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In this last video, I talked about some reasons to consider supplementation with creatine after the age of 50. And judging from a lot of the comments, it looks like many of you in your 50s, 60s, and 70s are already using it. But there's been a lot of talk online lately about mega dosing with creatine. Not just taking the standard 3 to five grams that most of us know about, but people taking 10, 20, 30, and sometimes even 40 g of creatine per day. And what's interesting is that they're not talking about it from the standpoint of muscle building. They're talking about it for memory, for brain fog, for pushing through fatigue, and surviving on very little sleep.
Now, I'm an ER doctor with a background in fitness and weight management, beriatric medicine as it's called. So, I've seen creatine from a few different angles. I've read the research. I've seen what people are doing in the real world. I also began using creatine in the late 90s participating in Bill Phillips body for life program. So I have a perspective which comes from that background. So in this video I want to talk about what mega dosing creatine actually means, why people are trying it, what the research shows so far, um, the potential risk or downsides of meggaosing, and then I'll give you my thoughts on whether I think it's worth it or not.
But first let me clarify the terminology. When you hear megga dosing, some people are actually talking about the creatine loading phase where you take 20 grams of creatine a day, usually split into four doses or so, for about 5 to 7 days with a goal of saturating your skeletal muscle with creatine quickly. Now, after that, most people drop down to around 3 to 5 g per day as a maintenance dose. That's the typical fitness and bodybuilding approach to taking creatine. That's been around for decades and it's been studied a lot. But when I say mega dosing in this video, what I'm really talking about are people who are taking 20 or 30 grams of creatine every single day and sometimes even more. Not just for a week, but for weeks or months at a time. And that's the type of creatine dosing that's getting a lot of attention online, especially for brain benefits and combating fatigue.
So, why would anyone take that much creatine? Well, here are the big reasons that are being touted. Number one, brain health and optimization. About 95% of creatine is stored in our skeletal muscle, but our brains also store creatine as well. The body makes about a gram of creatine daily. That's not very much, but the body obviously prizes creatine enough to produce it or it wouldn't make it at all. So, supplemental creatine gives your brain something it already craves and thrives on. But with mega dosing, what creatine doesn't get consumed by our skeletal muscle becomes available as an energy buffer for the brain. Using creatine to function more efficiently from an energy standpoint, just like the muscles do. And there are small studies suggesting that creatine supplementation can help with memory, cognitive function, especially in people who are sleep deprived or in vegans and vegetarians who start off with lower creatine levels to begin with. And there are lots of people, particularly online, reporting increases in mental clarity and sharpness, typically taking doses in the range of 15 to 25 grams of creatine per day. And though uptake of creatine to the brain tends to be somewhat slower than uptake to the muscles, many people report they're noticeably mentally sharper fairly quickly after increasing creatine doses to the 10 or 15 gram range and sometimes higher.
Now, number two, fatigue and sleep deprivation. While there's no massive large-scale trials, a study in 2006 found that individuals who took 20 grams of creatine per day for a week before 24 hours of sleep deprivation, it helped preserve reaction time, memory, mood, and balance. And a more recent study in scientific reports, a single high dose of creatine, .35 g per kilogram, that would be about 27 g of creatine for a 175 lb man taken during sleep deprivation actually improved working memory and processing speed for up to 9 hours. So there's real data linking these higher creatine doses to mental resilience under stress and with sleep deprivation. We're talking about faster reaction times, less mental fatigue, things like that. So, if you're somebody who struggles with shift work or you work long nights, you can see why this might get your attention. I'm an ER doctor in a setting where we do 24-hour shifts. So, I'm following this closely for obvious reasons. Creatine has been studied in traumatic brain injury, Parkinson's disease, even depression. The results are mixed. Some studies are really promising and others show little benefit. But the theory is if you can give brain cells more energy reserve, you may be able to protect them under stress.
And lastly, number four, this is the more must be better mindset. This is what we see in fitness and supplement culture all the time. If five grams of creatine works, then 20 grams should work better, right? Well, not always. Because for muscle and strength, studies show that once your muscles are saturated with creatine, taking more creatine doesn't necessarily do anything extra for you. 5 g per day will get most people there from the standpoint of muscle saturation. 20 grams a day long-term is just overkill where the muscles are concerned. For the brain, the picture's a little more mixed. Some studies have used higher doses like 10 to 20 grams per day and showed improvement in things like working memory and reaction time especially in people under stress or those who start out with low creatine levels such as vegans or vegetarians. But other studies have shown minimal to no benefit. And it's important to point out that most of these brain studies are short-term to begin with. We don't have long-term safety data on people taking 20 or 30 grams of creatine every single day for years.
So, what are the experts saying about all this? Dr. Peter Attia, who lives here in Austin, he's the author of Outlive: The Science and Art of Longevity. He's talked about creatine as one of the few supplements he recommends across the board, not just for athletes, but for longevity. He doesn't push or encourage mega doses. He generally stays in that five gram maintenance range for maintenance of strength and overall muscle preservation as we age. Andrew Huberman, a Stanford University neuroscientist and host of the Huberman Lab, has spoken about creatine on his podcast, particularly around the cognitive benefits, highlighting research showing improvements in mental performance under sleep deprivation. He's been an advocate for more of a weight-based approach to creatine supplementation. And in fact, Huberman says he takes 10 grams of creatine per day himself. He weighs about 220 lbs and he feels 10 grams of creatine is kind of the sweet spot for his particular weight. And he says if you weigh between 180 to 250 lbs, you should probably be taking about 10 g of creatine per day. Whereas if you weigh less than 185 lbs, 5 g or even 3 g of creatine per day may be sufficient. He feels like the adage that 5 g of creatine is ideal for everyone just doesn't live up to the scientific literature. Dr. Louisa Nicola, a neurophysiologist from Australia, believes that to get the best cognitive results from creatine that 15 to 20 gram per day is warranted. She didn't originally think this and she was in the lower dose camp like a lot of other people, but she ended up changing her view on dosing. She points out that patients who have already suffered some type of brain or neurologic insult such as a stroke or for people who are struggling with Alzheimer's or some form of dementia and have lost a significant number of neurons due to a pathologic process such as Alzheimer's or a stroke, often losing millions of brain cells, they're already neurologically stressed and the brain consequently needs a greater amount of energy just to perform tasks that may have once been done with ease. So, in general, she recommends women take 15 to 20 grams of creatine per day. And for men, she's recommending 18 to 20 grams per day. And then there's Dr. Gabrielle Lyon, the author of Forever Strong, a new science-based strategy for aging well. Dr. Lyon really emphasizes muscle as the organ of longevity. She's very pro-creatine, especially for older adults, because of its role in maintaining muscle mass, strength, and physical independence. But her focus is on practical evidence-based dosing. She typically recommends the standard 3 to five grams per day, sometimes slightly higher depending on the individual, but she doesn't talk about or recommend these ongoing 20 to 30 gram protocols at all. Then there's Dr. Ben Bickman. He's a metabolic scientist and physiology professor at Brigham Young University, and he researches insulin and metabolism. Dr. Bickman has also spoken positively about creatine, especially for muscle preservation as we age, but he leans more on everyday sustainable use and not pushing higher doses of creatine.
So when we look across this particular group of experts from Attia to Huberman to Nicola, Lyon and Bickman, though they vary in their reasoning to a degree, three points are congruent among all of them. And that's the fact that number one, creatine is felt to be very safe. And number two, most people likely don't get enough of it in their diet alone. And consequently, number three, supplementation with creatine is not only reasonable, but something that makes a lot of sense as a tool for healthy aging and longevity. But the vast amount of research on creatine and the doses most studied have been the typical 3 to 5 grams per day. The mega dosing side of things is still more experimental with a lot less data behind it and the long-term benefits or any significant problems with it are yet to be borne out. So, we're just going to have to wait and see.
So, side effects and risk. Relatively speaking, creatine is felt to be very safe as a supplement for healthy adults in general and specifically from the standpoint of maintaining muscle as we age into our 50s, 60s, 70s and beyond. At higher doses, the most common issues are generally gastrointestinal in nature. Bloating, cramping, diarrhea. Not usually dangerous, but not a heck of a lot of fun either. But here's something that can happen as a risk in the ER or it can happen in various clinical settings as well. And it's not insignificant. And I'm talking about lab interpretation. When you take supplemental creatine, your body breaks it down into creatinine, which is the most common marker that we use to measure kidney function. So, if you're taking mega doses of creatine, your blood work may look like your kidneys aren't functioning well, even if they're perfectly fine. And that can cause confusion, especially if you're on other medications that happen to affect the kidney. In fact, if you're being seen in the ER for an episode of food poisoning, chest pain, abdominal pain, or any condition where blood is being drawn, and your labs come back showing that your creatinine level is high, no one is going to want to send you home, and you could find yourself being admitted to the hospital to figure out what the heck's going on. When in reality, your kidneys may be just fine. So, one of the risks of meggaosing or supplementing with creatine in general is the real potential for creatine to muddy the waters where interpretation of your kidney status is concerned and leading to unnecessary hospital admission and a potentially expensive medical workup. One possible remedy to this is something called cystatin C. It's a filtration biomarker test that's now being used in some clinical settings as an alternative to looking at creatinine levels. And it can give some clarity as to whether kidney malfunction is present. But unfortunately, as of 2019, only about 7% of all US clinical laboratories have the ability to do that type of testing and the availability is still relatively limited. So for now, measuring creatinine as well as something called EGFR remains the primary way most doctors evaluate kidney function.
So what does this all mean to you? Practically speaking, it just means this. If you're being sent by your doctor for lab work or you happen to find yourself in the ER for a medical issue, you need to let people know that you're supplementing with creatine and especially if you're taking higher than normal doses so that your lab work can be interpreted through an accurate lens of what's going on. Multiple comments on this last video make it very clear that many people don't believe doctors have much knowledge regarding sports supplementation. And the reality is maybe that's true. So unfortunately, if you're going to supplement with creatine, you're in the driver's seat, and it's important for you to understand how creatine affects the picture it may create with your lab work in a medical environment, particularly where your kidney numbers are concerned.
So, is mega dosing creatine worth it? For muscle strength, I'd have to say no. You're not going to get more muscle benefit by megaosing once your muscles are saturated. For the brain, maybe. There's some interesting research, especially in sleep deprivation and possibly in older adults, but it's inconsistent and it's not enough yet to say that this should be routine for all of us. For most of us in our 50s, 60s, 70s, and even older, sticking with 3 to 5 g per day isn't unreasonable. That transfers proven benefits, better strength and power, and muscle preservation as we age. And that's where 99% of the evidence lies at this point in time. If someone really wants to experiment with higher doses, I'd suggest keeping closer to what's actually been studied, like 10 to 20 grams per day short term and not 40 grams indefinitely. Split the dose into smaller amounts to reduce stomach upset and GI issues. Stay well hydrated and see a doctor if you're on multiple medications or have health issues before trying this. Big picture, mega dosing creatine is interesting, but it's still experimental. It may or may not be the magic bullet that some online conversations make it sound like, but it's one of those topics that's getting a lot of attention because of some very promising and hopeful findings.
If you've heard about megaosing creatine or maybe you've even tried it yourself, I'd love to hear about your experience. Drop a comment below. And if you missed this last video covering a little history about creatine, check it out. Thanks for watching and please share this video with someone you feel would benefit from watching it as well. Be well and I will see you in the next video.
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