually forced

46:00 concussion in rodents taking creatine

46:02 beforehand the recovery symptoms are really

46:05 accelerated and in the only single human study was in children

46:09 as soon as these people in Scotland got head trauma

46:11 they put them on 0.4 grams of creatine per kilogram so

46:14 about 20 these are just children immediately and over six months

46:18 these children that were taking

46:19 creatine had substantial improvements in self-care

46:22 and efficacy no blood bile markers were taken but at least

46:25 it showed the Improvement in recovery so instead of waiting

46:29 till you get hit why not take the preventative role

46:32 and that's why again I think for me and again

46:35 it's it's it's opinion but we've seen some data to suggest

46:38 that 10 grams might be a good viable dose um more

46:41 or even a little bit less depending on why you're taking

46:43 it but I personally take it from a whole body

46:45 perspective I don't play any contact Sports um now but who

46:49 knows I could go and skate and fall and hit

46:52 my head or skiing or whichever and maybe that would help

46:56 accelerate recovery um I'm taking it just for any chance

47:00 to have some potential brain benefits but the big area it

47:03 does increase the recovery aspects of concussion so NFL NCAA especially

47:07 down here United States trillion dollar industry I got to believe

47:11 these players are taking creating in anticipation I know the quarterback

47:15 for the Dolphins I think he's had third three concussions

47:18 this year so his brain is so compromised right now

47:22 massive inflammation hopefully his medical team is at least considering high

47:25 dose with his other treatment program to get there so

47:28 yeah and they should be taking it for the the benefits

47:31 on on muscle you know AB you know explosive power ex

47:36 those you know high intensity moments um you mentioned earlier about

47:41 0.1 gram per kilogram body weight so how would you

47:44 adjust let's say you know you're taking 10 grams of creatine

47:48 per day and you're wanting the effects of the benefits

47:51 of muscle bone brain as do I however I do not

47:55 weigh as much as you so would you is there

47:57 a scalable amount per kilogram body weight you think would be

48:02 something that or is it hard that's an excellent question

48:05 and the answer would probably be no because when we go

48:07 on the scale we don't consider the head even when

48:09 we do dexa scans as headless so you know if I'm

48:13 80 kog I'm taking about there's the The Sweet Spot about

48:17 you know 9 to 10 grams a day uh taking it

48:19 from a weight perspective to the correlate to the brain

48:22 is almost impossible because we need to measure the the weight

48:25 and where it's a hard tissue it's a little bit soft

48:27 but it's usually hard tissue um I think overall body weight

48:31 um very similar how people do protein based on lean

48:33 mass or uh a total body structure so you can take

48:36 creatine based on lean body mass but it's very difficult you

48:39 would have to have some type of Imaging uh apparatus so

48:42 we just usually recommended on body U Mass they hit

48:45 the all the aspects that makes sense and it really does

48:47 seem like there's this sort of triaging where it's like okay

48:50 the muscles consuming it it's like the greedy one and then

48:53 whatever's left over maybe the bone but if the brain

48:55 stress Maybe you know it's funny how the body can figure

48:58 that out like you know the brain needs it um so

49:02 you know there was another there's some interesting research that you

49:04 also published kind of um in the in the brain

49:08 area is sleep right and um I'd love for you

49:12 to talk about that study I thought it was so interesting

49:14 these resistance training females and you gave them creatine and it

49:18 really seemed to help improve their sleep on training days

49:21 yeah it was uh colleagues at University of Oto and brown

49:24 and CJ brush and they looked at young healthy uh

49:28 individuals biological females and we gave a pretty high dose here

49:32 five grams plus we add a five grams of PBO

49:34 so 10 grams a day versus a 10 gr Placebo

49:38 and this was done for 6 weeks and they resistance train

49:40 um with a tonal home gym for um two days a week

49:44 and the interesting thing is Total Sleep duration on the days

49:47 they trained was substantially higher I think it was about

49:49 almost an hour compared to Placebo and again these are

49:53 young um university age students that were taking creatine about five

49:58 grams a day the nice thing is it also improved

50:00 strength there was no big fluctuations in weight gain which was

50:03 very very uh interesting no adverse effects um now there was

50:07 no mechanisms assessed but the logic was that on the days

50:11 these individuals are training um maybe they put in more

50:14 effort so creatine helped recover the body a little bit more

50:18 allowed that body to be in repair mechanism a little bit

50:21 more and they slept more for about an hour on average

50:24 more we still don't know the exact reason but it

50:27 is interesting that it improves sleep duration yeah and it's almost

50:31 kind of the opposite of what we were just talking

50:33 about we were talking about if you're in this context where

50:36 you're jetlagged or sleep deprived and you take the creatine

50:39 and it kind of helps you get over that brain fog

50:41 that like right you know you just you're not quite you

50:44 know on your game yeah it goes against most the uh

50:48 the comments I get where when people take highd do

50:50 creatine some people say they feel like insomnia or intermittent sleep

50:54 and the theory there from a rodent model at Belgium

50:57 is that maybe the brain is recovering quicker that it doesn't

50:59 need to sleep as long so we still need a lot

51:02 of work to do we need to look at different

51:03 stages of sleep we I'd really like to look at some

51:06 blood biomarkers indication of what's Happening from an inflammation perspective

51:10 uh so there's a lot of work in that area

51:12 to go yeah you know the other thing I was thinking

51:14 about Darren was I mean when so a dennine yes MH

51:18 is there is there a role because I mean it's Downstream

51:20 of ATP right so I'm wondering if there's any role

51:25 because a Denine is something that does make sleepy yeah yeah

51:27 I always think of caffeine the Adine and yeah no it's

51:31 possibly there um there's been a lot of speculation they thought

51:35 also glycine is implicated and where glycine is involved

51:37 in the in the synthesis of creatine so there's a lot there

51:41 um I think we'll talk maybe about homosysteine a little bit

51:44 later in the methyl so God there's a lot of areas

51:47 to look at and I think we thought we knew

51:49 everything about creatine and now it's taken on a new life

51:52 its own and again I'll have a jaw for maybe

51:54 20 or 30 more years looking at this so yeah before

51:56 we continue I just want to mention something important if

51:59 you're finding these episodes valuable

52:01 please consider subscribing to the channel

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52:18 don't miss any of it now back to the episode well

52:22 let's talk let's go back to the brain and talk

52:24 about another so we talked about brain aging you know traumatic

52:27 brain injury which is stress we talked about lack of sleep

52:30 you know and things that's stressing the brain I guess you

52:33 know neurod degenerative disease is a very stressful thing

52:35 on the brain as well it would be interesting to see uh

52:39 if creatine can help in that regard although again prevention

52:43 is always it's always better right if you can yeah we've

52:46 looked at the totality of limited evidence and we're not

52:48 seeing a lot of effects yet um there's benefits on young

52:52 boys with muscular distrophy but that's a little bit different

52:55 but when we look at ALS Parkinson's Huntington multiple sclerosis um all

53:01 those dementia and Alzheimer's we're not seeing a lot of problems

53:04 there's been a few small scale studies to show benefits

53:06 but when you look at a properly sample sized study

53:09 there was a big one five years in Germany didn't see

53:11 any greater effects um so again maybe the dose was

53:15 too when I look at the dose they use it was

53:17 very small compared to now our our body of evidence suggesting

53:20 higher dose big sample size and then of course what about

53:24 the the effects of the disease can creatine really rescue

53:28 the effects to give a significant effect we don't know preventing

53:31 would be the number one thing but uh we're starting

53:33 to do a study in Northern Iowa to look at the effects

53:36 of creatine now in individuals with cognitive decline um and I

53:39 believe there's a study out to Kansas that are actually

53:42 looking at people with diagnosed Alzheimer so super excited to see

53:45 these results if it can have any effect even help

53:48 one person um even regardless of a statistical effect if

53:51 it can have individual results I think it's something we need

53:53 to consider you okay well what I was going to get

53:56 to was the other um part of you know brain disorders

54:01 you have Neuropsychiatric disorders you have depression anxiety um

54:05 those are those are also unfortunately very common um nowadays even

54:08 in in younger adults and Adolescence so there's been some interesting

54:13 research with creatine and depression yes there has it's an emerging area

54:16 primarily to Utah there a great Psychiatry group there and uh

54:20 as a cavea no study has ever looked at creatine without

54:23 anti-depressant medication so they're always as adjunct so we're not creatin

54:26 could ever replace anxiety or anti-depressive medications but in these sub

54:31 populations primarily females with clinical depression it's really starting

54:35 to have some um speed up recovery and decrease some

54:38 of the symptoms the mechanisms are starting to emerge it's starting

54:43 to have a role primarily from RADS and this is implicated

54:46 in depression where uh they have reduced brain creatine stores

54:50 so maybe creatin supplementation can bring those levels up uh there's

54:53 potential to increase bdnf so that has been implicated there

54:56 as well and there's another thing called neurofilament um or light

55:00 chain it's an indication of neuronal damage uh and one

55:03 gram of creatin in your diet has been shown to reduce

55:05 that so there's potential there but the overarching thing with uh

55:10 anti-depression is it increases brain bioenergetics as you as you mentioned

55:13 and decreases again here we go mitochondrial Health uh decreases

55:17 reactive oxidative species all these are implicated in all the brain

55:21 and cognitive decline and primarily depression so I'm really excited

55:25 in that area big RCT needs to be done though um

55:28 because it's always being added to either cognitive behavior therapy

55:32 or ssris yeah for sure and there's also a big um

55:35 inflammatory component in depression there's

55:37 like inflammation in fact there have

55:39 been studies just in healthy young individuals where they induce inflammation

55:43 through like LPS it can cause depressive symptoms yeah yeah

55:47 and 100% so the anti-inflammatory role comes back there as well

55:49 so you'll start to hear these two words anti-catabolic and anti-inflammatory

55:53 people think of Advil or Tylenol from an anti-inflammatory but creatin

55:56 seems to work some very similar in the Cox inhibitors

56:00 as well and um but it seems to decrease cyto kindes

56:03 um so it could be something there to consider you well

56:06 what's interesting is you know activated lymphocytes te- cells consume just

56:13 enormous amounts of energy you know and and to to basically

56:18 become active and fight off pathogens right and so I'm

56:21 wondering if creatine is taken up by you know these immune

56:25 cells and it maybe helps in some way I mean

56:28 you're saying it reduces cyto kindes I mean a lot

56:30 of these t- cells are you know producing cyto kindes to fight

56:33 off things but um who knows if they have if

56:35 they have that energetic boost yes um how that could affect

56:40 you know just I would say like the broader like

56:43 not having this huge kind of war going on right yeah

56:47 there's been some cellular data around the immune system cells

56:50 around creatine specifically around tea cells or macroasia uh that's where

56:54 the anti-cancer idea came in from creatine specifically like regarding lymphoma

56:59 leukemia um so uh that's more inv vitro there's a lot

57:03 of work needs to be done but there's a lot

57:05 of studies now looking at the anti-cancer potential of creatines primarily

57:08 from the anti uh or the en heightened immune system

57:11 response you I wonder if there's any um has anyone ever

57:13 looked at you know creatine's role in helping prevent infectious

57:19 you know disease or respiratory illness fighting off pathogens like just

57:24 anecdotally uh I supplement with glutamine my 5 grams

57:28 of it's about 5.6 grams of glutamine I take a day

57:31 and with creatine five grams of creatine and it has made

57:34 a insanely big difference in my susceptibility to respiratory illness which I

57:39 have a I have a little seven-year-old who brings home

57:42 everything okay yeah it's like a vector um and and it's

57:46 it's made a really big difference and glutamine also is just

57:49 it's consumed by activated tea cells take a lot of work

57:51 on use for cancer yeah and treatment sepsis and things

57:54 like that yeah so I it it would be interesting if

57:59 but just at creatine as I know glutamine been shown

58:02 in endurance athletes like who are very prone to respiratory illness

58:06 like these marathon runners really like they're they're really just

58:10 getting getting to the catabolic state right yeah it's interesting because

58:12 I was the first to do glutamine fa high do

58:14 in weight training based on the premise that you know if

58:17 it did have anti catabolic effects for cancer long duration

58:19 and and and that was my master thesis and we didn't

58:22 see any effect probably going back to our initial start where

58:25 resistance might not be stressful or catabolic enough in continuous duration

58:29 compared to long duration um events so that's very interesting are

58:33 you familiar with any of that work of the of the long-distance

58:35 Runners and glutamine there's like a few studies showing

58:38 that these these um marathoners and stuff they they don't

58:41 get as much as many respiratory illnesses if they're taking glutamine

58:45 yeah no I'm very familiar I had to do the whole

58:47 literature search and uh um it was a higher dose

58:51 and they also looked at for sepsis but the immune system

58:53 response T4 and T8 I don't think were nearly High

58:57 um and that was from long duration and a young healthy

59:00 individual they probably might not notice any effect um but again

59:03 that was the idea the premise behind it was more

59:05 of an anticatabolic um and why it didn't work for me

59:09 it was a non-essential amino acid and of course the protein

59:11 synthesis you need all the essentials so it was uh

59:14 a trying moment when I was doing my masters but it

59:17 works out and understanding it yeah well there certainly doesn't seem

59:19 to be any shortage of interesting things to study with creatine

59:22 and it's like you know there's the field is exploding

59:24 so maybe someone out there be looking at that at some

59:27 point um another really interesting area is the the vascular

59:33 health and I mean there's just like we were just chatting

59:36 about a recent study coming out um endothelial cells have

59:40 Transporters for creatine they do right next to the asites which

59:44 don't so the endoc cells at the blood brain barrier

59:46 especially but around all the um smooth muscle they do have

59:50 the transporter so that was one of the theories Mike

59:52 Orby just put out a study in Eric rosson just recently

59:55 in older adults uh and that makes sense because you

59:58 look at a population that might get some benefits and they

1:00:00 show some very small favorable effects from creatine supplementation uh either

1:00:04 a week long or for up to four weeks I believe

1:00:07 it was a loading phase and then down to about

1:00:09 five grams a day um so it has some favorable effects

1:00:11 for in I think it was macro and microvascular function

1:00:15 so that might have potential down the road for cardiac rehab

1:00:18 or individuals with cardiovascular disease or even subsets of that like

1:00:21 type 2 diabetes or metabolic syndrome so that's an area

1:00:25 to stay tuned for as well as emerging um and um

1:00:28 same with type 2 diabetes there's potential there as well uh

1:00:31 potentially improving GL glucose disposal again if there's more muscle

1:00:35 activation you have more glute four doorways maybe more glucose gets

1:00:38 in so the Brazilian group is leading the way there so

1:00:41 it's gone from just athletes to now looking at the health

1:00:44 aspects for a lot of different uh conditions and interesting

1:00:48 chronic diseases has come to the Forefront which is very exciting

1:00:51 yeah I I've also come across some other like cardi

1:00:54 metabolic health benefits so glucose but also triglycerides and with cholesterol

1:01:01 in there too can you talk about that is that maybe

1:01:04 some mixed data I'm not sure if if if everything

1:01:06 is sh the same it's totally mixed um some show

1:01:09 decrease in triglycerides LDL um um and then others don't see

1:01:14 the effect and again I think it comes back when

1:01:15 you look at those studies with the population if they're compromised

1:01:19 as we get older there're probably going to be more

1:01:20 of an effect and then the question is was it dietary change

1:01:24 that did it or was it the creatine itself so

1:01:26 that's one of the big issues when we give a creatine

1:01:29 supplement if you don't consider what they're already consuming or now

1:01:32 they've initiated exercise compared to a true Placebo um there

1:01:37 is potential the mechanisms seem to be from a a triglyceride

1:01:41 perspective it seems to increase energy expenditure some thermogenic potentially

1:01:46 effect that might explain why creatin decreases body fat in individuals

1:01:50 18 and above uh but from the cholesterol perspective we don't

1:01:54 really know the mechanism there um and that's an area

1:01:57 I'm sure that'll be exploding down the road yeah so creatine

1:02:01 decreases body fat in combination

1:02:04 with resistance training compared to resistance

1:02:06 training alone correct yeah now small about 1% or about

1:02:10 .5 kg uh there's some potential mechanisms there but the thought

1:02:14 is maybe increase in lean tissue Mass increase energy expenditure

1:02:18 so a lot of people are very cautious they don't want

1:02:19 to take creatine because they think it's going to increase fat

1:02:22 Mass what the research is suggesting is increasing lean body

1:02:25 mass Mass potentially decreasing fat Mass so usually the number

1:02:29 on the scale barely changes after you do an intervention yeah

1:02:32 well going going back to this loading phase and this higher

1:02:36 dose I mean when I say higher I mean 20 grams

1:02:40 um all these studies doing that I mean barring the brain

1:02:45 stuff is it is it really just to like kind

1:02:47 of get their stores saturated quickly because the study is you're

1:02:50 not going to wait 30 days so it's really you

1:02:53 know all these other people trying to do this loading stuff

1:02:55 just kind of following the studies but really they don't

1:02:57 have to do that unless they like tomorrow when I hit

1:03:00 the gym and have that explosive power benefit or if you

1:03:04 need a really quick effect like Rehabilitation from an injury ACL

1:03:08 surgery something where you need to rehabilitate the muscle quickly

1:03:11 or you're an athlete the loading phase to me is not needed

1:03:15 from a muscle perspective now because we've talked about bone

1:03:19 and brain might need a bit more so now maybe

1:03:21 the new daily loading phase is maybe you know 5 10

1:03:24 grams a day or a little bit more but that athlete

1:03:26 20 g a day for 7 Days followed by the maintenance

1:03:29 that is only ever been shown to have beneficial effects

1:03:32 to muscle there's been a few studies that have looked

1:03:35 at it now from a brain but again that's from a different

1:03:37 perspective you just um brought up a point that I

1:03:41 was thinking of and that is surgery and and like you

1:03:45 know like or injury um how does how does create

1:03:48 because that's a stressful situation we're talking about you know really

1:03:51 creatine shining in that background of of some sort of stress

1:03:54 whether it's training or you know sleep deprivation but also

1:03:59 you know you can have something like an injury

1:04:01 or a surgery where you're planning a stressful event yeah it's multifactorial

1:04:05 the studies that looked at from a rehabilitation perspective creatin

1:04:08 seem the increase these things called myogenic transcription factors so without

1:04:12 boring your audience these are little guys that sort of tell

1:04:14 DNA to sort of increase proteins in a quicker way so

1:04:18 these myogenic regulatory factors went up during Rehabilitation uh and then

1:04:22 we did a study when we got individuals to put

1:04:24 on a cast volunteer and creatine seem to maintain strength going

1:04:28 back to the mechanism it probably has to do that reduction

1:04:31 in protein breakdown or the anti-catabolic anti-inflammatory effect again we

1:04:36 don't think it has anything from a synthetic perspective because creatine

1:04:39 doesn't but it does it has been shown increase satellite

1:04:42 cells which are needed for um recovery and Rehabilitation growth factors

1:04:46 igf-1 and decreases my Statin the one that increases protein

1:04:50 breakdown so all of these factors come into play it's like

1:04:53 the caramel secret there's a whole bunch of things that go

1:04:55 into that chocolate bar creatine seems to work in a very

1:04:58 variety of ways and then again on the other side

1:05:01 it's certainly been shown to decrease reactive oxidative species so

1:05:05 it seems to have more of a preservation to the cell

1:05:07 effect um but from an injury perspective um it seems

1:05:11 to speed up recovery do we know would it speed

1:05:14 up recovery if you took it before surgery uh the jury's

1:05:17 out on that we'd have to do ACL surgery or studies

1:05:20 on that long-term clinical trials we see a bit of Promise

1:05:23 in osteoarthritis um but not a lot of other ones

1:05:26 and because basically the studies haven't been done yeah and what

1:05:29 are the do what's the dose on on some

1:05:30 of those these are usually the loading phase with a slight maintenance phase

1:05:34 or if they're looking at it from a cellular perspective

1:05:36 it's usually just the loading phase seven days prepost they'll do

1:05:39 biopsies or cellular data so the 20 20 G A Day

1:05:42 loading phase and then the maintenance phase being about five okay

1:05:46 and if someone's already taking let's say five or 10

1:05:48 grams a day and then they're going to have a surgery

1:05:51 do they still need to do the loading or should they

1:05:53 just continue on I would just continue on or even slightly

1:05:56 a bit more because when the tissue is is under trauma

1:05:59 you get heighten inflammation reactive oxidative species or stress and then

1:06:02 protein breakdown so maybe could help speed up your ability

1:06:06 to recover quicker um we don't know any of the effects

1:06:09 of creating on Cross education where if someone has an immobilized

1:06:12 limb and they train the opposite limb we don't think

1:06:15 there's any effect it's a great study to do um

1:06:17 and that could have huge applications for professional athletes or individuals

1:06:21 that have are waiting for ACL surgery instead of sitting around

1:06:24 all day go to the gym and train the the healthy

1:06:26 limb and maybe creatine could potentially increase more drive there

1:06:30 uh it's a study I've always wanted to do we just

1:06:32 haven't done it yet yeah okay so it sounds like

1:06:35 you know in most cases you you know the creatine plus

1:06:38 the the the training resistance training endurance training um is

1:06:42 is the key but in in some some situations when there's

1:06:44 just a massive amount of stress from you know perhaps

1:06:48 an injury or surgery or sleep deprivation creatine can can shine

1:06:52 on its own is that correct yeah there's actually a small

1:06:55 body of search in healthy individuals young and old that say

1:06:57 creatine without exercise actually improves muscle performance so uh

1:07:02 those that I think of uh disuse bed rest immobilization uh sedentary

1:07:06 individuals um maybe they have functional uh mobility issues um

1:07:11 or people that don't know or have access to weight training

1:07:14 um creating by itself has been shown to improve muscle performance

1:07:17 improve strength endurance uh their ability to perform repetitions to fatigue

1:07:22 primarily in older adults but there's been studies in younger

1:07:24 individuals and that's sort of where uh creating research Blossom all

1:07:28 the initial studies were very acute 7 Days the loading

1:07:31 phase and then we saw improvements over time uh on muscle

1:07:34 performance and that sort of paved the way to lifelong um

1:07:39 interventions which include exercise is the main thing yeah for sure

1:07:42 yeah exercise is is definitely the most important thing but I

1:07:46 know I'm going to ask you to speculate a little

1:07:47 bit here but let's say let's say you do have

1:07:49 an older adult who is sedentary and um you know just

1:07:53 just getting up out of a chair is is hard

1:07:56 it's Challen it can be challenging uh do you think

1:07:58 that even supplementing with creatine in that regard maybe help them

1:08:03 a little bit more two meta analysis has been performed both

1:08:06 in Canada we were fortunate to do one St Phillips I

1:08:08 know has been a guest I think for you and um

1:08:11 uh we've done two meta analysis and then when you look

1:08:13 at creatine in older adults with resistance training though it did

1:08:17 improve tasks of functionality sit to stand so getting out out

1:08:21 of the bed off the toilet getting out of a chair

1:08:23 again that was with exercise without um exercise uh nothing

1:08:28 has been there so um I would love to say

1:08:31 Yes um but again the movement of exercise but the nice

1:08:35 thing is for those willing to do you know is

1:08:37 it resistance bands anything that you feel mechanical stress creatine will

1:08:41 give you a slightly greater benefit but for those that are

1:08:44 in Jeopardy of chronic disease I think you should consider

1:08:47 it uh absolutely yeah so another question of mine um you

1:08:50 talking about where creatine Transporters are where it synthesiz you

1:08:55 mentioned it's created in the liver and the Brain but you

1:08:58 mentioned it it goes to the testes there's a little

1:09:01 bit down to the testes so any organ that only has

1:09:03 the um enzymes to make it so since it's made

1:09:06 in the liver and brain it'll be dispersed to other areas so

1:09:09 the interesting thing is the area that it's created it

1:09:11 goes through circulation to different transports so male fertility has become

1:09:15 a big issue and there was a thought that oh creatine

1:09:19 since sperm Rel it's a FAL so since sperm are relying

1:09:23 for movement um on creating so much maybe it's downregulating

1:09:26 sperm production and my good colleague out of Norway sir joak

1:09:30 who's one of the world's best secreting researchers has looked

1:09:33 at this in many forms and not showing any effect of anything

1:09:36 it improves the vitality and mobility of sperm so that could

1:09:39 have huge implications for male fertility um so yeah it's

1:09:43 an area that you probably would never think of uh

1:09:45 but it's an area that has shown some evidence-based research behind

1:09:48 it yeah and that's that was going to be my question

1:09:51 is it affecting fertility it's going it's going it seems

1:09:53 improves it so again that could applications for uh individuals trying

1:09:57 to start a family or or male male fertility issues we

1:10:00 don't see any down regulation there's a thought of taking

1:10:04 in supplementation maybe that'll give your brain and liver a bit

1:10:07 of a break and there's evidence to suggest that maybe

1:10:10 if you're taking creatine on a daily basis those organs don't

1:10:13 need to make as much because you're you're offsetting

1:10:15 that um but again when you stop supplementation it goes back

1:10:18 to baseline or it doesn't disrupt any of that and and the good

1:10:21 thing is from a fertility perspective there's no evidence

1:10:23 to suggest it downregulates sperm motility Health uh we can

1:10:27 talk about hair follicle loss and thinning the same idea if

1:10:30 you if the viewers were looking at me but that was

1:10:32 the same idea maybe creatine was causing baldness so maybe it

1:10:36 must be doing the same thing to sperm it must

1:10:38 be killing off the cell and we just don't see any

1:10:40 of that research you so well good yeah well let's get

1:10:42 into those myths but before we get into those I kind

1:10:45 of wanted to to we've talked a lot about adults

1:10:48 we've talked about older adults the effect of creatine on many

1:10:51 different tissues in those populations but at the start of this podcast

1:10:55 you said something that caught my attention and that was

1:10:57 you said children and you said pregnancy and um you

1:11:00 know I'm a mother of a seven-year-old who's quite active you

1:11:03 know plays soccer and tennis and and I often wondered

1:11:07 um you know C can children take creatine I mean obviously

1:11:12 weight adjusted but is there any has there been any

1:11:16 you know evidence in children has anyone looked at children besides

1:11:19 the TBI study yeah not there has CH Chad gersi

1:11:21 and and ragum at the mail Clinic here in the United

1:11:23 States are the two most profound research in that area

1:11:26 and they've looked at study after study in children uh young

1:11:30 children adolescence and there's no adverse effects and why would there

1:11:34 be if our body doesn't like it we just excrete it

1:11:36 and there's a big push right now in some states

1:11:38 trying to uh ban creatine and younger individuals and they're just

1:11:41 not looking at the evidence-based research so overall there's no adverse

1:11:45 effects we still need to do a little bit of blood

1:11:47 work but it improves Health agility coordination muscle mass there's

1:11:52 no reason and so that's why I'm one of the big

1:11:54 proponents I argue including the fetus why someone couldn't take creatine

1:12:00 if we're already producing it it's not like caffeine a drug

1:12:02 effect we're already producing it that's like telling people you

1:12:05 can't take protein in your food or supplement that's just nonsensical

1:12:10 so I'm one of the big people say anybody can

1:12:12 take creatine um even if you have chronic kidney disease there's

1:12:15 some benefits because it'll help the kidneys absorb creatine and so

1:12:19 right now there's uh potential benefits for children for pregnancy

1:12:23 Stacy olivy in Australia is the leading researcher there in Abby

1:12:27 Smith Ry in UNCC and so they're actually looking at fetal

1:12:30 development having more brain bioenergetics for the female uh we now

1:12:34 know that the transporter from breast milk is is there uh

1:12:38 and then when you look at habitual diet uh again Serge

1:12:41 o has looked at an ha's data and for those children

1:12:44 taking less than one gram it leads to a lot

1:12:47 of potential detriments later on cognition impairments lean body mass

1:12:51 bone mineral so I mean a serving a salmon is

1:12:54 about 3 to four grams of creatine um a hamburger would

1:12:58 even have that so again in habitual diet unless

1:13:02 the child is vegan um they're probably getting a little bit

1:13:04 of them out and the dose two to three grams

1:13:08 or you can even do 0.1 gram because they're so much smaller

1:13:11 so if I had a child I just have animals

1:13:14 a dog um I would give my children creatine for sure

1:13:17 as early as possible cuz I'm looking at brain development bone

1:13:21 development muscle immune system it has all those benefits and keep

1:13:24 in mind if our body didn't like it we just

1:13:27 make expensive urine like we just excrete it um people see

1:13:31 this when they go for their blood requisition they see

1:13:33 creatinin on this Blood requisition form and that's all it is

1:13:36 a byproduct so it it's very safe um the safety

1:13:39 profile is exceptional yeah wow I mean so a few things

1:13:43 here so so um with respect to the the dose

1:13:46 with children so you said two to three grams or1 gr per

1:13:49 kilogram body weight or or is that is that applicable

1:13:52 to wellsely I mean if you want to do five grams

1:13:55 or more I don't see any reason why not do they

1:13:58 need to be taking the 10 and 20 grams we just

1:14:00 don't have the data to support that but a low

1:14:02 dose two to three five grams is is totally viable

1:14:06 and and vegan kids probably even more so right and then

1:14:09 pregnancy um has there actually been any human data looking at women

1:14:15 supplementing with creatine being safe just subjective questionnaire how they're

1:14:19 feeling things like that it's too dangerous in a sense cuz

1:14:21 we just don't know yet U and to get ethics

1:14:24 board approval at a a research institution is very difficult even

1:14:28 for uh teenagers and adults um under the age of 18

1:14:31 so I know Stacy is in our big myths paper

1:14:34 is concluded that we need more randomized control trials a big

1:14:36 trial uh because we definitely want to get this one right

1:14:39 make sure it's 100% safe not just for the unborn

1:14:41 child but also for the mother um so there's going

1:14:44 to be a lot more data to come out but overall

1:14:46 there's no reason to suggest there's any issues whatsoever you yeah

1:14:50 and and all again coming to the back to the vegans

1:14:53 that comes to mind you're talking about women who are

1:14:56 pregnant who are um only relying on their their liver you

1:15:01 know ability to make to make Crea team right so um

1:15:04 that would be phenomenal to get a study like

1:15:07 that done but do you think it'll be approved I think

1:15:10 down the road when they look at the hypoxic environment

1:15:13 of of fetal growth I think it probably will get approved

1:15:17 but we're going to need a lot more clinical data

1:15:20 to suggest it's safe and uh um maybe a polot study

1:15:23 in that the issue pilot studies they're usually low sample size

1:15:26 so then from a feasibility perspective it might be have it

1:15:29 actually I can see it in a multi country

1:15:32 to get a lot of people in different countries to come

1:15:34 together and make the sample size that high so that's

1:15:36 something to look out forward uh forward to as well especially

1:15:38 and and in addition to the neurogen diseases yeah um I

1:15:42 know I'm jumping all over the place here but um going

1:15:44 back to the kids you mentioned the creatine supplementation was shown

1:15:47 to improve agility it now why is that is that because

1:15:50 of the type two muscle fact or motor unit recruitment

1:15:54 or maybe muscle Activation so there's a whole plethora of ideas

1:15:57 from a a balance agility uh um coordination perspective it could

1:16:01 be that they're able to exercise at a higher capacity sort

1:16:05 of sort of almost hyper accelerate muscle development um those are

1:16:09 all the things that are in its infancy to to look

1:16:11 at again there hasn't been a study to look at blood

1:16:13 biomarkers for like liver and kidney enzymes but I would

1:16:16 be very surprised if a lowd dose study was done

1:16:19 and there was any issues yeah okay um well getting

1:16:22 into some of the supplementation you know questions and I think

1:16:26 we've been we kind of you touched on quite a few

1:16:28 but I want to kind of dive a little bit

1:16:29 deeper um you first mentioned of course I think a lot

1:16:32 of people that are in familiar with the creatine field know

1:16:35 creatine monohydrate creatine monohydrate is

1:16:38 that still the gold standard for supplementing

1:16:42 with creatine if so why yeah it's the only standard

1:16:45 so when I say creatine today it's monohydrate and the reason

1:16:48 being it's is based on its safety and efficacy so monohydrate

1:16:51 means that creatine is linked to water so when it comes

1:16:54 to your GI tract the water diffuses in the hydrochloric

1:16:57 acid of your stomach so that molecule it's very unique it

1:17:00 can actually get through our small intestine intact unlike protein which

1:17:04 gets degraded creatine is very unique it it's because the acidity

1:17:08 of our stomach is actually too acidic it doesn't like

1:17:10 it so much uh so it gets through and then when

1:17:13 it gets in our blood the creatine that you're taking

1:17:15 from supplementation monohydrate is identical

1:17:18 to what's being synthesize in the liver

1:17:20 so that's likely why the safety profile is so exceptional

1:17:23 now there's probably 50 different other Market forms of creatine out

1:17:28 there first it has to be creatine when it gets

1:17:31 into your blood so whatever Market form you want to try

1:17:34 make sure it is creatine getting into the blood or it's

1:17:36 useless second no other creatine has ever gotten into the cell

1:17:41 and had Superior effects there has been a few studies

1:17:43 to look at crean hydrochloride and with the Ester bond

1:17:46 to get sort of through the phospholipid Bayer of yourselves

1:17:49 quicker but no study has ever showed it to be safer

1:17:52 or more effective so I know monohydrated has been boring it's

1:17:55 been around since the 1990s but in my opinion why mess

1:17:58 with a good thing and probably because the efficacy and safety

1:18:02 behind it well why do people turn to these other

1:18:06 forms um is it is it because of GI distress

1:18:09 that can be experienced with monohydrate is it is it seems

1:18:14 as though like I get mixed reviews I'll talk to like

1:18:17 like almost like 50% of people say hey like I

1:18:20 get GI like stomach stomach distress GI problems if I take

1:18:23 creatin Mony R um some people have to go to another

1:18:27 form or they have to lower their dose why does

1:18:30 that happen are there any ways around that is there like

1:18:33 any any tricks to improving you know the ability

1:18:36 of your stomach to digest I think 99% of it is marketing

1:18:40 I think people get conned into buying something that's more

1:18:43 expensive or flashy um and maybe they're making some errors

1:18:47 with the monohydrate they're taking and probably from the loading phase

1:18:50 so creatine monohydrate has been shown to increase intracellular water so it's

1:18:56 based on the doorway it sort of brings water with it

1:18:58 and some people get GI tra irritation or some weight

1:19:01 gain and other forms of creatine are marketed to not

1:19:04 do that um I argue if it doesn't do that it's

1:19:07 probably not creatine in other words creatine is osmotic if

1:19:10 you're taking a form of creatine that doesn't increase intracellular water

1:19:14 a little bit I would question the validity of that type

1:19:17 of creatine um so I'm in the camp of 100% monohydrate

1:19:21 based on the mechanisms the structure of the molecule

1:19:24 and the efficacy behind it um do you need to spend more

1:19:27 on a fancy type of creatine if it works for you

1:19:30 I'm all for it but at the end of it

1:19:32 I don't think you need to well the question is

1:19:35 like getting back to what you said um if if it's

1:19:37 not increasing intracellular water then it may not be doing what

1:19:41 it's supposed to do and ultimately that's the whole point so

1:19:44 the you know the question is if you're taking creatin

1:19:47 HCL or you know there there's liposomal liposomal creatine or there's

1:19:52 there's a GNC brand that's like it's a creatine HCL

1:19:56 so it's like you know at the end of the day

1:19:59 the bulk of the research is done using monohydrate and 99%

1:20:03 of all the thousands of papers and the one I

1:20:07 I hear a lot is there's a better bioavailable form than

1:20:11 monohydrate I'm like wait a minute creatin monohydrates bioavailability is near

1:20:15 100% there might be a little bit extracted from the gut

1:20:18 so how can you get more than 100% And then

1:20:21 if it even got into the cell I've never seen

1:20:24 a study just show that it increased protein synthesis or had

1:20:27 any of the effect on satellite cells or whichever I'm

1:20:29 only aware that it increased creatin content so the good thing

1:20:33 there is in those cells I think it was hydrochloride

1:20:35 that means it is a form of creatine but did it

1:20:37 lead to Performance benefits better than monohydrate I've never seen

1:20:40 it so I just caution people just don't get um con

1:20:45 into a lot of these marketing forms really exp expensive

1:20:49 forms when monohydrate is is the one true Ines I'm going

1:20:52 to Germany and we're going to be talking for four

1:20:54 straight days and two weeks a monohydrate why because that's what

1:20:57 all the evidence-based researchers need to talk about because it's

1:21:00 the only form that seems to be very viable yeah well aside

1:21:03 from the marketing I think some people I know some people

1:21:06 personally that even taking like a five gram dose of creatine

1:21:09 monohydrate experience like stomach issues yeah so um what what

1:21:14 can those individuals do yeah so I recommend to these people

1:21:17 and it happens quite often um the sort of micro

1:21:20 dose so I would say if you're taking 5 gram take

1:21:22 about 2 and a half grams in the morning weight

1:21:24 at least SS and 2 and 1 half grams later uh

1:21:26 also take it with food so I put I have

1:21:29 for breakfast I'm sort of boring but I take Greek yogurt

1:21:31 collagen protein whey protein blueberries and I usually put 10 grams

1:21:35 of creatine in my yogurt um but some people can't so

1:21:38 if you want you want to put 2 and a half

1:21:40 grams there but if you want to start as low

1:21:42 as 3 gram 1 and 1/ half in the morning 1

1:21:45 and 1/ half in the evening or you could do one

1:21:46 and 1/2 in the morning another one and half with lunch

1:21:49 with food seems to increase the absorption because the insulin

1:21:52 from carbohydrates Andor some of the the effects of fat uh

1:21:56 the most times is when people just drink it with water

1:21:58 I find that's where they get the GI tra irritation

1:22:01 just because it's going through the GI track quickly uh taking

1:22:04 water with it but with food whenever we tell people

1:22:07 that they say it all went away yeah so that would

1:22:09 be an interesting experiment for someone to try that's experienced

1:22:12 um GI problems to try taking it with food and carbohydrates

1:22:15 seems Seems like it might be good really good okay

1:22:19 so um and then the other thing is you're talking about

1:22:21 like lower dose micro doing and spreading it out does

1:22:24 that is that something you'd have to do like forever

1:22:27 or is that like to to kind of get your gut

1:22:29 used to it or is it kind of both it's almost

1:22:32 from a a um a consistency perspective but there was

1:22:35 a study done in 2003 where they showed smaller more frequent

1:22:38 does were better than a super large 20 G Bolis dose

1:22:41 so it's almost like this retention idea um but taking you

1:22:45 know multiple 1.5 gam dosages or whatever it might not

1:22:48 be feasible on a daily basis but you know a quar

1:22:51 of a teaspoon 2 and 1/2 gram whichever that would get

1:22:53 your body used to then slowly titrate up so the best

1:22:56 way I usually tell people is start with 3 gram

1:22:59 one and a half morning and evening then move it up

1:23:01 to five 2 and a half then move it up

1:23:03 to nine but then I say three three and three then eventually

1:23:07 you're sort of getting tolerated it's like caffeine starting

1:23:09 with a small coffee and working up to a large your body

1:23:11 gets used to it and then there's more in circulation you

1:23:13 know well you you said um the these smaller doses were

1:23:17 uh more effective at what at the idea was that it

1:23:20 would get into the blood maintain Peak or platum plasma

1:23:24 levels since hopefully you can retain more than some being

1:23:26 excreted as creatinin the thought was a super mega bolao so

1:23:30 maybe 20 G um now there's new evidence that can get

1:23:33 in the brain but there's logic like some of that would

1:23:36 be cleared from the kidneys and because the muscle may

1:23:38 not be able to take that in all at once you

1:23:40 know okay so dosing studies need to be really done yeah

1:23:43 well this kind of this kind of goes to a another

1:23:46 question I had which was we talk we've been talking

1:23:49 a lot about dose but it's also about you know

1:23:53 if if like if you're taking um the cycling of it

1:23:58 so you know some people like to slam their protein

1:24:01 shake right after a workout is there any reason to worry

1:24:06 about that with creatine because you're talking about repl like saturating

1:24:09 the stores it seems like it's a okay well it's

1:24:11 like you're trying to saturate the stores I don't know that's

1:24:14 cycling around that's going to do anything yeah so that's

1:24:16 a two-part answer I think from a timing perspective and cycling so

1:24:20 from a timing perspective unlike caffeine we don't think the timing

1:24:23 really plays a major role there is one area that I

1:24:27 would just recommend it's post exercise or pre-exercise and the reason

1:24:32 for that is that we think blood flow or transport

1:24:35 kinetics is turned on with muscle contraction so if you

1:24:37 want to take creatine within an hour before you work out

1:24:39 or I drink five grams during my workout or right after

1:24:43 that seems like a very viable time but for the viewers

1:24:46 the timing seems to be irrelevant but that begs

1:24:48 the question what about cycling so if you've been taking creatine

1:24:51 for maybe two months 3 months it's very likely your muscle

1:24:55 stores are so saturated that when you're consuming the extra creatine

1:24:59 um that you would just be excreting it so some

1:25:01 people say hey I don't want to do that I don't

1:25:03 want to waste my money I'm going to cycle it

1:25:06 I now argue you should take it on a daily basis

1:25:08 because of the emergence of like okay I'm okay with the muscle

1:25:11 being full if someone's going down the toilet in urination

1:25:15 that's okay but now I'm hoping our bone is taking

1:25:17 in some our brain is taking in some so we used

1:25:20 to be in the camp where you just need creatin

1:25:22 on the days you work out now I say take it

1:25:24 every day and hope some is going to go to your brain

1:25:26 and muscle or sorry bone uh because on the days

1:25:29 you're not working out your muscle is not sucking it

1:25:31 in as as fast maybe those other tissues are getting replenished

1:25:35 so do you think it's better to take um creatine like

1:25:39 you taking it in the morning if you're going to work

1:25:41 out in the morning but what if you work out

1:25:42 in the evening do you want to take it in the evening

1:25:44 yeah I would take it any in close proximity exercise

1:25:47 I would take it so if you work out twice

1:25:49 a day you're taking creatine twice a day um but if

1:25:51 you take it in the morning and then work out

1:25:53 later in the night that's totally fine we're not seeing any

1:25:55 big differences but I'm a big advantageous proponent of taking close

1:26:00 proximity to exercise and that's when in an hour pre

1:26:03 and post okay so some of the other questions are interaction

1:26:07 with other supplements other compounds um for a very very

1:26:13 very very long time I put creatine in my my coffee

1:26:18 I put everything in my coffee cuz it just masks

1:26:21 everything and I just didn't do it in one I've never

1:26:23 really had GI problems with creatine supplementation myself so um

1:26:28 but I'm not sure that I'm supposed to be doing that yes

1:26:32 so I'm one of the rare people and most people argue

1:26:34 against me I don't do it either um so there's two

1:26:37 ways to look at this the phoc kinetics of creatine

1:26:41 and uh caffeine do not oppose each other but from a cellular

1:26:45 perspective they certainly do so remember when I talked about

1:26:48 the cop plasma reticulum caffeine likes to release calcium but likes

1:26:53 to take it in and some really good research out

1:26:55 of Europe have shown that they the two molecules oppose

1:26:59 each other from a muscle relaxation time but the dose

1:27:03 of caffeine seems to be the most important factor if

1:27:06 the dose is over 250 milligrams or even higher that's when

1:27:10 it seems to have the interference effect if the dose is

1:27:13 lower it doesn't seem to have an interference effect so

1:27:16 the average large black coffee from Starbucks might be 3 400

1:27:21 milligram of caffeine so if you were to put your of creatine

1:27:24 in there and sip on it for hours you probably

1:27:28 won't notice an interference effect in a few few times

1:27:31 but if you did that every day for months you might

1:27:33 notice a blunting effect um if you did it a onetime

1:27:36 shot uh you know you you were doing an experimental trial

1:27:39 you might not notice it so I never combine the two

1:27:42 I always have coffee early in the morning I love

1:27:45 coffee and then I wait at least two hours before I

1:27:48 take my first thing of creatine in anticipation of those cellular

1:27:51 interference but other people other big time creatine researchers say

1:27:55 no they I take it together if it works for you

1:27:58 great but there's something there that makes me a little

1:28:01 cautious and we've done the only training study it was underpowered

1:28:04 but they did interfere with each other you yeah okay

1:28:07 is is creatine heat sensitive it is it denatures a little

1:28:11 bit so if you warm up the um solution some

1:28:13 people don't like the grittiness um so when the temperature rises

1:28:17 it will decrease the uh or increase the solubility if

1:28:20 you will it will not degrade at the creatinin unless it's

1:28:22 super heated for a long long period of time so

1:28:25 if you are putting it in your coffee the heat is

1:28:28 not the act it seems like the caffeine molecule might

1:28:31 be the one that might interfere with it okay so you

1:28:33 don't have to worry so much about it being in like

1:28:36 a hot liquid like tea or no but if you had

1:28:39 like a normal K cup is 80 milligrams there should be

1:28:42 no interference effect you could have two of those but if

1:28:45 you get up to like a large coffee so

1:28:47 a normal cup of coffee here in the United States maybe

1:28:49 80 to 100 milligrams should be totally fine yeah yeah

1:28:52 okay um well this is all really good information I think

1:28:56 addressing some of these the the the myths and you know

1:29:01 questions the misconceptions I mean all those things because you've published

1:29:04 a couple of meta analysis or review articles I guess

1:29:07 or review articles on this and so um you talked about

1:29:10 let's let's talk about the the the fat gain right

1:29:13 so that was kind of one you touched on a little

1:29:14 bit I mean especially women women it's is it really

1:29:18 just because of the lean mass increase yeah we there has

1:29:21 been some cellular uh or animal data to show it increases

1:29:25 thermogenesis um but overall the decrease in body fat is there

1:29:29 but it's very low so don't run out and buy

1:29:32 creatine I think you're going to lose 20 or 30 pounds

1:29:34 we're seeing at best about a 1% decrease in body fat

1:29:37 and about 0.5 kilogram reduction over time in combination with weight

1:29:41 training now that could have implications for obesity type 2

1:29:45 diabetes or chronic uh diseases down the road but the nice

1:29:48 thing is a lot of people had a myth creatin increased

1:29:51 body fat we don't see any evidence uh to that okay

1:29:54 so doing the opposite um the hydration myth so what

1:29:59 about you hear I've heard some people talk about um cramps

1:30:02 it causes cramps or dehydration it's opposite it super hydrates

1:30:06 the muscle so it could be from the sodium potassium pump

1:30:09 or disruption from dehydration but if you're metabolically dehydrated creatine

1:30:14 is not the cause if anything creatine is trapping water

1:30:17 into the cell it also has been shown to increase in uh

1:30:20 extracellular water and total body water in some studies um so

1:30:24 from a cramping or dehydration perspective it's actually opposite so

1:30:27 for those exercising upcoming summer months uh NFL football players uh

1:30:31 2day practices in July creatine might actually help hydrate the muscle

1:30:35 and decrease the chance of uh muscle cramping or dehydration

1:30:38 oh that's super super interesting um has anyone directly looked

1:30:42 at that I think Rick cder's done some studies with that when

1:30:45 he looked at NCAA uh players um but a lot

1:30:48 of people don't take it the myth was that it was

1:30:51 dehydrating and we just don't see where did that myth

1:30:53 come from I think what happened was in the Inception

1:30:56 of creatine research a lot of people were not drinking water

1:30:59 or going through some practices like wrestling wearing rubber suits extreme

1:31:03 hydration they happen to be taking creatine and then they

1:31:05 said well I'm not creatine uh since it traps water therefore

1:31:09 my cells must be exploding or muscles and therefore was causing

1:31:12 cramping and we just don't see any evidence behind that yet

1:31:16 okay so it was like a correlation thing where UNT

1:31:18 was the opposite and sort of with you um okay we've

1:31:21 talked a lot about the kidneys and you're talking about creatinin

1:31:25 and I'd love to talk that that's that's one that I

1:31:27 hear a lot um that it can it's bad

1:31:30 for the kidneys it's bad for the liver can can you address

1:31:33 that it's probably the biggest concern um so we've looked

1:31:37 at study after study and rest assured from a clinical perspective

1:31:41 uh creatin does not adversely affect renal liver or cardiovascular

1:31:45 uh cells uh and we've given 11 grams a day

1:31:48 in post-menopausal females to a population where their organs are under

1:31:53 a little bit more stress and no adverse effects the theory

1:31:56 here was that when creatine enters your muscle when it

1:31:59 gets metabolized it's non-enzymatically metabolizes

1:32:02 something called creatinin and those watching

1:32:04 say oh wait a minute I just saw that my doctor

1:32:06 checked that off and and the reason they do that is

1:32:09 creatinin is a byproduct it's supposed to be filtered

1:32:12 by the kidneys so if you have high blood creatinin that means

1:32:16 your filtration rate in the kidneys is not working properly

1:32:19 think of your Brit of water filter it's clogged up so

1:32:22 unfortunately when lot of people go to their doctor they

1:32:25 don't say hey to the nephologist or GP I'm on creatine

1:32:28 supplements because it's logical that if you're taking creatine your creatin

1:32:32 might be acutely raised and then that causes a false positive

1:32:35 your uh uh estimated filtration rate is low so your doctor

1:32:39 says whatever you're taking stop it's killing your kidneys we

1:32:42 know that's not the case because when they do stop

1:32:45 their kidney function just comes back so it's just the metabolism

1:32:47 of the molecule okay well this is really important I've

1:32:50 had um a few people reach out to me and tell

1:32:52 me that they're was elevated and I don't think they told

1:32:57 their their GP that they were taking Crea creatine and so

1:33:02 so the so the idea here is that it's it's

1:33:05 the metabolism of the creatine to creatinin that's being excreted through

1:33:10 urine that's right so creatine and fossil creatine don't leave

1:33:13 the muscle it gets left in the muscle as creatinin creatinin can

1:33:16 also be raised with a very very high protein diet excessive

1:33:19 exercise or dehydration um but make sure if you're on creatin

1:33:23 supplement tell your doctor because it's logical that your creatinin

1:33:28 in the blood will be elevated that's just from the metabolism

1:33:31 of the supplement now if your liver enzymes are through

1:33:34 the roof that could be an infection so again make sure

1:33:37 you go and get medical uh um uh screening and and guidance

1:33:40 but every time we hear this it's usually a false

1:33:43 positive I see false positive okay so it's really good

1:33:45 to talk to your physician about that um baldness that's one

1:33:49 that's one it was that it was that rugby was

1:33:52 it rugby players that yeah yeah yeah um I was going

1:33:55 bald way before I started taking creatine so a lot

1:33:58 of people say oh well obviously um and it's interesting it

1:34:01 was a great study in a sense that they looked

1:34:04 at a novel concept so they had Elite rugby players do

1:34:08 a crossover design and a crossover design is really powerful

1:34:10 that means the group gets both Placebo and creatine so it

1:34:13 really controls for diet genetics hormones things like that and when

1:34:17 they took 20 g a day um might have been even

1:34:19 25 gram a day for 7 Days uh during the cre

1:34:24 supplementation phase they increase the hormone dihydroxy testosterone or DHT

1:34:28 and most people say oh I think I've seen commercials

1:34:30 about this it's a surr of testosterone but it's been highly

1:34:33 linked to hair follicle loss and thinning from a cellular

1:34:37 perspective they measured it in the blood so the correlation uh

1:34:40 you know it's just a a surrogate but when they went

1:34:43 up I think it went up by about 57% but it

1:34:47 was still within the physiological range and what I mean

1:34:50 by that is when you go to your doctor and they

1:34:51 measure your blood glucose and it comes back and the doctor

1:34:54 said no it's within the normal range cholesterol is

1:34:56 in the normal range even increasing by 57% I think

1:34:59 that was the number uh it was still within the normal range

1:35:02 when they were on Bo increased by about 40% so everybody

1:35:05 says Whoa hormone went up correlation causation everybody was freaking out

1:35:10 that this hormone went up they did not measure hair follicle

1:35:13 loss thinning cross-sectional area no dermatologist was involved but a lot

1:35:18 of people have run with this and to this day

1:35:21 they cite this single study um that even didn't look

1:35:25 at free testosterone there was no increase so just because

1:35:28 DHT went up a little bit and they started lower so

1:35:31 there was more room to improve people think it causes baldness

1:35:34 I've assessed easily over a thousand people males and females not

1:35:39 a single person that said hey whatever you're giving

1:35:40 to me BL double blind is causing my hair to fall

1:35:44 and I I got to believe a participant would say I'm

1:35:46 not taking this anymore my hair's falling out um and I

1:35:50 do know I can't talk about it because I'm not

1:35:52 sure but I do know that there's been a paper submitted

1:35:55 that have looked directly at hair follicle loss and thinning

1:35:59 with creatine supplementation and I that was going to be my next

1:36:01 question I mean has first of all has anyone replicated

1:36:04 this study it sounds like no no um and has second

1:36:08 has anyone you know directly looked at hair follicle it's

1:36:11 in it's in review right now um but if I had

1:36:15 to have a magical guess it doesn't affect hair follicle

1:36:19 La oring so if people are watching me they're like oh

1:36:22 and then they look at other creat researchers I can blame

1:36:25 my parents and primarily my mother for that for the maternal

1:36:28 DNA um but then there's other people with full heads

1:36:31 of hair so it can't be a cure it's like carbohydrates

1:36:34 cause obesity that's nonsensical it's it's everybody's different um but I

1:36:38 still get this on a daily basis both from males

1:36:40 and females they don't want to take it or their hair

1:36:43 is thinning and um I'm really glad that this study is

1:36:46 coming out because the way we should have answered this is

1:36:48 we don't know until the study emphatically says no we didn't

1:36:51 see any of the effects um we would to say

1:36:53 we don't have any evidence to suggest it does and we

1:36:56 don't have any evidence to suggest it doesn't and even

1:36:58 when the study gets published we'll probably have to do multiple

1:37:01 but um it just has never been done and no

1:37:03 rodent studies no rodent studies nothing I think it's an area

1:37:06 that people said no one cared about and then all

1:37:08 of a sudden everybody cared about it yeah that's so is there

1:37:11 is there any other uh really I think prevalent misconceptions

1:37:15 or myths that you want to talk about or je there's

1:37:19 so many I think the the big one um

1:37:22 that the big one we're getting a lot is does it increase

1:37:24 hypertension or blood pressure because if it increases water

1:37:28 into the body could that have any effects and we're not seeing

1:37:30 any adverse effects there um the other one is we do

1:37:34 not see any evidence it disrupts sleep although we talked about

1:37:37 the the study earlier doesn't have any negative effects there

1:37:40 um and then cancer so this is an area that is

1:37:43 difficult to answer or talk about um because we just

1:37:46 don't have a lot of human cellular data from the inv

1:37:48 vitro data um we're not seeing any in humans at least

1:37:52 from recommended dosages any uh malignant growth or any uh

1:37:55 cancer promotion if anything we're

1:37:57 seeing anti-cancer properties uh from improving

1:38:00 inflamm or anti-inflammatory responses there and in our latest paper

1:38:04 of the Miss and misconceptions part two uh one

1:38:06 of the world's best uh creatine researchers and medical doctor Mark tarnopolski

1:38:10 WR really good section on that um so if anybody's interested

1:38:13 read that and it seems to have some potential for cancer

1:38:16 Rehabilitation when you're looking at uh tissue loss caia seems

1:38:21 to have some beneficial effects there and um I'm with Kieran Fairman

1:38:25 in University of South Carolina looking at uh prostate and breast

1:38:28 cancer Rehabilitation so I think you're going to start to see

1:38:31 some medical applications growing more than just young healthy individuals

1:38:36 again the common denominators all these um are sort of asking

1:38:39 something for help so either Rehabilitation or prevention and that's

1:38:43 where I think creatine is really uh changed it used

1:38:46 to be for just young individuals who are healthy and now

1:38:49 it seems to have some of these Health aspects so

1:38:51 very exciting times to be talking about it yeah are are

1:38:53 you familiar with any of the research of uh Dr krie

1:38:56 Kier out of University Alberta yeah so cancer there I

1:39:00 don't think he's ever looked at creating but he does

1:39:02 a lot of Community Based yet I just had him

1:39:04 on the podcast and he was you know he does a lot

1:39:06 of um ex the role of exercise in cancer treatment

1:39:10 and you know not just not just aerobic but resistance training

1:39:14 so um that would be interesting for you guys to have

1:39:16 a discussion um the other thing that came to my mind

1:39:19 that I now remember I've I've heard a lot of people

1:39:21 talk about is creatine supplementation

1:39:25 increasing their urination um particularly

1:39:28 during sleep like like having to go urinate more frequently

1:39:32 I just answered this question on Instagram so an individual because

1:39:34 I I said I take a pre-sleep sometimes and they

1:39:37 oh that'll keep me out peeing all night and I said

1:39:39 oh actually that's interesting so in this Miss misconception paper

1:39:42 as well uh there's a section there that uh the creatine molecule

1:39:46 whichever does not increase um urinary output people thought since

1:39:51 it's creating creatinin you need to filter it we think it's

1:39:53 the increase in fluid ingestion that you're probably taking either

1:39:57 with exercise or what is usually recommended with creatine that's actually

1:40:01 a myth as well you don't need to increase tons

1:40:03 of water consumption but the molecule doesn't cause an increase in urination

1:40:08 it's not a diuretic or it doesn't increase uh urinary uh

1:40:12 flow that way I do hear that a lot my logical

1:40:15 guess is you're probably putting the creatine in 8 ounces

1:40:17 of water and you're probably drinking more water or exercising

1:40:20 and that's one of the things but there's no evidence

1:40:21 to suggest the molecule itself stimulat urination yeah okay well that's good

1:40:25 to know um I think we've covered a lot there's

1:40:29 one area I did want to talk about and we talked

1:40:31 about kind of saving at the end because there's more speculation

1:40:33 here and this is um just an an interest of mine

1:40:37 I remember several years ago a former colleague of mine

1:40:41 Mark shanaga um was talking to me about you know creatine

1:40:47 production in the liver being one of the biggest B

1:40:51 biggest um sort of syns for methyl as aprod you Hine

1:41:01 and so um he was talking about some at the time

1:41:04 I think it was pretty preliminary but some evidence showing

1:41:07 that if you did supplement with creatine that the the enzymes

1:41:13 in the liver that do produce creatine were there was

1:41:16 a feedback and they they sensed that and they they

1:41:19 didn't use so much of the the methyl groups were being

1:41:22 shunted to other meth Pathways and so um I was just

1:41:27 wondering if you've come across any evidence looking at creatine supplementation

1:41:33 and homosysteine levels for example yeah the most studies don't

1:41:37 support it and that's where we got to the point where

1:41:40 oh if it doesn't decrease homosysteine levels then maybe exogenous creatine

1:41:44 doesn't reduce our natural creatine synthesis the the studies that show

1:41:49 it does are in animals and I believe there was

1:41:51 one human trial uh but the Mo majority shows it doesn't

1:41:55 have any effect now that could be the dose there

1:41:57 but you're totally right methionine is donating I think it's 40%

1:42:01 of our our methyl groups to creatine synthesis so if I'm

1:42:04 taking more dietary creatine or or supplementation why use that why

1:42:09 why not decrease the amount being synthesized because that has

1:42:11 huge implications on enthal health and cardiovascular health um but ironically

1:42:16 the it's not even equivocal the majority suggests it doesn't

1:42:19 decrease maybe the studies are not long enough or maybe they're

1:42:22 not populations that needed as much yeah right so the question

1:42:25 is like maybe you need to start with a population

1:42:28 that has elevated homoy correct yeah vegans yeah yeah yeah

1:42:31 yeah because it's hard it's hard to detect small changes when

1:42:34 you already have it's easy to do you just look

1:42:37 at some of these blood biomarkers uh but there's not a lot

1:42:39 of there's probably less than 10 majority in rodents um

1:42:42 few in human and I think last time I checked it

1:42:45 was probably seven against three supported it so it's there's

1:42:48 a lot of methodology issues there well maybe someone will look

1:42:51 at it I ABS especially as we start to get

1:42:53 into vascular health for sure that's a huge area so I

1:42:56 would be shocked if more studies don't come out in vascularity

1:42:59 health or uh angio Genesis or anything like that potentially looking

1:43:03 at homocysteine as a surate marker for potentially explaining some

1:43:07 of the effects yeah because if homosysteine comes down you would

1:43:10 speculate endothal Health would go up and some of those things

1:43:13 yeah right well if you talk to any researchers doing

1:43:16 doing uh vascular Health be great um so I think

1:43:20 we've covered pretty much just a lot interesting did we there's

1:43:26 anything you wanted to discuss jeez um no you hit

1:43:32 the caffeine one I knew that was an important one for people

1:43:34 are there any other interactions with other you know let's

1:43:37 go back to the carbohydrate one because I think people uh

1:43:40 hear this um the best way to augment creatine into the muscle

1:43:45 is with muscle contraction which is great but the dose

1:43:48 of carbohydrates shown to sort of increase it is almost

1:43:51 over 75 G and I think most people are not going

1:43:54 to consume that protein is a great one to add creatine

1:43:58 too because it's insulin genic as well um so combining creatine

1:44:02 and protein will probably give you a superior effect and there's

1:44:04 been two studies that show you get a greater increase

1:44:07 in in muscle performance and lean body mass when you

1:44:10 combine creatine with protein in this protein case it was whey

1:44:13 protein it was only about 30 grams so now when

1:44:15 you're looking at your post exercise meal pre-exercise meal I think

1:44:19 creatine and protein are good friends uh consider them as something

1:44:23 that you may want to consider um especially in your post

1:44:26 exercise meal or like I take at least 50 grams

1:44:29 of protein with breakfast I put my creatine in there I

1:44:32 don't need to worry about it until later on and then

1:44:35 I usually drink it or have it with a meal

1:44:37 um most creatine is tasteless you can put it in food

1:44:40 um that's fine you can you know the heat would

1:44:42 denature it a little bit but it's something to consider yeah

1:44:45 I'm glad you brought this up because um it to clarify

1:44:48 maybe some people were confused when we were talking about

1:44:50 this earlier um the taking the the timing of the creatine

1:44:53 around exercise it was to improve the uptake of creatine

1:44:57 into muscle and that can be done before or after like

1:45:01 close proximity to the exercise yeah and if you don't

1:45:03 want to work out keep in mind it still accumulates maybe

1:45:06 just not as quick so the study in 1992 was very

1:45:09 elegant they had one leg exercise and that increased creatine uptake

1:45:13 by about 37% and in the other leg that didn't

1:45:16 exercise is still improved by 25% so at the end

1:45:20 of the day the person you know at home watching TV

1:45:22 taking creatine whatever for some time they're still accumulating but exercise

1:45:27 unlocks a lot of the doorways so to speak that sort

1:45:30 of get it in there more so it might give

1:45:32 you a little bit extra benefit and that's why I say

1:45:35 appr proximity exercise is a very viable time to take it

1:45:38 you but if you're looking for the benefit in terms

1:45:41 of improving or increasing your training volume and you know

1:45:46 that explosive power the strength um that it doesn't necessarily have

1:45:50 to be timed around the exercise right just take it like

1:45:54 if you don't want to take it all at once

1:45:55 take it in small dosages I think consistency I I now

1:45:59 recommend take it every day uh just get it like

1:46:02 a multivitamin whatever you're doing but just keep in mind it it's

1:46:05 giving you not only exercise benefits but I'm really happy

1:46:08 to see the emergence of the health benefits and I think

1:46:10 in today's society we could all use a little bit

1:46:13 of help yeah it sounds it sounds like there's no reason

1:46:16 not to take it I mean it's there's a lot

1:46:17 of benefits the the muscle the bone the brain very very

1:46:21 convincing um third party testing you can look for companies

1:46:25 that have been vetted that are that are you know reliable Brands

1:46:29 and and that's always like a yeah that's a big

1:46:32 thing that we didn't talk about so if you are considering

1:46:34 supplementation again you don't necessarily need it if you're getting

1:46:37 it through your diet uh but make sure third party tested

1:46:40 I would really focus on monohydrate um based on the evidence-based

1:46:44 research uh monohydrate has grass status creapure is from Germany

1:46:48 it's it's more scrutinized it has less purities um that's

1:46:51 an excellent form of creatine hydrate I make sure it's pharmaceutical grade

1:46:55 so all these things that you would do by putting

1:46:57 something in your body just do a little bit of homework

1:46:59 but if you're not seeing certified safe or third party test

1:47:02 it um that's something to be a little cautious and the other

1:47:05 thing is when you're buying a compound or ingredient

1:47:08 with a whole bunch of ingredients in there um we don't know

1:47:12 if the creatine is going to be effective or not

1:47:14 in these pre-workouts things like that there's no reason to suggest

1:47:17 not but when I've been talking about creatine in our experimental

1:47:20 studies we're giving 100% pure Crea we're not giving it

1:47:24 with 10 or or 12 other compounds that you got

1:47:26 at a grocery store things like that um but again so there's

1:47:30 a little bit more work that needs to be done if

1:47:31 you're considering a multi-ingredient compound yeah yeah and that's a good

1:47:34 um point because you're we were talking about taking you

1:47:36 know 10 10 grams a day which is your your sort

1:47:38 of goto and now soon will be mine um you

1:47:42 don't want to take 10 grams a day of some you

1:47:44 know mixture of things right you want it to be

1:47:46 just creatine now you mentioned cre cre creatine Pure or cre

1:47:49 cre pure monohydrate y that's very pure it's very pure

1:47:53 from Germany it's third party tested now as as a disclosure

1:47:56 I'm on The Advisory board for Crea pure so full

1:47:58 disclosure um and that's helped sponsoring the creating conference in Germany

1:48:02 in in a few weeks but it has grass status

1:48:05 um and when you look at the independent lab results it's

1:48:07 100% pure uh there has been some issues out of Asia

1:48:10 with transportation and not being third party tested so I

1:48:13 think the consumer just needs to do a little bit

1:48:15 of work most companies nowadays if you're on the shelves

1:48:18 of a product um are very reputable um and again if

1:48:22 it has third partyy test it safe just look at the ingredients

1:48:25 it should say monohydrate or if you're entertaining another form

1:48:28 of creatine that should be the only ingredient or at least

1:48:31 the most important ingredient on the product yeah what about micro

1:48:34 ionized yeah that's a new form to get away from some

1:48:37 of the things you mentioned on GI track irritation so

1:48:40 that's just being continually processed it's very fluffy I've noticed uh

1:48:45 um some of the new products it it dissolves exceptionally well

1:48:49 uh get away from that grittin that the creatine can cause

1:48:52 in in uh solution so these are just coming up

1:48:54 with new Alternative forms to help please a lot of individuals

1:48:58 make it more attractive um but it's another form that can

1:49:00 just uh sort of be um sort of solubility is

1:49:03 very high yeah is there any reason to believe it

1:49:05 wouldn't work it's because it's it's monohydrate right so it should

1:49:09 do the same thing 100% it's just a different way

1:49:11 to get it into your body uh if you like it really

1:49:13 really micronized um so it's purefine um I just take

1:49:18 normal cre and if there's a little bit of grittiness

1:49:20 at the bottom I that doesn't bother me but some people

1:49:22 they do yeah okay well excellent we've just covered so much

1:49:26 wonderful information and thank you so much for taking time

1:49:29 to talk about all this research with me today and thank

1:49:32 you for doing all this research I mean really um you've

1:49:35 just done an amazing job covering so much important you know

1:49:39 ground in terms of uh the effects of creatine on human

1:49:42 health right oh thank you so much for having me

1:49:44 had a great time thank you me too thanks thanks thank

1:49:47 you to Dr Darren k for coming on the podcast after

1:49:50 this episode was recorded a new stud was published suggesting

1:49:53 that creatine supplementation was not effective for increasing muscle mass

1:49:57 but that study is not what most people think it is

1:50:00 Dr kandal Who was actually one of the co-authors of the paper

1:50:03 joined me to break down what the study actually showed

1:50:07 what the data support what they don't and how to interpret

1:50:09 the findings in context you can watch that full breakdown

1:50:13 on the found my fitness Clips YouTube channel and if you

1:50:17 found this podcast valuable please consider sharing it with friends

1:50:20 with family colleagues anyone who might think benefit from this information

1:50:24 I think a direct link goes a long way thank you

1:50:27 so much for listening and I'll talk to you guys soon