Dynamic Dialogue with Danny Matranga - 257: Creatine. What, why, how. What YOU *need* to Know.

Episode Date: January 23, 2023

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it is that you're doing in life. I like to make sure that I'm recovering well and prepped for hard workouts. I like to make sure that my cognition is sharp and I like to make sure that I'm doing what I can to maintain my long-term health. And cold water immersion is a phenomenal tool I use and have used for a while to help me do this. Cold water immersion or taking ice baths is a great way to improve your recovery and performance. Just a few short sessions a week can really make a difference in how you recover. It can increase and improve your heart rate variability. It can enhance performance. It improves mood and brain function. It also provides an awesome boost of

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affordable way to do it reliably. You can head over to icebarrel.com slash Danny to take advantage of their 100% satisfaction guaranteed with again, a 30 day money back guarantee and save 125 bucks on your ice barrel using the promo code Danny. So again, icebarrel.com slash Danny and check out using the promo code Danny to save 125 bucks. This podcast has some awesome partners. And one of my favorite, of course, is Legion Athletics. Legion is my go-to supplement manufacturer for what I like to call my big rock supplements. This would be my protein powder, my pre-training formula, my post-training formula, and creatine, and my kind of ancillary vitamins and micronutrient protection. and my kind of ancillary vitamins and micronutrient protection. So why do I like Legion so much? What sets them apart? It's quite simple. Legion uses all natural ingredients. All the formulas include

natural coloring and natural sweeteners, no artificial sweeteners, just stevia. And every single formulation, be it a pre-workout or a vitamin contains clinically effective dosages of ingredients shown to work in humans in clinical research supported by robust trials. formulation, be it a pre-workout or a vitamin, contains clinically effective dosages of ingredients shown to work in humans in clinical research supported by robust trials. No filler, just legit ingredients in each and every formulation proven to work. The whey protein isolate is so light. It's fantastic. It mixes in water. It tastes amazing. And I drink it every day, even as somebody who's lactose intolerant. That's just how high quality this whey protein is. And it's sourced from Irish dairy cows that are raised well, eat their natural diet and packaged in climate friendly packaging. I love their plant protein too. For those of you

who like something that's a little on the thicker side and you aren't a fan of animal products. Also, I love Legion's pre-workout, but specifically the pre-workout that does not contain caffeine. That would be their Stem Free Pulse. I'm a huge, huge fan of beta alanine and L-citrulline, but I don't like taking in wildly high amounts of caffeine. So if you are somebody who likes pre-workout with caffeine, you can try Pulse. Or if you like it without caffeine, because you maybe want to enjoy your morning coffee or monitor your caffeine consumption, try the Pulse Stim Free. My favorite flavors there for sure are the new grape and the amazing, amazing tropical punch.

As for my creatine, I get that from Legion's Recharge. Five grams each and every day. I take it on the days I train as well as the days I do not because Recharge also contains L-carnitine, which can help with promoting muscle recovery and decreasing soreness, as well as some ingredients to help with creatine utilization. And of course, my favorite supplements for my ancillary micronutrient health are Legion's Multivitamin and Legion's Greens Powder. Not only do these two products contain a ton of high quality vitamins and minerals. They also contain unique adaptogens like KSM 66 ashwagandha and reishi mushroom, which I like to take each and every

day to promote my health. If you want to cover all your bases with a high quality protein, creatine post-workout or the ancillary micronutrient health stuff like greens, powders, and multivitamin, I encourage you to go over to legionathletics.com and check out using the promo code Danny. That'll save you 20% on your first order and you'll rack up points that you can use the same way as cash every time you use the code and you'll also be supporting the show. Welcome in everybody to another episode of the Dynamic Dialogue podcast. As always, I'm your host, Danny Matranga. And in this episode, we're going to be discussing creatine monohydrate, how to supplement with creatine monohydrate,

what you can expect from creatine monohydrate supplementation, various other forms of creatine and whether they may or may not be worth supplementing with, the pros, cons, ups and downsides of creatine supplementation, the health ramifications, everything that you would ever want to or need to know about creatine is covered in this special episode. I wanted this episode to serve as a reference. Anytime I'm asked about creatine supplementation, I wanted to have a podcast to refer that person to. So if you've wanted to know about creatine or you want to share something specific about creatine, a resource or a reference, something that would encourage the supplementation, I should say the thoughtful and mindful supplementation of creatine, this is an episode

to share. This is a two-part episode, first in which I'm going to be discussing my rationalization for creatine supplementation as a 10-year, 10-year fitness professional. And the second half will be an interview I'm doing with Dr. Darren Kandrow, who I believe to be the kind of predominant, predominant, preeminent? Predominant expert on creatine in the field. So sit back, enjoy this episode. I think you'll find you learn quite a bit from both first and the back half. And I hope this serves as a reference to you and being an informed consumer when it comes to supplements, but creatine specifically. Welcome in everybody to another episode of the Dynamic Dialogue Podcast. As always, I am your host, Coach Danny Matranga, and today's episode is going to focus on creatine. Now, I know what you're probably

thinking. I already know everything about creatine, or I know how it works, or I'm already taking it. And for most of you, you might be very familiar with it. But when I sit down to go through the questions that I field on my Instagram for these Q&As, I would say somewhere between 5% and 10% of those questions are related to creatine supplementation, probably more so than any other questions. The only questions that get anywhere close are those that pertain to things like reverse dieting or questions about body recomposition, particularly building muscle while simultaneously losing fat. Those are all really popular topics, but none more so than creatine.

So I figured I'd sit down and record an episode outlining what creatine is, how it works, why it's worth supplementing for healthy adults who wanna optimize performance, body composition, et cetera, and then also answer some of those more common creatine-related questions at the end. So for those of you who are not already taking creatine, consider this your creatine masterclass. And for those of you who already are, there's still going to be a lot to learn and we'll have a great conversation. So settle in and enjoy this episode about creatine monohydrate.

So guys, before we dive into kind of our breakdown of everything here with creatine, I want to first do a little bit of housekeeping. So currently in the middle of launching my coaching company at this point, my online coaching roster is close to being full, which is an absolute blessing, something I'm so grateful for. And I want to continue helping people, particularly with the methods that I put together over the last 10 years of coaching clients, either in person or online. And to do that, I had to grow and scale this business. So I am launching my new coaching company. It will be coming very soon. Core Coaching Method is going to be the name, borrowing from some other people in the industry

who I think have done very well. But again, the name Core is going to kind of fundamentally revolve around health-focused coaching that is still going to be very much aligned with whatever it is you want to accomplish with your performance, your aesthetics, whether you're just gen pop and you want to lose a little weight,

get in shape for vacation, whatever it may be, leading with health, but putting together some very nuanced, intelligent programming and nutrition coaching that supports people all around the world. And I've just gotten to a place now with the roster of clients who I have that I love working with that I want to continue to give those people my best. And of course, I will still be working with new clients because not everybody sticks around forever. That's part of why they sign up because they want to reach their goals faster. But I will be bringing on other coaches, people who I've

either worked with directly as somebody who maybe at one point in their career was a mentor, coaches who I know very, very well, who do a very good job, whose name I would or whose product I would put my name on. So this is going to be really exciting. And this is coming to you guys very soon. I'm actually finalizing some things on the new website, which I plan on launching hopefully by July. That's why the mentorship has been on hold. I just had to put that on the back burner for now. And then I think the mentorship will launch as part of the core coaching method brand. And hopefully that will be a pathway for more coaches to come and work with us and help us with our goal of helping as many people live life to the fullest through health and

fitness as possible. And lastly, guys, if you want to support the show, if you want to support me and what I'm doing, you can just head over to www.coachedannymetringa.com. Check out the free guides, check out the articles, maybe even check out the programs or online coaching that I offer there. That's the best way to directly support a kind of breakdown discussion of creatine and how it can help you with your gains. So first, let's talk about what is creatine, right? So creatine is a naturally occurring substance that you can find in muscle cells, right? It helps our muscles produce energy when we lift and we do intense activity, whether that's things like sprinting, even lifting weights, things that are of moderate intensity are going to use creatine as well. And supplemental creatine is quite popular, particularly in the performance enhancement space, particularly in

the athletic space, because it does help with, and we'll get to some of these effects down the road when we talk about the effects, but it does help with performance outcomes. You can buy it at almost any supplement store and it is non-hormonal, right? So it's not that it has steroid-like effects, but it does have performance-enhancing effects without the common performance-enhancing drug side effects or illegalities, right? So creatine is totally safe, totally legal. It is an organic amino acid derivative that our body will naturally make from glycine and arginine. I've heard methionine thrown in there as well, but it really depends on who you talk to. But our body can make a lot of it. The problem is we don't necessarily make enough when we're super active and we don't eat a ton of red meat, right? So how much creatine

we store can depend on how much muscle we have, things like genetics, things like testosterone, a lot of different things play a role. But the more active you are, right, the more you might need. And about 95% of the creatine in the body is actually stored in skeletal muscle tissue, which is really, really cool. And then a little bit is actually in our brain, which we'll talk about a little bit more in a minute, because there might be some neuroprotective benefits of creatine supplementation, but lots of cool stuff. And how it works is our body uses creatine to help recycle ATP, the body's energy currency, more quickly. And there are a lot of things that happen with regards to

water retention and muscular strength. We'll talk more about that. But you want to think about creatine as something that helps you produce a little more juice in the gym by virtue of helping you regenerate and recycle ATP. So how does creatine improve athletic performance? Well, there's a few ways, right? The first one I mentioned, and it has to do with enhancing our ability to regenerate ATP. And this in the long run is going to help us produce or create more work per unit of time because we'll just have a little bit more juice. However, creatine has also been associated with rises in hormones like IGF-1 or insulin-like growth factor, which is also beneficial for muscle growth.

And it's been shown to increase satellite cell signaling, which can help with things like growing new muscle tissue or repairing damaged muscle tissue. It also, and this is one of the main side effects that you will hear, will increase hydration of the main side effects that you will hear, will increase hydration of the actual muscle cell. And that is called cell volumization. And so the cell volumization effect that creatine has on muscle tissue really helps us hold more water in our muscle. And that in and of itself might play a role in how our muscles grow. Something else that's interesting is creatine might have a role in minimizing muscle protein breakdown or excessive protein breakdown associated

with perhaps inadequate nutrition paired with intense training, right? So if you train really hard and you don't get adequate carbohydrate intake and adequate protein intake, you might have excessive muscle protein breakdown. But that's far from ideal. And one of the things that can help buffer against that are hormones like insulin or IGF-1, but creatine might also help with that as well. So there's a lot of really cool things that creatine does for the body. But the main thing is it gives us the fuel we need to train hard, gives us a little bit more fuel in our muscle tissue, and might have some positive interactions with the endocrine system.

Let's say that positive for gains, okay? And that's all well and good. And I think that I have seen plenty of healthy men and healthy women take creatine with zero to no side effects. The most common one I've seen as a coach is digestive distress that I would sign off on it for anybody who's healthy and says, hey, I want to improve my performance. I want to take something that's going to help me train harder, work a little bit more in the gym, get a little bit more muscular, get a little bit more leaner. And we'll talk about in a minute some of the applications or populations that it might be particularly beneficial for. But that's really the gist of what creatine does, right? So

we know it impacts your muscle gains and your strength and your performance with a variety of different types of exercises. But something else that's really cool is supplemental creatine has been shown to potentially help with cognitive health as well as just generally helping your brain. Like I mentioned, 5% of the creatine that you store in your body is not stored in your muscles. Some of it's stored in the kidneys, some of it's stored in the liver, and some of it is stored in the brain. But supplemental creatine has been shown in research to be beneficial or potentially improve the following conditions. Alzheimer's disease, Parkinson's, Huntington's, epilepsy, stroke, motor neuron disease,

memory and brain function in older adults. So it can even just help with general cognitive ability by helping with memory and brain functioning in older adults. And that is a really cool side effect for, or I shouldn't say side effect, that's a really, really cool side effect for, or I shouldn't say side effect, that's a really, really cool potential application for this, right? Like we know that older individuals deal with sarcopenia, which is excessive muscle protein breakdown, usually due to sedentary lifestyles

and inactivity. But we also know that as people age, it's not uncommon for them to deal with some form of, let's just call it cognitive slowing, and potentially might see some negative implications regarding memory. Those things might get harder as people age. And that's not saying that, oh, every old person is getting Alzheimer's. It's absolutely untrue. And it's not that old people just lose brain cells or become less quick. Oftentimes, just things don't fire as quickly. That being said, creatine has application for that specific population in that specific mentality, right?

Like, okay, could you recommend it to a healthy older adult who wanted to enhance the properties of their mind? They want to improve their memory and their brain function? Quite possibly. Could you also recommend it to that same person because it would help them maintain their muscle mass? Quite possibly, right? So we think about creatine as being a supplement that is ideal for younger people in the gym looking to gain weight and get big, right? Because of that water retention effect that everybody loves to talk about when it comes to creatine. And again, we'll talk more about this

in a minute. We talk about application, but we're also talking about a population of individuals who might not be resistance training at all and might still benefit from supplemental creatine in the same way that they might benefit from taking a fish oil or a multivitamin and just exposing their body to this additional creatine, which might be quite effective at helping them age better. So creatine, of course, is a potent performance enhancing supplement, and it should be looked at as such. That is, it's probably best application. And a lot of what I've talked about with regards to the cognitive stuff is still relatively novel, and you could call it speculative at this point. But I would still argue that we want to begin to shift the

discussion about creatine as an industry. If you're a fitness professional, right? Listening, if you're an enthusiast, it doesn't matter. You're just choosing whether or not you can take creatine. Like that's fine. But if you're a trainer, we should make an effort as an industry to move the discussion about creatine away from just, you know, Hey, this is how it'll help you perform well in the gym towards, Hey, these are some of the potential health benefits of taking creatine for those who potentially do not even exercise that much or that rigorously. So it's not just for young dudes looking to get jacked. And that's something that we'll hear about a lot. Hey guys, just wanted to take a quick second to say thanks so much for listening to the podcast.

just wanted to take a quick second to say thanks so much for listening to the podcast. And if you're finding value, it would mean the world to me if you would share it on your social media. Simply screenshot whatever platform you're listening to and share the episode to your Instagram story or share it to Facebook. But be sure to tag me so I can say thanks and we can chat it up about what you liked and how I can continue to improve. Thanks so much for supporting the podcast and enjoy the rest of the episode. Lastly, some of the other areas where we've seen creatine play a role or where we can see creatine interacting is with regards to blood sugar, right? I mentioned that it has an effect on IGF-1, right? Which again, insulin-like growth factor. Those are things that are not too dissimilar, but it does have an effect on lowering blood sugar levels, which is wonderful. And also it can improve muscle quality in older adults, as well as treating non-fatty liver disease.

And so all pretty interesting things. When it comes to selecting creatine and creatine dosages, there are a variety of different types of creatine on the market. Cre-alkalin, creatine hydrochloride, creatine magnapower. There have been countless iterations of creatine over the years that supplement companies have made by taking a creatine molecule and trying to bind it to something else. So creatine magnipower was creatine bound to a magnesium chelate, if I remember correctly. And crealkalin was alkalinized creatine. And creatine HCl was creatine bound to a hydrochloride. And so what you ended up with were these different forms of creatine. But what we know from looking at the literature is that none of those forms of

creatine outperform the kind of tried and true gold standard, old school, unsexy creatine monohydrate, which one has more literature surrounding its support than any of the designer forms. And two is quite a bit less expensive to take. The price per dosage is a fraction of the price per dosage of all of the designer creatines I mentioned. And in the research, it's been shown to be very effective. Now, when people start taking creatine, we're going to just, again, we'll use the example of somebody who wants to improve performance. They're often recommended, and this is usually from the actual label of the product, they're often recommended to and this is usually from the actual label of the product, they're

often recommended to do what is called loading. And loading creatine is usually taking between 15 to 20 grams up front for about a week. Some people say three to four days. I've seen seven to 10 days. I would say probably you're going to land somewhere around seven days. And taking 20 grams of creatine split up into multiple servings, right? So you're going to drink that multiple times a day, maybe five grams here, five grams there until you get to 20 grams for about a week. And the thought process here is

that you're going to reach that maximally saturated level of creatine more quickly through loading than you would if you were just taking a maintenance dose of two to five grams a day. Now, somebody who I respect a ton in our space is Alan Aragon, one of my favorite nutrition researchers. If you guys don't follow Alan's work, I strongly recommend that you do. He knows a lot more about nutrition than I do, and he's a really intelligent human being, and I think he puts out a lot of nuanced content. And about five years ago, I was at a seminar in San Diego with Alan Aragon, Brett Schoenfeld, and Brett Contreras. And Alan was giving a discussion about the impact of loading versus not loading creatine. And what he said that he found in looking through the

research is you just read saturation a little bit more slowly when you do not load, and looking through the research is you just read saturation a little bit more slowly when you do not load, but you still read saturation nevertheless. And for me, like I mentioned earlier, the number one thing that I have noticed with my clients who have begun taking creatine, the only side effect that seems to show up with any degree of consistency is digestive distress. And I think a lot of that has to do with the loading phase and trying to, you know, leverage, you know, 20 grams of creatine in your favor when you haven't been supplementing with it at all. And one of the known potentially negative impacts is digestive distress. 20 grams a day is a lot to start with. And so I think by just starting with a maintenance dose and giving

yourself about, you know, two to four weeks for that to become fully saturated, for your body to become fully saturated, might minimize the likelihood of digestive distress, or even just trying to load creatine at a lower dose. So if we know that, and this is again, very unscientific, but if we know that 20 grams a day, we can reach saturation in about a week. Maybe we could assume that at 10 grams a day, we might reach saturation in about a week. Maybe we could assume that at 10 grams a day, we might reach saturation by two weeks, maybe a little more, maybe a little less. And at five grams a day, it might take four weeks, maybe a little bit more, maybe a little bit less. So that's what I would say. And again, very unscientific, I would recommend if you feel like you have had experience with creatine and digestive sensitivity, I would not recommend

a 20 gram a day loading phase or even 10. I would just say start with two to five grams a day and load it up slowly, build your saturation slowly. And that's what I do for my clients. I've never really had many, if any clients do a full blown 20 gram a day loading phase. I just think that in most instances, we have the time we need to allow creatine saturation to occur. I have heard that, and I have heard this from multiple different people who I trust, and the literature seems to support it as well, that if we're talking about when exactly the best time to take creatine is, it's probably going to be with a meal around training. And the reason I mentioned that is because insulin has the ability to help get creatine into cells more quickly.

And you will usually get an insulin bump from a meal that's rich in carbohydrate or protein, particularly dairy protein. And so if you wanted to optimize that window, and we know that our body is slightly more sensitive around that training window, and we know that our body is slightly more sensitive around that training window, and we know that our body might absorb it better in the presence of insulin, we can then go, okay, what if we had this around the workout, right, in that workout window, but with a food that might be insulinemic or help us produce insulin. So that could be our pre-workout meal or our post-workout meal. And so what I tend to recommend clients do is take their creatine after they finish training with their post-workout meal

or their post-workout shake, or just drink it when you're leaving the gym. And that way, when you go into your next meal, you have some circulating creatine, that insulin spike or insulin bump, if you will, will likely help with the absorption there. And so that's all really, really simple stuff, right? When to take creatine around your workout. If you want to really optimize it, probably with a meal, how much to take for most people. If time is not an issue and efficacy, you know, being equated, you know, we know what's going to be as effective at the end of the day, whether we start with loading 10, 20 or five grams, we know that at some point we're going to reach saturation and there's going to be diminishing marginal returns. Taking more isn't going to be any better.

I would say start with 5 grams a day and try to position that around your training with a meal. Not rocket science, right? And again, creatine has a lot, a lot of research supporting its efficacy. I'm not a doctor. You shouldn't listen to me about anything, right? of research supporting its efficacy. I'm not a doctor. You shouldn't listen to me about anything, right? But there are a lot of long-term studies showing that creatine is very safe to take. Now,

there are also some rumors going around that creatine might cause baldness because it somehow interacts with DHT. And I just have not seen this. I have no reason to believe that there's any validity to this. I think that you might, gosh, I might be wrong, but there might've been a study done that associated rugby players or lifters with supplement who supplemented creatine with increased likelihood of male pattern baldness. But I don't even know if that study looked to parse out whether these individuals were taking anabolic steroids, which do many of which do convert to DHT and do expedite hair loss. The other thing is, most of your, you know, like conventional male pattern baldness is going to be determined by your genetics. So if you have the genetic predisposition to lose your hair, maybe creatine would speed that along, maybe not. But if you don't have the genetic predisposition, I wouldn't

worry about it. And a lot of times I'll hear women going, oh, if I take creatine, am I going to go bald? Like, that's one of the many questions I get. And I can understand why a woman might be a little bit more concerned about that than perhaps a man would. Not that hair loss for anybody is a particularly fun thing to experience. I digress. But I just, I don't have any reason to believe that that's true. And I've seen a lot of intelligent people kind of step out and say, hey, not enough research here to draw a definitive line. And anecdotally speaking, we can't really say that it's particularly likely to cause baldness because we just don't seem to see people start taking creatine and their hair

magically falls out. Some people just have a tendency to lose their hair. So let's talk about populations or applications for who I think would be well versus taking creatine. Number one, anybody looking to build muscle or optimize performance should be taking supplemental creatine if they're healthy. That's my honest opinion. Population two, anybody who plays a sport competitively should be taking creatine, in my opinion. It will help you perform well. And having saturated creatine stores is not particularly expensive.

It's a very affordable supplement to take. And it's been proven to improve multiple different athletic metrics. So athletes, for sure. Anybody looking to improve their body composition, for sure. People who are trying to lose body fat. I'm often asked, well, if creatine helps you build muscle and it helps you get big, should I take it when I'm cutting? And my answer is absolutely, because remember, it has a protein sparing effect, and that's very beneficial when you're in a calorie

deficit. It will help you maintain muscle. It also has those positive benefits with regards to its interaction with things like IGF-1, its ability to get into your cells and help you lift a little bit more, help you lift a little bit more, help you push a little bit harder might be nice when food is at a premium. So that's another population that I absolutely recommend it for. And then that last little piece that we talked about, and again, it's more speculative, is just older adults who maybe they're fitness enthusiasts, maybe they're not, but older adults who want to stave off the potential deleterious impact of muscle loss by supplementing with creatine. And definitely, I think there's reason to be excited about the potential impact it might have as a neuroprotective agent, as something that protects the brain,

helps the brain, and interacts with the brain. So I would say that speculatively healthy older adults who lift or do not lift might also benefit from taking creatine. So that's a pretty robust list, right? We're talking about people across a variety of spectrums with a variety of different goals who could benefit from taking supplemental creatine. And the creatine that I take every day is Legion's Recharge. It has a couple other things added to it to help with absorption and just general muscle recovery, which I like because I want to get the absolute most out of my supplement experience. And again, if you're looking for ways you can support the show, guys, you can just head over to legionathletics.com, order your creatine there, use the code DANNY, save 20% on your order and get double points. And that helps support the show. So guys, that will do it for today's kind of creatine breakdown episode. I really appreciate you guys listening and supporting the podcast.

If you have not already, do me a favor and head on over to the iTunes store and just go ahead and leave me a five star rating or review. That's how more people find the podcast or do something even simpler, like share it to your Instagram story so that more people can see it. Because even though a lot of you probably have a very good handle on the nuances of how creatine works, and you maybe even have been taking it for quite some time, I think that a lot of people still have a lot of questions. And then special shout out to Rudy Maurer, who wrote a wonderful article on Healthline about creatine. And that's where I got a lot of the information that I shared with you guys today. And I even looked through some of the references and I must

say my man did a wonderful job. So you guys enjoy the rest of your day, have a wonderful week and stay tuned for the next episode. What's going on guys, Coach Danny here taking a break from the episode to tell you about my coaching company, Core Coaching Method, and more specifically, our one-on-one fully tailored online coaching program. My online coaching program has kind of been the flagship for Core Coaching Method for a while. Of course, we do have PDF programming and we have app-based programming. But if you want a truly tailored one-on-one experience with a coach like myself or a member of my coaching team, someone who is certified, somebody who has

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you. If you're a regular listener or somebody who gets value out of this podcast, somebody who's learning from me on your health and fitness journey, whether you're a trainer, a high-level athlete, or you're just getting started, other people need this kind of advice. And the best way for you to help me grow the podcast is to take a little bit of time, literally one to two minutes max, to leave a rating and review on the app that you listen to your podcasts on. The majority of you probably listen on an iPhone and you probably listen on Apple podcasts, but many of you listen on Spotify. Both platforms allow you to leave a quick, easy review. And if you could leave me a five-star review plus a short one to two sentence blurb

about what you like, not only will it help more people reach the podcast, it will help me to continue to refine what it is I bring you each and every week. Thanks so much for doing this. It means the world to me. It helps me achieve my dream of helping more people live a healthier life. Enjoy the episode. Hey guys, taking a break from the action to tell you about one of our favorite new sponsors, Underdog Fantasy. If you're like me, you love sports. Sports was actually how I got into fitness in the first place. And one of my favorite things to do when I'm not working out or working with my clients is watch and engage in sports with my friends. Underdog is the best fantasy sports app out there for best ball and for pick them. If you like football, basketball, baseball, hockey, soccer, WNBA, UFC, boxing, Underdog has something exciting for you. You can

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danny and they will match your first deposit up to $100. You'll have a blast playing underdog all season long. Back to the action. Welcome in, everybody, to another episode of the Dynamic Dialogue podcast. As always, I'm your host, Danny Matrenga, and today I'll be sitting down with Dr. Darren Kandao from the University of Regina in Canada, and we will be discussing all things creatine. Dr. Kandao specializes in sports science research, specifically sports nutrition research, and he is my go-to resource when it comes to all things creatine monohydrate and resistance training. He's produced over 87 peer-referenced publications in high-quality journals, and is a very, very well-respected

researcher specifically on the topic of creatine and creatine monohydrate, which is why I brought him on today so we can go through and work through all the questions you guys ask me. Whether it's, is creatine safe for women? Is creatine effective for hair loss? How much should I take depending on my body size? Can it affect my sleep, water retention? Every question you have ever asked me about creatine is getting answered on this episode today. So sit back and relax and enjoy my discussion today with Dr. Darren Kandow. Okay, guys, I'm joined today by Dr. Darren Kandow. We're going to talk quite a bit about creatine. He's somebody that I came across very recently when I was perusing some of the

creatine info space. And I found a really good podcast that he did where he answered a ton of questions. And I said immediately, I need to talk to this guy because there are so many questions I get from you guys, from listeners, from social media about creatine, from the most basic questions to stuff that is way outside of my area of expertise. And I want to kind of shed some light on this because I do think it's a supplement worth taking for most populations, but you always want to be careful. And Darren really seems like the guy when it comes to unpacking this and communicating the science in a way that's easy to understand. So Darren, before we get into the creatine, if you wouldn't mind, give everybody kind of a primer on how you

got into the field of sports science and nutrition. Yeah, well, first off, thanks for having me. And it was kind of by accident. I took an undergrad cell biology degree at a university in Eastern Canada, and I thought it was fascinating, but I just happened to luck into taking an undergrad exercise physiology class. And at about the same time, I started to lift weights and exercise more vigorously. And things just sort of came together from a visual perspective. And at about the same time, I started to lift weights and exercise more vigorously. And things just sort of came together from a visual perspective. And you start to learn about this compound called phosphocreatine and how it's really important for increasing potentially energy status of the cell, allowing an individual to potentially exercise longer. And sure enough,

I started to supplement with this product when I was 18. And I sure noticed gains. I sort of got bigger, stronger, and actually faster. And then it's taken on its whole life. My entire career for the last two decades has primarily involved researching the misgenic compound. I got very fortunate in my graduate work to work on creatine during my PhD. And we focused on older adults because we thought that was a population that may benefit with overcoming some of the negative consequences of aging, specifically muscle and bone loss. And ever since then, I mean, we've published, I don't know, 70 or 80 studies now just on creatine. And ironically, as we'll talk about today, I'm sure

there's still so many myths and misconceptions and in fact, lies about creatine that it's a bit ironic in a sense. There's over a thousand studies published, but a lot of the public still are misinformed or they're getting information that's not true. And so hopefully today we can provide a little bit of context and focus on evidence-based research moving forward. I'd love to do just that. I think you kind of nailed it for a supplement that has such a robust body of literature. I often compare it to something like omega-3, which has quite a robust body of literature as well, but there seems to be substantially more fear-mongering and misinformation associated with creatine supplementation.

Then I think perhaps the first reason for that is that at a fundamental level, people don't understand what creatine is. Because it is a performance enhancer, people assume that maybe this is a performance-enhancing drug or a steroid or some type of compound that might augment my physiology in a way that's likely to cause some pretty serious negative impacts. So I think the first and most obvious question is, just at a simple biological level, what the heck is creatine? Why does it help sports performance?

Yeah, and it's an excellent place to start. So you're right. Creatine is not a steroid, but people thought it had steroid properties because it was seeing the work in the majority of people. They'd say, Hey, I can get stronger. I put on muscle mass, I lost fat mass. So let's do the one-on-one cold nose version. Creatine is naturally synthesized in all of us. It's naturally synthesized from three amino acids you get from food products in the kidneys and liver. And we're producing about two grams a day on average. If you're on a high red meat or seafood diet, you're maybe producing or synthesizing or intaking a bit more.

And we simply excrete about two grams in our urine per day. So if it's two grams being synthesized, two grams is treated, there's a nice equal balance. being synthesized, two grams is treated, there's a nice equal balance. And you can live healthy and exercise quite easily, just on normal biological synthesis and breakdown. But what sort of blossomed in the 1990s, or sorry, 1992 specifically, is when the first study came out saying if you take in about 10 times as much creatine as we naturally synthesize. This is familiar to a lot of people called the creatine loading phase or 20 grams a day. It seemed to maximize the amount of storing capacity in our muscle. So therefore we maximize this high energy phosphate compound in our muscle. And I should preface this, the interesting thing with creatine, 95% is stored in our muscle,

but our muscle does not make it. So it has to be created or ingested through a supplement, travel in our bloodstream and get access into our muscle. And once it's in our muscle, it's trapped. It becomes very, very difficult to leave. And therefore we get all the magic. And so if you take in this loading phase or in times as much as we naturally produce, it was leading to phenomenal gains in muscle mass,

strength, power, endurance, people's recovery went up. And if you look at the basic physiology, it kind of made sense. It allows the cell to have a higher energy status. It decreases inflammation and oxidative stress. So the athlete or exercising individual, when you would ask them, how do they feel? They say, I feel phenomenal. I can exercise at a higher intensity. I do more work and therefore I can recover, allowing me to get back in the gym, on the field, whichever it is. So creatine is just naturally synthesized from three amino acids, arginine, glycine and methionine.

Or what's more popular is when people go buy a commercially manufactured product, it's easy to digest. There's no adverse effects if you take that at a recommended level. And again, ever since 1992, there's a thousand studies potentially published and the totality, the vast majority of evidence says it's very effective for the majority of individuals consuming it. It's perfect. So I think it's a nice segue into question two, one of the more common questions I'm asked. And again, speaking specifically to the commercialization of creatine, most of the literatures on creatine monohydrate, but that is not the only form of creatine. There

are multiple different forms of what people call designer creatine. And many of these creatine analogs are marketed as being more efficient or somehow safer or somehow more effective. From what you understand, is there any reason to take any of the designer creatines over the more prevalent and commonly studied? Because you're talking about the body of literature, which is mostly on creatine monohydrate. Is there any reason at all to bother with these designer forms if you're a consumer? There's absolutely no reason to ingest any designer purported form of creatine. And I'll sort of try to put this into a nice context. Creatine monohydrate is a creatine molecule linked to water. It's identical to the ones we naturally synthesize. And when you consume

creatine monohydrate, the water molecule just simply dissolves in our GI tract. So the creatine molecule is identical. When you have all these other purported brands of creatine, and I really want to preface this for your listeners, please make sure it actually contains the creatine molecule. If it doesn't, it's never going to raise your blood creatine levels. And then subsequently it will never get in the muscle, the doorway or transporter in the muscle. It's very, very specific, just like the lock and key idea to your house to creatine. So first off the compound that they're purported or marketed has to have creatine, but just because something gets in the blood quicker quicker doesn't necessarily mean it gets

into the muscle and leads to it. So there's been a couple of studies that have looked at other forms of creatine, such as creatine salts. It may get in the blood quicker, but it's never been shown to be more effective than monohydrate. Monohydrate bioavailability, that means getting into the blood and being taken up by the target tissue is near 100% anyway, even in the powder form. So I argue, I know monohydrate has been around forever. It's kind of boring because it's true or tried and tested, but why mess with a good thing? If it works, it has no adverse effects. Why not stick with it? So we only use monohydrate in the lab. I think all my colleagues would only recommend monohydrate in the lab. I think all my colleagues would only recommend monohydrate. If you're considering creatine, please only recommend or consider

creatine monohydrate and make sure it's in the powder form. The speculation on liquid or beverages has not been supported. The stability of creatine in liquid is very questionable. I've not come across any literature to say that the creatine molecule stays intact. If anything, it could be degraded in the GI tract. So mix your powder in food or water or whichever it is. If you don't like the solubility, you can heat the solution a little bit. Some people like to consume it with fruit juice or whichever. That's fine.

Again, there's a lot of ways to consume it. And again, the safety profile is second to none. Yeah, I think that's a great point too. That's the direction the literature points. That's what the people who are the most initiated and understand it the best are using. I do think that just as consumers, we go, but this is so cheap. I can get a ton of it for very low out-of-pocket expense. The more expensive stuff must be better, right? These designer forms of creatine, they must be more effective. They're newer, they're more expensive. And I think that's just how the supplement industry works. If they can nickel and dime you and take you for a ride, they're going to do just that. But with regards to dosing, a lot of these designer creatines, they tout, uh, you know,

reduced dosing criteria. You don't need to take as much for them to be effective, but we know that those are kind of bogus. So focusing then on the dosing of monohydrate, uh, it is popular to load creatine taking up to 20 grams a day, but do you need to do that to eventually reach a point where it's effective? Because I think for some people that's quite a lot to take in a day, or it's an intimidating amount to think about taking.

Can you get the benefits without loading? And if so, does it take longer? Yeah. And so this is probably one of the most important things we'll talk about today. There's in general three strategies with creatine. So as we talked about the creatine loading, that's where you take five grams a day for about four times a day for five to seven days. In other words, 20 grams a day for seven days. That was the method that was shown in 1992. And again, in 1996, to be extremely effective.

The downfall with this is this is where you hear some people say I have GI tract irritation, bloating or water retention. So again, creatine loading is really effective for increasing creatine stores in the muscle, but also very effective for increasing muscle mass and strength. That's typically a strategy used for individuals, athletes competing in a petition that's upcoming, they really need a maximal boost. I think the other strategies which we employ, and I think if the average individual is looking for health or exercise benefits, there's two other strategies that seem to not result in any adverse effects.

And this is very applicable to females. The one that we use a lot in our lab is based on the size of the individual. So we use it based on kilograms, and it's 0.1 gram per kilogram. So again, 0.1 gram of creatine per kilogram. So if I go on the scale and I'm 80 kilograms, I get eight grams a day. If a female goes on the scale and they're only 50 kilograms, they're getting five grams a day and so on. And this is based on the idea that the larger the person is, the more creatine transporters or doorways they have so they can utilize more or less. Sure. Very intuitive. Makes a ton of sense. Very similar to caffeine based on milligrams per kilogram or protein. And so we like that one

because we've shown multiple times across the entire lifespan that that relative dosing is very effective and safe. It has no adverse effects on the liver, kidney, or blood. And is this a loading dose or is this a long-term maintenance dose? Yeah, this is without a loading phase. This is start from day one. You just take in, it's probably roughly a half a teaspoon, nothing that's crazy or takes a calculator. You just kind of estimate as as you go and the the interesting thing is maybe after three months you weigh yourself again and if you've increased mass you could probably increase the amount of creatine or vice versa sure so that one's you

know you start right at the gate no problem um and so again on the supplement bottles you're ignoring their recommendation um but there's a high amount of evidence to support that third one is what we consider the lowest effective dose. And this is three grams a day right out of the gate, no loading phase that will accumulate in your muscles by about 30 days. Three grams a day is a quarter of a teaspoon, you would hardly ever notice it. If you start taking three grams a day, research has shown that over 28 days, it'll maximize your muscle stores. And then again, if you take that continuously, you'll maintain or get the extra boost from what we're achieving. So those seem to be the three general recommendations. If you combine all three,

excluding the loading phase, this is where the general recommendation of five grams a day comes. Five grams a day is two grams excreted, add in the minimal amount of three. In addition, that gives you five. Therefore we say, Hey, if you're looking for health benefits, and this is, I want to preface this, this is primarily from muscle. Five grams a day seems to be very effective. We don't see the effects on bone or a consensus on brain health at that low of a dose. So we might talk about this a little bit later for older adults. In my opinion, we may need more as we get older. And I can talk about why I think that is, but for the average person, three to five grams a day is a really viable safe effective strategy and the other cool thing for females listening is very difficult to keep females in a research study when we do a

creatine loading phase primarily because during the rapid creatine loading phase that can drag a lot of water into storing in the body and on average, anywhere between one to three kilograms of mass can go up and females specifically, and obviously males too, but the rapid weight gain in our experience has caused a lot of individuals to withdraw. The nice thing with doing a really, really small dose, hardly get any water retention that's noticeable. And then a lot of individuals can't adhere to it. You do want the water retention that actually unlocks all the magic of creatine. So if someone says, oh, creatine only leads to water retention, high five them. You're saying absolutely right. And then when the cell in the muscle will swell, that causes an increase in a whole cascade of

things, transcription factors, satellite cells. And that's one of the reasons you get bigger, stronger, leaner muscle. And of course, there is some evidence that if muscle goes up, your fat mass will actually go down as well. So even bodybuilders competing should never stop taking creatine. It increases intracellular water, not extracellular over time. Well, I think that's kind of the big one is specifically for women. Water retention is something that they're very familiar with because of the hormonal differences between men and women. Women tend to be more susceptible to volatility with regards to water retention, especially if they're in that age where they're menstruating. They see these water fluctuations change almost like clockwork every single month. And so adding to that is very intimidating. But from what I'm

understanding, it sounds like most of the water retention is going to be inside of the muscle tissue. It's not going to be subcutaneous. It's not just going to go to your face or to your belly. And that's the mechanism by which it works. And if you're particularly conservative with, I do not want to experience much water retention, I want to experience the minimum amount possible. Then you would start at that three gram a day dosage and then just kind of play it by ear from there. Does that sound pretty spot on? Yeah, it's a hundred percent correct. And you're right. It's during the follicular phase and then luteal phase. And so the water and body water, net body with, with creatine. And, and the

other cool thing is we've talked about creatine already, and we'll talk about the importance of resistance training. There's very minimal research that creatine by itself, like a Flintstone vitamin is effective. It can be, but resistance training kind of unlocks the potential. And if this metabolite allows male or female to exercise at a higher intensity inevitably they can put on lean tissue decrease body fat get stronger for functionality later on in life and there's evidence that creatine can actually increase thermogenesis or energy expenditure and again another side thing with the dosing is what we found is if the dose per recommendation three five eight grams whatever it is is too much the cool thing with creatine it accumulates in the body so maybe you

can reduce that to multiple small dosages a day like if you're taking five grams there's no reason you can't take two grams with breakfast maybe two and a half grams post exercise uh caffeine's different it sort of hits you all at once, but creatine accumulates. And again, if you want to split it up into multiple frequent dosages, there's no plausible explanation why that shouldn't be beneficial over time.

Maybe a big bolus dose of two gram shot at once, you're not going to absorb and you might excrete a lot in the urine. So we actually think smaller, more frequent dosages are the way to go. It's going to have a minimal effect, if any, on GI tract for those who are susceptible to IBS or something like that. I think that's spot on. And just anecdotally, from what I've seen working with clients, if in fact there are some gastrointestinal issues, which is rare. I'd say that's 10 to 15% of individuals who I've seen start supplementing with creatine. Going to a smaller dose or spreading

that dosage out across the day almost seems to eliminate that with a high degree of efficiency. A question though, before we segue out of this, because I think we really hit on something interesting, which is creatine metabolism and these water retention impacts seem to be somewhat acute, but the performance benefits aren't as acute. I've had many people say, hey, I've been taking creatine for a week and I don't notice any difference. And you gave a 28-day figure where you said after about 28 days, you've reached a saturation point or a point at which you can say like, Hey, I'm good to go. And you know, unless you're doing 20 grams, you might not see something after seven days. So creatine supplementation isn't going to lead to acute performance

enhancement. You have to reach a certain point is what I'm kind of getting here. Yeah. Yeah. As it accumulates in the muscle specifically, you're probably going to eventually notice an increase in muscle mass and strength. The one that we see almost right off the bat is an increase in recovery. The body or the person says, geez, I don't feel as sore or I have a lot more energy to get back. So all these things accumulate over time, but it can happen as little as potentially three to four weeks, depending on the dosage. And then we'll probably talk about timing. happen as little as potentially three to four weeks, depending on the dosage. Um, and, and then we'll probably talk about, uh, timing, but for those who say, geez, I'm taking creatine and I

don't really notice anything. There is something called a non-responder to creatine supplementation. Yeah. Um, and we kind of have this mythological maximum amount of creatine storage in our muscle. Of course, it'd be remiss if a 350 pound lineman has the same storing capacity as myself. So that's a little bit of a gray area. But in theory, if you're consuming a lot of red meat on a daily basis, you're probably not going to respond the same way as a vegan or vegetarian. So if you're already getting dietary creatine through red meat, already getting dietary creatine through red meat, seafood on a daily basis, you may not get the same response to supplementation where vegans and older adults seem to respond very well based on some of the physiological or habitual dietary patterns. I like that. And I do want to talk specifically

about populations here in a second, but just to kind of circle the wagons here and tie up this kind of 101. I love this, but the timing, is there an ideal timing for creatine supplementation for athletes or just in general for somebody looking to reap the benefits? Some of the literature that I've seen would lead me to believe that if you can do it around your training, you've got probably a small chance for a slightly better uptake. Is that true? Or does it really just boil down to taking it every day? Yeah. So I'll sort of do a double-edged sword here. So I agree with you that in close proximity to training before, during, or after consuming creatine has never been shown to be detrimental, but if anything, it's a viable strategy to increase muscle mass and performance. They've also looked at creatine in the morning or evening on the days individuals work out and they get the same benefits. So one interesting thought

was does the creatine or timing creatine really matter? And the totality of evidence suggests it does not. Now I need to preface this a little bit. If you take creatine in the morning, before training, during training, after training, before going to bed, the key there is that they've exercised. Stimulus to the body usually lasts for muscle synthesis anyway, at a young age of 24 hours and that study in 1992 simply showed that if you do muscle contractions and consume creatine in combination the muscle contractions sort of increase blood flow or they sensitize the muscle to take in more creatine and that's where this timing really came into play but when we look at all the evidence comparing studies that looked at

creatine before versus after training or in the morning or evening, you get the same benefits. The ironic thing is there hardly has been any studies that have looked at the timing of creatine in relation to a placebo. In the one study that did, and we performed this in older adults, creatine before or after was identical. There was no difference. However, in the group who took creatine just after their weight training sessions, they did get a greater increase in muscle mass compared to placebo. So that's the only line of evidence that we have that post-exercise creatine may give you a small

greater effect over just resistance training alone. Gotcha. When you bring it all together, it doesn't really matter when you consume creatine, just take it and make sure you work out. Very, very, very concise. And one last point here, you hit on something that really popped, which is if in fact contraction of the tissue is what helps with kind of stimulating or sensitizing the muscle to uptake creatine. Is it sensible to take it on the days you don't train? Is there a threshold of activity that somebody needs to kind of hit in order for it to be effective? How might one reconcile that?

That's an excellent question. So in older adults, older adults actually still get the same benefits or some benefits on just taking creatine on the days they work out. Hence going back to this muscle contraction idea. In young individuals and older individuals, we see equal benefits by taking creatine on your non-training days. So you get benefits from both, but I would probably encourage people to take it on their off days for a couple of reasons. We now know that creatine has phenomenal benefits on indices of cognition and brain health and recovery. And by taking creatine on non-training days, that still you may get other health benefits. So it's another strategy to make sure you're getting enough in the diet and or in the muscle. It's another strategy to make sure you're getting enough in the diet and or in the muscle.

But for those who say financially, they don't want to take supplements or whatever other reason, you will get benefits on the days that you train. It'll just take you a bit longer. Perfect. I think it's a nice transition into the cognitive benefits, which has kind of exploded within the last one to two years. I've been pretty familiar with this for a surprisingly long amount of time because my dad has Parkinson's disease. And when I started bodybuilding recreationally, I started taking supplemental creatine and doing all of the research in the world because there's so much misinformation and fear-mongering. I wanted to make sure that I was doing my due diligence.

And somewhere along the line, I found that there were different groups doing studies, seeing if in fact creatine could have any impact on Parkinson's disease. And I know the research there is mixed, but I asked myself, why is anybody doing research on this? How is it at all possible that this bodybuilding supplement could be impacting a neurological, what is effectively a form of cognitive decline that impacts the motor centers of your brain. How is this possible? And then fast forward a couple of years, I start hearing people talking about creatine being able to affect acute cognition and long-term brain health. And it appears that as much of a role as creatine plays in our muscular system, it does play a

small role in our neurological system. So in what ways does creatine interface with the brain? How long have we known about this relationship? It's a very promising body of evidence. And one of the main reasons I'm so passionate about recommending creatine supplementation is, you know, it's obvious that it does quite a bit for your skeletal muscle tissue, but this might be one of the best and most promising lines of supplement literature that we're kind of heading down now. Yeah, a hundred percent agree. It was kind of lost in translation. If you were the first paper that looking at creatine and brain accumulation was in the late 1990s as well but we were all focused on bigger stronger faster from the neck down and if COVID has taught

us anything the mental health impact that something can cause in addition to other traumatic things going on in the world the neck up has become more probably popular and probably more important. Most people would argue. Sure. In regards to, you know, just like our muscle and bone cells, sure enough, our brain cells rely on creatine for energy. And if the cells in the brain rely on creatine for energy during times of stress, so think of sleep deprivation, depression, anxiety, all these neurodegenerative diseases, you mentioned Huntington's, Parkinson's, MS.

And then of course, we talk about concussion and mild traumatic brain injury. So the big emergence, and we just published a paper a month ago on a big review on creatine and brain health. And it seems to have the most momentum and rightfully so. And as it stands right now, the brain is a bit unique. Our muscles like to take in creatine because they don't make it. Well, the brain says, whoa, we're a bit different. We actually like to make our own creatine. So we don't really want supplementation and there's parts of the brain that are very resistant.

So the theory with concussion, mild traumatic brain injury, or these neurodegenerative diseases is that it may require higher dosages of supplementation to accumulate and longer periods of time. But just like our muscle cells, our brain cells use creatine for energy. And what we're seeing is creatine really decreases inflammation and oxidative stress in many parts of the brain. Wow. So our big area coming up is on concussion. Can creatine decrease the prevalence of concussion and or speed up recovery? And that would have massive implications worldwide. But we're also looking at the effects on depression. Can the energetic status of the brain potentially offset some of the impacts of depression so for last 20 years it's been the neck down looking at and now we're focusing on a neck up you combine the two and it's a whole body um what i would consider now a health ingredient it used to be

just for athletes but now it's more of a health compound hey guys just wanted to take a quick second to say thanks so much for listening to the podcast. And if you're finding value, it would mean the world to me if you would share it on your social media. Simply screenshot whatever platform you're listening to and share the episode to your Instagram story or share it to Facebook. But be sure to tag me so I can say thanks and we can chat it up about what you liked and how I can continue to improve. Thanks so much for supporting the podcast and enjoy the rest of the episode. It's such a good point. Like when I was introduced to creatine, it was as a pure performance enhancing agent, which most of those agents are actually deleterious to the overall health of the organism in many ways. Like, you know, there are

trade-offs like you're like, okay, I know this is going to improve performance and I will deal with whatever the negative health implications may or may not be. And with creatine, it's like, okay, this is something that you can take for less than a dollar a day that might help with your long-term muscularity, performance, and metabolic health. Oh, and by the way, it also might be the single most affordable neurological enhancing neuroprotective agent that we know of. And we're just starting to scratch the surface. I remember I went to a sports science symposium, like maybe four years ago, five years ago at this time, uh, everything's blurred post pandemic.

Like it could have been 10 years ago. It could have been three years ago. Um, but there was a woman from UC Davis talking about the utilization of omega-3 and creatine for treatment of traumatic brain injury and concussion. And I was like, concussion? And I was like, what can this not do? And since that point, the literature has really exploded. You brought up depression, you brought up anxiety. I've even seen things that say creatine can acutely improve cognition. So if somebody says, I'm taking creatine, you had me sold on it when we were talking about muscularity, let alone what it can do for your brain. Do those dosage recommendations change if you're taking it to get the cognitive benefits? Do they stay the same?

If you're only interested in the cognitive benefits, does it matter? Because you kind of mentioned that the brain likes to create and synthesize its own creatine. It's not maybe as susceptible to supplemental. Yeah, no, those are excellent segues. We have a study right now or a paper in review on creatine and memory. And once it gets accepted, I can divulge. But anyway, it has promise. And I think the easiest way to look at it is I think if someone is going to orally

ingest creatine, just take a dose that'll eventually accumulate in the tissues and you will get the benefits. And for someone saying, I'm just, I just want the brain benefits. I need to take a high dose. Well, you're still going to get the muscle benefits as well. The difference becomes to the individual who does not exercise. Gotcha. There's minimal, minimal evidence that creatine will improve indices of muscle performance without exercise. Gotcha. But there is theory that obviously exercise may not be needed to get brain health benefits. So I think an average dose of five, even a little bit higher per day will eventually accumulate in all those areas. to five, even a little bit higher per day will eventually accumulate in all those areas.

And it's something you can take on a daily basis, mix it in yogurt, take it with water, whatever. And it just becomes easy. I think we, for the last, probably a decade ago with protein, we were getting very scientific about if you missed a specific ingestion time period, you need to set an alarm clock. Well, we don't just consume it. It's the total daily amount or at least your cake net seems to be effective. I love that. So segwaying now into populations that should, or maybe should not consider creatine supplementation. I think most of the people who listen to my podcast and most of my audience are active, healthy adults

interested in progressing their physique or their performance. So they're probably very high quality candidates for creatine supplementation. But within that population, like assuming you're active, are there any particular things that somebody should be aware of? Are there any contraindications? Before we talk about women specifically, older adults, vegans, all that, you're pretty healthy. Are there things you should know about and be aware of? I'll give you an example. When I was 17, I went to the hospital to have some labs drawn up because I was particularly dehydrated and my blood urea nitrogen and creatinine levels came back high and everybody was freaked out. And I was like, but guys, I take creatine. And so there are plenty of healthy people who may be aware that there's potentially some red flags, of course, with the liver and the kidneys.

What do healthy adults need to be aware of before they start supplementing? And then we'll segue into kind of these unique populations. Yeah. So one is the safety profile on creatine overall is magnificent, but you hit the nail on the head. So one of the things with creatine is when you take supplementation or increase the amount in the diet, creatine gets in the muscle, and then through its turnover, it produces something called creatinine. And creatinine

is a metabolic byproduct, it leaves the muscle gets into the blood. Now the issue here is when you go for your blood work, if you don't tell your medical practitioner or nephrologist that you're taking creatine supplementation or that you perform weight training, because weight training will increase creatinine as well, that will give a false positive that your kidneys are not working properly. So I can't stress this enough. Make sure when you go for blood work, you tell the nurse practitioner, medical practitioner that you're taking creatine supplementation and you exercise, you should expect high creatinine levels in the blood. That's all that's indicating is that you're basically some byproduct of creatine supplementation. That does not mean your kidneys are failing. Okay. So that's why kidney measures can be overestimated. But regarding a population perspective, there's probably no one on the planet,

and this includes pregnant females, that can't benefit from creatine. I can't think of a population, yeah, I can't think of a population that would not or would have any adverse effects from taking this naturally produced in the body compound. And that's why the IOC will never ban creatine, even though it's really effective and it's on their one of five ergogenic aids at work, you naturally produce it. It's not a testosterone,

it's not a steroid. So again, it's very clean, but it works. So people speculate there's something kind of fishy about this product. But again, hey, we just back it by evidence-based research in the lab and bring it to the practitioners. I love it. Secondary population that I think we both know probably would benefit this, but I'd like to talk a little bit about why. And that's those who eat a plant-based vegetarian or vegan diet. And that's those who eat a plant-based vegetarian or vegan diet. Now, we could also talk about whether or not creatine is a vegan-friendly supplement. I think the way it's manufactured in most instances it is. But why does that population benefit so much from creatine supplementation?

Yes. So that population benefits the most. And we've done a few studies with this. So let's look at vegans or vegetarians. They have no meat or red meat or seafood or minimal amounts, depending on the type of vegetarian they are. So therefore, their amount that's already in the muscle is probably going to be half the amount of someone who's on an omnivore diet that consumes red meat or seafood pretty much on a semi-regular basis.

So for example, if you have 100% of your muscle capacity for creatine, vegetarians are about 50%. Now that doesn't necessarily mean they're only working at 50%. That means they only have 50% of creatine storing capacity, they're exercising fine, and everything is great. But when you give a vegan or vegetarian creatine supplementation, they double the storing capacity in the muscle. And therefore they experience phenomenal benefits from an increase in lean tissue, loss of fat, increase in performance. The individuals already consuming high amounts of red meat or seafood a day, they're classified technically as a non-responder. They already might

be at 90% of their capacity and then giving a supplement, they might only get that small, greater effect. On average, the average person gets an increase of about 20 to 40% in their muscle from creatine supplementation. That totally depends on where they're starting with. So if you know anybody who says, hey, I take creatine, it doesn't do anything for me. When you look at your normal food intake,

you're like, geez, you're already taking a lot in your diet make no wonder you're not responding whereas you talk to a vegan they're like what's in this stuff i feel amazing i'm exercising at really high capacity and that's really why so like the carnivore dieters can probably skip it the vegan dieters absolutely need it it's funny because the amount even on the carnivore diet people say well i'm getting a lot of creatine i'm like yeah you are from a muscle perspective but the lowest dose ever been shown to increase bone mineral has been eight grams a day wow so we think as we get older especially in postmenopausal females eight grams might be the minimum and then we have no idea the optimal dose in the brain so i think someone would still benefit even if you're on a caveman

or carnivore diet. But the big push on plant based foods right now is, hey, this is something to least look into. You may exercise and be healthy the rest of your life. But this is something that might give you a small beneficial effect. Yeah, again, though, exercise needs to be the driving force. I can't stress that enough. It's a fair point. And it's a nice segue. You mentioned postmenopausal women. I'd like to start first with women who have not quite gotten to the perimenopausal window. And it's usually these questions come from women between the ages of, I'd say, the teenage years into their mid to late 50s worried about the masculinizing or potential masculinizing effect of a performance enhancing supplement. Because it just goes back

to that fundamental misrepresentation of, look, creatine is an effective performance enhancer, so is testosterone, so is Dianabol, so is Trenbolone, and they're not the same. They're all very different, not just in how they act in the body, but in what they do outside of their intended purpose. And is there any reason for a woman to be concerned about the masculinizing effect of creatine, if that's even a thing, or any of the downstream physiological byproducts like DHT, for example, which we're going to talk about when we talk about the hair thing? Are those kind of fears relatively misguided? Yeah.

And they're a hundred percent fear and myths and there's no scientific evidence behind that. So females substantially benefit from creatine supplementation or dietary creatine. And so if you're taking a recommended dosage, we've already talked about as little as three grams a day or up to five whichever you prefer i probably wouldn't recommend the loading phase unless the female is an athlete competing for a really upcoming event that could lead to water or weight gain so taking a small dose spread it out two meals or whichever it is it's going to increase the potential to exercise at a higher intensity then you would argue well if i'm exercising at a higher intensity, then you would argue, well, if I'm exercising at a higher intensity, I'm getting a greater metabolic and energy expenditure stimuli.

And lo and behold, over time, the individual says I put on lean tissue, I potentially lost fat mass, and I got stronger and then metabolic health and functionality goes up. So again, there's no reason females should not be taking creatine. If anything, I think it has massive beneficial effects. We've seen some beneficial effects in females on bone density in older adulthood, but why not start younger and start building up that bone mineral earlier on? And that's our next line of thinking in young females. Yeah. You'll habitualize it, right? Like if you've been taking creatine every day in your twenties and thirties, you can continue it into your 60s, 70s, and 80s. The bone density stuff is relatively new to me. It's something I've heard people discuss,

but it's not my area of expertise. It sounds like creatine is particularly promising for older adults for three reasons now, one of which is obvious. It's its ability to stave off sarcopenia because it's going to help you train hard. But now we've got the cognitive benefits, which we touched on, which is really exciting. But talk to me a little bit about the bone density, specific benefits and bone mineral density, because this is kind of new to me, not my area of expertise at all. Yeah, there's been about 10 studies published, and we're fortunate to have published about seven of these. Now there's a little bit of different distinction with bone. so bone takes a long time

to turn over so that's why it's very difficult really clinical trials they take at least a year to notice an effect and you need imaging and fancy technology um but as it stands right now if you take creatine without resistance training there's no bone beneficial effects gotcha but when you combine creatine about eight grams a day or more with weight training, maybe three days a week for at least a year, we see postmenopausal females have a beneficial effect around the hip and the lower part of the body in the tibialis, which is really applicable for falls prevention.

Yeah, it is. That's big time. I work with a lot of older adults, and those are the two things that break the most when they fall. And so if we can strengthen the bone or at least cause them to have a little bit better balance around the ankle and the calf muscles that could withstand the incidence of falls and fractures. So there's a small body of evidence to suggest that creatine about eight grams a day or more, and again, this is always monohydrate

with weight training, can decrease the rate of bone mineral density loss or increase bone strength. So we're thinking this could, with longer-term studies, have application for osteoporosis or osteopenia, more specifically for reducing the risk of falls and fractures in the lower limbs. I love that. And to kind of close this out, talking about special populations, these are all mostly largely beneficial, but there are three kind of physical phenotypical things that I find people tend to be the most concerned about when it comes to creatine. We already checked the box with water retention. The second one, and again, I think this, a lot of this has to do with just the general misconception that this is steroidal, but acne and skin quality.

Is there any relation or correlation between creatine consumption and prevalence of acne or cystic acne? Yeah, and there's no evidence whatsoever. I've heard this anecdotally quite a bit. And my only thought here, and there's no evidence to support, is maybe the person is exercising at a higher rate. And so their sweat rate has gone up. And depending on the material of clothing, that could be contributing it. But again, that's all speculation. But from a physiological reason, creatine has no adverse effect on hypertension or blood pressure or things like that.

And so again, I, I'm always speculating there when it comes to acne or skin irritation. I'm inclined to kind of lean that way too, just because so many of the individuals who are, you know, they're finding this correlation. They're oftentimes, as you said, they've increased their exercise. They've increased their sweat rate. Maybe they're wearing tight fit clothing for the gym. Maybe their hygiene hasn't increased proportionately. Or even think about when most young male individuals start taking creatine, 16, 17, 18 years old, when you're at the peak of that hormonal cycle, at which point you're oftentimes dealing with some of these things like acne. So there's so many correlations

there that it's easy to go. When I started taking that, that's when I had the acne without there actually being a direct link, which kind of leads to the last one, which is hair loss. Everybody's familiar with the, I think there's one rugby study, which again, it might be interesting to talk about the correlations there, but it did appear to maybe those who didn't parse it apart that here you go, this is it. You take creatine, you lose your hair, and creatine can increase DHT, which when people talk about male pattern baldness, they often look at DHT and you have all these different companies now that are kind of these direct-to-consumer pharma clinics where you can just call and they'll write you a prescription for DHT blockers, all kinds of stuff.

So people understand more about DHT than they ever have, and they understand creatine might increase it. So is there reasons here to be cautious? Who should be cautious? Is it all overblown? Where are we at with creatine and hair loss? It is by far, by far the number one question and myth and misconception across the entire at with creatine and hair loss it is by far by far the number one question and myth and misconception across the entire spectrum of creatine and so obviously if people can see me i have receding hair and a lot of other prominent creatine researchers are going bald too but i was

losing my hair before creatine i'll preface that um so this study as you mentioned it's probably the most famous creatine study done in australia and they took a really high dose of creatine about 25 grams a day for seven days and a nice thing about this study was a crossover design so they sort of controlled a lot of genetics and environmental factors and cool these males went about their training for rugby and took a high amount of creatine and they measure the rate of DHT or dihydroxy testosterone, which is simply a precursor for follicle death and hair thinning. So no hair thinning measure, hair loss was measured in this study, only an increase in this hormone DHT. And lo and behold, it went up by about 50 but it was still within the physiological range so we've we just briefly talked about going to a

doctor and you get uh you know blood work you get your cholesterol checked and triglycerides there's always a range well this still it went up and it was significantly gone up but again it was in the healthy range and and then of course when they on placebo, it didn't hardly go up at all. And, and people don't realize this from the study, but resistance training or training will increase DHT by itself. Um, so obviously they said, no, it had to be creatine and, oh, by the way, creatine is going to make you bald. And, and I argue, well, this study, all it simply did was show an increase in a hormone, which has been linked to hair thinning, and it was still within a physiological range. And in the thousands and thousands of participants that had been

through my lab and other labs, research participants are super amazing and smart. Do you think if they thought they were losing their hair, they wouldn't tell the researcher? Do you think if they thought they were losing their hair, they wouldn't tell the researcher? Not a single person in my lab or any other lab that I'm aware of or read in any paper has said, hey, I'm losing my hair on this stuff. We would have to report that to our ethics board because that's a substantial adverse effect. There's some adverse effects, but people are amazing and they will be honest. And if a male, especially if i started to lose

my hair and the only thing i did was take this supplement i would immediately tell the researcher and stop and we would have to uh disclose that and it's never been done so an increase in hormone you know the way to look at this is there's never been a study to suggest it doesn't but there's certainly no evidence to suggest it causes hair loss. Until a study does, we have no rationale behind it. So again, it's a myth as it stands right now, but I really rely on our participants. They volunteer and spend a lot of time and I have to believe if they're willing to tell me about a headache or something, they're sure going to tell me about hair loss, male or female. So I leave it to them and I just don't see it. I mean, maybe that's something we can do

in the future. We're just going to have to design a perfect study where we make sure that we isolate. Look, if you have this male pattern baldness, you're out. I want the fullest, nicest heads of hair we can get. Half of you are taking placebo. Half of you are taking 20 grams a day. We're tracking you for two years and we're going to count those follicles one by one. Like, I think you hit the nail on the head. You know, you've got a bunch of health conscious, potentially even image conscious people coming in and out of your lab all the time.

They'd absolutely notice if their hair was thinning. I went through a period where I had some stress-induced alopecia and I noticed almost immediately. And then interestingly enough, once you notice your hair is falling out, whether it's because of genetic predisposition for balding or stress, the stress of knowing your hair is falling out is making it worse. So I think if you started taking creatine and you noticed hair loss, you could even nocebo your way into it. But truth be told, from everything I've seen and from what we've talked about today, no reason to believe that. I think that's probably the best place to jump off. We've answered pretty much every question I get, and I really appreciate your time, Darren.

Can you tell everybody where they can find you and your work? Yeah, if you want to reach me probably on Instagram at Dr. Darren Candle, that's probably the easiest. You can direct message me for questions or follow me. We try to promote and put a lot of the creatine research that's coming out immediately on there. So yeah, give me a follow. It'd be great. And thanks again for having me. Dude, man, anytime. I'm very appreciative of your time. Thank you so much for coming on. Thanks so much for coming on thanks so much