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One of the best-researched supplements in terms of muscle strength and performance worldwide is creatine monohydrate. But recent developments in the scientific research world show there are a lot of other benefits that creatine can give you, especially when it comes to health from your neck and up. Cognition, mood, memory, and so much more are proving to be the next big thing in creatine research.
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Key Takeaways
If You Want to Utilize All the Benefits of Creatine, You Should:
Ensure that you are combining creating with resistance training in order to see results Dose in a way that supports both your overall brain and body health Don’t stress about the myths you have heard about creatine supplementationThe Godfather of Creatine Research, Dr. Darren Candow
Dr. Darren Candow, Ph.D., CSEP-CEP, is a Professor and Director of the Aging Muscle and Bone Health Laboratory in the Faculty of Kinesiology and Health Studies at the University of Regina, Canada. The overall objectives of Dr. Candow’s internationally renowned research program are to develop effective lifestyle interventions involving nutrition (primarily creatine monohydrate) and physical activity (resistance training), which have practical and clinical relevance for improving musculoskeletal aging and reducing the risk of falls and fractures.
Understanding the Many Benefits of Creatine
Most people know that your muscle content will increase when you combine creatine and resistance training. But what about the effects that creatine has on the brain? Creatine works best when your brain is stressed. This means that supplementing creatine for brain health has been shown to reduce depression and anxiety, reduce concussion symptoms, improve immune system function, and more.
Supplementing creatine while combining it with exercise creates the potential for bone and brain health improvements, and the research proves it.
The Proof is in the Research
While the effects of creatine supplementation on the brain have only recently started to be explored, the research is very promising. In fact. Dr. Candow believes that creatine is going to be an interesting supplement to study for the next 50 years, given its wide-reaching benefits.
The benefits of creatine are not just opinions. This is why I feel it is important for you to hear from Dr. Candow, so you can get a first-hand understanding of why there is a potential possibility for so many clinical applications when it comes to creatine. It is an exciting time to be diving into the world of creatine supplementation; join us!
What interests you most about the benefit of creatine supplementation for the body and the mind? Share your thoughts and experiences with me in the comments below.
In This Episode
Get an insider look into what it is like to conduct a scientific research trial (5:37) One of the most obscure facts about creatine that you probably don’t already know (12:38) Understanding the effect of creatine on fat mass changes and chronic disease (22:47) What you need to know about creatine, memory, and the brain (33:31) How to properly dose your creatine to do the most you can for your brain (41:54)Quotes
“[Creatine] has become a total body supplement, not just for athletes looking to get bigger faster. I think anybody on the planet, I am really struggling to think of anyone on the planet who would not benefit from creatine in some form or another.” (11:36)
“We can conclude that basically, if you are 18 years of age and above, creatine and resistance training will decrease fat a little amount, and it will not increase it, which has the implications for avoiding a lot of chronic diseases later in life.” (24:26)
“Creatine acts as a neurotransmitter and reduces oxidative stress. And individuals with a diagnosis of depression, anxiety, or maybe even PTSD, have a reduction naturally in brain creatine content. So if you can give them more creatine through their diet or supplementation, that has been shown to have some promise by decreasing depressive symptoms.” (37:35)
“I would guess we will be looking at creatine and the brain for the next 50 years, just given the infancy of it.” (40:56)
“Creatine is the sprinkle or the cherry on the cake, and that cake is exercise… the magic of creatine is unlocked when you combine it with exercise.” (43:52)
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Creatine, Bone, and Brain Health W/ Dr. Darren Candow Transcript
Steph Gaudreau
One of the best research supplements in terms of muscle strength and performance in the entire world is creatine monohydrate. But you may not be as familiar with some of its other very important benefits, such as the benefits to bone health and brain health. And on today’s podcast, I’m welcoming creatine researcher Dr. Darren Candow to the show, to really fill us in on what are some of the most interesting, newest developments on what we know about Korean teens. Other important benefits.
If you’re an athletic 40, something woman who loves lifting weights, challenging yourself, and doing hard shit, the Fuel Your Strength podcast is for you. You’ll learn how to eat, train and recover smarter, so you build strength and muscle, have more energy, and perform better in and out of the gym. I’m strength nutrition strategist and weightlifting coach Steph Gaudreau. The Fuel Your Strength podcast dives into evidence-based strategies for nutrition training and recovery, and why once you’re approaching your 40s and beyond, you need to do things a little differently than you did in your 20s. We’re here to challenge the limiting industry narratives about what women can and should do in training and beyond. If that sounds good, hit subscribe on your favorite podcast app. And let’s go!
Steph Gaudreau
Welcome back to the podcast. Thank you for being with me today. Before we go any further hit Subscribe on your favorite podcast app and also head over to YouTube. Subscribe here and ring the bell for more notifications. I’m really excited to welcome creatine researcher Dr. Darren Candow to the podcast. Because today we are diving into some of the newer research on Korean teen’s potential benefits for things like bone health, and the brain really looking at things like cognition, mood, and so much more. It turns out, as of course, I’m sure you suspect there are so many benefits to creating other than just benefits for muscle. And there are specifically some differences and things like dosing that you may want to consider. So keep listening for all of that. And before we dive in, if you are a woman over 40, and you’re really trying to maximize strength, muscle, and performance, you know that it’s time to do things differently than when you were in your 20s.
But if you’re not quite sure how to do that and how to work with your changing physiology and strength nutrition a lot is the program for you. This is my group program, it’s going to help you weave together evidence-based principles on fueling, training, and recovery and of course, provide the coaching and support that you need to really implement this long-term and see the best possible outcomes, then check out Strength Nutrition Unlocked and apply over at StephGaudreau.com/apply. Alright, let’s go ahead and dive into this episode with Dr. Darren Candow. Hello, and welcome to the podcast. Dr. Candow. Hi, how are you? I’m so good. I’m super stoked to do this with you today. Getting into even more topics about creatine because let’s be honest, people need to hear about it. And it’s also probably paradoxically, the thing that we get so many questions about at least in terms of supplementation. So thanks for being here on the show.
Dr. Darren Candow
No, thanks for having me. I’m really passionate about this. This should be very exciting.
Steph Gaudreau
Yeah, for sure. You’re kind of like the godfather of creating research. So I’m really pumped when you kind of contacted me through Instagram, dm’s, and we started chatting back and forth. And we’ve had Scott Forbes on the show before. You know, just to recap for the listener, I did a review on what the sort of current body of literature says about women increasing across the lifespan. And that was Abby Smith, Ryan’s you know, paper that she had it up. So, you know, even since then, though, I’m sure a ton of stuff has changed. And we were talking about just even the more recent developments, what’s to come. And so it’s just like, it doesn’t seem like this area of research shows any signs of slowing down.
Dr. Darren Candow
No, it’s actually taken off more than we probably thought it could. And it was like a roller coaster, we had a whole bunch of momentum going in the late 1990s and consistently forbid, and then it’s taken off a new clinical and health aspects of it now. So that’s kind of where it’s at. And I hope I’m a good messenger with all the great researchers around the world doing great stuff. And yeah, let’s it’ll be a great discussion.
Steph Gaudreau
Y’all are the real heroes like out there doing all the research and really putting in the time and the effort and, you know, getting the funding and I don’t think people necessarily like realize the scope of you know, we just kind of see the average person out in the world who’s not in the science research like they might see a headline on their favorite news. Is outlet, right? And it might be that kind of snapshot. It’s turned into, like some common speak. But if you kind of take it back, and I thought this could be an interesting thing to really talk about is like, Y’all just had a big study come out, that was like a two-year trial in Canada. And you were giving me some statistics on this when we were chatting, and it was like, this is a huge undertaking, like, how can you walk the listener through like, kind of the broad brushstrokes of how do you even get to like, what kind of work is involved? How do you get to that point of doing something like a two-year trial? Yeah, by the time it gets to them, and they see it on TV or something like what all has gone into that?
Dr. Darren Candow
Yeah, I think this is a really underappreciated area. I think a lot of people on social media, for example, you know, a lot of individuals will post that they publish a paper, and then all of a sudden, people say, gee, it must be easy to publish in a journal, because these guys seem to be doing it more frequently. And, and I look at them, and I’m like, Oh, my God, only if you knew behind the scenes, and, for just say, for example, for a six-week study, it probably takes 12 months to complete from start to finish. And the cost is, is extraordinary. So depending on what you do, for example, the one we just talked about, it was a two-year study with supervised exercise and creatine every day, in order to honor postmenopausal females, I wrote the grant with a colleague in 2003.
Dr. Darren Candow
Or sorry, 2013, yet still on time, and then the trial didn’t get completed until 2019. And then it took us a few years to comply with all the data and all the blood and urine analysis. And then it just came out. So an entire decade of work on one study, which the person watching or whatever might say, Oh, that’s really cool. It was over 1000 hours of research, and it cost over half a million dollars. So it was an enormous undertaking, it was the largest RCT ever have been shown to combine exercise good colleagues of mine in Brazil have looked at two years in postmenopausal women without exercise, but the appreciation for the amount of work is unbelievable. And the ironic thing is, a lot of us researchers have very minimal followers, I would say maybe a few 1000, whereas social influencers can have millions, and they sort of get all the fame and glory, which is fine. I mean, we’re not in this academia for the fame and glory. But behind the scenes, it’s an enormous amount of work.
Dr. Darren Candow
And I think that’s why else academic academics, or teachers, or professors, whichever it is, are so proud of when we publish something, we sort of jump for joy because it’s a huge undertaking to do that. And so yeah, a lot of work. And I think the knowledge translation in that study, especially for postmenopausal females, maybe it can improve bone strength, could that ever reduce the risk of fracture, potentially in the hip that would have enormous implications for your mother, grandmother, and great-grandmother, and for young females that are growing up trying to build up their bone strength as much as possible. And so I can’t wait to talk about this the rest of the time. But I love that intro. There’s a lot of work that goes into it.
Steph Gaudreau
Yeah. 100%. So I studied biology, and human physiology, in my undergrad, and I was working pretty closely with some of the researchers that were looking at these like endocrine disruption and almost went into sort of, you know, post-undergrad research with one of them. But yeah, just like to even to kind of glean at that point, you know, as an undergrad, like gleaning all of the things that go into in the time and the effort and the, like, true dedication, and you have to have that passion for it. Because, you said, you’re maybe not the ones who are, like, able to, you know, use your names on the paper, but like, again, to the average person, they’re sort of like, they’re seeing the headline seeing the topic, you know, but they’re not appreciating like, maybe you been studying this for, like your entire professional career?
Dr. Darren Candow
Yeah, It’s been two decades at least. And I first started with some excellent colleagues by chance in 2001 was the first paper I guess. And now it’s 2023. And I have double digits of papers in review and working on so we’re still toying with the questions and things that people are really interested in. You know, just creating cause baldness may be the most popular one I get on a daily basis. But we can take it from there.
Steph Gaudreau
For sure. What initially, you know, got you interested in creatine? Is that an area of study?
Dr. Darren Candow
Yeah, it was by chance. So I was actually kind of looking at the amino acid glutamine for my Master’s. So because there was a lot of sort of hype, I guess, the marketing behind this non-essential amino acid. could it actually be taken by athletes to improve muscle performance and we give the highest dosage in any study and it was kind of worthless, it was no good And then placebo and, and it makes sense it’s a non-essential amino acid, we can actually create the only times and may work because if you have cancer, sepsis or other types of metabolic disease, and so it was kind of cool to show that something that was very popular did not work.
Dr. Darren Candow
And if you look at the total body of research, in my opinion, glutamine is probably one of the most worthless supplements for a healthy individual to take. So that was good to get information out there to people to say, hey, maybe saved your money. And at the same time, creatine was just sort of getting a lot of momentum. Linford Christie won the gold medal at the Olympics in the late 1990s. Two seminal papers came out in 1992, and 96, simply showing that a high dose of creatine is really, a really small amount to have the same effect by saturating the muscle. And if you have more energy currency in your muscle cell, that’s what creating does, could that allow you to do more repetitions, maybe exercise longer, and just as importantly, recover at a faster rate from the gym and maybe allow you to maintain an exercise frequency? And then I would guess There are well over 1000 studies that have looked at creatine.
Dr. Darren Candow
But now the emphasis has gone from athletes to more clinical populations, the average individual takes him for help. We have a lot of emphasis now on neck-up cognition concussion, bone health, and of course, muscle. So it’s become a total body supplement, not just for athletes looking to get bigger, stronger, faster, I think anybody on the planet, I’m really struggling to find anybody on the planet that would not benefit from creatine in some form or another.
Steph Gaudreau
Hmm. I, you know, I think it’s always so serendipitous how people stumble into the things that they’re really, you know, they either end up devoting a good part of their life’s work to they’re also hopefully, really passionate about. So I appreciate that, because I think sometimes out in the world, like even people who are maybe newer coaches, newer trainers, nutritionists, etc, are like, Oh, I have to have it all figured out. And like, I have to know what is the thing that’s going to just really, you know, take my interest, and sometimes you just never know, you’re just going to maybe stumble upon it, and it could change the trajectory of your life.
Steph Gaudreau
Well, I was thinking about what kind of fun questions that I asked you. And so I thought of this one, to kind of kick it off, what is one of the most obscure slashes, I don’t know many strange things about creatine that people like have no idea like maybe something super interesting, something really unexpected? Because we again, we hear about like, all this stuff, creatine is for meatheads, and it’s for the gym, but anything that you feel like is really just super, super cool and out there.
Dr. Darren Candow
Yeah. And I, you know, I think the information on bone health, which we’ll talk about is kind of in its infancy, and not a lot of people know about the beneficial effects for pregnancy. That’s an emerging area as well. But I think the big one is from the neck up now the brain cognition memory, and it really only seems to work overall when the brain is stressed. So I think this is an interesting thing for students to night shift workers, when you’re going through sleep deprivation, or times of metabolic stress when the brain is really fatigued.
That seems to be why creatine at really high dosages for long periods of time may be effective. But overall, it seems that the dosage of creatine is really starting to come into question depending on the tissue that it is. So I think one of the biggest things is people said, Oh, I heard three to five grams a day is great. That’s potentially only for one tissue of your body. What if you’re taking it for bone health or brain? It’s totally different. So that’s something that I think is a little eye-opening for a lot of people.
Steph Gaudreau
Yeah, I appreciate that. And we’ve definitely talked about crazy and a lot in terms of the performance aspect, like muscular performance, and things of that nature. So I’m excited to dig into some of these other topics for you. So first, I wonder if we can circle back around to the two-year trial that y’all did in Canada and talk about the bone health aspect again I think there are a lot of people listening to this podcast who are in the 40. And over category, mostly women who are concerned about things like, you know, their bone health, osteopenia, osteoporosis, especially as we’re aging, and I think in the US alone, by 2060, there’s going to be, is it 90 million women over the age of 50? Like, it’s just a growing drug growing population?
Steph Gaudreau
So in terms of the bone health aspect, can you run through a little bit more about what you kind of give them the brush strokes, but what did that? Try it. What did you learn from that trial? And like, what are some of the subtleties that people might miss? Again, if they’re out in the world, and they’re like, oh, this big study was done with creatine and, and bone? What were some of the things that you found that you think are really interesting for people to know?
Dr. Darren Candow
Yeah, the foundation was based on some Rodin model and some healthy older adult models. So when you combine resistance training and creatine supplementation, it’s very well established, muscle will go up. And the theory was that if you have more muscle So there’s going to be pulling on the bone when you’re exercising, so could that stimulate bone growth, if it could, that has enormous implications for again, both sexes, but primarily females who may be more prone to osteoporosis or age-related bone loss. And so one of the best populations to assess this is postmenopausal females where the cessation of estrogen is complete, and we went a little bit further and normally defined postmenopausal as 12 months last menses, but we did 24 months to ensure everybody was in an equal about and to be properly statistically powered, you need a really high sample size.
Dr. Darren Candow
So we were extremely fortunate to get over 200 postmenopausal females to volunteer for the study, they were randomized into two groups, creatine or placebo. But our previous status just said that the typical dose which you know most people say is five grams was not nearly high enough to not only induce an increase in muscle mass, but potentially bone. So we did something very unique, we did a relative dose. So if everybody went on the scale, you would know how much you weigh in kilograms, we gave the highest dose that has ever been shown to be effective 0.14 grams per kilogram. So if you’re 70 kilograms, that female was taking almost 10 Grams of Creatine a day, they took it every single day, including off days for two straight years. Now most people say whoa, I thought you were only supposed to take five grams a day for a little bit and take time off, we see no evidence that you need to creatine cycle. Not only do we give creatine every day for two straight years, but we measure liver and our sorry, liver and kidney function from blood and urine analysis to make sure it was safe every six months.
Dr. Darren Candow
And lo and behold, when you looked at the totality of the data, two years of a very high dose of creatine and resistance training plus six days of walking, it did not have a beneficial effect on bone mineral density, which we did hypothesize, but it did increase bone strength. So what does this mean if you were to take your pencil or pen, the bone is more flexible or resistant to breakage, whereas in the placebo group, it might crack more. So if you think of your femur hip range, and if you were to fall on an icy road, the individuals on creatine may be able to withstand that fall better. So it improved bone strength and the World Health Organization uses bone strength as a main predictor for functionality and osteoporosis. And not only did improve some of these bone geometry principles, but it also caused individuals on creatine to improve their walking speed. So this allows these individuals to walk faster, which is a measure of functional ability. And for the viewers that are familiar with sarcopenia, that is now used as the main criteria to diagnose that clinical condition. And finally, in a group that was considered compliers, to resistance training, exercise, walking, and creatine, they improve lean tissue mass.
Dr. Darren Candow
Now there’s some hesitation with increasing lean tissue mass because it’s not muscle mass. But lean tissue mass is still correlated with a lot of beneficial things primarily glucose disposal. Anybody that’s familiar with type two diabetes knows that the more lean tissue you have, the more glucose can enter the cell. So all in all, it was very beneficial. Strength did not go up, maybe because the resistance training program was equally beneficial. But just as important, there was absolutely no greater side effects over two years on the creatine group on a high dose compared to the placebo. So what we’re starting to see now, when you look at all the data, three to five grams has zero effect on bone health. If anything, I higher dose of eight grams or more can have a small beneficial effect on bone mineral density and or bone strength. But the cool thing is 10 grams or more for two straight years had no greater effect from a side effect perspective. So I think it’s something to really consider.
Steph Gaudreau
Yeah, I appreciate you going through that. And I think for the listener, there’s going to be a distinction here and a couple of things that you said, and again, this is why it’s so great to talk to people like yourself with such deep knowledge. Because what folks hear in the world, you know, maybe it gets translated through somebody like me, and I’ll be the first to say, there are probably things that I miss as well. I’m not a researcher, I’m just somebody who understands how to translate from, you know, what the science says to more of a practical takeaway, but they’ll hear things like bone and then you were talking about bone mineral density versus suddenly like bone strength, and how those might be related in some way. But they’re not necessarily the same metric or have the same effect.
Dr. Darren Candow
So bone mineral density is well established in the Osteoporosis world is kind of just thinking about the weight of your bone, the density of the bone got stronger, whereas strength means the bending of strength when it’s under compression. And when you look at all the data, we don’t really see a great beneficial effect, if any, from creating bone mineral density, we definitely see an effect on bone strength. And the other cool thing is when you think of an anti-catabolic effect for any of your viewers that are taking bisphosphonate that’s an anti-catabolic drug, creatine really seems to have some beneficial effects by reducing bone breakdown. So it sort of preserves the skeleton. And then if you add in resistance training and put on more muscle mass, maybe you get a total effect of increasing muscle mass maintaining or strengthening the bone. And we can actually talk about some of the effects small effects of creatine on reducing fat mass in young and older adults as well.
Steph Gaudreau
Yeah, for sure. And it kind of the next thing that you said which I want to, like reiterate for people is you’re talking about the difference between muscle mass and lean mass, right? And from research from a physiological perspective, what does that actually mean?
Dr. Darren Candow
Yeah, so if you for anybody and the viewers, they go on their scale the BIA or get a DEXA scan. And sometimes they get really alarmed when they jump on and say that lean tissue is this or percent body fat. So most lab measures of lean tissue mass are probably primarily done through something called Underwater weighing, air displacement plus tomography, or a DEXA scan, in which a lot of individuals’ parents have gone to the hospital and got a bone mineral density scan, the main issue with lean tissue.
Dr. Darren Candow
Again, this is not muscle mass, lean tissue encompasses muscle, water, organs, and blood, but it also encompasses something called fibrotic tissue, so a whole bunch of things in the cell. Whereas more sophisticated technology uses a muscle biopsy, or some 3d or even 4d imaging, and look at pure muscle. So if you increase or decrease lean tissue, that is not the same as an increase or decrease in muscle mass. And so that’s just something for a lot of the viewers to be aware of. And again, that’s more important when you go to a personal trainer, and they measure your lean tissue mass, and it may be as high or low as you were thinking that’s not the same as measuring a muscle biopsy, you’re looking at proteins in the muscle.
Steph Gaudreau
Yeah, absolutely. I appreciate that. So because it is there’s like some subtleties here. And sometimes in the world, we like to interchange certain terms, and it can we can start to lose a little bit of the definition. Like if you kind of squint, you’re like okay, like that’s sort of in the right realm. But the details really matter here. And so you mentioned just before talking about things like fat mass, can you talk about that too, because I know that a lot of people are, you know, they’re concerned, they’re thinking about, especially for postmenopausal, or like through the menopause transition. We know, for women, the risk of cardiovascular disease rises, we have talked about things like visceral fat, and so on and so forth. So what do these particular studies show about things like fat mass, and how that might change with creatine?
Dr. Darren Candow
Yeah, so the two-year data, fat mass was basically unchanged over time in two years. But the cool thing is, it did not go up. And it had minimal effect on any changes. But we did perform two years ago, a meta-analysis looking at adults 50 And above, looking at the effects of creatine on fat mass changes, absolute fat mass in kilograms, as well as percent body fat. And the interesting thing is older adults 50 and above combined with resistance training, lost 0.55 kilograms of fat. Now, when you extrapolate that here in Canada, less than two pounds or in the United States, 0.55 kilograms, that’s probably insignificant from a big-picture perspective. But I argue, Well, wait a minute, there were a lot of big myths about creating causing a lot of water retention, and a lot of people said they felt fatter. And I’m saying, Well, if you combine exercise with creatine, you’re showing a small reduction.
Dr. Darren Candow
That’s huge for clinical obesity and type two diabetes. But the percent body fat was statistically significant. So that means these individuals lost a little amount of body fat. In general, they would have probably put on lean tissue mass or muscle mass with creatine. So I think that has massive implications from a body composition perspective. And we’re just doing the younger adult meta-analysis now. And I guess I can say this, the results are identical. So if you’re under 50, it was a mirror image. So we can conclude basically, if you’re 18 years and above, creatine and resistance training will decrease fat a little amount, but it will not increase it. And therefore that has implications for a lot of chronic diseases maybe later on in life, obesity, cardiovascular disease, metabolic syndrome, but the big thing I’m getting interested in is type two diabetes and the huge increase in fat.
Steph Gaudreau
Yeah, absolutely. I appreciate that. And I think, you know, we, you and I talked about this in our direct messages. How one of the biggest and I appreciate you bringing up like that the the fat mass change was, you know, slight, maybe not like massive, but there was no fat mass increase. I think that’s important for women, especially to hear as they’re going through Um, perimenopause, menopause transition, there can be a redistribution of fat stores, for example, and a lot of people really just go through a tough body image time at this time of their lives. And, you know, time and time and time again, and I see it from my perspective, from my side of things.
Steph Gaudreau
And I’m curious what you see when you’re running these studies is that women will start taking creatine, they get super excited, they’re like, Okay, this is going to have so many benefits for me. And then they’re like, I feel puffy, or like the scale went up, or, and they just freak out. And I, I say that with a lot of love and compassion, because it was definitely a time 1015 20 years ago, where if I started taking, you know, maybe I started taking creatine and I got on the scale, and every day, it was like it the scale went up. Forget it, it was like a disaster, right? So what can you let any insight you can share? Because you were talking about even a higher dose than, you know, five grams, which is kind of that three to five range? What do you see?
Steph Gaudreau
And, how can you have any insight about how we like to get around or deal with that, the subtlety here of, the scale might increase, but it’s not fat mass, like, I always call it hashtag muscle water, like, you know, for people. But what are your thoughts on all of that?
Dr. Darren Candow
it’s definitely the biggest barrier, especially for females to participate in a research study. So let’s back it up a little bit. The most water retention that will occur is during the loading phase, which can be effective in use in certain populations, but it’s not needed. So the loading phase is typically 20 grams a day. And keep in mind, we’re only producing naturally about two to three grams. So again, you’re taking in 10 times as loud as what we’re naturally making. So 20 grams a day for about five to seven days is a very effective way to saturate the muscle that’s been shown time and time again, to be probably the most rapid way to do that.
Dr. Darren Candow
Creatine is a unique compound, it’s something called osmotic, and it will drag water from your blood around demanding tissues, and primarily its muscle mass. So very common with the loading phase, when people say to us, I increased my body mass on a scale by one to three kilograms during the week. Some males love that some females love that. But most young females do not like that and they withdraw. So depending on the statics of the population, and the sport they’re in body fluctuations may not be viable. What we’ve done is shown that maybe a really small dosage can be ingested more frequently throughout the day. And that primarily does not lead to bulk or bolus water retention. So for those that are very susceptible to water retention, I say do not do the loading phase. Okay, you can reduce it to as low as three grams a day. If you’re looking at it from a muscle perspective, as low as three grams a day, it’ll take about 30 days to saturate your muscle.
Dr. Darren Candow
And then you can take three days or three grams a day, if you want or a little bit more, basically till the day you die if you’re looking at it from a muscle overall potential performance perspective. And I even go you could take that three grams today in one gram dosages with breakfast, lunch dinner, it will accumulate in the muscle. There’s some evidence from Roger Harris, who showed that one gram per ingestion may not be enough to get into the cell. So I think if you’re going to do three grams a day, you can just take that in one bolus if you want to divide it up. In our lab, we typically do 0.1 grams per kilogram across all ages. And so again, if you’re 70 kilograms, that’s seven grams a day for 10 kilograms or 100 kilograms, you’re taking 10 grams a day and we simply divide that in two dosages, sometimes with a meal. And we’d like to give one right after exercise because I think your transport kinetics are activated. So if a female or male is very susceptible to water retention, I say take your daily dose and divide it up into smaller frequent dosages.
Steph Gaudreau
Okay, good. I’m glad that you know, we have some practical takeaways here. Because I hear this so often. And, you know, usually, it comes down to like you said, there’s their loading. And so like, Can we back that off and just, you know, as long as there’s no rush to, you don’t have like a competition or something coming up? And that can cause some of the concerns, you know, being in and around weight class sports, like for basically my whole athletic career, like it can be a concern for people. But I think to your point, like there are other ways to approach it, and it’s just staying the course if you will.
Dr. Darren Candow
And the other big one was with caffeine. So this is really important to be clear here. If you plan on taking creatine and caffeine for more than a week, maybe you’re taking it for resistance training, please don’t mix them together. There’s good evidence to suggest that more than three days of creatine in combination with caffeine can blunt each other. So I’m a coffee junkie and most people are so if you’re going to consume the two, I say simply consume your coffee or caffeine pre-workout and you’re in your creatine after. And pre-workouts have a combination of a whole bunch of things in there. So you never know what’s working.
Dr. Darren Candow
But the good cellular data, say creatine and caffeine oppose each other at a really important compartment in the muscle. And we showed last year actually that in a very small population, the group who took creatine and caffeine powder together for several weeks of resistance training did not get the same benefit from one measure of a muscle compared to creatine alone. So there’s indirect evidence or theory that they can interfere with one another. So I think that’s another thing that your viewers may want to consider at least.
Steph Gaudreau
Absolutely, everybody, I’m a coffee lover myself, but everybody wants to put everything in their coffee in the morning. And I’m like, Yeah, okay, you got to get to be a little bit…
Dr. Darren Candow
And that goes with the timing of creatine is pretty much irrelevant. You can take from eating at any time of the day. There’s really no difference pre during or post. But I really promote post-exercise creatine, because you decrease all the energy stores and turned on a whole bunch of things in the body with exercise. And if creatine can be there in the body with an increase in blood flow, or transport kinetics, that’s a very viable strategy. And you could also argue, using that logic, to take it before exercise when things are activated. So those are two very viable strategies that people can use.
Steph Gaudreau
For sure. Yeah, I usually just sip on mine like this before, like as I’m going through training, and then I finish it up after I’m done.
Dr. Darren Candow
I do the same thing.
Steph Gaudreau
Yeah, I make like my shaker bottle, and I’ve got my electrolytes in there and my creatine and then just like sip on it as I’m going through. So just keeping it easy.
Dr. Darren Candow
Note that exercise is probably the best way to get creatine into the muscle. So muscle contractions really stimulated carbohydrates and protein to do that as well. But if there’s someone who’s really trying to maximize the amount of creatine uptake by exercise or muscle contractions is the best way.
Steph Gaudreau
It’s almost like that’s just how things are designed to work, right? It’s like, can we take advantage of all of those things, those like great beneficial effects that we get from actually getting the muscle to contract and challenging ourselves with, you know, lifting appropriate enough loads that we’re getting those maximal contractions, and using all our muscle fibers, I love it, I couldn’t do it on that nerve all day.
Steph Gaudreau
I would love though, to shift a little bit and talk about some of the above-the-neck stuff as you called it, because I think that again, with this population, even as athletic folks, you know, I’m in my mid-40s, a lot of people listening to this show are like maybe creeping up to their 40s or in their 50s as well. And we’re starting to think about things like seeing our friends and family aging, and like maybe taking care of parents or seeing how cognition memory, mood, like all of those things, and you mentioned stress earlier, can play into, you know, are starting to be borne out in some of the creative and research.
Steph Gaudreau
So I would love to kind of pick your brain no pun intended on sort of some of the things I guess maybe a good place to start would be something like memory, since that, you know, again, is something people are kind of noticing, maybe they’re like, Oh, I’ve kind of like brain foggy or stuff that’s going on there. So what do we know about creatine in the brain, creatine, and memory some of these things?
Dr. Darren Candow
Yeah. So this, we have to sort of lay the foundation for why it’s different than a muscle. So our muscle does not create creatine itself in the body creatine is primarily created in the kidney and liver and oh, it actually is created in the brain. So right off the bat, there’s a big difference, which may turn on a light bulb and say old adults, which might be a bit different. So from the neck up, it’s very protective. We all know that the brain has something called the blood-brain barrier, it does not allow things into the brain it doesn’t want to. And the brain is also very unique. It can synthesize its own creativity. So unlike muscle, which relies on our diet or natural production, the brain can make itself so that the brain is making creating itself, you would speculate whole, maybe it’s resistant to supplementation.
Dr. Darren Candow
And if it’s kind of resistant, maybe you need a much higher dose for a longer period of time to accumulate. And that’s kind of where we’re starting to see the differences in dosing. So, creatine supplementation has been shown to increase brain creatine content, even the supplement can get into the brain by a bow on average of 6%. But this is where it gets quite different than muscle. If we were to say muscle can benefit between three to five grams a day, every day, you will get some muscle-beneficial effects. We’re starting to see about 20 grams a day is needed in the brain for periods of weeks, if not months.
So that’s the loading phase just for the brain. There’s been a few studies that have shown some beneficial effects at lower dosages. But those individuals were diagnosed with depression on depressive medication. So if you take those studies away, the existing data, which is a very small body of literature is saying really high doses are needed for subsequent weeks on end. And when you look at that, over time, if creatine can get into the brain, we see all these neurological conditions concussion, traumatic brain injury, sleep deprivation, that naturally reduces brain creating content.
Dr. Darren Candow
So supplementing the diet that can have some therapeutic effects. And when it comes to memory and cognition, this is really important. aging adults seem to respond very well to improving cognition and memory. younger individuals, we don’t really see that effect at all. And if we do, it needs to be when the brain has stress. So I always think university students going through final exams are very, very stressed, could creatine, be an adjunct to proper sleep and diet and overall healthy lifestyle to potentially maintain some memory or cognition, some meta-analyses have shown some improvements primarily in older adults. Unfortunately, though, we’re not seeing any improvement in individuals with Alzheimer’s to mention Parkinson’s or Huntington’s. Also, we’re not seeing any good benefits with multiple sclerosis. The probably logical reason for that is we need a lot more studies done in those clinical populations with very large sample sizes.
Dr. Darren Candow
We have on the other hand, looking at it from a positive lens, seeing some beneficial effects and stroke rehabilitation populations, improving gait speed, but the big one is young boys with muscular dystrophy. This condition is based on a recessive gene that has been linked to excessive muscle and bone loss and functional impairments. And a few really good studies have looked at creatine with just activities of daily living and improved bone health as well as muscle function. So there’s some potential in looking at neuro-physiological or neuromuscular diseases. But the biggest area of emergence is depression and anxiety.
Dr. Darren Candow
I think with COVID, especially depression, anxiety rates, I would guess, have gone through the roof. And we’re starting to see a lot of promise in creating and acting as a neurotransmitter and reducing oxidative stress. And individuals with diagnoses of depression, anxiety, and maybe even PTSD, have a reduction naturally in brain creatine content. So if you can give them more creatine through their diet or supplementation, that has been shown to have some promise by decreasing depressive symptoms, and we’re starting to now look at that a lot in our lab, independent of depressive or anxiety medication, I think that’s the key, we need to take away the medication.
But from an ethics standpoint, I’m not sure how we’re going to do that. So there’s a lot of potential promise there. We’re not really seeing any big push on speech pathology or sensory issues. But there are two studies on concussion, which I think is the hottest topic. And there’s a lot of press that if we can put creatine into the brain, we now know concussion substantially reduces the amount that’s there, can creatine act as an oxidative protective candidate to heal the tissues around certain areas of the brain, especially brain blood flow.
Dr. Darren Candow
And in the only two studies to ever look at this in children, these children were diagnosed with head trauma and immediately put on creatine or placebo, the dose was quite high, 0.4 grams per kilogram, and they measured them multiple months later. And really surprisingly, the children that were on creatine really had significant improvements in speech, self-care, and self-efficacy, whereas the children that didn’t, did not, so it showed that maybe creating has the potential to improve post recovery of concussion. We don’t know if you load or take creatine, before you get a concussion, would it speed up the rates of recovery? That would mean you’re taking athletes dividing them up on creating or perceivable before they have a concussion. And God forbid if they do, then you can measure later but a C application obviously, you’re in the United States NCAA football or contact sport, UFC. Boxing, this could have potential therapeutic benefits. All we can say is there’s some small preliminary data as to suggest it can improve symptoms of getting a concussion. We don’t know when we probably will never be able to tell cannot prevent a concussion. We don’t think so.
Steph Gaudreau
Huh? Super, super interesting. Something you said earlier. In terms of the brain and cognition, it seems to benefit older adults. Creatine seems to benefit older adults more than younger adults unless those younger adults are under stress. Is that because our brains are producing less creatine as we age? Is it because we just see other associated changes in memory and cognition as we’re aging like what’s Do you guys have a sense of what the mechanism is there?
Dr. Darren Candow
Yeah, it was a phenomenal study that came out of Brazil by some of the leading researchers in creatine and they looked at sex, diet, and age and the effects of muscle versus brain, and the brain is very unique. It doesn’t have any difference when dependent on vegetarians’ plant-based diets are omnivores, the brain-creating content remains relatively the same. Aging is relatively stable and might be a little bit reduced. But we don’t know the biological or pathological processes going on with the aging brain, no different than your bicep, you know, sarcopenia, it’s going to get smaller as we get older. The theory just like any other muscle or organ in the body, it may be jeopardized with aging as well.
Dr. Darren Candow
So that could be coming into play is some of those tau proteins that we look at in dementia and oxidative stress and things like that. So these are all areas for future research, I would guess we will be looking at creating in the brain now for the next 50 years and just get in the infancy of it.
Steph Gaudreau
Yeah, sounds like there’s just a lot to explore there and a lot of potential and possibility for those clinical applications. Let’s say hypothetically, you’re a woman, let’s say you’re a woman, and you’re like maybe early 50s, you’re kind of on the cusp of being postmenopausal. And you are interested in, you know, like building strength and muscle mass, you know, is something that’s important, like you’ve, you’ve, you’ve listened to this podcast, or other people out in the world, and you’re like, okay, like I need to preserve my muscle mass and build what I can, you know, you’re concerned about things like your bone density, bone strength. But you’re also concerned about some of these cognitive effects. And you want to do like the most you can for your brain and that sort of thing. How would you approach dosing in that way, knowing that the two appear to be kind of leagues apart in terms of how you would dose that?
Dr. Darren Candow
Yeah, so I personally take at least 10 grams a day for the overall health, we haven’t even talked about the immune system, which can actually utilize creatine there as well. So if it’s 10 grams a day and you’re looking at it from a muscle, bone, and brain health perspective, and going quickly, back to bone, the lowest dose was around eight grams. So here you are. Now you’re like, Well, we know there’s potential little issues with the loading phase, but you kind of are approaching that higher dose. I think you want to take smaller, more frequent dosages throughout the day, and just hold on and get past that first week of the water retention, it will subside. So it really comes down to why that individual has taken it. If you’re not really concerned about going on stage or looking in the mirror and saying, Oh, I gained two pounds of water retention.
Dr. Darren Candow
I think the population wants to take something if they are considering creating supplementation. In addition to exercise from a health perspective, I think smaller, more frequent dosages. So that could be as little as two to three grams a day, maybe three times a day, that that’s one way to do it. So I personally take at least five grams with breakfast, and I drink five grams during my workout. And then on days, I’m really metabolically stressed, writing boring grants or papers or whatever, I’ll take another five grams. And I’ve been taking creatine ever since I’ve been 17. No stoppage. No need to stop. Ah. Yeah, I just sort of back what I researched. And the big thing too, is I’m not just giving you a personal opinion here. I’m giving you everything evidence-based research. And I think that’s really important when you have academics, opinion is okay, but you want to base it on facts.
Dr. Darren Candow
And there’s some things that creatine doesn’t do. And at the end of the day, it only has a small little beneficial effect more than exercise alone. So I always say it’s a sprinkle or cherry on the cake. And that cake is exercise. I think, if you’re taking creatine without exercise, you may experience some small beneficial effects. But the magic of creatine is sure on lock when you combine it with exercise.
Steph Gaudreau
Yeah, that’s the one thing I feel like it’s so tough, right? We even in the United States, I know Canadian, for example, physical activity recommendations are really similar to the US. But you know, here in the US were two muscle-strengthening sessions a week and 150 minutes minimum of moderate-intensity cardio or 75 minutes of vigorous cardio. If you’re going to swap in intensity. You know, I think that we have this, perhaps like in at least I know, in my bubble, it’s like we were we’re talking about this stuff. And it’s like people are pretty accepting and are really doing a great job with implementing exercises to help promote habits and things of that nature. But it’s like seeing the percentage of folks who are still yet to come on board, especially with the strength training element. You know, it’s like women between the ages of 18 and 64 here in the States. I think it’s like one in five.
Steph Gaudreau
Yeah, thereabouts is doing and meeting both the minimums for the muscle strengthening and the cardiovascular stuff. So it’s like, You’re right without, like, it’s, it’s, it’s hard for people who aren’t quite mastering that, those habits, those things they do and show up consistently for every day. And I think to hear, then, like, Oh, I’ve got to take this supplement on top of it. I think some people are a little bit like, you know, what should I focus on first, what’s the most important, but I can, I can definitely appreciate that. And I think, you know, the more we can kind of work on those things in tandem. You know, exercise doesn’t have to be a boring, horrible thing. You can find what you like and, really continuing that on through as long as you physically can is so so important.
Dr. Darren Candow
Yeah, I totally agree. Start as young as you can. That myth about exercise and children’s development is one of the biggest myths ever created. No different than a protein hurting your kidneys. Don’t worry about any supplements. Don’t worry about any type of the key, there is a supplement food first proper sleep and move the body the body was meant to move. And unfortunately, in society, we’re extremely sedentary. COVID Locked everybody in their house and I’m just waiting for the data to come out on the chronic diseases, that’s COVID pause from inactivity. And there’s come up some phenomenal benefits. We’re now looking at home-based exercise with rubber tubing as a Bible strategy for people in long-term care facilities. So we got to move the body, it doesn’t have to be continuous.
Dr. Darren Candow
But if you can throw in some type of resistance training, carrying groceries, and shoveling the driveway that still counts. And I think if you say I need to get 115 minutes in a week, or however you want to do it is very viable. And please note, there are only five supplements that the IOC even says are effective. And of those five, the effects are very small. Okay, so these might just give you a small extra booth caffeine, beta-alanine, beetroot juice, sodium bicarbonate, and creatine. Protein is a food-first supplement. But people are always asking about job roles mega mass 9000, I heard it says this, it doesn’t, you probably excrete this down the toilet. Yeah, quite often. So there are only a few out there. And what I just talked about the majority are found in food.
Dr. Darren Candow
Man, if you’re a plant-based individual vegetarian or vegan, getting creatine is going to be very difficult. And maybe that’s why supplementation is looked up from a protein perspective, you can get all the protein you want from all your plant-based protein. So you just need to eat a little bit more. And I think we’re so hell-bent on pills and powders as the magic. sure nothing is magic, it takes a lot of work to do. And I agree with you, if we would just move the body and put less pressure on ourselves about how we look, there are so many things influencing our metabolism, and just try to eat better. And if you have the luxury of entertaining a supplement, if you need it, maybe you’re deficient in vitamin D, maybe you get a multivitamin. These are little things that can just help but nothing will replace exercise. If you were to ask me what’s the best thing for a fountain of youth or anti-aging, it’s exercise.
Dr. Darren Candow
And if you exercise at a higher intensity more often, if you’re riding your bike outside, and there’s a hill, try to do it. Little things can add up. If you have a chance to walk through the source of the driving, take advantage of that. And record the number of steps on your phone or watch. These are little things you can do. If you’re working in an office job, great, a lot more water goes to the bathroom more often. Steps. So it’s not difficult. But I think we said well, if I can’t work out in the gym with barbells and dumbbells, 60 minutes a day, I barely have time to take care of things in my life, how am I going to exercise and we’re humans are very lazy, we have prime and Netflix and everything. And the shows are great. And now there’s no commercial. So you don’t even have an excuse to get up and move around.
Dr. Darren Candow
I think we’re going a little bit backward, but I just would move more often. If working out in the morning is the best for you, great, there’s no perfect time, just do what’s best for you. If you have to get up early to go to bed earlier. I mean, nothing really happens well later in the evening when you’re watching Netflix and sitting on the couch. So maybe you go to bed a bit earlier and get up earlier. It’s some little strategies you can adopt. Yeah, and I totally agree with you.
Steph Gaudreau
Yeah, absolutely. One that a lot of people in my community I’ve been doing and I’ve been doing for a while now as well as rocking. So just throw on a weighted backpack as you’re doing your walk, especially if you feel like you know, you’ve been you’ve developed a walking habit and you’re just trying to like, maybe eat a little bit into, you know, a little bit more intensity or walk up a hill. You know, those sorts of things to your point about like, you know, not avoiding that hill on your bike but like to take on that challenge.
Steph Gaudreau
I think those are all really great practical tips where people want I think one more question that I have is and I’ve been hearing this a lot is the idea of creating nonresponders. And there are sort of like incidents at least and maybe the experimental populations that you’ve seen because quite often I’ll hear from people hey, I’ve been taking creatine for a while. I just don’t feel any different. I don’t know if people even know What to expect that they’re going to feel or notice. So I would love it if you touch on that as maybe a last question, and then we’ll kind of wrap things up.
Dr. Darren Candow
Yeah, so the responder-nonresponder issue is legitimate. And it’s only from a muscle perspective. So please note is not from a bone or brain because we haven’t got there yet. But when someone says, I’ve taken creatine, and I didn’t triple the amount of weight, I can lift because that’s what I thought creatine did and no, it’s not multiple anabolic steroids. It’s a natural product, you’re consuming it and producing it in the diet. So when people say I’m a nonresponder, what that means is your response to creatine is primarily dictated by four things.
Dr. Darren Candow
But by far, the biggest issue is the amount you naturally already have in your muscle. So from a muscle perspective, we have a maximal capacity, put in layman’s terms, about 180 grams to 200 grams of potential capacity for creatine, a vegan only has about 80 to 100 grams at rest. So a vegetarian or vegan should respond very well, they wouldn’t be considered a responder because you’re technically having the ability to double the amount of creatine in the muscle. But if you take someone on a carnivore diet, who eats red meat and seafood, they might already be near the ceiling. So if you take a supplement, they may not respond at all.
Dr. Darren Candow
And they say, Hey, I didn’t notice any increase in repetition or weight. So the initial amount of creatine in your muscle is by far the most primary factor. The second is age and sex. There is evidence that females do not respond the same way from a muscle-building perspective, compared to males, and they don’t seem to have the anti-catabolic effects. The females respond very well from a muscle strength perspective. But if you were taking a group of males and a group of females, on average, the male is going to get a larger amount of muscle mass over time. So maybe some females especially may not respond as well.
Dr. Darren Candow
Same with aging. There is some evidence that older adults have reduced creation in their muscles. That’s why we see that these populations respond well over time. And the fourth one is your habitual dietary intake. Creatine is naturally found in high amounts in red meat and seafood. If you don’t consume any of those products, you may experience a greater response. But if you’re consuming a steak a day, and maybe salmon, you may not respond as well. So those are the four big areas, but by far, it’s the initial amount in your muscle.
Steph Gaudreau
Appreciate that. In your opinion, is it still worth considering taking even for the like, we’re talking about the above the neck and some of the other nonmuscle, you know, benefits that people can experience?
Dr. Darren Candow
Yeah, 100% to get that high amount of creatine per day, even on an omnivore carnivore diet is really difficult. Again, the responder idea was based on a muscle performance perspective, but we have no idea how much you need as a responder for bone and brain. And if it is 10-20 grams for the brain over a long period of time, that’s very difficult to get, there’s probably about three to four grams in a large red meat steak or two servings of seafood. So you’d have to be eating pretty much meat all day long, seven days a week to get the same response.
Dr. Darren Candow
Whereas you could consider a supplement. The cool thing with creatine is do you need to supplement? No, you can get the basic small amount needed to maintain your baseline levels naturally through your diet or what you consume food products because we synthesize about one to three grams per day. So does someone absolutely need creatine 100%? No, a lot of vegetarians and vegans can exercise or be healthy their whole life, creatine just may give an extra small beneficial effect.
Steph Gaudreau
Okay, appreciate that. The last question, I guess is what are you working on now that you’re really jazzed about anything interesting coming in the pipeline for you?
Dr. Darren Candow
Yeah, we have a huge creation of a brain health paper that’s hopefully coming out in the next few months. And then also in our lab, we have a number of studies planned, we’re going to now look at depression and anxiety and young females post-exercise. And we’re going to really put the question to rest does the timing of creatine at different times of the day really matter? We have two unique studies that will sort of answer that as well.
Dr. Darren Candow
And then the big shift is on individuals diagnosed with sarcopenia or older adults, we now want to look at creating and home-based exercise, they can stay in the comfort of their own homes, we go to their homes and do the assessments with portable equipment. And that could be very viable for individuals that are shut-ins, long-term care facilities, where God forbid, another pandemic comes up, they can still exercise at home. So there are seven or eight studies, ongoing or planned. And quite a few papers already in review and things like that. So I love it. It hopefully never ends.
Steph Gaudreau
Well, thank you so much for sharing all of your expertise with us and walking through some of these different subtleties. I think it’s really important for people to hear from folks like you who are the primary researchers in these fields. Frankly, you know, putting in the long, hard hours and trying to just help us better understand how things work like how can we not only find the edges of like human performance, but also from a more general population point of view, with health and well being and all the challenges that go on in this world, so I really appreciate you the things that you all are doing.
Steph Gaudreau
And I think the more people can hear from the people behind the research and the studies and, you know, hear your passion, I think it’s very, very, very contagious. And I really think it helps people to, to have that humanized element to have like, these are real people doing this research, you really do care and, and are trying to help us all better understand collectively. So I appreciate you.
Dr. Darren Candow
Thank you for the opportunity. It was great. And I’d really appreciate it.
Steph Gaudreau
Yeah, thank you so much. And I look forward to seeing all of your new studies that are coming out. We’ll definitely share those as they come out in the world and help get folks more interested in creating conversation.
Dr. Darren Candow
Thanks again. It was great.
Steph Gaudreau
Thank you. Thank you so much for tuning into this episode with Dr. Darren Candow. I hope you learned something about bone health, brain health, aging, creatine, and really where the frontiers of creatine research are headed. I know that I appreciate very much his time on the show today. Make sure you hit subscribe on your favorite podcast app. And if you’re not already listening on YouTube, head over there, hit subscribe as well, and ring the bell for more notifications to see when new videos get posted.
Steph Gaudreau
Of course, if you’re ready to just start putting these into practice, you know there’s no more time to waste. If you really want to get going on your strength, and muscle mass performance, then head over and apply for Strength Nutrition Unlocked and we’d love to have a conversation with you to see if you’re a great fit for the program. You can do that at StephGaudreau.com/apply Thanks so much for being here. I really appreciate it and until next time, stay strong.
Creatine, Bone, and Brain Health W/ Dr. Darren Candow | Steph Gaudreau.
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