In short
The episode tackles the supplement hype cycle, arguing that the 1994 Dietary Supplement Health and Education Act classifies supplements as “food” (not drugs), so they don’t need to prove safety/efficacy like medications. It then uses creatine as a case study: what it does, who benefits, safety concerns, and how to choose a trustworthy product.
Guests/backgrounds
No guest is interviewed. The hosts are Dr. Jesse Mills (urology/ED/male fertility/Peyronie’s/low testosterone specialist) and Jordan Runtog. The episode also references Cynthia McFadden and “Eating Interrupted” only as promo.
Key claims
Creatine is generally safe; “high creatinine” on labs can reflect muscle turnover, not kidney failure. Only about 30% of ingested creatine reaches the body. Benefits are small for already-fit people but larger for frail older adults and some vegetarians. Choose brands with USP/NSF third-party testing.
Notable examples
Cystatin C vs creatinine testing; frail men/older adults gaining ~6 lb muscle in 3 months; cognitive claims mainly from vegetarian diets; Huntington’s MRI-based studies showing short-term slowing but unclear long-term relevance.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOSummer Health and Trends
0:41 to 2:03
Discussion about summer health trends and the importance of regular check-ups.
“ZepBound Terzepatide may be able to help.”
Summer Health and Trends
3:20 to 6:02
Discussion about summer health trends and the importance of regular check-ups.
“Let's talk about it Let's talk about it, the mailroom Welcome to the mailroom Yeah, welcome to the mailroom, everybody.”
Navigating Dietary Supplements
6:02 to 10:50
Exploration of the dietary supplement market, focusing on safety and efficacy.
“But let's kind of break it down, if that makes sense to you.”
The Case for Creatine
10:50 to 14:37
A deep dive into creatine as a supplement, discussing its benefits and safety.
“Without, you know, again, I meet people where they're at.”
The Case for Creatine
14:42 to 16:08
A deep dive into creatine as a supplement, discussing its benefits and safety.
“That's genesight.com forward slash iHeart today.”
Regulation of Supplements
17:24 to 18:25
Discuss the 1994 ruling on supplements and its implications.
“So supplements are classified as food and therefore held to a significantly lower standard.”
Understanding Creatine
18:28 to 24:18
Explore the safety and effects of creatine as a supplement.
“I mean, we talked about this all the time, but I can start to sell the Melroom supplement by Dr.”
Challenges with Supplement Absorption
24:19 to 26:19
Learn about the body's absorption of creatine and other supplements.
“So one of the other things that's super important is that you can spend so much money on creatine, but the brand-to-brand comparisons really don't show much of a difference.”
The Importance of Food and Digestion
26:46 to 27:38
Understand the complex relationship between food and the body.
“And yes, it's one of life's great pleasures.”
The Importance of Food and Digestion
28:04 to 28:17
Understand the complex relationship between food and the body.
“with zero to moderate gene-drug interactions.”
Show all 17 chapters
The Importance of Food and Digestion
28:22 to 29:44
Understand the complex relationship between food and the body.
“ZepBound Terzepatide may be able to help.”
The Role of Creatine in Weight Training
30:51 to 40:43
Discuss the benefits and experiences related to creatine use in weightlifting.
“I started seeing a trainer to do weightlifting about two years ago, and I had never done anything like that before.”
Creatine and Cognitive Function
40:43 to 42:01
Explore the potential cognitive benefits of creatine supplementation.
“I feel like we got to add like a like a ding or like this gets the the mailroom, not garbage seal of approval.”
Understanding Creatine: Benefits and Considerations
42:01 to 42:54
Learn about the physiological effects of creatine and its relevance in muscle building.
“And so if you really are building muscle that takes a lot of water.”
Teasing Future Topics on Supplements
42:54 to 43:12
Discover upcoming discussions on various trending supplements.
“So next time around, we'll, we'll look at a lot of maxing, some fiber maxing, some mag maxing, some, some mad maxing even.”
Teasing Future Topics on Supplements
45:43 to 46:02
Discover upcoming discussions on various trending supplements.
“if you're nursing, pregnant, plan to be, or taking birth control pills.”
Teasing Future Topics on Supplements
46:09 to 46:35
Discover upcoming discussions on various trending supplements.
“If you're a lineman in charge of keeping the lights on, Grainger understands that you go to great lengths and sometimes heights to ensure the power is always flowing.”
Transcript
Automatic transcript. May contain errors.0:00This is an iHeart Podcast. Guaranteed human. Let's be real. Eating is a huge part of our lives. It fuels us. It brings us together. And yes, it's one of life's great pleasures. But once a meal's over, we don't think much about what happens next. Unless something starts to feel off. Introducing Eating Interrupted, a new podcast from iHeartRuby Studio, hosted by longtime journalist and Crohn's patient, Cynthia McFadden. Listen in to unpack what it means when your body doesn't always respond to food the way you expect and what science is now revealing about why. Listen to Eating Interrupted on the iHeart app, Apple Podcasts, or wherever you get your podcasts.
0:40Are you looking for support in your weight management journey? ZepBound Terzepatide may be able to help. ZepBound is a prescription medicine used with a reduced calorie diet and increased physical activity to help adults with obesity. or some adults with overweight who also have weight-related medical problems to lose excess body weight and keep the weight off. ZepBound is approved as a 2.5, 5, 7.5, 10, 12.5, or 15 milligram injection. ZepBound contains terzepatide and should not be used with other terzepatide-containing products or any GLP-1 receptor agonist medicines. It is not known if ZepBound is safe and effective for use in children.
1:20Don't share needles or pens or reuse needles. Don't take if allergic to it, or if you or someone in your family had medullary thyroid cancer, or if you've had multiple endocrine neoplasia syndrome type 2. Tell your doctor if you get a lump or swelling in your neck. Stop ZepBound and call your doctor if you have severe stomach pain or a serious allergic reaction. Severe side effects may include inflamed pancreas or gallbladder problems. Tell your doctor if you experience vision changes before scheduled procedures with anesthesia. If you're nursing, pregnant, plan to be, or taking birth control pills.
1:51Taking ZepBound with a sulfonylurea or insulin may cause low blood sugar. Side effects include nausea, diarrhea, and vomiting, which can cause dehydration and worsen kidney problems. Talk to your doctor. Call 1-800-545-5979 or visit zepbounds.lily.com. Hello there, it's Tabitha Brown. Let me tell you about YouTube Premium. I can watch my favorite videos without ads interrupting me. And honey, when I'm cooking, I don't need no interruptions. The onions need me. My garlic needs me. Plus, I can download videos for when I don't have Wi-Fi and keep listening with background play. Try YouTube Premium for two months free at YouTube forward slash premium.
2:34If you like YouTube, you'll love YouTube Premium. Trial eligibility varies, terms apply, and cancel anytime. Sixteen years ago, I started working as a CNA in the hospital. I loved it. On the day I decided to enroll in the nursing program at Rasmussen University, because afternoon, my 35th birthday, I was hanging out with a friend, and they had just questioned me what I was going to do with this next chapter of my life. I immediately had said, I want to go to nursing school. So I actually had contact information from an advisor at Rasmussen, contacted her, and actually ended up starting like three weeks later.
3:04My name is Cherish Adams, and I'm a Rasmussen University graduate. Learn more at rasmussen.edu.
3:20Let's talk about it Let's talk about it, the mailroom Welcome to the mailroom Yeah, welcome to the mailroom, everybody. No, that's not going to work, Jordan. Let's go back. Yeah, I don't think I quite have that Wolfman Jack thing down. I was, you know, all right, rock and roll kids. Let's go back to Dr. Mills before I lose my voice. But gosh, you know, it's so fun to be here. How you been, man? I've been great. I'm always happy to be on mic with you. We are in August now. We are heading towards late summer. Got anything planned for, although it's always summer in L.A. Always summer in L.A. It's really, I don't want to sound like that guy, but it's really hard to say, where should I go on vacation?
4:02That's true. You know, when I live where so many people vacation, the weather's perfect. You know, we're not on fire, which is really cool. And sadly, a lot of the country and the continent and European continent is. And so I certainly really deeply empathize with those people since, you know, I was part of the Palisades conflagration not too many months ago. So now I'm kind of just chilling. And summer's a good time to go to the doctor. A lot of guys, you know, have the time off. I do a lot of vasectomies in the summer. And I think, you know, if the kids are at sports camp or something like that, it's a big time for guys to get that snip that we've talked about.
4:38And so it's a very popular time for that and elective surgeries. And so, so yeah, I don't really have seasons, Jordan. I think about my accountants when they come into the office and I, God bless those guys because wow, I can only imagine the intensity with which they practice their craft, you know, for a couple months of the year and yet they're busy all year anyway. But every time I see an accountant that comes in my office in March, I'm like, that guy really, really has to be here. You know, I mean, he has to be. It's true. Yeah. So it increases the urgency with which I'm going to take care of him.
5:08But, but yeah, man, it's a, it's a good summer. Yeah, everything is chill. So we were talking last time about, you know, kind of, I don't know, sort of a grab bag of stuff you shouldn't ignore. And this episode, maybe the next couple are going to be actually stuff you can't ignore because you're constantly in your face, right? Like every time you open your socials, you're going to get an ad for something, for berberine, for ashwagandha, for creatine. I mean, all kinds of stuff. And I figure I would love to just give our listeners an idea of what's real, you know, what's legit, what's out there, what have you been hearing on your feeds?
5:47And kind of get to an idea of is there something out there that you're getting bombarded with if you are on sports radio, if you're listening to anything, including our show, right? You're going to hear stuff that has some data and maybe stuff that doesn't. But let's kind of break it down, if that makes sense to you. Is that a reasonable game plan for the next little bit? That is great, because I feel really passionate about it, because I feel, I was just thinking this, seeing ads on the subway for, I won't name them, but brands of what I'll loosely call supplement medicine somewhere in between, all these things that seem to occupy this increasingly large gray area of not FDA-approved medication, but things you can get anyway.
6:29and it's scary to me and I feel like and I'm sure you have a lot of thoughts on this the pandemic really broke open uh everybody became experts in their own little unique fields and started taking things that you know some of them are more natural than others things like shilajit and ashwagandha mushrooms which I at least those I can kind of understand to things that I understand less about yeah well remember if something is coming into your feeds somebody is trying to sell you something. So that's the first, that's the first thing is that you're not doing it because they've decided that they're taking a vow of poverty and they want to let you in on a secret, you know, that is, you know, that has cured them of cancer, sort of the, you know, the Steve McQueen, go to Mexico, get your green tea enema and save yourself from metastatic prostate cancer.
7:21I mean, this isn't new, Jordan. I mean, this is the crazy thing is that, you know, we think this is all new and it's certainly more accessible, but this goes back centuries, you know, really it does. And, and one of the shocking things actually is in some ways, I'm going to, I'm going to say something that'll probably get a little bit of heat, but in some ways we're actually worse off now than we were in say 1906. And the reason for that is if you look at the history of the food and drug administration, the FDA, it really came out of the modern era, at least it came out of Teddy Roosevelt, 1906, when he said there are people literally dropping dead of food poisoning and eating and drinking and taking all kinds of medications and foods that are toxic and sometimes lethal.
8:07And there was no regulation of that at a federal level, even at any level, is if you sell it, if I tell you, Jordan, I'm going to cure you of rheumatism if you take this pill, and that pill is chock full of mercury or chock full of opiates or chock full of alcohol or anything, they had no labeling. They had nothing. You just had to trust the person that was selling that to you. And you think, God, that's a horrific time, right? This is terrible. This is why the FDA started to really monitor the food and drug supply. It was an active Congress that led to this, where modern companies, modern as of post-1906, had to prove two things before a product was approved for human consumption, and that was safety and efficacy.
8:48Okay, great. Makes sense, right? Well, 1994, Congress passed something called the Dietary Supplement Health and Education Act, and they declared that supplements are food and not drugs. That actually set us back almost 100 years because everything I just said, anything that you buy that doesn't have a prescription associated with it, it doesn't have to prove safety or efficacy. And so prior to 1994, there were about 4 ,000 products on the shelves in nutritional supplements. So if you walked into Walgreens, CVS, Kmart, anybody? Montgomery Ward? No, I don't think they sold things. I don't remember where we were shopping in 1994.
9:27But they had multivitamins, right? You know, one a day, whatever. And the revenue for those 4 ,000 products was around$4 billion. That's billion. Sorry, just let that drop for a second. I was trying to show a cool billionaire. Billionaire. Supplements are billionaire, right? There's so much money for a branch of medicine with little data. $4 billion. Well, just give me an idea of what happens in 2025. In 1994, there were 4 ,000 products, right? They made 4 billion, which sounds like a lot. In 2025, 100 ,000 products without any FDA warnings, labels, scrutiny, 100 ,000 products. The FDA tries their best, they inspect about 500 facilities a year, which represents 5 % of what you're sitting there buying on the shelves, 5%.
10:18You know, the combined, the conservative reported combined annual revenue of all of those 100 ,000 products was over$210 billion. And that's just the stuff that you get in gas stations and Walgreens and Target, you know, the whole internet, gray market, whole different thing. There's no way even tracking, but it's probably at least double that. Right? So in some ways, what we're going to talk about is there's going to be data on some of the things that are on your feeds. And then there's just going to be complete garbage. And I think that's what we're going to have to figure out. Without, you know, again, I meet people where they're at.
10:52If a guy comes in, tells me they're taking this, as long as they're not killing themselves, I'm going to say, you're probably going to be okay. Right? But by the same token, we're going to talk about it. So if you have to navigate this market space, you're going to say, okay, Mills, well, what if there's something out there? I'm going to use creatine as an example, and we'll kind of unpack that, whether you and I or our listeners should be on creatine, both men and women. There's a couple of things that I want you to look for, and it's surprising how few supplement companies actually have this, but there are third-party inspection certificates.
11:24And so look on your label. If you're buying it online, make sure that they have USP and or NSF certifications. Those are sort of the gold standard labels where people actually have to submit samples to these labs for them to decide whether or not this stuff actually is okay and it contains what it has. because I can't tell you over the decades of labels that were poorly written out have ingredients that don't belong there. The classic one from a year or two ago was what I called, I think we talked about truck stock Viagra, right? Where you don't think you're getting Viagra, you're getting something that's going to turn you on, horny goat weed, something else that seems safe and natural.
12:06But a lot of those actually have contraband phosphodiesterase inhibitors in there. So if you're a guy driving down the street, and you're getting chest pain, and you have nitroglycerin, which some guys still take to relieve their angina, and you take one of those, then, you know, you drop dead on the highway. So, you know, you got to know what you're getting. The USP and NSF labels at least gives you a little bit of, I don't know, a little bit of security that at least you're getting what the label says you're getting. But the quantities, how much actually is in each milligram tablet is variable, and also poorly regulated.
12:41And again, that's where the FDA kind of turns the other cheek as of 1994. So unpack that. Have I, have I knocked, are you wearing socks? And are they, have they been knocked off? Other than my terrible Wolfman Jack impersonation, I probably cringed and edited that out.
13:10Let's be real. Eating is a huge part of our lives. It fuels us. It brings us together. And yes, it's one of life's great pleasures. But once a meal's over, we don't think much about what happens next unless something starts to feel off. Because what we eat and how our bodies respond to it is complicated. From the very first bite, food kicks off a chain reaction, signals moving between the gut, the brain, the immune system, a constant back and forth we can't see and often don't fully understand. Again, introducing Eating Interrupted, a new podcast from iHeartRuby Studio, hosted by longtime journalist and Crohn's patient Cynthia McFadden.
13:49Eating Interrupted explores everything from food allergies and intolerances and why they seem to be on the rise to how digestion changes as we age and what it's really like to live with a chronic GI condition. Through personal stories and expert insight, listen in to unpack what it means when your body doesn't always respond to food the way you expect and what science is now revealing about why. Listen to Eating Interrupted on the iHeart app, Apple Podcasts, or wherever you get your podcasts. Struggling with side effects? Your genes might tell you why. The gene site test may reveal which mental health medications require dose adjustments, be less likely to work, or have an increased risk of side effects based on your DNA.
14:33If your medications aren't working for you, discover how the GeneSight test may help. Visit genesight.com forward slash iHeart today. That's genesight.com forward slash iHeart today. Are you looking for support in your weight management journey? ZepBound Terzepatide may be able to help. ZepBound is a prescription medicine used with a reduced calorie diet and increased physical activity to help adults with obesity or some adults with overweight who also have weight-related medical problems to lose excess body weight and keep the weight off. ZepBound is approved as a 2.5, 5, 7.5, 10, 12.5, or 15 milligram injection.
15:14ZepBound contains terzepatide and should not be used with other terzepatide-containing products or any GLP-1 receptor agonist medicines. It is not known if ZepBound is safe and effective for use in children. Don't share needles or pens or reuse needles. Don't take if allergic to it. Or if you or someone in your family had medullary thyroid cancer or if you've had multiple endocrine neoplasia syndrome type 2. Tell your doctor if you get a lump or swelling in your neck. Stop ZEPBound and call your doctor if you have severe stomach pain or a serious allergic reaction. Severe side effects may include inflamed pancreas or gallbladder problems.
15:48Tell your doctor if you experience vision changes before scheduled procedures with anesthesia. If you're nursing pregnant, plan to be, or taking birth control pills. Taking ZEPBound with a sulfonylurea or insulin may cause low blood sugar. Side effects include nausea, diarrhea, and vomiting, which can cause dehydration and worsen kidney problems. Talk to your doctor. Call 1-800-545-5979 or visit zepbounce.lily.com. Hey, what's up guys? It's Haley Bailey. Okay. I need to tell you about something. I just got YouTube premium. It's got tons of awesome features like offline downloads, so I can download my favorite videos before I travel and watch them whenever I don't have wifi because we all know airplane Wi-Fi is the worst.
16:32I get ad-free, I get backroom play, and there's like a ton more in there. You should try it. If you like YouTube, you'll love YouTube Premium. Try it now for two months free at youtube.com slash premium. If you like YouTube, you'll love YouTube Premium. Hi, I'm Sean Evans from Hot Ones, and I want to tell you about YouTube Premium. It has offline downloads, so you can watch without Wi-Fi. Background play, so you can lock your phone and it still plays, baby. Oh, and it is completely ad-free. Yes, I said it, ad-free. Try YouTube Premium for two months free at youtube.com slash premium. Trial eligibility varies, terms apply, cancel anytime.
17:14time.
17:24I'm really disturbed. I was not aware of the 1994 ruling. So supplements are classified as food and therefore held to a significantly lower standard. Is it right? Not medication. I don't even have anything intelligent to say to that. I just find that deeply, deeply troubling. Yeah, not to get too political, but I got to just mention that at the time, one of the key senators was a guy named Orrin Hatch from Utah, whose family happened to be deeply and still are deeply, deeply invested in the supplement industry. And I'm not saying that there's a conflict of interest there. I'm just saying that, again, these guys, you know, at a high level are probably producing very high quality supplements that are doing a lot of good for people.
18:06That's the plus. But by the same token, they've opened up, you know, the gates of hell to any unscrupulous person that doesn't put their supplements through regulation. And so by protecting their brand and making sure it's in the shelves without going through FDA scrutiny, that act has opened up the Wild West, probably wilder than the Wild West. So, yeah, it's a thing. And it's so easy to sell. I mean, we talked about this all the time, but I can start to sell the Melroom supplement by Dr. Jesse Mills that because I'm a specialist in erectile dysfunction, male fertility, Peyronie's disease, low testosterone, I can give you one pill that will cure all of those things.
18:44And if you believe in me enough, that placebo effect was going to carry at least 30 to 40 % of people refilling their order. Or I'll put you on an auto refill so you don't even have to give me your credit card every time. It just keeps coming in the mail, one after the other, after the other, after the other. and so it's out there man it's out there so so let's talk about a real life example right what do you know about creatine i know i hear a lot about it at the gym and i see a lot of smoothies being made with it i uh but that beyond that very little i mean creatine is a sort of a naturally occurring peptide and so it's it's easy it's cheap and so it really is more like protein powder or something that probably does go more towards food than medication.
19:28Because all it does is it gives you a building block, potentially to make more muscle. So creatine, I started with this, because this is a little bit of a, I've changed my mind scenario, because I'm a skeptic, but I also, you know, I'm also a zealot about health and wellness and nutrition and things work. And, and so, you know, I remember as long as even back to medical school, that when bodybuilding was, I wouldn't say this is infancy, but Arnold was still Terminator 1 at that point. So it was a thing. But we were taught, no, creatine is really bad for your kidneys, and it can lead to renal failure and all these horrible things.
20:06And so I recommended men not to take creatine for a long time. But the literature on it actually is at the minimum benign, and in certain populations actually it may have some effects. Because again, this I do believe is more of a food additive rather than a medication that is masking or getting along the side of federal scrutiny as a supplement when it's actually truly should be a prescription. But that's one thing is that creatine can kill your kidneys and it really doesn't. Even guys that have impaired renal function doesn't work that way. And so we have to be a little bit careful when we say that.
20:43It actually is a little bit associated and also confused with a biomarker that we use to judge renal health, and that's called creatinine. Totally different molecule, but we use creatinine, which is a breakdown of muscle turnover, which is a good thing. If you're a bodybuilder, you want your muscles to break down so they can double in size and propagate, and that releases a lot of creatinine into the bloodstream. And if you're on creatine, the idea is that you can improve, especially if you're an elite athlete, marginally you can improve muscle mass. And there's data to show that. So that your creatinine, that renal blood test, can go up doesn't mean you have renal failure.
21:24And here's sort of a shout out to anybody out there that is really packing on the mass and not skipping leg day. When you go to your primary doc and they're saying, hey, let's get a checkup for you, Jordan. and you're looking like you've put on some major, major muscle mass and they check your creatinine, it might be high. And that's something that you have to let your doc know, hey, look, I'm lifting a lot. I'm taking supplements. I'm doing what I can to boost up and gym max. And there are more accurate blood tests for bodybuilders or people that are hitting the gym pretty hard than creatinine because it is going to be higher simply because you're making more muscle and therefore you're turning over more of that molecule.
22:03So there's something called a Cystatin C test, which you can ask your doctor to order, say, hey, look, if your creatinine is high, higher than what would be normally associated with your age or your gender, then you should get a Cystatin C. So that's my little public service announcement that my creatinine, my personal creatinine is always hovering between 1.2 and 1.4. And I'm, you know, not the massivist guy that I could be, but still I'm a little on the high side just because I do hit the gym every once in a while. And so bottom line is creatine, the supplement, is probably safe, but let's really break down what it does.
22:43And so this is where I think is interesting is that if a guy is on creatine because they think they're really doing great things in the gym, I'm going to say they're probably just really doing great things in the gym. And they should give themselves credit for that because what you see is unless guys are starting from a position of frailty. So one of the better studies on creatine and if it does anything, looking at men in their late 60s, early 70s that were actually a little bit on the frail side and putting them on a vigorous gym activity plus a weight-based creatine dosing schedule, meaning that we said, okay, if you're 50 kilograms or 70 kilograms, then we're going to put you on an appropriate level of creatine.
23:28And we'll get into that in a bit, you know, what guys should take if they want to take creatine. And they did see in three months an increase in muscle mass of about six pounds, which is pretty impressive. But if you're not frail, you're already kind of as buff as you're going to get without really, really increasing your gains, then you're not going to see much. And in fact, when you look at improvement in elite athletes taking creatine, performance rates go up in a single digit percentage points, you know, whether they're looking at weight gain or, you know, speed times. But again, if you're an elite athlete, 1 % improvement, that could be your PR, you could be a world record holder.
24:03So for the average guy like me, I'm not working out enough that I probably need creatine, and I'm not frail enough that I need creatine. I'm just an average guy that goes to the gym and works out to maintain good bone density. It's not going to probably do much for me, but it also isn't going to hurt me. It's also really cheap, right? So one of the other things that's super important is that you can spend so much money on creatine, but the brand-to-brand comparisons really don't show much of a difference. So as long as you're getting it from a reliable source that has that third-party scrutiny that you're actually getting it, you're probably fine.
24:35You don't need to spend a lot of money on some of these much more advanced creatine or things that put in things like nitric oxide boosters, which as we know is just arginine or citrulline. You're just buying a brand and buying a label. And so that's the take home. Do you know also when we do studies and look and see, you know, how much creatine actually gets absorbed? This is the other thing that bugs me in general about all this talk about peptides and supplements. And we're going to get into this in a little bit with another hot topic, which is when your body, when you ingest something, you drink it, you chew it, you swallow it, whatever you chew and swallow your gut and your liver and everything is going to break it down into its fundamental building block.
Read the full transcript
25:17So if you take in something like collagen, for example, people are really big into collagen and colloidal collagen. Your body does not actually take the collagen in your gut and then do nothing with it. And then you just sort of like customs passport through and all of a sudden it's collagen in your body. It breaks it down into all its components and then it synthesizes what you need based on your demands. And so when we look at studies of creatine that people actually, will they take it tagged to something? Usually we do something like tridiated hydrogen, which is basically a hydrogen molecule that can show up when you're looking for it through radio tracing.
25:53Only about 30 % of the creatine that you actually ingest even makes it into your system. And the rest of it just, you know, gets digested out and it, you know, goes into the toilet, especially if you're fiber maxing, which is a little foreshadowing there for us. So, yeah, what you eat, you get only about 30 % of it that actually gets synthesized in anything. So I don't know. I think I'm not like a huge fan of creatine for average bodybuilders that go into the gym and just trying to put a little mass on. But I don't think it can hurt you. So if it makes you feel better, if you think you're doing it, great.
26:28But in the end, a lot of it just gets pissed away.
26:46Let's be real. Eating is a huge part of our lives. It fuels us. It brings us together. And yes, it's one of life's great pleasures. But once a meal's over, we don't think much about what happens next, unless something starts to feel off. Because what we eat and how our bodies respond to it is complicated. From the very first bite, food kicks off a chain reaction, signals moving between the gut, the brain, the immune system, a constant back and forth we can't see and often don't fully understand. Introducing Eating Interrupted, a new podcast from iHeart Ruby Studio, hosted by longtime journalist and Crohn's patient Cynthia McFadden.
27:24Eating Interrupted explores everything from food allergies and intolerances and why they seem to be on the rise to how digestion changes as we age and what it's really like to live with a chronic GI condition. Through personal stories and expert insight, listen in to unpack what it means when your body doesn't always respond to food the way you expect and what science is now revealing about why. Listen to Eating Interrupted on the iHeart app, Apple Podcasts, or wherever you get your podcasts. Do you find yourself spending too much time on healthcare visits? In a small study, patients taking medications that had significant gene-drug interactions had nearly twice the number of total healthcare visits compared to those taking medications with zero to moderate gene-drug interactions.
28:12Time is precious. See how the GeneSight test may help you spend less time at your doctor's office. Visit genesight.com forward slash iHeart today. Are you looking for support in your weight management journey? ZepBound Terzepatide may be able to help. ZepBound is a prescription medicine used with a reduced calorie diet and increased physical activity to help adults with obesity, or some adults with overweight who also have weight-related medical problems to lose excess body weight and keep the weight off. ZepBound is approved as a 2.5, 5, 7.5, 10, 12.5, or 15 milligram injection. ZepBound contains terzepatide and should not be used with other terzepatide-containing products or any GLP-1 receptor agonist medicines.
28:57It is not known if ZepBound is safe and effective for use in children. Don't share needles or pens or reuse needles. Don't take if allergic to it. Or if you or someone in your family had medullary thyroid cancer, or if you've had multiple endocrine neoplasia syndrome type 2, tell your doctor if you get a lump or swelling in your neck. Stop ZepBound and call your doctor if you have severe stomach pain or a serious allergic reaction. Severe side effects may include inflamed pancreas or gallbladder problems. Tell your doctor if you experience vision changes before scheduled procedures with anesthesia, if you're nursing, pregnant, plan-to-be, or taking birth control pills.
29:33Taking ZepBound with a sulfonylurea or insulin may cause low blood sugar. Side effects include nausea, diarrhea, and vomiting, which can cause dehydration and worsen kidney problems. Talk to your doctor. Call 1-800-545-5979 or visit zepbounds.lily.com. If you like YouTube, you'll love YouTube Premium. It's destroying athlete, creator, and YouTube Maxer. YouTube Premium enhances how I use YouTube with awesome features like offline downloads so I can download my favorite training videos before I hit the gym. So no Wi-Fi doesn't turn leg day into loading day. Plus, I get ad-free videos, background play, and so much more.
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30:47premium. Trial eligibility varies. Terms apply. Cancel anytime. That's a mouthful.
31:02Well, let me ask you this though. I mean, I'll use myself as an example. I started seeing a trainer to do weightlifting about two years ago, and I had never done anything like that before. I had no background in it at all. You mentioned that if you're really frail or really, really buff, everybody in the middle, it kind of has a negligible effect. Would that have been a helpful thing for me to take when I was first starting out and was considerably, okay? Yeah. So there are what's called loading doses of creatine where when you're saying, hey, I'm going to start ramping up because nobody wants the DOMS, right?
31:35The delayed onset muscle soar. So it's not like day one is day two or three when you're like, oh my gosh, I can't even walk. I remember the first time that that I really learned to work out I was a freshman in college and I had a roommate who was just like so buff and a great bodybuilder and he took me to our rec center at UCLA the wooden center and I was also working ironically in the mail room and uh and there were these old buildings at UCLA where you had to carry the mail up two or three or four or five flights of stairs because there's no elevator and he taught me to squat and I'm like this is great.
32:08You know, I was like 165 pounds learning to squat. And I remember that I actually had to crawl up the stairs to deliver mail the next day because my legs were so wrecked. It was embarrassing. I was crippled by leg day. And I'm still traumatized to this day, 30 odd years later. But yeah, that's real. And so there might be some data that if I had loaded up on creatine, as I was starting my weightlifting journey, or as you were starting your weightlifting journey, that that loading dosing and then kind of maintenance dosing, which is usually about half of your loading dose is, is a reasonable thing to potentially help improve muscle turnover.
32:45Cause I, I was, you know, stupid 19 year old, 18 year old thinking, uh, yeah, I'm super strong. I was a pretty good athlete in high school and, uh, oh man, that just wrecked me just crawling up, like holding this broad iron railing step by step, you know, and thank God nobody was there. they would have probably called an ambulance to get me up. And I'm like, no, it's just leg day, man. It's just leg day. Yeah. So, so that is a good point is that, that, that might be a role for it, but maintenance, it's, it's hard to do, you know, first of all, it's hard to comply with all of these things in general, you know, when you think about compliance, sort of a side topic, but medical compliance, prescription compliance is dismal, right?
33:26And if no matter what the drug, the guys that will refill their prescription shockingly is around 50%. I was surprised even in the testosterone literature. So when, when, uh, androgel, which was, we've talked about this in the, in the testosterone history section of our podcast, but we, you have this medication, you put it on every day, you put it on, you know, kind of like a hand sanitizer, body lotion, easy to do, makes you feel good. But the refill prescription rate of androgel when it first came out was only 50%, even though it's a drug that makes you feel better. So imagine a statin, right, can be a life-saving drug for cholesterol and heart disease prevention.
34:06The prescription refill rates for statins are even worse, where you take it, your muscle aches, whatever, you're not compliant. So noncompliance is huge. So now imagine the compliance rate for supplements. We don't even know if it works, but you saw a commercial, you said, dude, I need to get jacked like that guy, I'm going to start taking it. Honestly, none of us is very good at complying with supplements. Anyhow, it's this. And that's what's so crazy about the market share being so high is that the number of refill, I can't call them prescriptions. So refill orders is pretty low. But creatine is another one of those things.
34:40I personally have been on and off it more times than I can count in 20 odd years, because I think, yeah, that's it. I'm going to ramp up. I really want to start, you know, I'm going to, I'm going to hit my 315 bench. I need it. And I I do it for a while and I'm like, ugh, you know, doesn't taste very good. It's kind of bitter. But the data are there. So I think that's a long answer to your question. The other thing that comes up a lot in creatine that's really having a moment is this idea of cognitive function studies. And is there a place for creatine in help improving brain function, maybe warding off cognitive decline?
35:15And the answer to that is a little mixed, but also somewhat positive. You know, so if you have a history of early onset dementia, for example, in your family, and we don't really have another way to prevent it, there have been some studies that show that it can improve cognitive performance. Again, you have to look at where the data come from. So creatine naturally occurs in meat. So if you have a typically, you know, American diet where you're eating a lot of beef, chicken, poultry, those actually have enough creatine in that you're probably not going to see much of an effect. But if you have a very strict vegetarian diet, it's a lot harder to get creatine on a non-meat-based diet.
35:56And so there have been studies, but again, the studies that a lot of people are quoting about the improvement in cognition were done in people on vegetarian diets. So again, figure out the patient population or the subject population in terms of whether that fits you. So if you're a strict vegetarian, you're worried a little bit about your cognitive future, as we all are, then there may be a role. However, if you look at the true benefit to doing creatine to improve cognitive function, it's something you need to start early, like in your 40s, 30s. And then you got to stay on it for 30, 34, 5, 40 years to know if it's even working.
36:35So to break that down a little bit, if you look at the literature about certain kinds of cognitive decline, do you remember, here's a little, we got to bring it back to music. Do you remember what Woody Guthrie died from? If you especially saw a complete unknown, maybe it talks about his deathbed there when Timothy Bob Dylan Chalamet is by his bedside. Is it MS? Huntington's disease. Yeah, but MS is a good guess. Yeah, Huntington's Korea. Yeah. Yeah. So it's an autosomal dominant disorder, means that you have a 50 % chance of getting it. So imagine the terror and fear that Arlo Guthrie lived in.
37:12Existential fear, really, that you don't know when your dad suffers from it and you're a kid, then you know it's a coin toss that you might get it. And you're not going to know because most of the symptoms of Huntington's don't show up until guys are in their 40s, 50s. And so here's Arlo Guthrie doing this little dance about, geez, do I get tested? Do I not? And he elected not to get tested. He just lived in this existential limbo, but he knew philosophically that there were no treatments for it anyway. So, you know, he just decided to enjoy every good day you have. Enjoy every sandwich at Alice's restaurant, of course.
37:47You just can't enjoy Alice. At least not if you're Arlo Guthrie, but man, that was a long run for a shallow cut. I don't know where I went with that. Oh, yeah, yeah, yeah. We're talking about studies in Huntington's Korea. So in guys with Huntington's disease, which again is a very rare, but very dramatic cognitive and movement disorder decline, it's kind of like having dementia, Parkinson's and schizophrenia all in one because you get hallucinations. It's a horrific, horrific condition that we truly don't have a cure for. But dating back about 10 years, there were some studies about creatine that could potentially delayed the onset of people that knew that they were going to develop Huntington's chorea as they aged.
38:29And this was MRI-based data. So that's kind of cool, right? I mean, you have actually objective data showing not only on cognitive-based scoring testing, but actually MRI, functional MRI that shows that creatine in both men and women with Huntington's can, in fact, slow the progression of the disease. And they did the study over 18 months. And so that's really cool. Now, sadly, after about four years, that decline didn't seem to help much. In other words, there's sort of an asymptote or a law of diminishing returns where the same study four years out didn't show much stabilization and functional decline.
39:06But even if it gave people a little extra time in a horrific disease, then that actually seems pretty good. But this is what we call a programmed cognitive decline, right? I mean, they know that as the Huntington's disease gets worse, they're going to decline in an almost stepwise appreciable objective fashion. Well, that's not the normal person that doesn't have Huntington's, right? That's not if you're saying, hey, look, my dad, my mom got Alzheimer's, I want to prevent it. So I'm going to take creatine. You can't really extrapolate those data. And so that's what kind of makes me a little bit squidgy about this is that there are studies, and that's what people are quoting.
39:46But look at the people they're studying and realize that either they have dietary habits that are not yours, In other words, people in very strict longitudinal vegetarian diets where they might be a little bit creatine deficient, or they have a known neurologic disorder that you can't really extrapolate to the general population. So I don't know. My take home on creatine, I think, is just buy the cheap stuff. You don't need fancy supplements, tagged in nitric oxide boosters, or there are some that are out there with nootropics and all these boutique supplements du jour. really no data that they work any better than just creatine that should cost you about 10 to 15 bucks a month.
40:24So I think it's a cheap supplement. I think there are enough data. I think if you want to take yourself from being, you know, relatively good athlete to being an elite athlete, or if you think that it may help with cognitive decline, because there's a little bit of data out there, then I don't know, I think I'm okay with it. So this is one where I've changed my mind, and I'm not, oh, supplements are garbage, and they don't do anything, because I've never said that, and I never will, because I think supplements are such a wide open, as we know now, anything that's not a prescription that isn't looked at at the FDA is a supplement.
40:56So that's what I got for you. I feel like we got to add like a like a ding or like this gets the the mailroom, not garbage seal of approval. Yes. Yeah, the fact or fiction is it's it's fact. It's very specific fact. I think that's right. So we'll give it a, I don't know, a thumbs up. I don't endorse any creatine products just to be, just if everybody knows that, that I have no supplement bias at all, but certainly not with creatine. So yeah, so that's it. So if you want to take it, I did say, you know, that dosing wise, it's for sort of the normal guys that are thinking about taking it, you know, loading doses where you say, okay, I'm going to really try to not try to hit Dom so hard that I can't walk up a flight of stairs in the next couple of days after leg day, then you can look at doing, you know, between seven and 10 grams a day.
41:46The one thing I will say is that it does really make you thirsty. I mean, it really can dehydrate you. So to make sure that you're taking tons of water with it to counteract it, because it's a very metabolically expensive supplement to process. In other words, your body, building muscle takes a lot of work. And so if you really are building muscle that takes a lot of water. It takes a lot of hydrogen and oxygen turnover, cellular phosphorylation, ATP production, all of that molecular physiology. So yeah, drink lots of fluids if you're going to hit the creatine, but continue on your healthy diet and, you know, let me know how it goes, but it definitely works.
42:23You just got to depend on who it works for. So that's creatine in a nutshell. I don't know. That's creatine at least in a little bit of a, 35, 40 minutes of figuring out whether it's right for you or not. But I think ultimately, take home messages, you know, you could be a good candidate for it, do your homework, make sure it's coming from a reliable source. And, and we'll let it rip for anybody out there that is creatine curious. Well, I know we've got a lot of other buzzy social media supplements to tackle. So next time around, we'll, we'll look at a lot of maxing, some fiber maxing, some mag maxing, some, some mad maxing even.
43:03Oh yeah. That's for my movie podcast. I will thunder drum you. I'll see your mad max and raise a fallen Hollywood hero. Yeah.
43:21Let's talk about it. Let's talk about it.
43:29Let's talk about it Let's talk about it in the mailroom Let's talk about it Let's talk about it in the mailroom The Mailroom with Dr. Jesse Mills was a production of iHeartRadio. It was executive produced by Jordan Runtog. It was edited, mixed, and mastered by Bahid Frazier, and the theme was provided by Long Transit. If you liked what you heard, please subscribe and leave a review. For more podcasts from iHeartRadio, check out the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows. This program is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.
44:19Consult your health care provider for any medical or other related questions or concerns. The views and discussions aired on this podcast are those of Dr. Mills and do not represent the official positions of UCLA or UCLA Health.
44:53some adults with overweight who also have weight-related medical problems to lose excess body weight and keep the weight off. ZepBound is approved as a 2.5, 5, 7.5, 10, 12.5, or 15 milligram injection. ZepBound contains terzepatide and should not be used with other terzepatide-containing products or any GLP-1 receptor agonist medicines. It is not known if ZepBound is safe and effective for use in children. Don't share needles or pens or reuse needles. Don't take if allergic to it or if you or someone in your family had medullary thyroid cancer, or if you've had multiple endocrine neoplasia syndrome type 2.
45:30Tell your doctor if you get a lump or swelling in your neck. Stop ZEPBound and call your doctor if you have severe stomach pain or a serious allergic reaction. Severe side effects may include inflamed pancreas or gallbladder problems. Tell your doctor if you experience vision changes before scheduled procedures with anesthesia, if you're nursing, pregnant, plan to be, or taking birth control pills. Taking ZepBound with a sulfonylurea or insulin may cause low blood sugar. Side effects include nausea, diarrhea, and vomiting, which can cause dehydration and worsen kidney problems. Talk to your doctor.
46:02Call 1-800-545-5979 or visit zepbounds.lily.com. If you're a lineman in charge of keeping the lights on, Grainger understands that you go to great lengths and sometimes heights to ensure the power is always flowing. which is why you can count on Grainger for professional-grade products and next-day delivery, so you have everything you need to get the job done. Call 1-800-GRAINGER, click grainger.com, or just stop by. Grainger, for the ones who get it done. Shortly after I enrolled at Rasmussen, I was diagnosed with breast cancer. It was like a bomb had just been dropped in my life. I reached out to Rasmussen.
46:51They immediately were like, Rosa, take what time you need. You can come back when you're ready. We are cancer-free today, and I'm just so grateful for Rasmussen for all of their support throughout my journey and for my own village. Rasmussen University. Find your seat and start now at rasmussen.edu. I love the little everyday moments with my dog, especially treat time. But dental care? Not always so fun. Until we found Greenies Dental Treats. These are more than just tasty. They're vet recommended and designed to support the four areas vets check the most. Plaque, tartar, gums, and breath. Their unique texture cleans down to the gum line and supports cleaner teeth after 28 days when fed daily.
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From the publisher
Dr. Mills takes a closer look at creatine—what it does, who may benefit from it, and whether it lives up to the hype. He breaks down the evidence on muscle growth, athletic performance, kidney health, and emerging research into possible cognitive benefits. Dr. Mills also explains when creatine may be most useful, how much of a difference it can realistically make, and why you don’t need to spend extra on elaborate formulations.
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