The Art of Manliness - The Safe, Effective Supplement That Can Improve Your Body and Brain

00:00:00.000 brett mckay here and welcome to another edition of the art of manliness podcast

00:00:10.760 what if there was a supplement that could build muscle maintain bone health fortify the brain

00:00:15.880 against cognitive decline due to age and stress and alleviate depression has been proven safe

00:00:20.340 and comes with almost no side effects well there is such a supplement it's been around for a long

00:00:24.880 time and it's not even expensive it's creatine here to unpack the myths benefits and recommended

00:00:30.580 ways to use creatine is darren kandow professor of exercise physiology and nutrition who supervises

00:00:36.020 the aging muscle and bone health laboratory at the university of vagina darren specializes in

00:00:40.600 studying creatine and has published over 70 papers on the subject today on the show darren explains

00:00:45.440 how a supplement often associated with bodybuilders may actually be beneficial for just about everyone

00:00:50.060 athletes and non-athletes and the young and old alike he impacts what creatine does in the body

00:00:55.040 and how its benefits extend beyond the body and into the brain he offers recommendations on the

00:00:59.720 formulation of creatine to use suggested dosage and whether it should increase with age and how to

00:01:04.360 avoid the bloating effect he also shares what we know about creatine safety including its effect on

00:01:09.140 the kidneys and whether it can cause hair loss after show's over check out our show notes at awim.is

00:01:14.480 slash creatine

00:01:15.360 all right darren kandow welcome to the show thanks for having me really excited to be here

00:01:31.400 so you research a supplement that i'm sure a lot of our listeners have taken or have probably heard of

00:01:37.760 and that is creatine and we're going to do a deep dive into creatine today i think there's a lot of

00:01:43.280 misconceptions about it so start off with just basic questions what is creatine yeah actually

00:01:49.940 creatine is very similar to a protein it's naturally found in our diet if you eat red meat or seafood

00:01:55.980 you're getting about one to three grams a day but a lot of people don't know we actually naturally

00:02:00.960 produce this in our body primarily in the liver and brain so those are the two main areas and of course

00:02:08.120 that leads into the third probably the global area which is creatine supplementation so again it's in

00:02:14.560 our diet we naturally produce it in our body and it's probably why it has an exceptionally high safety

00:02:19.500 profile all right so creatine our body makes it we get it from food what does it do we'll talk about

00:02:25.500 specific effects creatine has on our physiology but in general what does creatine in our do in our body

00:02:31.520 like why does our body make it and why do we need it from food yeah basically why we make it and or get

00:02:36.920 it from food is is because it helps maintain the energy currency of all our cells so a lot of your

00:02:41.580 listeners are familiar with adenosine triphosphate or atp but we need atp to do any activities of daily

00:02:47.860 living and keep our body moving so carrying groceries lifting weights running your muscles primarily are using

00:02:54.140 atp to maintain the movement and creatine in the form of phosphocreatine just comes to the rescue

00:03:01.400 it's kind of like batman and robin a batman is atp or energy and robin is the sidekick that helps

00:03:07.620 maintain those energy currency of our cells so that probably why a lot of people who take creatine or

00:03:12.980 increase it through their diet they can exercise longer more intensely they can recover better in

00:03:18.580 other words athletes usually get bigger stronger faster okay so creatine we use it

00:03:23.200 for metabolism that is that is correct okay and then i mean kind of sort of recap of metabolism

00:03:29.620 we've talked about this on the podcast before there's different levels of metabolism there's

00:03:33.100 oxidative metabolism that's where your body's primarily using uh fat and oxygen to create atp is

00:03:41.320 that right did i get that right that is correct yeah think of when you're walking yeah okay and that

00:03:45.700 form of metabolism it creates a lot of energy but it takes a long time to produce that energy yeah

00:03:52.600 that is correct it's a very slow process to break down body fat as we all know it's step by step by

00:03:58.820 step process and it does take a long period of time yeah and then after that if you increase the

00:04:05.220 intensity of your movement of your activity that's when you use anaerobic metabolism and you're using

00:04:11.560 carbohydrates or glucose to create atp that is a hundred percent correct from the muscle or the liver

00:04:18.280 that's correct okay and that's so you're using anaerobic and like you're not using oxygen in

00:04:23.100 that form metabolism is that right yeah if it's a hundred if it's a hundred percent pure anaerobic

00:04:27.400 very little oxygen is actually incorporated or utilized so anything maybe over 30 seconds of intense

00:04:34.880 exercise that's only when oxidative phosphorylation or capacity really kicks in or predominates but if

00:04:40.940 you were at the watching the olympics and a hundred meter sprint is less than 10 seconds these individuals

00:04:45.500 are actually not breathing when they're running which might be a little counterintuitive to a lot

00:04:49.120 of people listening they hold their breath they use something called myoglobin which is an oxygen

00:04:53.560 storage form in the muscle but they're also highly relying on creatine creatine is an anaerobic compound

00:05:00.540 that really comes into aid during really explosive high intensity movements sprinting weightlifting comes to

00:05:08.280 mind intermittent sports but once you're finished the event that's when the mitochondria or oxidative

00:05:15.480 capacity comes in to replenish those creatine stores so the interesting thing is a lot of people

00:05:21.220 taking creatine have done it during weight training they do a set they rest for a couple minutes they do

00:05:25.720 another set where we see the big bang for its dollars when creatine is coming to the aid in sets

00:05:31.240 two three and four they can perform more weight or more repetitions because they had higher amounts in 0.60

00:05:37.000 the body and that's really where it became famous right and so what creatine does it takes a phosphate

00:05:42.380 molecule and kind of adds it to the whole metabolic system to create more atp yeah so when when we can

00:05:49.240 produce creatine just say in the liver or we eat it just say if you had a salmon steak it takes about

00:05:54.280 an hour to sort of peak in the blood and then it goes through a specific doorway into our muscle

00:05:59.240 primarily and when it's in there you're right it's linked to a phosphate bond and then it becomes too

00:06:04.840 large to just disassociate and leave the muscle so it becomes trapped but when it does get metabolized

00:06:10.880 with exercise whichever it's broken down into something called creatinine so when creatine

00:06:15.680 leaves the the cell it's in the form of creatinine but when it's in the cell it's linked to phosphate

00:06:21.040 and that's when it becomes fossil creatine which gives all the magic with it okay so overall creatine

00:06:27.440 plays a role in metabolism it helps create atp which allows us to do move like sprint run lift weights

00:06:34.460 do a heavy deadlift everything i think most people when they talk about creatine or think about

00:06:40.040 creatine they associate it with muscles so let's talk about that specifically what are the benefits

00:06:45.080 of creatine when it comes to muscle mass and strength why are bodybuilders taking creatine

00:06:50.280 yeah the the benefits are enormous and really elegant so there's probably over a thousand peer

00:06:57.020 refereed studies now showing that creatine improves lean mass some areas of pure regional muscle mass

00:07:04.200 strength endurance power and also muscle recovery so when you have more creatine in the muscle

00:07:09.120 it increases the capacity to do work so this is really important creatine without exercise will

00:07:15.680 give very minimal effects you can get some acute effects maybe an improvement in strength or endurance

00:07:21.140 with a really really high load without exercise but exercise unlocks all the magical benefits from a

00:07:27.580 muscle biology perspective with creatine so there's really good established mechanisms for that but in

00:07:33.280 in summary when individuals take creatine through supplementation or the diet their muscle has a

00:07:39.680 greater ability to perform more work that either is more reps more sets and potentially more frequent

00:07:45.440 training sessions so usually training volume will go up and that probably explains why a lot of people

00:07:50.860 either get an improvement in strength lean tissue mass or endurance okay so that's a good point the creatine

00:07:56.680 itself doesn't increase muscle mass or strength it just allows the muscle to train harder for longer

00:08:03.260 which will give you more stimulus to drive hypertrophy and strength yeah all the good mechanisms that get

00:08:09.940 turned on like things like satellite cells and insulin like growth factor and things like that that we could

00:08:14.600 probably talk about from a pure mechanistic standpoint they have been shown to be increased primarily in young

00:08:20.560 adults with creatine supplementation in combination with resistance training very minimal research suggests that

00:08:27.760 these pathways get turned on in a meaningful way they might get turned on in from a biological way but from a

00:08:34.160 meaningful human way without exercise okay so if someone's doing i mean you would see the effect of creatine if

00:08:40.020 you're so let's talk about these weightlifting as an example if you're on set two if you didn't supplement with

00:08:46.260 creatine you'd probably feel that i'm kind of depleted i can still do it but i'm it's pretty

00:08:50.540 tough if you have supplemented with creatine your muscle had been saturated with creatine like your

00:08:54.700 muscles have something to fall back on to to create the atp it needs to go really hard in that second

00:09:00.040 set a hundred percent so even if you didn't change the weight let's say for set one the group that was

00:09:06.200 on creatine did 100 pounds on the bench press the group that was on placebo also did 100 pounds

00:09:10.700 the first set maybe they're each group did about eight to nine repetitions no difference now when it comes

00:09:16.820 to sets two three and four the creatine group still with 100 pounds can definitely do more

00:09:22.000 repetitions in sets two three and four so when you add up the total amount of repetitions over those

00:09:27.800 sets the creatine group in theory did more and if you do that over weeks and months that's probably

00:09:33.080 why an individual will put on lean tissue mass and definitely improve muscle performance does creatine

00:09:38.160 have any effect on the neuromuscular aspect of strength like does it help you contract your muscles

00:09:43.700 harder and things like that oh it does it really reduces relaxation time so the muscle can contract

00:09:49.720 more often and the other theory is there was hope for multiple sclerosis where the the axon going to

00:09:56.240 all our or the the power cord if you will going to all our muscles was frayed there was some hope there

00:10:01.200 with multiple sclerosis but we didn't really see a lot of promise in that disease state clinical

00:10:05.400 population but creatine now has been shown to act as a neurotransmitter pitcher caffeine you know

00:10:11.600 something like that but creatine there's a little bit of evidence to suggest that acts as a

00:10:15.440 neurotransmitter which kind of makes sense because now you may be able to recruit more muscle fibers

00:10:22.040 primarily those type 2 muscle fibers and that may be why some of the best evidence suggests that creatine

00:10:27.800 improves maximal strength and measures a muscle power so that is huge applications for athletes

00:10:33.320 yes allow you to lift a one rep max that's heavier yeah i would say the one rep max is probably the

00:10:40.200 most established benefit from creatine supplementation over time next to it would be probably more

00:10:45.760 repetitions performed to volitional fatigue or indices of muscle power but by far if you had to

00:10:51.660 ask me what's the best reason to take creatine i would probably say overall it's the improvement in

00:10:56.320 muscle strength okay all right so creatine it can increase muscle strength can increase muscle mass

00:11:02.200 because it allows you to do more volume which gives you your muscles more stimulus to drive muscle

00:11:08.560 protein synthesis but creatine isn't just about muscles it in fact creatine helps a whole bunch

00:11:14.600 of other stuff and this is what a lot of your research is showing and one thing i was surprised

00:11:18.160 about is that creatine can help with our bone health so how does creatine help with our bone health

00:11:23.700 yeah it's taken on almost a new life of its own it's pretty much for anybody across the lifespan and

00:11:29.940 and a study done in 2003 or switzerland when they put bone building cells if you go all the way

00:11:36.240 back to biology if you put bone building cells in the presence of creatine in a petri dish

00:11:40.180 these cells became energized and so the theory was wow if these bone building cells have more energy

00:11:46.400 maybe they can potentially in a human start laying down more calcium and phosphate salts and maybe the

00:11:52.260 skeleton can get stronger and of course that would have enormous application for males and females

00:11:57.780 but primarily biological females prone to osteopenia and osteoporosis and there was a couple of 0.99

00:12:03.760 pioneering rodent studies done out of mcmaster university in ontario showing that rodents

00:12:08.260 improved bone mineral density when creatine was added to their food and then of course as a segue

00:12:13.700 of you mentioned we've done a number of clinical trials now looking at long-term creatine supplementation

00:12:19.820 and exercise bone tissue takes a long time to turn over so you probably need at least six months of

00:12:25.520 exercise and we've shown from anywhere 0.1 gram to 0.14 grams per kilogram so that's about 8 to 12

00:12:33.440 grams for the average person if you take that per day in combination with exercise primarily weight

00:12:39.360 training you can preserve some aspects of bone health primarily around the hip region this is

00:12:45.160 primarily shown in post-menopausal females but we've also shown some benefits in healthy males

00:12:50.240 now i will preface that we did not increase bone mineral density at best we preserved bone mineral

00:12:58.400 density in some of those regions and simply showed that there's improvement in bone geometry but there's

00:13:04.460 only been about four studies to show that the vast majority do not show these effects so we need a lot

00:13:11.280 more clinical research especially in disease state populations but there is some evidence to suggest it has

00:13:16.520 some bone beneficial effects okay and you have to do it in combination with exercise it's not just like

00:13:21.580 you take creatine and you're you're going to maintain bone mineral density yeah so this is crucial there

00:13:27.540 is some studies regarding skeletal muscle that without exercise creatine can have some very small

00:13:32.460 very small favorable effects but we don't see any benefits without exercise on bone so you need that

00:13:39.160 mechanical stimuli from brisk walking or more importantly weight training to cause the muscle to pull on the

00:13:45.620 bone all throughout the day to cause bone to improve so there's been studies in brazil worldwide not

00:13:51.460 showing any benefits from creatine without exercise and a little bit different than skeletal muscle the

00:13:57.020 lowest dose ever been shown to have any bone benefits is eight grams a day whereas skeletal muscle

00:14:02.520 the lowest dose has been about two to three grams a day so there is a difference from a tissue perspective

00:14:07.160 okay so this is interesting research if you have an older parent or maybe a wife starting you're going

00:14:12.120 through menopause but this would be useful to know take some creatine and exercise it can help maintain that

00:14:16.880 bone mineral density do we have any research on whether creatine helps connective tissues like

00:14:22.560 tendons and ligaments we don't and i've asked a few colleagues i think now with the big push on

00:14:29.280 collagen where collagen is kind of not really that great for muscle protein synthesis but i thought wow

00:14:35.640 what if we could combine creatine and collagen protein into a research study i think it would have

00:14:40.420 some potential benefits there especially for people prone to osteoarthritis osteopenia or osteoporosis

00:14:46.660 i think those two synergistic compounds might play a role but again we need the research to do that

00:14:52.860 but as creatine by itself nothing on tendon bone or cartilage per se okay so creatine can help increase

00:14:59.960 muscle mass and strength it can help potentially stave off osteoporosis you mentioned creatine supplementation

00:15:06.500 can help endurance athletes walk us through that because typically when i think of creatine i think

00:15:11.100 of it you know as far as you know for sprinters or power lifters how can creatine help you know

00:15:16.820 someone running a 5k or a marathon yeah that area has really come into its its own in the last five or

00:15:24.460 six years and you're right creatine was just for anaerobic athletes get bigger stronger faster and

00:15:29.080 and then we started to look at research in soccer players long distance running some of the best studies show

00:15:34.920 that creatine really speeds up recovery in in post ironman and post long marathon training but it has

00:15:41.700 improvements in agility and balance and recovery and swimming soccer so it's not just for the weight

00:15:47.960 room it seems to be a metabolite that can really have some promise for endurance type athletes as well

00:15:53.220 and i think it's important to to note even if you're taking part in an endurance activity like you're not

00:15:59.680 just in that oxidative metabolism state where you're using fat like when people think about metabolism

00:16:04.640 they often think of it as sort of these like very discreet things like you're either in fat burning

00:16:09.080 zone or either in carb burning like it's like a spectrum it's all going on at the same time it's

00:16:13.780 very dynamic and so in any endurance event i've run a few 5ks i know at the end you do that kick

00:16:21.000 you're going as hard as you can you're basically doing a sprint i imagine an athlete who's got a you

00:16:27.080 know good store of creatine in their muscles they're probably going to do better at that point in the 0.82

00:16:31.780 race than someone who does it yeah and and you're right all three energy systems are turned on

00:16:37.260 simultaneously no matter what you're doing it just depends on the activity which would dictate

00:16:42.400 predomination and so you know if you're on a treadmill or as you said you're doing the marathon

00:16:47.920 and then you sprint you don't have time to wait for your anaerobic a lactic system to kick in has

00:16:51.720 already kicked in at the beginning it's just which one predominates and you're right the more creatine

00:16:56.300 that's in the muscle that can actually delay glycogen depletion a lot of people don't realize

00:17:01.540 this but if you utilize creatine more anaerobically that'll offset the reliance on glycogen which we

00:17:07.040 only have a little bit amount in our liver and skeletal muscle and then that'll further delay 0.84

00:17:12.100 oxidative phosphorylation so that's probably why individuals when they do take creatine they can sort

00:17:17.560 of exercise at a higher capacity really train that anaerobic system and that'll delay the reliance on a

00:17:23.300 really slow producing energy system such as fat burn okay so marathon runners can benefit from

00:17:29.340 creatine supplementation or just increasing their creatine levels right some other exciting research

00:17:34.220 is coming out about creatine creatine doesn't just affect your athletic performance it can also

00:17:39.760 influence or affect our brain health so tell us about the research about creatine and brain health

00:17:44.480 yeah this is so exciting so this is probably the big focal point for the next 20 or 30 years and

00:17:50.700 creatine can get into the brain but it's really difficult so as we all know the brain has the

00:17:57.040 blood brain barrier that little force field that prevents toxin particles from getting into our

00:18:02.740 precious tissue a creatine can accumulate into the brain but it's at a slower rate so our skeletal muscle

00:18:09.580 acts as a vacuum it sucks up all the creatine from our blood but the brain is resistant to that so when

00:18:15.660 it does get in it takes a long time and also that's different our brain does make its own creatine

00:18:21.760 so the brain might say hey we don't really need a lot from supplementation only during times of

00:18:27.760 metabolic stress creating supplementation can accumulate in the brain which is fantastic and

00:18:34.040 it's now been shown to have some cognitive memory benefits for older adults and what's really coming

00:18:41.280 to the forefront is during times of metabolic stress in the brain such as sleep deprivation

00:18:46.060 so i don't know anybody that's not sleep deprived or sometime i would consider jet lag up there as well

00:18:52.420 the mechanism seems to be very similar to recovery of the muscle the brain does rely on creatine just like

00:18:59.400 bone and muscle and so when the brain is stressed it needs help even though it makes its own it may need

00:19:05.320 help from circulation so i think when the brain is stressed students staying up all night if you're

00:19:11.060 flying to europe and you're susceptible to jet lag sleep deprivation whatever it is that's when you would

00:19:16.900 probably notice the benefits from creatine if you are not metabolically stressed you get adequate sleep

00:19:23.440 everything's good you're probably not going to notice those beneficial effects okay so creatine can help

00:19:28.820 your brain during times of stress so sleep deprivation so what is the how are you going to notice it so

00:19:34.800 let's say you don't supplement with creatine and you're sleep deprived everyone knows like you feel

00:19:39.500 just groggy and tired and kind of cranky how would you feel if you take supplement with creatine

00:19:44.240 yeah i'll put it from an experimental perspective and i'll tell you what happens in me specifically

00:19:49.940 so from an experimental perspective it's very easy that when we have people volunteer overnight to be

00:19:55.960 sleep deprived they're able to do sort of puzzles and sort of like a task on a computer more

00:20:01.140 steady compared to those on a placebo so maybe performing tasks of daily living the next day is

00:20:06.240 easier i sure notice my fogginess goes away i've had covet now three times and i've had sort of the brain

00:20:12.540 fog twice but when i go fly to europe or other parts of the world i find creatine really decreases the

00:20:18.920 fogginess and allows me to sort of get back to the feeling normal the next couple days and i even

00:20:24.820 increase my creatine a little bit more when i am flying overseas just for the hope that it can have

00:20:30.480 some beneficial effects and then you also talk about you just mentioned that it can help with

00:20:34.780 age-related mental deterioration so yes what tell us about that research yeah so there's been a couple

00:20:41.700 meta-analysis showing that in healthy adults these are individuals without dementia or alzheimer's or

00:20:46.660 related they've been able to have an improvement in memory and some cognitive function and that might make

00:20:51.900 sense as the brain just like any other organ starts to deteriorate as we get older so we are starting

00:20:57.920 to look at some areas maybe dementia and alzheimer's which would have massive implications moving forward

00:21:03.960 but overall we're not seeing any huge benefits in parkinson's huntingsons there's been no research

00:21:10.680 that's been published on alzheimer's but stay tuned for that i know those studies are in the works

00:21:14.960 there's a great group out of utah a group of psychiatrists which have clearly shown huge benefits

00:21:20.740 primarily in females with clinical depression creatine when added to their medication program seems

00:21:26.820 to alleviate symptoms of depression anxiety and ptsd so some more randomized control trials will be

00:21:33.800 coming up there and and one of all the main mechanisms with all this seems to that it decreases

00:21:38.840 inflammation in the brain or oxidative stress we need a lot more evidence to look at other

00:21:43.600 mechanistic actions but seems to be the theory yeah the uh that's interesting creatine's connection

00:21:48.740 to mental illness and inflammation we've had a few podcast guests psychiatrists and psychologists who've

00:21:55.520 explored inflammation's connection to right mental illness particularly depression like there's the

00:22:01.160 guy i forgot his name but he he studies uh sauna use okay and how it alleviates depression and some

00:22:08.260 some types of depression and the theory is there is that depression is an inflammatory or a type of

00:22:13.080 depression can be an inflammatory response and so by adding the sauna you acutely increase inflammation

00:22:18.900 and your body can better handle inflammation and reduces inflammation overall and then there's another

00:22:24.860 guy who had a book out i forgot again i can't remember off the top of my head but basically the

00:22:28.780 argument he made a lot of the mental illnesses that we have their metabolism problems in our brain

00:22:34.400 right yeah yeah there's there's so much out there now an important distinction is that some of

00:22:41.100 these studies that show brain benefits have been without structured exercise so now this is important

00:22:47.220 as the question came up should i just take creatine on the days i work out i now tell people take it

00:22:51.800 every day just in hope that some of that creatine will be trickling into the brain on a daily basis and

00:22:57.080 eventually accumulate it takes a long time to accumulate in the brain if you're taking a low dose

00:23:02.300 of creatine it could take several months if you're taking a super high dose a little bit less but now

00:23:07.440 that's why it's recommended to probably take creatine on a daily basis either from one of those potential

00:23:13.040 mechanistic standpoints but we're actually seeing some benefits without structured exercise so to that

00:23:18.760 question should everybody on the planet consider creatine i i can't say yes or no but there's evidence

00:23:24.440 to suggest it has some potential to have some beneficial effects we're going to take a quick break for a word

00:23:30.120 from our sponsors and now back to the show okay so we talked about the many benefits of creatine um it

00:23:38.120 helps build muscle strength and mass can help with endurance maintains bone health it can improve

00:23:43.500 cognitive function when you're sleep deprived or jet lag can also maybe help cognitive function as you age

00:23:49.360 might help with depression are there any other benefits of creatine we haven't talked about that

00:23:54.400 you're excited about yeah i think the big one is that we're starting to see some problems from

00:24:00.380 pregnancy all the way across the lifespan especially in females and we'd like to really start looking at

00:24:07.240 young bone and children and adolescents can that improve a coordination development things like that so

00:24:13.000 there's a lot coming down the pipeline it's starting to have some potential beneficial effects on

00:24:18.100 cardiovascular health so it's sort of gone from athletes to pretty much anybody on the planet

00:24:23.220 may or may not get a potential benefit just depending on their situation all right so we

00:24:27.840 talked about the benefits a lot of benefits to creatine let's talk about supplementing with

00:24:31.300 creatine first question is is supplementation even needed or can you get enough creatine from your diet

00:24:37.160 so the correct answer is no you definitely do not need to supplement with creatine unless you're born

00:24:43.140 with a creatine deficiency and the validity to that is vegans vegetarians have healthy muscle cells

00:24:49.320 and they're only relying on what they're naturally producing however when you do take a little bit

00:24:55.280 more you can get substantial beneficial effects so the technical answer is no but there are other

00:25:03.100 individuals that would probably argue that it's conditionally essential but i i fall in the other

00:25:08.400 category to be an essential nutrient like an essential amino acid if you don't consume it you would die

00:25:14.420 we're actually producing enough to get by so it's a tough one to answer so if you're looking for

00:25:19.860 optimization you'd probably want to it'd be easier just to supplement yeah and you don't need a lot

00:25:25.220 like most people take creatine for muscle benefits you could probably take as little as three grams a day

00:25:30.600 that's a quarter of a teaspoon and that'll accumulate in your muscles in about 30 days but of course if

00:25:36.140 you're looking for bone and or brain benefits you may need a bit more okay let's talk about dosing

00:25:41.900 if you're going to supplement with creatine i think the typical dose when you buy creatine

00:25:47.360 is they recommend i think it's five grams a day yeah it depends so a lot of the companies will say

00:25:53.360 hey we want you to load creatine which is primarily just for athletes that's 20 grams a day for five to

00:25:59.180 seven days it's an extremely reliable fast rapid strategy to saturate your muscle to get the best

00:26:06.040 benefits out of it the only problem and why i'm really hesitant on recommending the loading phase

00:26:11.480 is that creatine is an osmotic compound so it drags water with it and so when you're taking in that much

00:26:17.280 creatine you're going to take a lot of water inside the cell and a lot of people say oh i gained weight

00:26:22.360 during the first week or i had some bloating or gi tract irritation that kind of logically makes sense

00:26:28.060 but you can take as little as three grams a day you can probably move it up to a really effective

00:26:32.920 dose of five grams a day that five grams a day your muscles should be saturated in about 15 to 20

00:26:38.620 days we don't know if you can saturate the bone or brain but again once your muscles are saturated

00:26:44.380 any excess would go down the toilet or hopefully it's going into other demanding tissues in our lab

00:26:51.020 we use a relative dose based on the size of the person about 0.1 grams per kilogram so if you're 70

00:26:57.060 kilograms you get seven grams a day if you're 100 kilograms you get 10 grams a day and you can divide

00:27:01.680 that up into multiple smaller dosages so for example if you do want to take five grams a day

00:27:07.320 you can take two and a half in the morning two and a half in the evening the timing is is essentially

00:27:12.160 irrelevant it's really up to you i would not recommend going anything less than one gram per

00:27:18.500 serving a classic study showed that one gram just wasn't enough to accumulate in the blood and

00:27:23.540 eventually get into the tissue how much creatine do you take a day i personally take um i take 10 grams a

00:27:30.140 day now for probably the last decade based on a whole body perspective not only muscle and bone

00:27:35.560 but now the brain so muscle just say is about three grams bone anywhere between eight to ten and the

00:27:40.980 brain the best studies show 20 grams so i just simply divided all those dosages by three and i get

00:27:46.920 about 10 grams and i take five grams in the morning and then i actually mix the other five grams in a

00:27:51.880 water bottle and i drink it during my workout and that seems to really be an easy consistent way for

00:27:56.340 me to get it in okay and can you take creatine every day yes you can yeah and i think i've changed

00:28:04.080 my opinion on this primarily due to the brain that you know take it every day because you want some

00:28:09.200 hopefully trickling into your brain after the muscles fall let's talk about the type of creatine

00:28:14.340 to take there are different formulations out there on the market which do you recommend

00:28:20.600 i only recommend monohydrate so i know it's the boring original but it's the one that's been shown

00:28:28.420 in all the studies to be effective and safe all these other marketed forms of creatine first they

00:28:34.840 have to be creatine when it gets through your small intestine if it's not the creatine molecule

00:28:38.860 your cells will not allow it in so then it's useless and all these other things linked to it

00:28:43.440 to me are irrelevant the bioavailability of pure creatine is near 100 percent so if someone you know

00:28:49.940 wants to spend way more money on a fancy bottle go ahead but at the end of it it has to be the

00:28:54.780 creatine molecule and i only recommend and talk about monohydrate okay and that it's pretty affordable

00:29:00.060 i mean i think it's gotten more expensive i've seen the price go up a little bit but overall it

00:29:04.580 creatine is pretty it's pretty affordable it is and you know we're not talking like protein where you

00:29:09.520 need hundreds of grams if you want to start with three grams a day that's great you're probably going

00:29:14.220 to get some benefits down the road another question i have about taking creatine i remember when i was a

00:29:18.900 teenager i read in the muscle mags like if you want to get a better absorption of your creatine

00:29:24.280 you need to take it with a quick absorbing carbohydrate like orange juice is there anything

00:29:28.760 to that yeah there's a lot of good research out of the uk validating that the only problem

00:29:34.120 is that the dose of carbohydrate or high glycemic sugars is so high that most people nowadays won't

00:29:40.120 even go near you know 50 to 100 grams of sugar and luckily for everybody listening if you're not a big

00:29:46.380 fan of simple carbohydrates exercise muscle contractions will stimulate creatine uptake

00:29:51.880 into the muscle really well and that's probably why a lot of people take creatine in close proximity

00:29:57.060 to their workouts take it before during or after blood flow is is upregulated and these doorways that

00:30:02.480 allow creatine are stimulated so it's a great time to take creatine continuing on just dosage does your

00:30:08.900 creatine supplementation need to increase as you get older oh that's an excellent question i'm in the

00:30:15.480 opinion yes it's very similar to the blunt response to protein we've done a meta-analysis showing that

00:30:21.360 our creatine stores are sort of negatively affected in the lower limbs as we get older so my thought is

00:30:27.560 that we need more as we get older to offset some of those age-related declines okay so let's say you

00:30:33.780 take five grams a day as a 30 year old guy maybe when you get to your 60s are you taking 10 grams a day

00:30:41.480 and there's been some studies all the way up to 30 grams showing some beneficial effects that's quite

00:30:46.300 high but you know for me i think you know 10 grams is more than enough on a daily basis unless you had

00:30:53.520 some metabolic disease or other conditions such as caxia or maybe cancer where it was really

00:31:00.300 inflammatory i just don't see why you would need more than that on a daily basis do we know how early

00:31:05.900 we can start taking creatine yeah we so this is a an area of controversy for sure and i got to be

00:31:12.380 careful how i i preface this but there's some really good potential during fetal development and

00:31:18.200 during pregnancy and most people will shake their head and say what did he just say but yes there's

00:31:22.280 good research out of australia now again they're using the rodent model but they have been shown some

00:31:27.000 benefits that creatine during pregnancy for the mother and the fetus has some substantial benefits

00:31:32.260 again decreasing inflammation and oxidative stress uh good researchers in the united states

00:31:37.800 andrew jagham and chad gersick is clearly shown now that creatine is beneficial for children and

00:31:43.080 adolescents um at the recommended dosage is no adverse effects we're still waiting on the blood

00:31:47.980 biomarkers but i'd be very shocked if there was any adverse effects there so it's sort of transcended

00:31:53.460 and now it seems to be something that anybody on the planet can't consider and one of the main reasons

00:31:59.000 is again we're naturally producing this right our body recognizes it and if we don't like it we

00:32:04.480 excrete it down the toilet so we need a lot more research in those younger years but the current

00:32:09.600 body of research suggests it is safe and potentially effective so if you've got a teenage kid who's an

00:32:15.440 athlete and they're like i want to take creatine like you it'd be okay to do that no safety problems

00:32:20.180 there that we know a hundred percent and and if i had a child that young they'd be taking creatine for 0.81

00:32:24.740 sure okay does creatine supplementation should it differ whether you're a man or a woman

00:32:29.260 no there's no big sex differences uh when it comes to creatine i think i saw something the other

00:32:35.420 creatine was marketed for females which is just quackery the only thought was that biological

00:32:40.920 female may have smaller muscle so their creatine stores may be at rest already higher so they may not 1.00

00:32:47.100 respond as well and there's been a few studies to suggest that females may not improve lean tissue mass 1.00

00:32:52.840 at the same rate as males and from a mechanistic standpoint we think for some reason maybe estrogen

00:32:58.780 is involved that females don't experience a decrease in protein breakdown at the same level 1.00

00:33:04.520 as males and the only logical reason there is maybe estrogen is involved but we just don't know

00:33:09.740 okay so i think a lot of people there's a lot of people out there might be wary of taking creatine

00:33:14.660 because right they may have heard some things i remember when i first started taking creatine in high

00:33:18.980 school this was in the 90s this was when the um the home run race between mark mcguire and sammy

00:33:24.840 sosa was going on and then mark mcguire said oh yeah i just take creatine i mean he's actually taking

00:33:30.220 steroids yeah and i remember my mom or my dad and one of my parents heard this like you shouldn't take

00:33:36.180 this it's like steroids and you're gonna mess up your liver and your kidneys walk us through like 0.77

00:33:40.700 is creatine safe i mean we i think we kind of mentioned it throughout this conversation this research

00:33:45.100 says it's pretty much safe but is there any can creatine damage our kidneys liver etc yeah so we

00:33:52.280 can go through many myths so for one creatine is not a steroid there's been study after study and

00:33:58.200 we've done a two-year study in post-menopausal females looking at long-term high dose creatine 0.95

00:34:03.380 on kidney and liver health and there's been no greater adverse effects and that's been replicated

00:34:08.600 around the world so in summary creatine has no adverse effects on liver kidney or even

00:34:14.000 cardiovascular function it does not lead to muscle cramping and if anything it actually decreases

00:34:20.640 it because it super hydrates the muscle and that was another big myth so you know it does not increase

00:34:26.120 fat mass it actually we've shown a few times that it decreases fat mass i think the bloating just do

00:34:32.380 not do the loading phase and start with a really small dose but the big safety profile of creatine has

00:34:37.920 been well established it's probably the safest most effective dietary compound even above

00:34:43.640 caffeine i recommend the dosages that a human can take and it's the most studied like you said

00:34:48.380 there's like over a thousand peer-reviewed studies on creatine let's dig deeper into the the kidney

00:34:53.480 thing because you mentioned earlier that one of the byproducts of creatine is creatinine so this is a

00:35:00.400 marker that your doctors look at to check your kidney function whether your kidneys are you know

00:35:05.240 working the way they're supposed to do and elevated creatinine levels is a sign like oh something's wrong

00:35:11.400 with your kidneys you need to look into this when you take creatine your creatinine levels are going

00:35:15.580 to go up because like you have more creatine so you have more byproduct so how does this not mean

00:35:21.140 your kidneys are messed up yeah it's a false positive almost 99 out of 100 times so when you

00:35:27.720 take supplementation as you mentioned it goes into your demanding cells and when it gets utilized it

00:35:33.600 leaves the cell in the form of a metabolic byproduct called creatinine it's measured on all blood

00:35:39.860 requisition forms the doctor will check off something called creatinine and right below it

00:35:43.840 it has e gfr so that's estimated glomerulation filtration rate they use this to assess the health

00:35:51.600 of the kidney and so think of the kidney as a filter like a brita or a water filter it's filtering

00:35:57.760 things in the blood and what it doesn't like they leave the body so it should be filtering creatinine

00:36:04.320 therefore creatinine levels should not change however when you take supplementation creatinine

00:36:09.860 levels go up the kidney is still fine it's just those levels went up and when you happen to go to

00:36:15.160 your doctor when they measure it they're like whoa why is your creatinine so high and your e gfr so high

00:36:21.340 that means uh sorry your e gfr is lower that means you're not having a filtration through that so one of

00:36:28.080 the biggest things i tell people is that if you're taking creatine supplementation please tell your

00:36:32.560 nephrologist or gp that you're on it typically your creatinine levels in the blood are elevated that

00:36:38.200 does not necessarily mean you have any kidney issues yeah and the other issue too if you take creatine

00:36:44.360 you're also probably lifting weights and strenuous exercise can also raise creatinine levels which can

00:36:52.260 and dietary protein 100 yeah dietary protein and then also something else i've learned if you reduce

00:36:57.720 body fat if you're right have more lean mass your creatinine levels are going to be higher

00:37:02.180 that's right on a relative position that's correct yeah on a relative base so is there another test

00:37:07.440 you can take let's say your doctor freaks out because i've had this happen a few times like

00:37:10.760 your general practitioner are typically not you know they got so much going on they don't have enough

00:37:14.480 time to you know stay on top of the research on nutrition and in physiology so they see this elevated

00:37:21.080 creatinine level and you're like i'm fine they're like no we gotta we gotta send you to a

00:37:25.860 nephrologist is there another test you can take to show that your kidney function is okay and it

00:37:32.100 takes into account that you're supplementing with creatine yeah and there is there's one i believe

00:37:36.820 i'm pronouncing it right it's cystatin or cystatin c it's a new type of test that a lot of individuals

00:37:43.280 can ask their doctor to get and usually when that's done it doesn't consider the estimated error of

00:37:48.620 measurement in the the filtration rate or the amount of creatinine being filtered gotcha and then again

00:37:54.300 to the liver nothing shows that creatine negatively impacts liver function no only at super physiological

00:38:00.840 doses in the rodent model have we seen this but in humans no okay all right so overall creatine seems

00:38:06.680 to be safe it's not going to damage your kidneys but i have heard that if you have some kidney issues

00:38:12.460 maybe you got to talk to your doctor or nephrologist before you start supplementing with creatine

00:38:16.920 yeah a hundred percent since those organs are involved in the synthesis and or metabolism creatine

00:38:23.180 we always recommend that they consult their doctor before they're taking not not only creatine but any

00:38:28.840 other dietary supplement absolutely right and then bloating if you want to manage that just don't do the

00:38:34.220 loading phase does your body adapt if you take the lower dose every day does your body eventually just

00:38:39.640 adapt and you get back to normal you're not going to experience any of that water retention

00:38:42.940 yeah and that actually happens after the loading phase as well our body does adapt and the funny

00:38:48.800 thing is when we measure someone's weight before the study and after usually it's unchanged maybe

00:38:53.860 muscle mass went up and fat mass came down so typically it does subside after about seven to ten days

00:38:58.760 okay another thing people might have heard and i've seen this on the internet is that creatine can

00:39:04.720 increase dht levels yeah which you know increased dht levels can cause hair loss so for those who

00:39:12.120 aren't familiar what is dht and its connection to hair loss and where did this idea that creatine

00:39:17.080 plays a role in that come from yeah it's mind-boggling that this one study in south african rugby players

00:39:23.600 and dht is dihydroxy testosterone is derivative of testosterone linked to hair thinning or hair

00:39:30.940 follicle loss but this study simply looked at the loading phase for seven days in rugby players and the

00:39:37.700 hormone did go up compared to placebo but it was still within the physiological range like when you

00:39:42.640 go to the doctor and measure your blood glucose there's a low end and a high end and this hormone did

00:39:47.640 improve or increase in response to creatine but again it was in the physiological range they did not

00:39:53.780 measure hair thinning hair follicle loss no study has i believe there is one study now being done in the

00:40:00.220 south pacific starting to look at hair cross-sectional area but at the end of the day there's no evidence

00:40:05.280 to suggest that creatine has been linked directly to hair thinning or hair follicle loss i've assessed

00:40:11.240 over a thousand people and not one time as someone came to me and said hey darren whatever you're giving

00:40:16.000 me is causing my hair to fall out that's a subjective answer but again we have no empirical evidence to

00:40:22.200 suggest that it increases hair follicle loss or thinning okay so sounds like creatine pretty dang safe

00:40:27.920 from what we know so far absolutely and i mean we've looked at some studies two to five years in

00:40:34.000 duration at higher dosages and we're just not seeing any evidence that has greater adverse effects than

00:40:39.440 placebo that's good it's five that's a long-term study so that's yes it is yeah they're hard to do

00:40:44.420 um but uh we we did a two-year one which took almost a decade to finish um so kudos to those researchers who

00:40:51.080 can do these really long-term studies especially in humans who have a lot of things going on in their

00:40:54.880 life to stay in the study all right and so we've covered a lot of great stuff so i think you know

00:40:59.340 you've you've been interested about creatine supplementation we gave you some things to check

00:41:03.520 out the dosage creatine monohydrate and you're going to be good and you mentioned that where

00:41:09.500 research is going now is what creatine can do for young people right is that where you're kind of

00:41:14.720 yeah almost about anybody across their lifespan where you know just think of uh females we'd love 1.00

00:41:20.240 to know the effects during the premenopausal stages during the perimenopausal stages we just don't

00:41:25.380 know much there then of course postmenopausal stages and then look at young males as we're

00:41:30.160 going through the peak testosterone ages during the pre-andropause and then we get into old age

00:41:35.380 what about frailty and these you know your grandparents and that so i think it's something

00:41:40.260 in combination again with exercise i i use this analogy but like you know exercise is the cake

00:41:46.240 protein is the nice icing and creatine might be the sprinkles on top that allow you to eat it a little

00:41:51.180 bit better but at the end of it supplements give a small effect exercise has to be the driving force

00:41:57.760 behind anything from a healthy longevity perspective fantastic well darren this has been a great

00:42:01.880 conversation where can people go to learn more about your work yeah i think nowadays on instagram

00:42:06.420 at dr darren kando i try to produce and promote a lot of things not only creatine related but exercise

00:42:11.560 and health related so uh at dr darren kando on instagram fantastic well darren kando thanks for time

00:42:16.460 it's been a pleasure great thank you so much for having me my guest day was darren kando he's an

00:42:21.740 expert on creatine you can find him on instagram at dr darren kando also check out our show notes at

00:42:26.520 aom.is slash creatine where you find links to resources we delve deeper into this topic

00:42:30.440 well that wraps up another edition of the aom podcast make sure to check out our website at

00:42:41.840 artofmanly.com where you find our podcast archives as well as thousands of articles that we've written

00:42:45.560 over the years about pretty much anything you think of and if you haven't done so already i'd

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00:43:00.040 it's brett mckay remind you to listen to the podcast but put what you've heard into action

00:43:15.560 you

The Art of Manliness - September 18, 2024

The Safe, Effective Supplement That Can Improve Your Body and Brain

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