Creatine, a compound initially identified in the early 20th century, has garnered significant attention in recent years for its multifaceted benefits beyond its historical association with bodybuilding and strength training. In this episode of the Mind Body Marathon, I, Dr. Leo Kormanik, alongside my esteemed colleague Dr. Jared Bugaj, delve into the intricate science behind creatine supplementation and its implications for both athletic performance and cognitive health. We elucidate the extensive body of research that supports creatine's safety and efficacy, particularly highlighting its potential benefits for neurodegenerative conditions and athletic recovery. Our discourse also addresses prevalent misconceptions surrounding creatine use, including its effects on renal health and hydration. Ultimately, our conversation aims to provide listeners with a robust understanding of how creatine can be judiciously integrated into various health and fitness regimens.

The discourse surrounding creatine, an ergogenic aid traditionally associated with muscle hypertrophy, has evolved significantly since its initial isolation in the early 19th century. Dr. Leo Kormanik and Dr. Jared Bugaj delve into the multifaceted applications of creatine beyond mere muscle enhancement, exploring its neuroprotective benefits, particularly in aging populations and individuals with neurodegenerative disorders. The conversation elucidates the historical context of creatine's adoption in the fitness community, tracing its ascendance from a niche supplement to a widely researched compound integral to both muscle recovery and cognitive function. Notably, the discussion reveals that creatine supplementation may confer advantages not only to strength athletes but also to endurance athletes, challenging prevailing assumptions regarding its utility.

The episode further scrutinizes common misconceptions surrounding creatine, such as its purported link to renal impairment and water retention. The hosts articulate that while creatine is synthesized endogenously, supplementation can be beneficial, especially for those adhering to vegetarian or vegan diets, who may not obtain sufficient amounts through dietary sources. The narrative addresses dosage considerations, advocating for a tailored approach that balances daily intake with individual physiological responses. The safety profile of creatine is thoroughly examined, reassured by an extensive body of research affirming its efficacy and minimal side effects when used appropriately.

In concluding the episode, the hosts emphasize the importance of informed supplementation and the necessity for individuals to approach creatine as a viable option for enhancing not only physical performance but also cognitive resilience in various demographic groups. The conversation serves as a critical resource for both practitioners and laypersons seeking to navigate the intricate landscape of dietary supplements, underscoring the transformative potential of creatine in modern health and fitness paradigms.

Takeaways:

• Creatine has been utilized primarily in the bodybuilding community, but recent research indicates its benefits extend to endurance athletes and cognitive function.
• The safety and efficacy of creatine supplementation have been extensively researched, making it one of the most studied ergogenic aids.
• Supplementing with creatine can enhance energy production, particularly during muscular contractions and in cognitive tasks requiring high energy.
• Creatine supplementation may not only assist in physical performance but also support recovery in individuals with neurological conditions such as PTSD and depression.

Links referenced in this episode:

• Faster Without Fail
• Amazon
• Running Rehab

Companies mentioned in this episode:

• Vitamin World
• Vitamin Shop
• gnc
• Amazon

Foreign yo, yo, everybody.

Here is another episode of the Mind Body marathon.

And on today's show we're going to be talking about creatine.

And I'm your host, Dr.

Leo and this is Dr.

Jared.

Hello.

Hello.

And old Bugoat's gonna be helping us walk through the, the murky waters of creatine and some of the unique aspects of this.

And I feel like this is a conversation that's been really prominent with us in the clinic over the last six months in terms of helping people out and helping people understand this molecule creatine.

And as a consequence to that, it sort of got hijacked as a strength and conditioning and power sort of bodybuilder supplement, you know, and it and that community sort of just kind of had a lockdown on it.

And I would say over the last like five years and definitely over the last couple years there's just so much more research coming out on its benefits for, you know, neuro effects, brain effects, aging, you know, as a dietary supplement, you know, you know, for multiple things and obviously for endurance athletes, which is something that really has perked our interest.

But yeah, I think, and, and even as like an ergogenic aid for sleeping.

So there's just a lot of different effects that we'll kind of devil upon.

But you know, sort of the, the biggest thing is that with creatine it's fairly safe to use.

Being probably the second most researched ergogenic aid or supplemental aid for performance to only caffeine.

Wow.

I think, didn't know that.

I think there's more research articles on caffeine than creatine.

But creatine is probably number two and maybe even as of recent development, maybe even coming and surpassing number one as the most researched, like published released articles on the molecule.

So its safety and its efficacy is quite a bit, you know, research.

It's quite a bit sifted through.

So some of the things we're going to talk about today are it's not a controversial statement.

These are just published research.

It's not really anything we need to be super concerned about from a health standpoint.

So we'll kind of address a lot of these things.

But you know, on a salient perspective.

You got any initial input?

Yeah, I think, you know, if we just start off with, you know, Debunking some of the myths out there in the fitness world.

Um, you know, you may have heard that if you have kidney damage or kidney disease, that by supplementing creatine, that that could exacerbate that condition.

But the research actually shows that people with kidney damage, kidney disease can take creatine, but it is advised that, that it's monitored.

And also probably not high doses either, for sure.

Maybe more just like 5 grams.

So let's just kind of start there.

Just as a, a traditional serving would be 5 grams.

So if you go to like a Vitamin World or Vitamin Shop or whatever, gnc, and you buy creatine, most of the time the scoop will actually be 5 grams of creatine monohydrate.

And we'll get into pulsing and higher dose stuff later.

But as of right now, like, for the most part, like, that's just considered sort of a normal dose.

Yeah.

And, and also, like, you may have heard that creatine causes water retention.

So it's going to make you blow up, it's going to make you balloon up.

That, that's, that is a myth.

You may experience some transient intermittent water retention, but that would be from like extremely high doses for a very long time.

Yeah, yeah.

So, yeah.

And I, I kind of feel personally like it's a little bit like salt, where if you have a big bolus of element or salt, you might feel a little bit of that for an hour or so until your body sort of like works through the molecules and just kind of like normal balances out the electrolytes.

I'm sure probably the same thing happens with creatine.

You know, you probably take this big bolus and maybe your body's just like, all right, well, let's just kind of retain a little bit more water to handle this for the next hour or two, but then after that it just sort of washes out.

Yeah.

Um, fun fact.

Did you know that the body actually synthesizes its own creatine Internally?

Yeah, about 1 to 2 grams per day.

You know, the traditional recommendation is 5, 5 grams of creatine supplementation per day.

But we do actually get it synthesized internally from glycine, methionine and arginine.

Yeah.

So those three amino acids make up, make up the creatine.

That's pretty cool molecule.

Yeah.

So, you know, what does it do, like when it gets into the body, what does it do?

So creatine supplies and phosphate molecule, when adenosine triphosphate or ATP gets utilized.

So when we perform skeletal muscle contraction or heart rate or you know, even using our neurons, the first energy source to replenish that ATP, which is then adenosine diphosphate, meaning there's only two now.

Yeah.

Is the creatine phosphagen system where the creatine molecule donates a phosphate to that ATP, to ADP at that time to regenerate it to adenosine triphosphate ATP.

And it's just readily available in the cell, like it's just kind of floating around.

And that's how it can easily dedicate the phosphate, as far as I know.

Yes.

Yeah, yeah.

And that's I think why having a decent amount of it in the system is beneficial.

Yes, most of it, you know that, that you get dietarily is going to be from your red meats and fish.

So individuals who use like a vegetarian diet or a vegan diet can actually benefit more from the supplementation of creatine because they're not getting it through their food and, and animal based sources.

Yeah, that's a great point.

Yeah.

And it can then create less of a drag on the B vitamin system and all that CO factor sort of.

Thing as well, especially with vitamin B12.

Yeah, so that's a, that's a important thing to consider.

So a good point.

Now when should people take it so personally?

I, I've experimented with it a little bit at any point during the day.

I've even taken it right before bed.

And I've noticed that like my dreams that night are actually pretty recharged, but especially before exercise.

And the research has shown that by taking creatine in addition to a carbohydrate source, a simple car carbohydrate source speeds up its absorption.

So creatine is more readily absorbed in an insulin environment.

So insulin is released into the bloodstream when, you know, we're consuming foods, when we're taking in our proteins and our carbohydrates too to absorb that energy into the cell.

And um, creatine is highly absorbable during those, those times.

So you know, if you have like honey or a slice of bread or, or, or something that is just a, a carbohydrate, you know, pre workout energy source, then that's gonna speed up your intake and utilization of creatine.

Awesome.

And one of the things that I, I, I personally just take it whenever it's convenient, which happens to me in the morning or after a workout.

And, but I do think there is some decent research showing that it can help with being, you know, at night and, and calming the system down and just kind of creating a little bit more of a free energy for the brain cells, which kind of then creates that less of a drag on the body.

So you can get a little bit more into the REM sleep.

Yeah, for sure.

You know, and mixing it with other, you know, like electrolytes, like an element packet.

That's like one of my favorite things to do, especially in the morning, you know, get the body rehydrated, give it the energy for the day and then, you know, give it some electrolytes.

So, you know, that's really going to help the, the brain and the, and the muscles perform.

About 20 of the blood flow at any given time is in the brain.

Right.

And it's whenever you can get a huge bolus of a phosphate rich molecule like creatine, that's what helps provide the energy for the brain.

So whereas we thought previously this was just sort of a bodybuilder thing, now we're finding it's beneficial for neurodegenerative disorders like Alzheimer's, dementia.

It's, it's good for staving those things off.

So even if you're a little bit older and you're trying to prevent that sort of stuff, I think it would be beneficial to take some.

What they find though is that if you only take 5 grams, that you are just basically going to utilize that for the musculoskeletal system, that you have to basically take higher doses, 15, 20 grams a day to, for it to be readily utilized by the brain.

So if you're looking to get the neuro degenerative effects, if you are supplementing it for somebody who has these conditions or you're trying to prevent it, then basically you want to make sure you're closer to 15 to 20 grams.

And I think most people would say it's smart to pulse it, meaning you don't necessarily do this, you know, 365 days of the year.

You might go a couple weeks at 15 to 20 grams a day and then maybe take a week back where you are only at 5 grams and then kind of pulse it every now and again.

And I think studies show that that creates an environment where you're less, you develop, you develop more of, less of a resistance to tolerance to it and you can absorb it better and utilize it better in that scenario.

Yeah.

And you know, off of that point, the research has shown that individuals that have depression, ptsd, traumatic brain injuries and concussions.

Concussions, yeah.

Have low brain creatine levels.

That's, that's, that study that's known.

And so, you know, in the recovery process, along with your magnesium and your, your omega 3s, creatine is a, a viable molecule to be supplementing with, especially in, you know, with people that have those things going on.

So.

Yeah, so not even just like neurodegenerative aging disorders, so even for, you know, a high school athlete that just had a concussion or somebody who, you know, post traumatic stress syndrome, something like that, depression, just trying to recharge the brain, stimulate the brain, get it some free energy, this can easily be a cheap.

Yeah.

And effective and safe way to help speed up the recovery.

And the mitochondria too, you know, that's, that's helping the, the mitochondria replenish and regenerate.

And neurons are highly aerobic, aerobically dependent.

And so having the creatine in there to, to stimulate the mitochondria to, you know, produce more ATP, to regenerate that ATP quicker, so that, that can power the, the enzymes and the, the cellular processes.

So if you are training for a race or a big event like an ironman or a marathon or something like that, going through phases where you also pulse creatine would be smart.

So whereas you might, you know, in a given training period where loads are very high, so you might want to get your creatine again, 15 to 20 grams.

When you take a bolus of creatine like that, whether it's for, you know, just general lifestyle changes or for recovery, um, I don't think there's really been any difference showing that whether you should space it throughout the day or have it in one big bolus.

I would say from a palliative standpoint and, and satiety standpoint, it's probably smart to take it in a couple waves.

So maybe have like 10 grams in the morning, 10 grams in the evening.

20 grams of creatine at a given time is not very pleasant.

It's very basic and bitter.

Not crazy bitter, but like that much of it is definitely annoyingly bitter.

So gritty.

So you just kind of maybe want to space it out just from a, you know, a palliative standpoint.

So with that being said, so if you're training for these heavy events, you want to be smart about, like, pulsing it and especially as you're coming into a peaking phase.

So two weeks out, you know, you can ride 20 grams all the way through to the event.

And, and I think that's a smart way to make sure that your body is catching up on those final modes of healing throughout the peaking phase.

So the 10 days, the two weeks as you're dropping volume and getting ready for the, the peak event.

Yeah.

What's your preferred form of creatine?

I know there's, there's different forms, there's pills, there are, you know, capsular forms.

You know, there's creatine monohydrate, which, that's the form I prefer.

I think the greater the surface area, the more easily it's digested.

Yeah.

But I think some people might find that, you know, the capsule or the pill based form allows them to get it down a little bit quicker and easier.

So what are your thoughts?

Yeah, I'm the same, I'm powder form.

But you know, when I'm thinking of my kids, like I have a couple step kids that don't like to swallow pills and so they're just gonna obviously just want it sort of embedded in a shake of sorts.

And.

But then my stepdaughter who's autistic, she actually only takes pills.

She knows if you mix a powder in something, she doesn't like it.

So she would actually be more of a candidate for a pill form.

Okay.

Yeah.

The, I think this, the most common one that you'll see is the creatine monohydrate micronized.

So micronized just means that the, the particle size is very small so that it's able to be absorbed much quicker.

And that makes sense because the, the digestive system can digest things greater and more efficiently when it has more surface area for the enzymes to act upon.

So I think that makes makes sense.

It also shows a great benefit.

So let's back up.

So like we established before, there's bodybuilders, there's weightlifters obviously that are going to benefit from it, but endurance athletes, actually from a functional performance standpoint, an improvement performance standpoint, they literally actually do better reacting to higher doses of creatine than actually weightlifters.

Wow.

Really?

Yeah.

So like the meaning the performance gain in an endurance athlete with high dose creatine is, is better than the performance gains of high dose creatine with weightlifters.

Interesting.

And it's just, think about it, it's just energy production.

Just think of how much more caloric, you know, density there is with usage of fuel and phosphate transfer and ADP to adp.

All of that, that happens in like if you run a marathon.

So you need more readily available creatine for that.

If you're gonna be in the gym for 30 minutes to an hour, like that's a markedly Easier scenario from a energetic standpoint versus running a long distance event.

Interesting.

I noticed that when I was supplementing with creatine pretty regularly and back in chiropractic school and doing track workouts, preparing for the marathon.

I just felt stronger during those intervals and the recovery, like I wasn't going into the next mile repeat or 1k repeat or whatever.

I wasn't feeling like I was behind it felt like I was just instantly ready to go.

That's cool.

And you know, the power output, like you feel like you have like this extra buffer zone, I guess you could call it.

Yeah, yeah, that's a good point.

Yeah.

And I think that's one of the easy ways to measure performance benefit, obviously with that perceived exertion side of things.

I used it for a couple of my marathons when I was running a bunch of sub 3 on low mileage.

I really specifically went into a couple marathons with it with loading.

And I did notice that the last 10k was much more pleasant.

I wasn't having to struggle and dig as deep in Those that last 10K.

One of the things that's really another point that's really interesting with this is the bone health.

Showing a lot of benefit with bone health.

So if you're osteopenic, osteoporotic, or if you have a family history of this, please consider taking creatine as a ergogenic aid to help prevent this or help you heal from this.

There's a lot of studies that show that it's benefits with bone health.

Yeah, the osteoblasts which actually lay down the bone minerals.

Creatine has been shown to be able to stimulate those.

Yeah, it stimulates osteoblast which builds osteoclast, tears it down.

So it does actually stimulate the builders.

Yeah, that's awesome.

Kind of on the more aerobic fitness and, and performance side that, that we were mentioning when we take creatine, it actually supports glycogen resynthesis.

So the, you know, one of the recovery measures is, you know, being able to, you know, build back those carbohydrate stores and the glycogen resynthesis following, you know, like a hard workout.

Yeah.

When taking creatine after with a carbohydrate source can also speed up the, you know, generalized recovery process energetically.

And that's one of the main, that's one of the main benefits of running like long runs and doing runs over 90 minutes is what you're really trying to do.

Obviously there's a lot of physiological adaptations.

But the.

One of the main things you're trying to do actually is.

Is strip down your glycogen stores.

So that way, when that happens, you have about 2,000 calories of glycogen storage in your body.

When that happens, your body sort of flips out and it goes, well, crap, if they're going to keep doing this, we need to store more glycogen.

So you can kind of squeeze a couple hundred more calories of glycogen in there.

And creatine is very active in speeding up and actually bolstering that process of recovering that glycogen.

So when you do those long runs, if you, you know, use creatine specifically around that time and make sure it's sufficiently loaded in the system, both pre workout and post workout, then you're gonna create an environment where you're gonna build that glycogen back better.

Yeah, yeah.

And the other thing to consider, kind of as we're coming to a close in the episode, we're gonna have another episode on this in a couple weeks where we kind of really dig a little bit deeper in the research and kind of dig on it.

But I think today we wanted to just kind of hit on some high spots and just some important things that we just consistently tell patients.

But for today, I wanted to kind of finish up saying, this is safe for children.

Yeah, this is safe for pregnant women.

It.

So this is safe for elderly people.

You know, this is safe for people with renal disorders.

This is.

This is a safe molecule.

I mean, like I said, it's.

Would you ever tell, you know, somebody who consistently drinks coffee that is not safe for them?

No, I mean, it's like you wouldn't even say that, Barry.

It's like, because we know caffeine is safe for certain conditions.

Well, the same thing with, with creatine.

It's really well studied.

We know it's.

It's going to be safe for most people.

If you were obviously concerned, if you have a special case with the diagnosis, then obviously clear it with your doctor.

But for the most part, it's.

It's a green light for most people.

I would say, personally, I wouldn't give it to, like, a young child.

I would give it to a highly active child, meaning somebody who is starting to get involved in sports, you know, 8, 9, 10 years old or something like that, where they're maybe doing consistent sports year round.

I can think of times when I first jumped in with my step kids and they were doing dance, you know, six, seven, Days a week they were going to competitions and you know, numerous times my, you know, stepdaughter at the time, she was 8 or 9 and she just would be completely exhausted.

So I would say in that scenario that would be safe.

Obviously I have a three and a half year old Mariah.

I'm not going to give it to her, like she doesn't need it.

But once they started getting involved in formal sports, I think it's safe.

And teenage years is definitely safe.

I mean that's obviously been well studied with, you know, performance gains and football and, and, and lifting weights and all that sort of stuff.

And same thing for pregnant, pregnant ladies.

I mean they need energy too.

So it's really important for them to kind of have that, you know, environment where there's a lot of phosphate around where they're not kind of getting it through those slumps where they can help their body kind of heal, especially if they're active through pre pregnancy as well.

Very cool.

Cool.

Any final points on this kind of short and sweet episode?

I mean I think we covered quite a bit.

Yeah, we did good.

We drove by a lot of really key topics.

So you know, I think if you're listening, if you listen as far like I'd maybe go back and kind of just listen to some of the earlier parts and just kind of remind yourself on some of these things.

And I think in a couple weeks we're going to kind of have a little bit more of an hour long episode where we delve into some of the specifics and research and, and kind of get a little bit more nuanced with it.

But I think this is an important episode for most people to kind of get their feet with wet with trying it and, and implementing it and understanding that it's safe to do.

It's awesome.

Thank you for listening till another day.

Foreign.

Here.

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Faster without fail.

Appreciate it.

Dr.

Leo here.

If you want to catch me in another setting, be sure to check out my YouTube page, Running Rehab where you will find exercises on how to stay healthy with running, how to improve your running form, and a bunch of other tips and tricks on how to get over common injuries.

So again, running rehabilitation.