Best Of The Body Pod - Women and Creatine: Everything You Need to Know w/ Dr. Darren Candow - Benefits, Myths & More

30:19Okay. What about, can it affect iron levels? Not, I'm not aware of anything with iron. I mean, unless someone is iron deficient in anemia, but creatine really where it's an anaerobic compound and the red blood cells don't even have a nucleus or mitochondria, it shouldn't interfere with the heme protein. But again, it's not a bad idea to talk to your doctor on that, but there's nothing that we're seeing. Okay. So the Mayo Clinic's website states creatine when used orally had appropriate dosages. Creatine is likely safe to take up to five years. What are your thoughts on limiting use about like maybe cycling on and off?

31:03Yeah. So the idea, I think the reason the clinic did that is because the longest study was in gyrate atrophy and long-term care facilities up to about five years. So until we have a 20 year study or 30 year study, I think legally, that's why they would put that there. I've been taking creatine consistently for at least two decades. There was a myth that we thought creatine reduce your natural production. We don't see that in humans. If anything, I'm Mark Tarnopolsky from McMaster showing that the protein content is not there. But I love the question with cycling, because this is probably one of the most prevalent questions I get.

31:39And of all the studies, we actually still don't know the answer to this. So we've never had a study where a group did cycling versus continuous. There is some theory of why you may want to cycle. And I'll give you an example from a muscle perspective. Once your muscle stores become saturated, just like hormones, they become desensitized to the amount that's continually coming in. So if your muscles are completely full and you're only metabolizing maybe one or two grams a day, but you're taking in 10, 20 grams, you're going to be excreting the vast majority of that creatine or begging that some will go to your immune system, cells, bone and brain.

32:15And that's kind of why I still take a little bit higher dose. So you kind of maybe saturate your muscle cells and our doorways called creatine transporters. That is logical. but we don't know should you do that compared to continuous dosing i'm a big proponent of continuous dosing now recently for a couple reasons but the biggest is on the days you're not working out and maybe that includes just a brisk walk or whichever it is my hope is that if your muscles are still full some of that creatine will go to your bone and brain so now it used to be could you take creatine just on the days you work out and we have evidence to suggest that was a very viable strategy and for anybody listening that's a that's an okay way to go as well but i think taking it every day you might get those extra benefits primarily from a cognitive perspective can it cause muscle cramps it does the opposite so there was a myth when you'd have these anecdotal effects of wrestlers wearing um rubber suits excessive heat so creating actually super hydrates the muscle it's osmotic so it takes um sort of water and sodium with it into the muscle and it swells the intracellular compartment.

33:26So the majority of studies suggest that creatine will trap water into the muscle. And of course, dehydration metabolically is one of the main causes. So we actually think it's super hydrates the muscle. It's very beneficial to take in hotter environments because the muscle environment or what they call the cytosol part of the cytoplasm would have more aqueous potential and that could have some beneficial effects. if you take a break from size weight lifting we talked okay let's see we talked about that to cycle on versus off would it potentially or scars so you just cut out there for a sec can you repeat the question oh it's i'm not quite sure what they're asking but would it potentially help with physical healing of muscle or scars?

34:12So regarding a soft tissue or connective tissue perspective, creatine has been shown to decrease the rates of something called NTL peptides, which is a marker of collagen breakdown primarily from bone. But there is some potential to say that it may speed up tissue rejuvenation or healing, but it hasn't been shown yet. Do we think creatine in combination with collagen supplementation. I've been very curious to look at that to see, can it have some bone or anti-arthritis effects? But to answer your question, we don't know yet, but there is a little potential there when you look at some of the effects.

34:51Okay, great. Last question on this page. I have a history of reduced renal function, but consequently I have borderline biomarkers when having blood work. So they're just elevated EGFR, abnormal. My doctor prefers I do not take creatine supplement, but what are your thoughts? Yeah, I think you do need to leave it up to the medical community. That individual is really well-versed on this patient and we're not allowed nor would I ever trump a medical practitioner. So that's really important. Each person is unique. their pathophysiology of creating metabolism in general should be the same. But if you have an underlying condition, you always want to rely on the medical community.

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36:23Let's make you happen. it. Okay. I don't know if you can answer this one because it's saying in addition to creatine, what are the non-negotiable supplements for women in their forties looking at energy, brain and gut health? Well, first off, you need to exercise. All the stuff we talk about will have no effect unless you have the driving force of exercise. The other big one is protein. You know, I think you've had, you've talked, you had Bill on there many times, but protein, I think the minimal amount around 1.2 grams per kilogram, uh, or higher, the, the side effect of having more protein is you're probably going to lose fat from the thermogenic effect.

37:01Um, but the RDA is so embarrassing at 0.8 grams per kilogram. Um, we now know if you were to take that dose, as you get older, you will develop sarcopenia or sarcopenic like symptoms. So, uh, creatine can be there, but I always use the foundation of exercise as the cake protein is the delicious icing on it and creatine may be a few sprinkles to cause an individual to eat it a bit more without the underlying foundation none of these things work yes it's a cake and and it curbs the that's right okay um is it safe to take creatine if you suffer from gittleman syndrome room there should be no reason you know let me rephrase that first off that's a unique disease regarding different types of immunity and responsiveness um you definitely want to get medical clearance because i'm not aware any studies that have looked at creatine in any of those type of conditions even around loop no so i can't really answer that they'd have to talk to their doctor and it's always tough when there's no research on it you can speculate do i think it would exaggerate any of the symptoms i don't think so but again please rely on the medical community for that okay does creatine make you gain weight and what is the right amount to start with so if you do it incorrectly it will make you increase weight during the initial stages so for any of the females watching ignore the loading phase that's on the label that's where it gets a little haywire and there's some side effects with that.

38:37I think it started as little as three grams a day, but divide that up into two 1.5 gram dosages, one in the morning, one in the afternoon. You should have no bloating, should have no GI tract irritation, nothing like that. And then slowly progress maybe up to five grams, eight grams, whichever it is. So that's kind of the way I would look at it. But the interesting thing is when we look at pre post, the weight of the individual usually never changes. But what we do see is lean mass went up and fat mass either stayed the same or came down a little tiny bit. Okay. So this is a vegan who knows they should be taking creatine, but recently overcame breast cancer and were worried about those studies in the rodents, it sounds like.

39:22But the two sides of creatine and cancer, do you have any additional information if creatine is safe for breast cancer survivors? She's just got this question two days ago on Instagram as well. I wish I could talk more about the paper that we're resubmitting to the International Society of Sport Nutrition this week. But one of the best creatine researchers, Mark Tarnopolsky, who's a medical practitioner, has looked at all the data. And specifically regarding breast cancer, colon cancer, we sort of put all the cancers into a general family. and we see some anti-cancer properties if consumed at recommended dosages.

40:02We don't really have anything specific on breast cancer. I know serum ferriman sort of looked at that and we're proposing that soon. So a really long-winded answer to that is we don't specifically know and we're not really advisor permitted to say this is going to cause or help cancer. We can only talk about the studies that show anti-cancer properties. Okay. So we answered, you answered that you can mix it in your yogurt because you said that you did. I do it every morning. Perfect. I don't know if I need to change my breakfast, but I do it every morning, every now and then. Hanging out at the pool is great.

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40:57Dr Darren Candow:SpinQuest is a free-to-play social casino. Avoid where prohibited. Visit spinquest.com for more details. So we know the standard. Okay, so the standard dose is 5 grams when taken daily. But why is that the standard? And does height, weight, age have anything to do with that number? The three to five grams is probably from a general consensus on a muscle perspective. And when you take a five gram dose, it seems to elevate in the plasma or blood in about an hour or two. And then it seemed to be effective in that 1992 study. So that's really where it comes. You could also argue, hey, I saw that Eric Holtman study in 1996 at three grams a day.

41:40It takes about a month, but it does saturate your muscles. That's kind of where the three to five grams comes into play. But please note, that's from a muscle perspective. Five grams has been shown in a few times to have some cognitive benefits over the long term, several months. But the lowest dose from a bone perspective is eight grams. So if you're just taking five grams, I have no reason to believe that over several months, you're not going to benefit all those tissues. But if you say I'm only taking creatine for four weeks and I'm taking five grams a day, you're probably only going to notice some muscle benefits.

42:12Okay, so to avoid bloating, you can really look at, you know, spacing it out, one and a half grams, one and a half grams. Is three, you're still going to get positive benefits for those who say that they're, like, go up to five and they don't have, they start having some side effects, but three is fine. Yeah, three for the younger population, I speculate that's a bit too low as we get a little bit older. i think if you want to start with three to see how you um adjust or adapt during the first week or two that's fine and then maybe work your way up to five or a little bit more i like the nine gram down the roll because you could do three three and three so that's an easy way to do it and a lot of my female clients are doing that and they're starting to see some effects again bone we're seeing about eight to eleven grams in post-menopausal females but i think most people take creatine nowadays for body composition repurposes or brain health benefits uh the brain is in its infancy the dosing is all over the place and we don't know if it affects the gray matter white matter different areas but we do know that low dose can get in but you need several months higher dose can get in quickly but then there's that potential bloating gi tract irritation so they the person needs to decide why am i taking creatine am i taking it for just general health am i an elite athlete really it comes down to why they're taking it and what dosing strategies they use okay um can it can you take creatine if you have high blood pressure that's part of this new paper and we've looked at hypertension and we're not seeing any adverse effects or reasons an individual uh taking creatine has any jeopardizing effects to hypertension okay uh let's see this is well i guess you just covered this about the opinion about people with a history of of cancer taking creatine i hear about the many benefits of it but it was recommended previously by a naturopath that i away from it if it's not the timeline post-cancer treatment when it would be safe to introduce yeah i mean one of the when you look at the history of cancer the caxia or the catabolic effects there's severe muscle and strength loss functionality losses so creatine can be used as part of a therapeutic rehabilitation program uh for maybe during post-cancer recovery or the maintenance of the disease when you're going through remission or things like that.

44:34But there are some cellular data suggesting that creatine has anti-cancer properties for cells of the immune system. So again, it may have an adjunct either, you can't boost the immune system, but you can sort of enhance the health of it. And therefore it's one of those things. So we've, we're looking at it currently with prostate cancer survivors in North or South Carolina, and now we're going to be proposing that with breast cancer in the same state. okay great so when we're looking at brands what's the safety and efficacy of creatine when it's mixed with something else like we know there's one for taurine uh you know some other combinations out there are they just as good or i mean what are your thoughts on that yeah there's not really anything that'll interfere with the bioavailability of creatine per se maybe high dose caffeine chronically could but caffeine or sorry creatine seems to work very well with any of the amino acid, so taurine would be sort of lumped in there as well.

45:30It works very well with carbohydrate. There's no really big suppression from fat, but a recent study came out showing that a high fat diet might suppress the effects of creatine. But creatine is very aqueous. It doesn't bind up in your bloodstream. It sort of goes through the hydrochloric acid of your stomach and it remains intact. So that's why it seems to be a very viable compound and probably helps explain some of its it's high effectiveness in the literature okay and there's no um effects on sleep outside of positive with someone like in the in the opposite way of having sleep issues because of it yeah so this is interesting one um so i'll talk about what the the publications say and then what i hear almost daily on instagram so we uh just published a recent study and i think you saw it on instagram showing that females on the days they worked out when they consumed creatine, their total sleep went up compared to placebo.

46:27And we can understand the mechanisms. The brain relies on creatine bioenergetics. And if you have more creatine, maybe the brain doesn't need as much sleep. Or it could allow the individual to put more of an effort into the gym, and therefore they can sleep better. Creatine decreases symptoms of clinical depression and anxiety. But what I'm hearing almost daily is they're like hey dr kando i'm taking creatine and i'm having a lot of issues sleeping and then when you look at the rodent data i can see where there could be some logic to this if you take exogenous creatine in combination with what your brain's already making maybe you're speeding up the recovery of the brain so you don't need as much sleep we don't know that for sure it has to do with glycine but i've heard this anecdotally people say i've tried creatine and that's the only thing I've changed and my sleep patterns are a little disrupted but we're going to start looking more at that over time yeah oh I love this and how it's always changing and all new things yeah every day I wake up it's changed yeah yes any issues taking with creatine with citrulline malate no there's not I mean water soluble there would be no issues you Okay.

47:45Is creatine safe for our kids or teens? And if so, how much? Yeah, there's pretty good accumulating evidence to suggest that it's totally fine for children and adolescents from a sports performance perspective, exercise perspective, subjective adverse effects. We're not seeing any. And then a couple of good colleagues in the United States are starting to look at blood biomarkers now for children. I'd be very shocked if there's any adverse effects, because when creatine is either made in the liver or taken in through the diet, if we don't like it, we simply excrete it down the toilet. And that's probably why Stacey Ellery in Australia is starting to look at creatine during pregnancy, not only for the developing fetus, but obviously the mother.

48:24And it's something we're naturally producing. It's not a foreign compound. When you're taking monohydrate, it's identical to what the brain and liver is making. So that's probably why it's safe and we're not seeing any adverse effects. Okay, great. What about someone that feels like they get awful headaches for the first few days? Have you heard of that as a side effect? Yes, I have. And usually when you dig it a little bit deeper, they're taken in combination with exercise and they're either not, they could be slightly dehydrated or pushing themselves a little bit harder because of creatine's mechanisms.

48:57So when you dig a little bit deeper, we usually see that the person has increased their exercise intensity. They probably may be slightly a little metabolically dehydrated, which could cause some of those effects. We don't know for sure, but you dig a little bit deeper. We don't think creatine is the main road of that. Okay. So I think I know your answer here. What do you say to your primary care doctor when they don't support creatine and tell you to stop taking it? Yeah, no, it's it's it's it's never happened to me directly. I'd probably just laugh or giggle. But I would probably come back at them and say, well, what's your opinion and why would you say that?

49:37A lot of GPs obviously have phenomenal medical training, but they may not be up to date on the current literature. with creatine, just like everything else. You can't know everything. And the evidence-based research from a clinical perspective has really blossomed in the last two decades. And it's not just for athletes. It's pretty much gone now mainstream to a lot of other applications. Yeah. Yeah. Okay. So this person took creatine for a month and then gave up because they were definitely gaining weight and felt full and fluffy. Any ideas? Yeah. The dose might've been too high or even the smaller dose might have been causing too much osmosis or water retention.

50:18And in those individuals I've worked with before, we usually divide it up into what we call micro dosing. So the one to 1.5 gram, see how you adopt over time. And that's one of the main causes. Hopefully the individual is putting on lean mass, but we now know from meta-analysis that creatine will decrease body fat and fat percentage a little bit. so if there was some weight fluctuations it's probably just water retention okay so for postmenopausal women nothing different on the dosage as far as three grams five grams I mean you said a little higher probably AIDS yeah no the lowest dose in postmenopausal females is about eight but in the best studies we've looked at a little bit higher so about eight to 11 grams a day on a daily basis.

51:05And that was for at least a year. The Brazilian group had shown that one to three grams a day was ineffective. So for postmenopausal females, eight to 11 grams seems to be an average daily dose from and that's primarily from a bone and muscle perspective. And even those results were inconsistent. Hey, guys, Lady Luck here. Are you going on any road trips this summer, I know I'm going to be going on a bunch of road trips. And being that I'm going to be Passenger Princess, I love playing on SpinQuest.com. SpinQuest has all of my favorite slot games, live blackjack, live craps. Head on over to SpinQuest right now and get yourself a $30 coin pack for just$10.

51:49Dr Darren Candow:SpinQuest is a free-to-play social casino. Avoid where prohibited. Visit SpinQuest.com for more details. Okay. What are any other side effects that we haven't covered? that are common outside of potential headache, bloating, sleep disturbance, anything like that? No, it would be that, well, we've already talked about the creatinine. That's a big one. I think it would probably be the short-term weight gain if you take too much all at once, but then it does go back over time. So I think we've touched on the main ones, especially for females. Okay. So this question, I mean, we answered, we touched on this with the perimendo crowd where it's a little bit harder, but what are some of the limitations of the studies on creatine and peri postmenopausal women and how are you addressing it in your research?

52:37Yeah. So there's huge limitations or things to be aware of. So for example, if they're on medications like glucocorticoid steroids or estrogen or hormone replacement, how does that influence the bioavailability of creatine? So we, we usually only allow individuals that are restricted from those conditions the perimenopausal populations we've really not done a good job of including them into research and we're trying to do that as well but you need to do a lot more blood work to see when the luteinizing hormones or other ones are fluctuating i'm in agreement with everybody else that the menopausal cycle has no effect on muscle but we don't know the effects on cognitive function or brain in regards to creatine so So those are all big areas of concern that we need a lot of more randomized control trials for.

53:25Okay. So it definitely does not raise blood pressure. And if somebody is on blood pressure medication, it's safe to take. No, let me rephrase that. So it can acutely raise blood pressure because it's trapping water into the circulatory system, but it may not have any adverse effects on diagnosed hypertension. So I think the question originally was someone with high blood pressure, could they take it? They can because we don't see a big drastic effect. But sometimes when you take creatine, that inevitably can trap water. And therefore, you're going to have more pressure in the arteries, veins and capillaries when you measure blood pressure.

53:59So your systolic might be a bit higher. Your diastolic shouldn't go up. But anybody who has hypertension, please talk to your doctor to make sure this is OK in combination with your medication. Because you could be on an ACE inhibitor. You could be on a beta blocker. You may even be on a statin. we want to make sure that cocktail of medication is okay to take. Okay. And so there's no ill effects of taking smaller doses of creatine long-term, but what is the longest study performed in women? Would you imagine? Yeah. So we've done the longest it's two consecutive years and we gave about 11 grams a day.

54:34This was in post-menopausal females. And we did measure renal and blood as well as liver function annually. And we didn't see any greater adverse effects compared to placebo. So the longest term in healthier individuals is two years. In clinical populations, it's been up to five. Okay, great. So creatine versus whey versus casein, not the same thing, but what is best and or necessary for women's strength training? Well, definitely protein has to be there. Make sure you're getting your adequate protein. And it doesn't take a lot in addition to your diet. And then creatine on top, there's been a few studies to show that the combination of whey and creatine was superior to other whey protein or creatine alone we don't know the effects of creatine and casein in different populations okay what age is recommended to start supplementing is there like a baby in theory as soon as you're born you could because you're naturally producing it but there's no minimum or maximum age that has been established okay um is creatine contraindicated if you have kidney stones the answer is probably no however when you have some type of pathology you're predisposed to kidney stones or any other type of renal issues uh you want to make sure that the level of creatinine that's being produced from creatine is not going to expand those symptoms so again talk to your nephrologist for sure to see any of the effects.

56:08I have celiac disease and when I tried creatine even though I was marked gluten-free it caused intense intense intestinal issues. Is creatine linked to celiac response? Is there a type of creatine or dose that would give benefits without stomach distress? Yeah the small body of research suggests that creatine has anti-inflammatory effects and it could be beneficial for people with IBS. Maybe the dose was a little bit too high there where creatine will trap water in the GI tract, specifically around the small intestine that could cause some of those adverse effects. So for that listener, maybe if you're thinking of it, start with a really, really small dose, maybe the 1.5 gram, even as low as that per day to see how you do tolerate it.

56:49But there's some anti-inflammatory and anti-catabolic effects of creatine. And in people with IBS, there has been evidence to suggest it helps decrease inflammation. that's great so if if someone is a little bit bloated when does that water retention kind of wear off on average we're starting we see it about seven to ten days is when the individual will sort of the body will go through homeostasis they'll street more water um or retain more if they need it but it doesn't take long it's just you need to have a little bit of patience and And again, we don't really see that at all with a low, low dose on a daily basis.

57:27It's the loading phase where we really see a high amount. Okay, great. Issues of taking creatine. Oh, we talked about that. I am a breast cancer survivor. I know we talked about this, but is what's your opinion on creatine and hormone positive cancer and if HMB is worth using? So overall, HMB has a lot of profound benefits, primarily for the aging population in with exercise. There's some studies that have looked at the combination there. So I don't see any reason not to consider it. It probably won't cause the great effects you're hoping, but it is something to consider at least to have some beneficial effects.

58:04There's a position stand coming out on HMB very shortly where we looked at all the data and it actually has some good beneficial effects, primarily for clinical populations and aging adults. Okay. Well, that wraps it up. That was a fantastic, almost hour, just rapid fire question. So if we're wrapping it up, pretty safe to take for everyone. Obviously talk to your physician. We know that creatinine levels will be affected more than likely. Maybe cycle off of it four weeks before if we're talking about, you know, wanting to see an accurate blood test. safe for postmenopausal women, safe for teens.

58:46You know, three to five grams is the basic, but we could go up to potentially 10 or more depending on those benefits that are coming out in current research and future research that we see. And then we know that the Perry crowd is, it might get some love on some studies. That's right. Yeah. And, and for those, uh, I often get asked, well, how much creatine is in like a serving of salmon or red meat? It is about three grams. So again, if you're traveling and you didn't take your powder and you say, Hey, I'm trying to get three grams in addition, a salmon steak or a chicken breast or whichever will have a contributing amount.

59:29Um, so it's not that difficult. Again, the, the dose that we're talking about is so small compared to protein. Half a teaspoon of powder, a couple of those gummies or whichever, you don't need a lot. And don't expect a lot, but again, you don't need a lot, yeah. Okay. And then we're just looking for a pure brand. Obviously, I'm guessing you can't recommend necessarily. Yeah. As long as the brand on the label is certified safe or has NSF or some type of third-party tested, that does increase the validity and credibility of that. On the back of the label, you're primarily looking for something called creatine monohydrate.

1:00:06And then if it has a whole bunch of other things in there, we can't comment on that. But then again, the main driving force is exercise and then creatine can be unlocked with that. And then you may experience some of the benefits that most people do. You know that I say it for you because you won't say it, but I call it the magic supplement. Okay. Yeah. Or the miracle supplement. Yeah. It seems to have a lot of applications for a lot of people right now. So great. Well, thank you so much, Darren. This has been fantastic. I feel like everyone got an incredible amount of information and all of their questions answered.

1:00:39So we appreciate you taking your time to share all of your expertise with us. No, thank you so much for having me. Thanks for listening. If you enjoyed this episode, please consider giving us a five-star review and sharing the body pod with your friends until next time happy birthday america it's time to celebrate and play your favorite las vegas casino games by american-owned spinquest.com what's better than fireworks and american pie hitting a black check in the palm of your hand and you won't lose your fingers over a thousand games including slots and live dealers and$30 point packs are on sale for 10.

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