Transcription
Are we deficient in creatine?
There are small populations with, unfortunately, they were born with the inability to synthesize creatine. Uh, they would have a deficiency and they are required to take supplementation. The other unique population is vegans and vegetarians. So, a vegan and vegetarian diet is extremely healthy. The downfall, though, is they're not getting any dietary creatine because creatine is only found in animal-based flesh. So, red meat, seafood, and poultry. They're naturally synthesizing about one to two, maybe even three grams a day through amino acids in their food. But vegans and vegetarians respond literally the best on the planet because now they're taking in a supplement to allow that in.
And is it thought that historically we would naturally have consumed more creatine?
That's a good point. So, back, you know, hunter and gather age, a lot of meat, they were consuming quite a bit through dietary products. Just say if you only wanted to get three grams of creatine through food, you'd have to eat quite a bit of meat to do that. And then it comes into the dilemma of what if you don't eat meat or you just can't afford it.
Yeah, creatine has exploded over the recent, over the last couple of years. I, I saw a stat that said, I think in women, it had gone up to about 3% of women take creatine and, um, in men, it's slightly higher. It's still a little bit lower in terms of consumption in women from the stats that I saw. And I think that in part is because there's still some prevailing myths about creatine. When I, when I speak to some of my friends, people know that I interview a lot of, um, health experts and scientists and PhDs on that have done research on supplements. They ask me, the first question I get asked a lot is, "What other supplements should I definitely take?"
Yes.
And when I mention creatine, it's always met with a certain set of rebuttals because there are some prevailing myths.
You've got some myths?
Yes.
About creatine on the cards in front of you. Can you reveal one by one what they are?
So, this is definitely the number one myth. Creatine damages your kidneys. So, when you take in creatine to the body, it gets stored as creatine, but when you metabolize it, sort of, sort of thinking leaking from the muscle, it gets leaked out as creatinine. And most people watching, like, "Oh, that was on my blood requisition form." And right below creatinine was something called eGFR. So, glomerular filtration rate is an estimation of your kidney health. So, the problem is when individuals on creatine supplementation, they go to their doctor for their annual blood work, their creatinine might be a little bit elevated, and that's only from the breakdown of the, uh, the compound. And then, unfortunately, their filtration rate is lower. So, then their doctor gets really surprised and they're like, "Stop taking creatine because it's hurting your kidneys." What typically happens? They go back or stopping creatine and then they check their kidneys again, and it's fine. So, I would say 99 out of 100 times, uh, that it's a false positive. So, this is by far the biggest, uh, myth. And there's been randomized control trials for several years showing that creatine causes no detrimental effects to the kidneys.
I had exactly that twice on my blood test.
Yes. And if you're also, creatinine can be elevated if you're on a high meat diet, a little bit dehydrated. So, those that are exercising, uh, is very, very elevated. So, always tell your doctor you're on creatine supplementation because your creatinine could be a little bit higher.
Okay.
Yep. Myth number two, creatine makes you retain water. So, this is really important, and I think this is one of the main reasons females were really hesitant to take creatine. If you take too much too soon, it can lead to an increase in water retention. So, you've probably heard of the creatine loading phase. This is where supplement companies want you to take about 20 or 30 grams a day for about five or seven days. That has been shown to increase water retention acutely. So, maybe it'll reside there for about three to five days, but after that, when you go on a maintenance phase of about three to five grams a day, uh, that water retention goes away. So, in the initial stages, if done improperly or too much, it can cause a little bit of water retention. The good news for everybody watching is after about the first week, that water's inside our muscle. So, now we're volumizing the size of our muscle, sort of like a balloon here. It's full of water. Now, after a while, the water is now going into our muscle. It's a lot bigger compared to a deflated balloon or muscle that didn't have any water. So, creatine is osmotic. Water likes to follow creatine. So, by taking it into the muscle, it gets a lot bigger. And that's good because a swollen muscle stimulates protein synthesis to get bigger and stronger.
Oh, really? A swollen muscle stimulates protein synthesis?
Synthesis. Yeah. So, when you have water coming in, that's a really good thing. And creatine does that. And that's one of the main mechanisms why it works.
So, what does that mean? Does that mean that if I have creatine in my muscle, I'm more likely to gain muscle?
That is potentially the, the factor because when you're having or trapping water, it turns on all these signaling pathways that are involved in protein synthesis. And one of the biggest robust evidence is that creatine increases lean tissue mass and regional muscle thickness with weight training over time.
Oh, wow. Okay. Yeah. Because a lot of people are concerned that they're going to put on lots of weight and be bloated with creatine.
The interesting there is if you take smaller, more micro-dosing, there's hardly any effect. And this might come surprising, but if you did a six-week study pre and post after creatine, you only increase mass by .86 kg.
Oh, wow.
And the majority of that is lean mass. So, at the end of the day, you know, a pound and a half is not a lot.
Lean mass.
Lean mass. Yeah.
Which is...
We think of lean mass, most people think of it as muscle, but lean mass in our body, that includes water, connective tissue, organs, as well as skeletal muscle. And about 50% of our lean mass is muscle.
Okay. Yeah.
It's great.
Okay. Okay. Myth number three, creatine is only for men. Uh, this is 100% false. When you go through the totality of all the evidence, uh, females respond extremely robustly to creatine supplementation. They get profound benefits in strength, endurance, and performance. They lose a little bit of body fat. So, there's another idea that people thought water retention was causing an increase in in fat mass. We've done some meta-analyses now showing that creatine reduces fat mass. Uh, females get an increase in lean mass as well. Uh, and I'm happy this one came up because from our lab with bone health, females do respond very favorably with creatine and bone. And we can talk about that as well. Myth number four. Oh, I can't believe you did this one to me. Creatine causes hair loss. So, obviously looking at me and, uh, I'm a prolific creatine researcher and taking creatine religiously for like the last two and a half decades. People would look at me and say, "Well, obviously looking at him, creatine caused this." And I was going bald before I started taking creatine. This myth came from a study in rugby players decades ago, uh, where creatine, about 20 to 25 grams a day for seven days, increased a hormone called DHT. It's a precursor for testosterone, which unfortunately has been linked to hair follicle loss and thinning. Uh, but the ironic thing is when creatine was given to these young males, the hormone went up, but it was still within the biological range and no measure of hair follicle thinning or loss, uh, was done. The cool thing is just a few years ago, they decided to put this, uh, uh, theory to the test. And 5g in young males for about six to eight weeks of training caused no, uh, detrimental effect, uh, from hair thinning, foll. So, my appearance was probably based on something else. So, there's no evidence to that as well. Myth number five, creatine causes muscle cramps. No, I think this is so overplayed. When creatine is taken into the body and water will follow it, now you're super hydrating the muscle. So, one of the main issues with muscle cramps is it could be, you know, uh, uh, dehydration in the muscle. Some people have heard of sodium potassium. That's why Gatorade was invented. But if anything, sodium decreases muscle cramps and it super hydrates. So, in the hotter environments, June, July, August, creatine is going to be one of your best friends. So, those are the five myths. We talked there about weight training. What is this very curious graph? It seems to show that creatine helped gain muscle mass through a training regime.
Oh yes. So, this is actually showing now that, uh, when you take creatine supplementation, you're actually getting an improvement in training volume. So, when you go in the weight room, you look at the load you're lifting by the reps by the sets. So, it actually goes up. Um, and then when you don't, obviously, it would go down over time as well. So, the cool thing here is that one of the main reasons you get an enhancement in performance is that creatine seems to enhance training capacity. So, a lot of people say, "I've taken creatine, now I got an increase in the number of reps or, uh, sets that I can perform." That probably leads to a stimulation over time.
So, this is an 8-week study?
That is an 8-week study, very short-term as well. Also, you can see that the number of weeks came, uh, down when they weren't taking creatine and then when they started to take it, it went up as well. And this leads to another important point. So, and it's often not talked about. When you take creatine for at least a month, people say, "Well, how long does it stay in my muscles? If I go on vacation, what if I can't take creatine?" And in skeletal muscle, it takes about a month for those elevated levels to come back down. In the brain, we don't have a lot of evidence, but it's speculated it takes about anywhere between five, uh, weeks to about three months for those elevations to come back down.
And this essentially means that if I take creatine, I will be able to train harder?
Harder or longer or more frequent. So, one of the things with creatine, it allows the muscle to recover quicker. So, you might be able to get back to the, uh, you know, if an athlete's training twice a day. Um, so either one of those seems to be one of the most plausible mechanisms. And why is there a big dip in the middle of this graph?
So, that is actually showing where the individuals would train and then without creatine and then take it over time as well.
Oh, okay. So, they'd, they'd stop.
It's a training and then taking it again. Correct.
Okay. So, they start taking it?
Uh, taking it at, at week four, and then that's where the elevations go up.
Oh.
Yeah. So, it goes to show that when you have creatine, everything is elevated. If you stop taking it, it takes about four weeks to come back down. But you'll notice that it was at the same level as a placebo. And then when they take it again, they get a rebound effect. So, I think this has application for people who have injured themselves and they now need to go back and start training. If you take creatine, it can accelerate the rehabilitation program.
And it does it, I guess, because it makes your training volume increase?
Correct.
It makes your muscle mass gain increase?
It can gain increase in muscle mass. It's not great. That's probably going to be a bit surprising to a lot of people. A lot of people take creatine for huge increases in muscle. You get an increase in lean mass by about 1.2, 2 kg. But as I, I said previously, remember, only half of that is skeletal muscle. So, creatine, yes, can with weight training improve muscle mass, but it has more robust evidence for muscle performance.
Is there anything else we need to know about creatine's link to muscle mass?
I think one of the big things is that it decreases something called protein breakdown. So, that might allow the muscle to maintain its integrity or recover quicker. Uh, but overall, when you combine creatine with a standard weight training program, you should expect a greater increase than weight training alone. Absolutely. And that is, that's across all ages, which is really important.
Okay. And the studies you've done in your own lab, what are those? How wide varying are those and how many have you done?
We've, oh god, we've done at least 30 to 40 studies, um, in our lab. I've published over 120 papers just on creatine alone. Wow. And the interesting thing is that from young individuals to middle age to older adults, we see a very common, uh, theme that combined with weight training, uh, creatine, about 5 grams or more, uh, we use typically a little bit more, seems to have, uh, beneficial effects on muscle mass, uh, muscle strength, as well as performance. Absolutely.
Can you show me what 5 grams looks like?
Absolutely. So, this would be a standard 5-gram dose.
Which is one scoop, really.
One scoop. Now, keep in mind that can be found in, in meat or seafood, but you're going to require a lot.
Yeah.
Okay. So, 5 grams is one scoop.
One scoop.
And you're saying we don't necessarily need to do this loading phase that bodybuilders would?
Correct. So, the loading phase is the most rapid way to saturate your muscles. Now, that's very beneficial, but that would be four scoops. So, four scoops is a loading phase per day, and it's very effective. But the issue is, can it cause some adverse GI tract irritation, things like that? That's where anidoli people report that. But a lot of people, from a muscle perspective, will start with just five grams a day, and that's very beneficial.
And at five grams a day, what benefits am I getting?
Five, oh, across from a skeletal muscle perspective, you get a whole plethora. So, you definitely get an increase in lean tissue mass or muscle size, uh, and then again, muscle performance, uh, muscle strength, power, and endurance. And the other one that never gets a lot of press, which should, is function, functional ability. An older adult to sit to stand. Uh, this has applications getting off the toilet, out of the bed, out of a car. So, as we get older, we're losing muscle strength and performance, as well as functionality. And creatine and weight training seems to come to the rescue there.
And is there anyone that shouldn't take creatine?
You know, I can't find anybody that can't or shouldn't. The safety profile is exceptional. If they have pre-existing medical conditions, they definitely need to speak to their doctor. Uh, besides that, I'm not seeing any reason a healthy individual can't take or shouldn't take creatine.
And pregnant women?
So, that's an interesting, uh, colleague of mine, Dr. Stacy Eller of Australia, is now finally looking at human, uh, trials with pregnancy, going into breast milk, into, uh, the fetus. So, it's still in its infancy. The jury is still out, but as it currently stands, it seems to be relatively safe and well-tolerated.
Okay. So, not all creatine is made the same?
Right. Correct.
There's lots of different types of creatine. People, some people take creatine gummies. Um, I mean, I have some different types of creatine here. Creatine monohydrate, creatine hydrochloride.
Okay.
I remember looking when I was on a shelf a couple of months ago and seeing like five or six different types of creatine.
Um, what is the, the optimal type of creatine to take and why?
So, by far, creatine monohydrate. And that goes against all the new marketing forms. So, creatine monohydrate is simply creatine linked to one water molecule. When you take it into the body, the water molecule dissolves. It is identical to, uh, what's being produced in the liver and the brain. All the evidence that you ever hear about the safety and efficacy of creatine is based on the old, boring from 1832, creatine monohydrate. There's new market forms of creatine such as hydrochloride, which does have evidence behind it. There's many other forms, but the only downfall with all these market forms is it's never been shown to be safer or more effective than creatine monohydrate. The other big thing for your viewers is make sure it has Creapure or some form of creatine monohydrate on, uh, the label. And then, and that it's also third-party tested.
Creapure?
Creapure is from Germany. It has the highest, um, standard of qualification and, um, scrutiny. And then NSF certified or another third-party certified. So, those are the three things that I personally would look for. Monohydrate, Creapure is the type, and then NSF certified or third-party certification.
Which is that little logo at the bottom?
That little logo here at the bottom. That's right. What does that mean? So, NSF is the National Sanitation Foundation. It's a third-party organization that will independently take the, the supplement and then third-party test it. And then you get a certificate of analysis to make sure there's no, uh, contaminants like lead or arsenic or things like that. So, that's something for the consumers watching to definitely be aware of when you go to, uh, the store.
And we've got this, uh, thing here in front of us. This is the dosing dilemma.
Um, we talked about muscle there.
Have we checked muscle off, or is there anything else to cover?
No. So, how many scoops do you think is optimal for skeletal muscle?
Oh, uh, skeletal muscle?
Yeah. Your bicep, your tricep, you know, Arnold Schwarzenegger.
Five. Five grams.
Five grams. So, that's only going to be one little scoop.
Okay.
Okay. That's probably very viable. And you're correct. Across the lifespan, five grams has been shown to be effective. But here's a little bit of a caveat. If you're over the age of 50, maybe you want to have a little bit more because as we get older, the creatine in our lower legs is more jeopardized and therefore you might need a bit more.
Okay.
Okay. This is without the loading phase. So, this is if you just want to take a little bit per day.
And do you have to take it consistently?
Good question. So, ideally, yes. There is evidence that you can just take it on the training days, but we haven't talked about the brain yet. And the reason why I think you should take it every day is it likes to go to other tissues on a daily basis.
So, that's about seven grams? How?
That's about seven or eight grams, and that seems to be a very safe and viable, uh, dose to be shown to be effective for improving muscle mass.
Okay.
And performance.
I, I do have, um, an issue sometimes when I take a little bit more creatine, which is I feel, I wouldn't say loaded, but I get a little bit dizzy almost.
100%.
What is that?
So, there is a mechanism. So, creatine is the biggest methyl scavenger in the body. And without boring your viewers, but methyl groups are used for everything. They're also used to synthesize something called adrenaline and our neurotransmitters. You know, the things that we get excited about. So, when you take in too much creatine, typically on an empty stomach or in a dehydrated state, that will spare methyl groups in the body to be used because you're taking so much in. And then it says, "Where can I go?" So, since creatine is now being taken into a supplement, these methyl groups are available in your body to go elsewhere to do work. And they like to synthesize adrenaline. And that's why you feel more, uh, um, energetic, so to speak.
When you say synthesize adrenaline, what does that mean?
Yeah, that means you're creating more of the hormone called epinephrine. And that, you know, you hear about fight or flight, or you're nervous, or whichever it is, it gives you a little bit more of that. So, that's why sometimes you feel a little bit jittery or things like that.
Yeah. Yeah. Sometimes I can feel a little bit sick as well if I do too much.
Yeah. And so that's where it's sort of the new area of interest for me is this micro-dosing based on that. So, we're starting to see some evidence now that if you take smaller amounts all throughout the day, it does not have any adverse effects. If anything, it seems to be a little bit more tolerable. Um, so you could take a few grams in the morning, a few grams in the evening, or whichever. I think one of the best, uh, ways to take it that never gets any press is I put five grams in my water bottle during my workout.
Mhm.
And so now I'm consuming a little bit of creatine as I do my weight lifting or cardio, and then I'll consume a little bit in the morning as well. So, I take about 10 grams a day at minimum on on a daily basis. Other people will take more or less, but that's just how I get it in.
Yeah.
I find that if I do take a little bit in the morning and then a little bit later, it's much better.
100%.
I don't get any weird feelings.
That's correct. And, uh, it seems to be more consistent and appreciated for individuals because if you do or are susceptible to any fluctuations in weight gain, water retention, or GI tract irritation, those seem to to definitely go away. And we've, god, we've assessed over a thousand individuals in my lab, and that seems to be a very viable approach. Not a lot of taste to it, is there?
It's not the best tasting.
It's very bland, very boring. Um, but there's other companies trying to make it more flavorful, things like that. The cool thing is with creatine, you can put it in anything. You can put it in yogurt, uh, uh, a juice, whichever it is. You can now put it in coffee. There's a little bit of controversy over the dose of caffeine. I think anywhere lower than 350 milligrams is fine, and that's going to be most standard, uh, coffees or teas as well. So, whichever allows you to become consistent is is a great way to do it.
Yeah.
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