Ep. #872: Darren Candow on the Latest Research on Creatine Supplementation

Mike: Hello, and welcome to Muscle for Life. I’m Mike Matthews. Thank you for joining me today to hear about creatine. This podcast is all about creatine because I’m talking with Dr. Darren Cando about some of the common questions regarding creatine, some of the myths that are still in circulation, as well as some of the latest research on.

Creatine can benefit everyone, not just people who are looking to get more jacked. And while creatine isn’t a new subject for my podcast, Dr. Darren Cando is a fantastic guest. To dive deeper on the topic and to address some of the. Fornier concerns that people have these days. Like for example, years ago when I got into the fitness racket, many people were asking about bloating.

Does creatine make you bloated? And Darren and I talk about that in this episode, but. Not so many people ask about that these days because it’s not as much of an issue as it once was, or at least as it once was perceived to be by many people. But these days there are other concerns, more serious concerns.

Like many guys who ask me if creatine is going to make them go bold or if it’s going to accelerate their balding and. Darren does talk about that in today’s podcast. Parents will ask me if their kids, if their teenagers should take creatine, and we talk about that. People will ask about upset stomachs because some people, they just.

Don’t do well with different forms of creatine. Why is that? And what can they do about that caffeine and creatine? Is it detrimental to combine them? Is it detrimental to take a pre-workout that has caffeine and creatine, or to take a pre-workout and then add some. Creatine, maybe some, just powdered monohydrate.

And so those are all things that Darren and I talk about in today’s episode. And in case you are not familiar with Darren, he is a professor at the University of Regina. And yes, I check the pronunciation on that. That is correct. And his research has been focused on creatine and resistance training. He has produced 87 peer-reviewed studies on that, and his work has been cited thousands of times.

He knows a thing or two about the science of creatine and about evidence-based supplementation in general. Okay, listen up. If you want to learn breakthrough diet strategies for melting stubborn belly fat faster than OID Hornet, as well as ancient Greek training techniques for packing on brain, shrinking amounts of muscle in 30 days flat.

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If you’re a guy for 99 cents or thinner, leaner, stronger if you are a gal for 99 cents. Hey Darren, welcome to my podcast. Thank you for taking the 

Darren: time to do. Yeah. Thanks for having me, Mike. It’s excited to be here. Yeah, I’m super excited to, to talk about Create team. So let’s get right to it.

Mike: Yeah. When I got the email from you it immediately, I thought, oh, that’s a good idea because I’ve written about, and I’ve spoken a fair about a fair amount about creatine over the years, but it’s been more just general overview. Here’s what this molecule is, here are the proven benefits, here’s why.

If you are into. Weightlifting in particular, or into resistance training it really makes sense for you to take it. And even if you’re not, here are some reasons to take it. But I still get asked quite a few questions. This is one of the supplements I get asked more frequently about, and I have touched on some of these things tangentially, but I thought this could be a great interview that it’s self-serving because I’m gonna now be able to send people to it as well, who are gonna a ask questions that we’re gonna be, are gonna be discussing given your background and how knowledgeable you are in cine I thought it’d actually be more fun and more.

Informative actually, if I brought you on and gave you some of these questions and let you talk 

Darren: about them. Yeah, absolutely. And it’s become a multifactorial product now. It used to be just for athletes and now it’s basically for everybody on the planet and for different special populations, conditions and potentially disease treatment.

So yeah, there’s a lot to talk about a lot of different areas and it’s still a very popular topic. So super excited. Help us provide a bit of information and or discussion on it. So 

Mike: why don’t we start with a quick overview of what creatine. Is what the molecule is. Many people think of it just as an amino acid that’s not exactly accurate.

And maybe a brief overview of the mechanisms of action. What is it? What does it do in the body? And then for people, just to give people a little teaser, we might as well go from that right into. Is creatine the reason why you lost lost some 

Darren: of your hair ? Absolutely. Good segue.

Obviously for everybody listening or have an interest, they’ve heard of creatine and creatine interest enough is not a steroid. We get that as all the time. So creatine is naturally produced in the body through three amino acids, so arginine, glycine and matting in the kidneys and liver. So it’s a very basic process that’s required for all cellular energy to produce atp, which is our main energy currency of the cell.

So really we’re naturally producing. In the kidneys and liver primarily about two grams a day. And then of course once we produce it for the exercising individuals, it just enter circulation after it leaves the liver and then is taken up primarily into our sali muscle. And the more creatine you have there, it just increases the energy status.

Of the cell i e being in your muscle. So when you’re exercising such as weight lifting or performing sports, it should allow you to exercise at a higher capacity or also referred to as an increase in training volume. So that’s the basic 1 0 1 of what creatine does, and there’s many other. Avenues, which we’ll probably talk about with bone and brain, but most people take creatine or herd of it from muscle.

So when you take a supplement, and this is primarily in the powder form the creatine monohydrate molecule, which is the most consistent, established form of creatine developed. It’s identical to what’s being produced naturally in the body. The reason we call it monohydrate, there’s just a water molecule attached and that easily dissolves once it gets primarily to your.

So when you’re taking creatine supplementation in a powder form, it’s identical basically to what’s being produced in the body. And so for, therefore, if you take more creatine in your diet and or supplementation and from diet, you can get this primarily in red meat and seafood. The issue is to get the amount that’s shown to be effective can be difficult.

And with the big push now on plant-based diets, or if you’re a vegan or vegetarian, it’s near impossible to get dietary creatine. So that’s why supplementation. It is so popular. And so 

Mike: Just to provide an illustration to people, how much meat or fish would you have to eat to get to even the supplemental five grams a day?

That’s the maintenance 

Darren: regimen and that’s an excellent question. So to get five grams or additional grams, you need to have about four salmon Phillips or about two servings of red meat that’s on a daily basis. So you can see times by seven over a week. It is very daunting. For many ethical or financial reasons, a lot of people don’t.

The average container of cre per serving is pennies per serving. So that’s why a lot of people will consume the supplement. And overall, 

Mike: all the prices have been going way up Yes. With all the, with all this supply 

Darren: chain? That’s correct. And I think c especially wherever the products are coming from.

So overall creatine is still the most safest and effective ver aid. It even tops caffeine when you’re looking for an overall performance perspective. And there’s a multifactorial array of things that it does do, but the one on one is it gets in the muscle, it enhances the. The capacity in the muscle, and that allows the muscle to do more work.

So over time, the muscle should get bigger, stronger, and faster. Very minimally. Would we ever see experimental research show beneficial effects from creatine without training? So the key here is that the magic of resistance training or weight bearing exercise seems to unlock the additional boosts that creatine provides is no different than protein and resistance training.

Exercise will always, it’s 

Mike: very different than steroids 

Darren: in that regard. A hundred percent. And you get enough 

Mike: testosterone, you have to do anything and you’re just gonna get bigger. 

Darren: Yeah. And that’s a hundred percent correct. So again, it’s not an anabolic steroid. Still a myth and a lot of people think just because it has some antibiotic properties, but know it’s an organic acid naturally produced in the body and or synthesized and consumed either in red meat, seafood minimal amounts of poultry, but the most common is commercially manufactured products.

Mike: And from there I know some people are wondering does it shut down your own natural production? And what happens when you when you stop taking it, is there a period when you have low creatine? But I think we can, we’ll get there. However, we might as well just again, get right to what I get asked most frequently.

And that is, Does creatine 

Darren: cause hair loss? Yeah, and it’s, I’m not the best example to say it does or does not, cuz obviously I’m falsely challenged. But the ironic thing is it is still the number one question that you get asked. And even in academia, we get asked in rugby players way back in 2009.

And they looked at, it was a crossover design, so it was a powerful design, but they did not measure any incidence of hair follicle thinning or hair loss. So the whole theory with this is that these individuals supplement with a high dose of creatine. It’s 25 grams a day for a week, and then they went on a maintenance phase and all they did was measure creatine supplementation during their normal training for.

And then of course they measure dht, which is abbreviation for die hydroxy testosterone. And all that really means is testosterone is enzymatically created to dht and dht when it combines or influences the hair molecule can make it shrink or die. So that’s where all the theory came from. And lo and behold, in this study, and it was the only study to ever look at this, the individual supplementing with creat.

Increased DHT by 56% during the loading days, and then it reduced down to 40% during the maintenance days, whereas when the same players took placebo, there was no significant increase. So everybody just concluded. An increase in this hormone will obviously cause hair loss. Again, no hair follicle thinning loss or hair patterns was measured.

But if you look closely at the data, the, when they were on creatine, they actually started with dhg levels much lower. So the rate of change is a little deceiving, and if you have access to the paper, when they went to the maintenance phase the elevated dose of dhg came substantially. So all of this is showing over three weeks the hormone went up.

But again, there’s no evidence to suggest that it led to hair follicle, thining, or loss the cavity. It was still within 

Mike: the range of normal, right? If I remember 

Darren: correctly. That’s exactly right. The range was normal. So anybody on listening, you know when you go get your, an annual physical and you get blood work and urine analysis, they’ll give you a range cuz there’s a lot of standard deviation and things like that.

But there was no mention of where the creatine came from, what type of creatine it was, their dietary patterns, things like that. Were they already having any increase in the hormone regulation? Cause these individuals were 18 to 19. It’s never been to look at an older individuals. I can attest that I was losing my hair before I even started a creatine.

So it’s just like the correlation and causation. So until a study is done where we actually measure hair thinning and loss over time in. Gender, male and female, and specifically at different ages. We just can’t conclude. But a lot to that point of science, we can now say there’s no evidence to suggest it causes folding, but we don’t have any evidence to suggest it doesn’t.

So as we stand right now, just like science, we need way more research. And that study surprisingly needs to be done and it hasn’t been done. 

Mike: And something else that people will ask me about that paper is if there are any effects on testosterone levels. Cause usually, you are, if you’re gonna take exogenous testosterone, DHT is gonna go up, for example.

And so were there any effects to. Testo total or free testosterone. 

Darren: Yeah. The total testosterone was marginally increased, but free testosterone, which is unbound, was not, again, so there you go. There’s other factors that are affecting it. The big one that never gets any presses. Exercise at a high level can increase DHT naturally.

And depending on the type of training they were doing, that could have been the caveat because the placebo was considered 50 grams of glucose. So we still know it was a nutrient. So again, that’s where these studies need to be replicated before we can consider, but I know so many people that won’t even consider creatine because they think it’s gonna lead to hair loss.

Yeah. Or just 

Mike: maybe speed up the process a little bit. That’s what people will say to me, and it’s not worth it to them, is the way they look at it. And I understand that. I do understand that creatine is probably the best. Supplement that we have natural safe, like you said, for improving performance in the gym and just speeding up speeding up the gains a little bit.

But it is still a little bit, it’s a natural supplement. It’s totally fine if you leave it out, you’ll still get to where you want to be. You might just get there a little bit faster with creatine and you might have a little bit more fun along the way cuz you’re getting there a little bit faster.

But so I understand when some people, the risk reward analysis to them. They just go, eh, even if there’s only a 1% chance that I’m gonna lose my hair a little bit faster with this stuff, I’d rather just leave it out. And I do understand that. Yeah. I do as well. Yeah, 

Darren: absolutely. 

Mike: And so with that study, one other question again that people will ask me is mechanistically speaking, is there a viable hypothesis as to how creatine could lead?

An increase 

Darren: in dd. Yeah. The theory was that it was more the exercise stimulus that could cause some type of anabolic or hormonal regulation. Creatine has been, has shown to. Influence insulin, like growth factor myta, some of the other endocrine markers. But this, again, it was just a short term study, but it was more of a hormonal regulation.

And it just so happened that during the creatine session it went up. But again, it, to your point, it was a normal physiological range. So it’s total speculation. 

Mike: And if I hear you correctly then this is a type of effect that has been seen in other studies involving intense exercise Yeah. Of 

Darren: the, I’ve done d Yeah, that’s correct.

Exercise training can naturally increase as, while the authors elegantly even stated that in the paper, but just but it gets, that gets lost. That get lost. Too late , that’s. The alarm 

Mike: bells are 

Darren: already going, and That’s right. Yeah. It’s it is funny. So if the viewers can actually read the paper.

There’s a lot of interesting information in there about how exercise can actually play a role in this as well. 

Mike: Okay, cool. I think that’s all that can be said at this point. And so again, anybody listening if you’re not taking creatine because you have maybe male pattern baldness in the family or your hairline is receding and you don’t wanna take the risk, it’s understandable.

But Darren, would you say it’s. Fair to say that I guess you already said it. There’s certainly no evidence that it is going to cause hair loss there. Would you say that there, there isn’t strong evidence to say that it’s going to have any effect one way or another on your hair, but we can’t say for certain.

And unfortunately this paper has raised a question that it has more raised a question than provided an. That’s 

Darren: correct. It’s raised a total speculation and multiple studies that have to be replicated had to be done. And again, there’s the evidence right now saying it doesn’t show that it does and it doesn’t show that it doesn’t until we do that.

Yeah. Okay. 

Mike: All right, cool. So why don’t we now talk about this natural production point that I mentioned previously, which is a natural kind of follow up question that I get when people learn, oh, my body produces creatine and now I’m swallowing it. So does that shut my, and this kind of goes with the thinking of it like a steroid kind of mindset, right?

Where they, it’s the idea that if you take this stuff. And you add it to your natural production, your body’s gonna go whoa. This is too much creatine. Let’s shut down the natural production. And then what happens if you stop taking it? Are you supposed to cycle it? All these things go together.

Darren: Yeah. So there was some minimal evidence way back in the early two thousands that showed that high dose creatine, such as a long term loading phase, Can decrease your natural or endogenous production, but as soon as you stop ingesting it, it immediately comes back. So that’s got the question of should I cycle creatine because of that myth as well?

And the totality of evidence suggests that creatine ingest. If it does decrease your endogenous production, it’s not to any significant level where it’s gonna have any adverse effects. As soon as you stop high dose, your body will not naturally compensate for that as well. And that’s led to, and 

Mike: of course you wouldn’t take a high dose.

I generally don’t recommend loading cuz it’s not necessary. And I just know hearing from people over the years, it can cause upset stomachs and. Why, so I don’t even recommend it. I tell people, I guess if you want to get it into your system quickly sure. But you don’t have to load 

Darren: it.

Yeah. And that’s an excellent point. The loading phase is probably for the athlete that’s short term, big event coming up. And, but you’re right, we see a typical increase in mass, and that probably could be some water retention, but one to three kilograms during that first loading phase. And so in our lab we typically do a relative dosage or a lower dosage.

The population we see that might get some extra benefit from the loading is all our adults. That could be because. Their muscles are shrinking from a type two muscle, fiber size, or they’re not consuming a lot of red meat. But for the average young individual, there’s no evidence to suggest that you need the key where there’s need to, to cre low.

You can take a low dose and it will accumulate in the muscle in as little as four four weeks. 

Mike: And in, in the case of a, of an older adult. So how would that loading phase, would it, how would that work? Cause what, it’s normally no more than two weeks, right? It’s normally a one to two week or Yeah.

Are you looking at it over a longer, and then what would be the benefit? Let’s say, let’s just take somebody they’re middle aged or maybe even golden aged, right? And they’re starting creat. Scenario A would be, eh, they just take five grams a day and they let it accumulate at that rate versus the 20 to 25 grams a day.

And for how long? 

Darren: Yeah, exactly. So typically if we do the loading phase, it’s about 20 grams a day for about five or seven days. In young individuals you start excreting that creatine after about two or three days. So we think the muscle can be saturated pretty quickly depending on your habitual diet.

If you’re a red meat eater, you’re probably gonna have a lot of creatine naturally, and so you might not need as much, whereas vegans or vegetarians would need a lot. But with aging, we see a huge reduction in meat consumption. We see a decrease in activity levels at high intensity. And then the other big one is a decrease in type two muscle fibers.

So the loading phase may be something to consider for an older adult, and we consider this maybe in their fifties, sixties, and so on, to give them a more rapid boost to hopefully engage and continue to perform resistance training. But for the younger individuals, three grams a day. For as little as a month has been shown to saturate your muscle.

So again, not a lot is needed because you’re naturally producing about two grams a day. So if you listeners ever wonder where this five grams seems to come from, it’s two grams is about naturally produced and the lowest dose ever been shown to be effective is three grams in addition. So taking five rams a day seems to be a very viable strategy from a muscle perspective.

That’s not the case when we get the brain or. And 

Mike: that’s a perfect segue cuz my next question is regarding brain cognitive benefits. That’s something that has been getting more air time more. More talk recently. I, and I’ve been getting asked about 

Darren: Yeah. Yeah. It’s the, probably the most emerging area.

And we actually just submitted a paper today. There was about nine of us that have looked at all the potential effects on brain. And overall creatine supplementation can definitely increase brain creatine content. However, the dose seems to be a little bit higher or speculation. It might be needed to be higher.

For two reasons. The muscle does not synthesize creatine, so therefore it could probably uptake all the supple, whereas the brain does and the blubbering. Is a little resistant to supplementation, so you may need more coming in to get enough into that resistant tissue. But that subsequently has been shown to have some beneficial effects on decreasing symptoms of sleep deprivation, depression, ptsd, and anxiety, which is hugely important.

And we’re thinking of putting a paper together now about the potential adverse effects of covid. Isolation, lockdowns on muscle loss and all the mental health issues. Creatine has shown some promise for neurodegenerative diseases such as Parkinson’s and Huntington’s, but the research is limited and very equivocal.

Sometimes it doesn’t show any effect but the main area we see probably the biggest UPS screen upswing in benefits is concussion and mild traumatic brain injury. So these are areas that is showing some a phenomenal. And I would say the next 10 years will, the majority of clinical trials will be on indices of the neck up which is hugely important.

So for those taking creatine and, if you like it for muscle mass or performance, lo and behold, you’re probably getting a lot of cognitive from brain health benefits, which is enormously potential. And what’s 

Mike: the dosing like for that? Cause now people are wondering a lot of people listening, they take five grams a day.

Yeah. Is that enough to get any of those benefits? And if they were to go to more than that would they? Even if they wouldn’t necessarily. Notice it. , is it likely or is there evidence of further efficacy? 

Darren: Yeah, so the acute studies have shown that the loading phase plus a maintenance phase of about five grams or so, can’t have some beneficial effects.

There’s only a few studies that have not done the loading phase and just went with a five gram dose. But it seems that a higher dose, maybe five grams or more for a longer period of time. So I think this is a caveat. If the average individual is taking creatine for health benefits, part of their training program, and they’re like, Hey, I’m gonna take this for multiple months or years.

They have nothing to worry about. Eventually it’s gonna accumulate in the brain, but if an athlete says, I’m just taking creatine for two weeks, they probably won’t get the effect. So this really seems to have promise for individuals saying creatine is part of my daily strategy, just like protein and carbohydrates, if they’re willing to consider in their diet and or supplementation.

This probably will accumulate over time. We do see the greater benefits at a higher dose and this is where the theory that maybe 10 grams a day for concussion, mild traumatic brain injury could be beneficial. I’m not a hundred percent sold on having a low dose on a daily basis. I’m not seeing any evidence from all the research that a higher dose is detrimental.

And so like you’ve heard with protein anabolic resistance, we need more protein as we get older. I think a theory is that maybe more protein could be beneficial, cuz now we know it’s not just used for muscle, it’s used for your bone density, brain health, and probably other areas. So the five grams a day is great for muscle performance, but if you’re trying to get a holistic approach, more is potentially better.

And we’re not seeing any negative effects. So again, that’s something that we need to do a dosing strategy. But in my opinion, I’m seeing a bit better. At higher dosages for cognition and brain. And that would apply to all age ranges, that would as well. So you can take five grams a day, or the ones we use in our lab is 0.1 gram per kilogram.

So that keeps it equivalent for everybody. Very similar protein or caffeine. So if you’re 70 kilograms, that’s seven grams a day. If you’re 50 kilograms, it’s five grams a day. The theory though, is that the larger you are with more muscle. You’re gonna have these more creatine doorways or transporters into the muscle.

So the theory is that if a larger individual just say 250 pounds playing professional sports, they’re probably gonna need more creatine on a daily basis or have the ability to take it into the muscle. And that’s where you hear about the differences in cre. Uptake is no different than caffeine, small coffee versus an extra.

Mike: Or even similar to protein absorption, something totally separate subject, but something people ask me about, and for everybody listening quickly is the question normally is, Hey, how much protein can I absorb in one sitting? And this has been touched on in different ways in research that I’ve seen, but I think it’s fair to say that.

A very large individual can eat more protein and effectively process more protein in, in one sitting. Maybe it’s a hundred grams plus for the 250 pound linebacker in the nfl, and maybe it’s I less than that for. My wife who weighs a hundred pounds and has some muscle cause she rides horses, but she’s not a bodybuilder, 

Darren: Yeah, exactly.

Yeah, that makes sense. The pro, we could talk to her blue in her face with the protein, the 20 grams, how much you digest and absorb, but you’re totally right and the analogy’s the same. The more training you are. Of course, St. Phillips put up the meta-analysis with protein, 2.2 grams per kilogram seems to be the upper threshold, but even stool will tell you about 1.2 to 1.6 is probably about the most we can use from a muscle protein perspective.

But again, protein is used for everything in the body. So maybe having more is not a bad idea. 

Mike: Yeah. And then there are the other benefits like satiety, that helps a lot of people just being full so they can, better control their calories. 

Darren: That’s a hundred percent right.

If you 

like 

Mike: what I’m doing here on the podcast and elsewhere, definitely check out my sports nutrition company Legion, which thanks to the support of many people like you, is the leading brand of all natural sports supplements in the world. So what about children? And this is something I get asked about teenagers in particular because parents will usually reach out, sometimes it’s the teens themselves, but usually it’s parents whose teenage kids are now getting into weightlift.

And of course they hear about creatine and they’re all excited about it. And sometimes I get asked also for even younger, usually it’s, kids playing sports, they could be 10, 11, 12. What 

Darren: are your thoughts? Yeah, so it’s, it. Obviously a cautionary area and we can even talk about pregnancy, but there was a number of us that looked at special issue in Nutrients journal this year.

We looked at all facets and Andrea AUM from the United States is probably one of the world’s leader on creatine and children, and he’s done some really nice review articles looking at all the articles and research. And to this day, creatine can definitely have some beneficial effects on improving some indices of muscle and bone and coordination.

Even in disease state children such as boys with muscular dystrophy. And when you look at all the data, there’s no adverse effects. And so a lot of people say, Hey, can my children or a child take creatine? I say, absolutely. There’s not a person on the planet that. And I say the reason is indulgently or naturally produced in the body.

And so since we’re taking something in naturally protein or creatine, there’s no difference. Your body’s gonna adapt to it. Now, if it was a pharmaceutical, that would be different or an anabolic hormone. But yeah, you take creatine into the body at a normal recommended safe dosage. And right now, as it currently stands, we’re seeing no reason a child or adolescent cannot take creatine.

If anything, it may have. Potential protective or neural protective effects for brain development and muscle skeletal as well. So as it stands right now, the research or evidence based research suggests it’s very beneficial with no adverse effects to this date. 

Mike: And also something nice about creatine is there are a lot of third party tested and validated sources.

There are a lot of reputable companies that sell it. If all you want is creatine, monohydrate now Foods, for example is one of these brands that has stood the test of time. . Whereas with many other supplements, you don’t necessarily know what you’re getting actually. And so I always tell parents that.

The to let’s not get too much in, let’s not be shoving too many pills and powders into a, into our kids, and let’s just focus on, exercise, activity, make it fun, eating good food. And there’s an asterisk there. And creatine, I think, fits into that, but there aren’t too many that getting.

So Omega-3 fatty acids is smart as well. I think there are a few things that it makes sense with kids and, or even a well formulated children’s multivitamin. Yes. If it’s a gummy, like I give one to my kids and there are a few things that make sense, but I’ve just heard from parents over the years, I think, who are a little bit too enthusiastic even about my stuff.

Where again, it’s like your kid doesn’t, they don’t need to be swallowing like handfuls of pills. 

Darren: Yeah. I think, I always say supplements and there’s only about four or five that actually work or basically the sprinkles are icing on the cake. Yeah. But especially in children sleep, proper nutrition, hydration.

All that comes first. Supplements are gonna be near the bottom and typically most that are purported to work from a health standpoint, only work if they’re in deficiency. There’s only a handful that are from an perspective, but there’s a lot of other things for children development and the average individuals that should be looked at first.

If you don’t have adequate sleep, you can take every supplement, as much coffee as you want until you’re blue in the face and you’ll never train at the optimal level. There’s a lot of other things that we do. Unfortunately, 

Mike: everything just gets worse and worse. I know. Absolutely. You can’t get around it.

I wish it we’re not that way. I know. That’s the greatest supplement. There it is. Sleep. It’s true. A 

Darren: hundred percent 

Mike: if you’re not getting enough, that’s for sure. Absolutely. You mentioned caffeine. How about that? There’s the question about combining creatine with caffeine because some pre-workouts, for example, have creatine and caffeine or, okay, I had some caffeine before I trained.

Do I need to wait x number of hours before I take my creatine? 

Darren: That’s right behind baldness. This one is right up there, so I’ll try to do justice to the small, moderate body of literature. There’s been a handful of studies that have looked at acute creatine ingestion, or sorry, acute caffeine ingestion during a creatine load.

So if you take 20 grams a day of creatine and then all of a sudden on the last day before you’re gonna do a time trial cycling, or whichever it is, you take a bowls of caffeine about 300 milligrams or a large coffee. That seems to have no interference effect. In other words, caffeine seems to bolster performance and or doesn’t have any negative effect.

I don’t know who that would be applicable to. Maybe the Olympic athlete or someone training for a specific a task. Where it gets a little gray is that when you look at the studies that did creatine loading and chronic caffeine ingestion during it, so for example, three or more days of caffeine ingestion where the ca or coffee or caffeine was mixed with creatine, that seems to have the interference effect.

And they seem to oppose each other at a part of the cell. So that’s where a lot of people say, geez, maybe you should spread it out again, all those studies were acute where they did one type of exercise task in the lab. So we were fortunate to publish the only paper this year where we looked at caffeine and creatine combined, and now the caffeine was the powder during a weight training program for six weeks.

The sample size was low, but what it did show. Is that the group who took caffeine and creatine together on a daily basis for six weeks did not perform nearly as well from a muscle growth perspective, as those on ca are creatine alone. So that indirectly suggested if you combine the two during a long-term program, they may blunt each.

So we didn’t measure anything. 

Mike: Is it blunting each other or is the hypothesis that it’s the caffeine blunting, the creatine. . 

Darren: Yeah. They seem to play tug of war. It’s something called the Sarco Plasm reticulum. Caffeine likes to release calcium, which is required for muscle contraction and creatine likes to take it up immediately so they interfere with each other.

So that was the theory. We didn’t measure that. And it was a small case study, but it did show that the creatine group increased muscle thickness in the quadricep, but the creatine and caffeine group did not. So it’s speculating. Although it’s minimal the most general recommendation is to try to spread it out.

If you can take your caffeine within 16 minutes before creatine, after. Now, an important distinction is what about in pre-workouts? The vast majority of pre-workouts will have caffeine in preteen. But keep in mind, this, 

Mike: by the way, is why I did not put creatine in mind. Okay. And this was years ago.

Yes. When the evidence was even more tenuous than it is now. But I figured why risk it, so to speak? Yeah. When people are also accustomed to having creatine in a post workout. Meal or supple. Or setting. And I would rather not have to come back and eat crow and take it out when more evidence comes out, when I felt like I could just avoid this and make customers happy that people aren’t demanding it to be 

Darren: in the pre-workout.

And I totally agree to that point. Like caffeine is immediate stimulant. Within 60 minutes, it peaks into blood, whereas creatine takes a few hours to maximize. So in theory, it makes sense to take caffeine, pre-exercise, and potentially creatine hours before exercise, or more specifically probably post-exercise seems to be an important factor because exercise blood flow seems to turn on those transporters to allow creatine in the body.

I recommend basically the easy strategy, pre-exercise, caffeine, post-exercise, creatine. But in a lot of those pre workouts, there’s gonna be a totality of other compounds in there that we don’t know if they have some synergistic effect. Like maybe if one had nitrates and branch chain amino acids and all these other things, maybe some cancel each other out.

So again until more research is done specifically on the mechanisms I don’t know if I would recommend combining the two, but in. Limited studies, they seem to interfere with each. Yeah, 

Mike: that, that point of synergistic effects or counterbalancing effects, or countervailing effects is something that Curtis, who has headed up research and development for, really since the beginning.

And then now we have more people who work with him on that. But that’s something that they were always very cognizant of and trying to avoid things even if it wasn’t concrete, it wasn’t something. Had enough evidence to say this is a thing, or we think this is very likely a thing.

Yeah. We try to avoid that really in all of our products as much as possible. Because especially in the case of a pre-workout or anything just the kitchen sink approach. It makes for a nice label. Yes. And it can make for some nice marketing. But it would be unfortunate and it would be dishonest too if the company knew, or at least if they never even looked into it, they’re like, ah, just throw everything in there.

Who cares? It’ll just sound good and Right. I never liked that approach. 

Darren: Yeah. And I agree. And the other big thing is, since the, based on the acidic profile, a lot of GI track reports come up when you combine caffeine and creatine and that was something that a lot of people said, I probably wouldn’t mix some, the two Hey, spread ’em out.

You’re gonna get the benefits of both. If there is a chance they interfere with each other, the longer you spread ’em out, the greater you’ll get the benefits of. And 

Mike: you mentioned about taking creatine after a workout. Also, a common question. For some time it was generally believed or accepted that post workout with some food.

, ideally some carbohydrate. That’s ideal. And then more recently, at least in the evidence based fitness space, more people are saying, eh, it probably doesn’t really matter. 

Darren: What are your thoughts? Yeah, as it stands right now, we’ve done probably the majority of the timing. It, the timing is probably irrelevant when it comes to creating no different than probably protein.

But the nice thing. Adding in, creating post workout. And even if you decide, Hey, I’m gonna take it before or during your workout session at the timing doesn’t seem to matter that much cuz it’s an accumulating metabolite. But there is some evidence to suggest that. By doing muscle contractions in the weight room or on, on the court, whatever it is, the blood flow to the muscle seem to act as a vehicle to allow the creatine to get in the muscle, and so it can open those transporters.

So post exercise, creatine to me is a very viable and easy strategy to consume. Post exercise can be probably anywhere before your training or after your training program until you go to bed. There is evidence though, around close proximity to exercise is a very viable and beneficial effect compared to morning and evening.

But again, the timing is not nearly as. Just like protein, we now know you can consume protein throughout the day, and as long as you hit your total daily amount, you’re probably gonna achieve those benefits. And as 

Mike: far as post exercise or not total absorption, I’m assuming doesn’t change either way. Even with this, Priming effects, so to speak.

Yeah, that’s right. Because some people, that’s what they’ll hear oh, so I’m gonna absorb it better if I take it after I train, 

Darren: Yeah, no, once, it’s, creatine is about 99 if not a hundred percent bioavailable. So it’ll still get into the bloodstream and then take it up to the muscle for your next subsequent exercise belt, and then takes a wall to accumulate.

So again they have the luxury, they don’t have to have the blender in the weight room. Go right after they can go home and enjoy a meal and consume it. But to your point, there is good evidence 

Mike: Or the water jug. The pink water jug. The pink water jug. Yeah. 

Darren: So exercise contractions will increase creatine uptake but creatine combined with carbohydrate will as well.

But for those who do not want to consume carbohydrates or simple refined carbohydrates, that’s fine exercise and it will get in the muscle to a significant degree over time. It’s pretty easy strategy. There’s not a lot of complications to it. Yeah. 

Mike: For me, it’s just a matter of remembering to take it and easy to just stack it with something else, and for a lot of people that’s after they work out, it’s just a thing. Then they take their creatine, they eat some food, and they move on with their day so they don’t forget. Yep. I agree. I agree. What about bloating? That’s another question I get if I, and particularly from women who let’s say these, let’s say the question is, this is for people who have not taken creatine.

So they haven’t experienced bloating, but they want to know, is it gonna make them bloated? They hear that, oh it just increases water weight, and that doesn’t sound. 

Darren: Yeah, so the totality of evidence, a couple things. Creatine does not increase even total body water, but it can increase water in the muscle, and that’s how we think it unlocks all its potential.

So sometimes individuals taking creatine at the beginning stages, typically within the first 10 days, may experience an increase in mass and or have a bit of bloating. But that’s creating, working to take water from the bloodstream into the muscle, and that’s typically why individuals gain size.

To limit that substantially. Do not do the loading phase. The loading phase is typically where we see a huge increase in BLO or GI track irritation. You can start as little as three grams a day or increase it however you like. That will substantially decrease the amount of water retention during the acute stages.

Mike: And then once once, once you’re over, let’s say your past four weeks or so. , and so you’ve probably reached reached saturation at that point. And going from that point forward, if you, if somebody did what you just said, they probably shouldn’t notice anything negative in the way of bloating.

And then from there on out, it’s just again, the five grams. 

Darren: Or you could even reduce it to three grams a day if they’re an on an omnivore diet. So if you’re still producing about two grams a day and you’re consuming the odd serving of red meat or seafood a week, you could reduce that as little as three grams a day, which is probably about half a teaspoon.

You’re not gonna notice it and that substantially reduces it. You can go higher, but after about 10 days, if you did feel any water retention it us, your body adapts and you subside that over. 

Mike: And that also then would apply to a higher dose. Let’s say someone is thinking with, just based on what you had shared regarding brain benefits.

So eh, I’m gonna, I take five grams a day, I’m gonna go up to eight to 10 grams a day. Actually, I’m a bigger guy, 

Darren: And so what I would suggest there is do it multiple times a day. Maybe you have a little sprinkle breakfast, lunch, dinner. The more times you divide it up into smaller dosages, the body will obviously absorb it all.

It probably more palatable and maybe it’s just something you do say, Hey, every time I eat I put a one third of a teaspoon on and I don’t even notice it. And we’ll accumulate it and you’ll get the effects. That makes 

Mike: sense. Yeah. Can you talk to us about some of the myths regarding how men and women react to creatine?

I know there are some ideas floating around out there that men and women react differently to it and it’s usually people are thinking it’s more for men, not for women. Yep. 

Darren: So both males or females respond very favorably to creating supplementation across the entire age spectrum. There is some evidence to suggest that males get a better response overall, and when we look at the data, we see that females for some reason may be less responsive for two hypothesis or purposes.

One is that they may have higher amounts of creatine in the muscle cuz their muscles are smaller, so then they might not respond as well to a supplement cuz it’s already fuller. Higher concentration. But more specifically, we see the females for some reason creatine doesn’t break down something called muscle protein breakdown in females nearly as well as males.

And we think that estrogen could be involved. So overall both males and females respond very favorably from a bone perspective and muscle, but males seem to respond overall a little bit better, only specifically based on muscle protein breakdown. Okay. 

Mike: And what about the kidneys and safety? 

Darren: Yeah, so again, a huge question, very similar to pie protein, DIYs in like kidneys and both are emphatically a myth.

If anything, preteen is an essential nutrient for people on dialysis or some kidney issues. And so of course people said, oh, my doctor said don’t take creatine because I had a high well, or even don’t eat 

Mike: a high protein diet. I still did protein diet. Cause they go get some blood work and then creatinine levels are high and that they don’t understand that.

You should expect that with a weightlifter who’s on a high protein diet. And so funny with creatine. 

Darren: Yeah, so very, basically your kidneys there are there to clear creatine from the body or specifically something called creatinine. So when creatine goes into your muscles and you’re working out, it’s breaking down to a byproduct called creatinine, and it leaves your muscle, enters your bloodstream, and then your kidneys are responsible for filtering it.

So sometimes when you go to your doctor and get blood work and they say, oh wow, you have high creatinine, That must mean you have poor kidneys. No, that could mean you’re on a high red meat or seafood diet. You’re taking creatine supplements or you’ve actually just worked out. So it’s a proxy marker, but when you look at all the evidence, there’s no detrimental effect of creatine supplementation on kidney or liver function and recommended dosage.

And for continuous over years of supplementation. So just like protein, it’s a complete myth. Even in individuals with preexisting kidney abnormalities, it doesn’t expand or accelerate any of the indices there. So it’s a, based on the totality of evidence it’s a myth for sure. 

Mike: And what about forms?

There are many different types of forms of creatine. And what’s going on there? Is it mostly marketing? This is what I get asked. Or is there? Cause you know, people, I understand that they’re always looking for what’s new and exciting and creatine. Monohydrate is neither new. Nor exciting and but, supplement company XYZ says that, ooh this new form this has special benefits.

And I think the claims I don’t even pay too much attention, but I think they generally revolve around absorption. And bottom line is you’re gonna get. Bigger benefits from this special form. 

Darren: Yeah, no, I totally agree with you. I recently talked to Eric Helms about this. It’s funny. You take something that’s good, tried and tested, and people say, we gotta make it better.

And I’m like, okay, so let’s backtrack. Creatine is about a hundred percent, if not 99% bioavailable. That means whatever you ingest, monohydrate, goes through your GI tract, gets into the blood, and this is the key. It gets transported into your muscle. And so people say we need to make it bigger, stronger, and better.

And I’m like, you can’t make a hundred percent better, but let’s try. So there’s been, oh my god, creatine hydrochloride is out now and there’s a lot of press there and in rows and mice. Is that a thing 

Mike: again? HCL was a thing I remember. Oh, I must have been 21 or 22 when the first HCL that I saw came out, and I remember they probably sold a lot of it.

There was a lot of hoopla. It’s 

Darren: number one right now of the new type and price, and so there’s creating, so after we can go on, but there’s all these port, this is important. All the purport forms of Korea team. Have never ever been shown to be consistent and effective when it comes to a performance perspective like Monohydrate.

So this is important just because a form of creatine gets in the blood better, that does not mean it gets into the muscle and leads to performance better. Nothing has come closer, even comparable to Monohydrate from a performance per. There is some reports of some forms of creatine and it can, it has to have the creatine molecule and it might have something attached to it, but it has to have the creatine molecule to getting the bloodstream then being taken into the muscle through a specific transporter.

So just because you might get a form of creatine that gets into the blood better. and it could be increased in the muscles similarly to monohydrate and Micone. We need to see this re repeatedly done in skeletal muscle, my opinion. And but you already said the uptake 

Mike: is already 99%. 

Darren: 

I know what’s on what.

So my recommendation, 

Mike: so that’s why the marketing they’re focusing on it’s just, it’s slight of hand really. Yes, it is. It is. It’s, instead of on the bottom line, what are we trying to accomplish? Which, as you said is already happening about as good as it possibly can happen with with 

Darren: Monohydrates.

Please stay with Monohydrate for the consistent proven benefit. Now 

Mike: what if somebody gets an upset stomach? I do get people who reach out and they would like to supplement with career team, but it does upset their stomach consistently. And that’s with a basic monohydrate product. Is there anything they can do?

Darren: Yeah, so the most effective strategy we’ve used is reduce the dosage per serving, but increase the quantity through it today. So let’s say if they’re taking five grams a. Maybe knock that down to about two and a half, twice a day, or even, you can, if you want a gram every five times a day, but reduce the amount per serving, I usually recommend and mix it with food.

Therefore, it’s easily digested. And that seems to be a really viable strategy when research participants say, Hey, yeah, it went away. I’m good to go. That’s probably the most effective, a practical situation. 

Mike: And that also answers a, another question is it. Take with food, is it better to take with food?

Do I need to take it on an empty stomach? But 

Darren: I think we’ve already touch as bio availability. It goes with its own pathways and that’s fine as well. Yeah. If anything, food might enhance its absorption because of the carbohydrate. Although high fat intake may have some detrimental effects with GI tract.

But a lot of people will consume creatine and water even though it’s not as soluble as a lot of people think. But by adding it to food is fine as. 

Mike: It’s obnoxiously. Insoluble. Yeah, I know. Even micronized. It’s, I know, it’s pretty annoying actually. Exactly. And what about endurance athletes?

I’ll get people asking who maybe they do some resistance training, but that’s not really their focus. They’re more into endurance training. Yeah. 

Darren: A lot of accumulating evidence suggests that anybody involved in high intensity anaerobic sports or intermittent such as basketball and football and things like that, it can have soccer official effects a hundred percent even lower.

Or lower intensity. Aerobic sports are starting to see some benefits on recovery. So for example, marathon or triathlon post exercise, it seems to decrease some inflammatory markers. So it seems to have some promise either from a performance benefit or more specifically from a recovery period. Seems to have some beneficial effects for a lot of.

Mike: And me mechanistically if you wouldn’t mind just sharing a quick quick breakdown of how does it help with recovery? People will ask me that, like they’ll understand how it just with ATP and, okay. I guess I, I can see how that can improve performance but why does it also help me recover?

Less 

Darren: muscle soreness. Yep. So some of the strongest evidence with creatine is based on its recovery properties. So it’s considered now to have some anti-inflammatory effects. A lot of people will take an Advil or something, but creatine seems to decrease something called a reactive oxid of species. It seems to increase mitochondrial function, which is basically our power host of the cell.

But it also really has a positive effect on decreasing proteins called cytokines, which are highly increased during exercise and during times of metabolic stress. So creatine seems to have this anti-inflammatory or anti catabolic property to allow the body to recover faster. And then of course, that could lead into more repetitive training sessions or at a higher intensity.

And, 

Mike: And this is the follow up question that some of the more educated people will ask me is, will say but inflammation is some, inflammation can be good. This is part of what we are trying to accomplish in the gym. And for example, there’s evidence that if I were to take anti-inflammatory drugs after I train and I did that consistently, it, it’ll probably get in the way of my progress to some degree.

Will creatine have a similar effect?

Darren: Yeah. The cool thing with creatine, it’s anabolic and anti catabolic, so it decreases the non anabolic environment for muscle growth. And then of course, it can have the positive effects, but it doesn’t jeopardize the natural inflammatory response to jeopardize recovery.

If anything, it just allows it to recover. And therefore you can actually get back in the training room. Over time. It’s like protein. It decreases protein breakdown, increases synthesis. So you combine the two and get the synergistic effect. 

Mike: Makes sense. That was all of my questions. Are there any other questions that you get commonly asked that we haven’t covered?

I tried to make a, I tried with one. One of the guys who works with me on the podcast, we were like, all right, let’s come up with all the questions. Let’s make. This the definitive q and a for creatine as of January 25th, 2022. 

Darren: Yeah. The other big one is when we took it, consider aging individuals or people, prone to osteoporosis or sarcopenia or frailty.

It’s having a lot of promise there in combination with exercise. But again, it’s something you can get through your diet or through supplementation. But the benefits are substantially outweighing any potential adverse effects and we’re just not seeing it. So overall, it seems to be a lifelong or overall product that a lot of people that can take or at least consider from that standpoint.

Mike: Yeah. Yeah. It really is one of one of the few supplements that everyone can benefit from in one way or another. You almost could class it, it’s not as essential, of course, as an omega3 fatty acid or a vitamin D , you gotta make but it probably deserves similar status in terms of, hey, if you have the budget and if you have the inclination you don’t need supplements, but if you’re going to, if you’re willing to spend some money on these things this one should be at the, toward the top of the list for everybody, regardless of what they’re doing.

Darren: That’s right. A hundred percent correct. 

Mike: Awesome. Thanks again for taking the time to do this is very informative and if people wanna check out your work , where should they go? How do they find some of the research you’ve published? Is there anything else that they should know?

Darren: Yeah, for all our articles, you can just go to PubMed and search creatine monohydrate. Or if you wanna follow me on Instagram at Dr. Darren Cando, I usually post a whole bunch of our most cutting edge research that way. So yeah, that’s probably the easiest ways to go and thanks again for having me.

It was fantastic., 

Mike: Yeah absolutely. I hope you liked this episode. I hope you found it helpful, and if you did subscribe to the show because it makes sure that you don’t miss new episodes. And it also helps me because it increases the rankings of the show a little bit, which of course then makes it a little bit more easily found by other people who may like it just as much as you.

And if you didn’t like something about this episode or about the show in general, or if you. Ideas or suggestions or just feedback to share. Shoot me an email, mike muscle for life.com, muscle f o r life.com and let me know what I could do better or just what your thoughts are about maybe what you’d like to see me do in the future.

I read everything myself. I’m always looking for new ideas and constructive feedback. So thanks again for listening to this episode, and I hope to hear from you.