B (5:51)

Yeah, so who should be taking creatine? It could very well apply to most people, even younger people, older people, people training, people who are not training. We don't have all of the answers to that now, but the story goes as follows. In the early 90s, there was a group of British scientists who had discovered that it did have a significant impact on ballistic performance. And then that translated into them getting creatine. There was the global supply was 1 kg. And they said, wow, this could give our British Olympic athletes a real advantage. So they had to figure out a way to get manufacture it and get it to their athletes quickly. So they did that. That led to a man named Linford Christie winning the 100 meter dash, which is one of the most watched Olympic events. And afterwards he talked about his usage of creatine in his training. And what do you think happened to the world of global athletes after they saw that this advantage was conferred by creatine? Interest grew. And so even in the United states alone, by 1995, the market for creatine was about $30 million. And just three years later, it had grown even further to $150 million. So it had gone from Olympic athletes. Now all professional athletes wanted to see if it could benefit them. Then it went to weekend warriors training. Seriously, but not in a professional context. And for about two decades, all of the research was in that area. And that's why I'd had the lore of it being an ergogenic aid only. But around 2010, the research field widened and researchers realized, if this is supporting energy in the body, maybe it's useful for other things. And that's when you started to see it being investigated for lots and lots of different purposes. And I think we're at the tip of the iceberg. We're not at a place where we've really tapped out or exhausted our understanding of all the areas that creatine can support. But sitting here in 2026, we're at a much different place than we were 15 years ago with the societal understanding of what creatine is good for. And so I've been really excited to get the word out about creatine because there's still a lot of work to do to talk about it in new ways so that more populations can benefit from it because it is a pretty remarkable compound.

A (8:33)

Let's actually talk about some of the myths that seem to perseverate around creatine particularly. I think a lot of women are afraid that creatine is going to cause water retention and bloating.

B (8:45)

Yeah.

A (8:46)

So let's start with that one. There's a couple of other ones that I want to dismantle with you as well. But does creatine cause bloating?

B (8:52)

So creatine is a hydrophilic water loving compound and that means that it pulls water towards it. But where does creatine go? It goes into cells. It goes into your muscle cells. And so when we think of bloating, we think about that extracellular water, that's that squishy feeling. We do not think about that full muscle feeling. And a 95% of creatine is going into the muscles, but it goes elsewhere too. We'll talk about that. And so the feeling that a person has when they've taken creatine for, let's say a week is that their muscles feel a little bit tighter, not that they feel a little bit softer and squishier. So that bloating idea was falsely associated with the fact that people would gain. Many times people will gain some weight, it's water in response to taking creatine. And that happens pretty quickly. But that's, that's not the same thing as bloating. It's water in your muscles mostly.

A (9:53)

Yeah, yeah. I think this is a really important distinction because you, what you actually want is you want the muscle to be swole. Right. As the gym bros say. Like you want the muscle to actually have that, you want it to be moisturized, I guess is one way to say it, because it's just going to give that full look to the muscles. No, you're not going to look bulky. No, you're not going to look like, you know, you belong on a bodybuilding stage. But it is just going to fill out your muscles that can otherwise look very flat, especially if you're not stimulating the muscle on a regular basis.

B (10:24)

Yeah. Think about it this way, like you do a workout and maybe the way that creatine makes you Feel is like a half an hour after you're done working out, not like right away when you've just done a set and your muscles are really full from blood flow going to them. But like, a half an hour later, they're still feeling a little bit tighter. That is the feeling that becomes now your default. And that's a. That's a good feeling that most people like. And you're absolutely right. Creatine does not bulk you. It certainly would not be something that creeps up on you. Like, you take it, and now all of a sudden, you look like a very serious crossfit athlete that's been training for years. It requires years of training to get there and with that particular goal in mind. So, yeah, it doesn't make you bulky, but it will make your muscles feel a little bit tighter.

A (11:12)

I've had a lot of women say, well, creatine. I went and I did a blood test. I was taking creatine, and my doctor freaked out because I had this really high level of creatinine, which looks like creatine on paper, but it's not on my lab. And my doctor thinks I have kidney disease. Talk to us about what that molecule is.

B (11:37)

Yep.

A (11:38)

And why we maybe should tell our physicians if we are going in for blood work that we are taking creatine because we are going to see this other molecule potentially elevated.

B (11:47)

Yeah, so you nailed it. Creatinine is a breakdown product of creatine. So all molecules get, you know, metabolized, and in the process of getting broken down, then you can see some of those metabolites, and one of those is creatinine. Now, this is one of the parts of the creatine story that has sort of come into modern times. But back in the day, the elevation in creatinine made doctors think that your kidneys were struggling. And that is because in a context where you're not taking creatine and you have high creatinine, it is a sign that. That your kidneys might be struggling a bit. And so that association was made. But it's very explainable when you're taking a lot more of something, you're going to have a higher level of creatinine, but it doesn't mean that your kidneys are being damaged in any way. And that has been looked at directly. So because you don't want to make an assumption that it's just because it's a metabolite, it's probably fine. But this has been looked at multiple ways over years. A part of other, you know, studies like, let's monitor this. Let's see how their kidney function has done. And in no way has there been an identification of kidney problems in response to taking creatine to qualify this appropriately. What about people with existing kidney issues? Are they okay to take creatine then? And that there's less data on that? And so you could argue that perhaps it might even be good for people that have kidney issues. Why? Well, remember, where does creatine start to be made internally? Well, in the kidney. So would taking creatine actually ease the burden for your kidneys for having to make it? And might that actually free up some energy for the kidneys to do other processes if they're struggling to keep up? That is a hypothesis that has not necessarily been proven, but I'd love to see that studied. So we actually might find ourselves in a situation where the opposite of what has been thought of as a fear related to creatine is true, that it's actually good for a struggling kidney, but not causing the kidneys to struggle.

A (14:12)

Yeah. Can you take it with heat? I've heard mixed reviews on whether or not you should put it in your coffee or not, and I don't. I never do. I always just put it in a glass of cold water. But I know that I will sometimes put collagen in my coffee.

B (14:25)

Coffee.

A (14:27)

So is. Can we do heat or is that. Is that a no?

B (14:30)

No. So heat and acidity will break down creatine, but you're losing a couple percentage points. You know, maybe. Maybe it degrades by 5%. So it's not that significant. It's probably one of those things. In the grand scheme of things, it's actually not a big deal. It's probably a bigger deal if you put it in your coffee and it takes you a couple of hours to drink your coffee. If you put it in a cup and you drink it, you're losing a little. And if you keep it in your coffee cup and it takes three hours to have your coffee, then it's. You're probably losing enough where it would matter.

A (15:03)

Don't nurse your coffee. Is the take home, drink it in the first 10 minutes the way God intended?

B (15:10)

Yes, exactly.

A (15:13)

Okay, I want to talk about hair loss, because I think this is another one, another big one that I get from women. Is my hair going to fall out? It's going to. You know, where first, where did this come from? I don't think I actually understand where this myth even started. And is there any evidence to support that excess Creatine or any creatine supplementation can lead to a thinning of hair. Like. Yeah, what is going on here?

B (15:41)

Yeah, I think a lot of what becomes a part of the rumors or the associations has to do with the fact of where this molecule started. And that was in a bodybuilding. A lot of bodybuilders were taking it. Are bodybuilders taking anything else? Yes, they are.

A (16:04)

No, they're all naturally like that. No.

B (16:09)

And so that gets falsely attributed to whatever their also ingesting protein, creatine. And it has to do with the egg. Yeah, exactly. It mostly has to do with the hormonal manipulation from exogenous androgens. And we know that hair loss in some ways can be driven by dht, which is a version if you will breakdown product of testosterone. There are DHT receptors in the scalp and those will over time. People that do have a lot of DHT conversion will have premature hair loss. Would creatine contribute to that? Well, we don't really see significant impacts on hormones. We see energy stability during hormonal fluctuation. We might see a greater preservation of hormone output in a very natural way during health span if it's supporting those cells to do their job. But not like a major boost boost. Again, think of creatine as not something that's going to drive a major boost, but preserve function, natural function. That's a really good way to distinguish it. And let's actually take a moment and go back to sprint performance. Do you see people sprinting faster? No. They can sprint longer at the fastest pace. It is preserving your current abilities, not giving you heightened ones. And that actually has a pretty special privileged place because it's whenever you're manipulating in the body and you're pushing your biology around, if you were to try to push your, your energy levels up way higher than natural, that might disrupt nor normal homeostasis. That might not necessarily be a good thing. I'm much more personally, and this is my own bias, I'm much more about trying to preserve natural function than playing God and saying I'm going to now control my, my biology and these highly significant meaningful ways. Because whenever you do that, you might find very well that there are some benefits, but they're also preceded by some significant side effects. And that's why when we're thinking about peptides and everything else, whenever you're doing something that is biologically unfamiliar from an evolutionary perspective, you need longer time periods to understand the whole effects in the body in general. That's just me inserting A little perspective that of my own, going back to the hair, when this has been looked at directly. There is no hair loss directly from creatine. That the early feeling was that this was from changes in, you know, hormones that people were taking. There could actually be benefits for your cells if this was used in a topical fashion. And there are some people that are now looking at topical applications for skin and potentially for hair. So can we get creatine into various thermal layers and then might that also then be taken up by skin cells, dermal cells, and utilized to again maintain function? And yes, there's evidence for that. I found about 12 studies that are looking directly at creatine for skin and helping it withstand UV radiation better and handling different things that are going to cause damage. And so, yeah, there's. I think we'll probably see some application for topical creatine in the next year or two.

A (19:35)

Oh, that's fascinating. As someone who has a side project, a love of skin care. All things skin, all things hair, all things nails. I'm like, do I need to make. Am I mixing this with water and like smoothing it all over my face? Maybe, maybe.

B (19:51)

Yeah, maybe. I have not personally done that, but I was. I found the evidence for it to be pretty compelling. So you did see.

A (20:01)

And what is it? What is, what's the evidence for? Is it. Is it skin barrier function? Is it, Is it the energy system that we've been talking about, it's just renewing the skin's ability to produce energy and therefore skin turnover. Like what is happening at the level of the skin? If you're putting it topically, it always

B (20:18)

comes down to buffering energy. And then the corollary of buffering and maintaining energy in a cell that is struggling to maintain energy production has specific outcomes. So what we have seen is in supporting processes like collagen synthesis and cell renewal, and those are fundamental conversations related to skin care, reducing wrinkles and improving skin texture. So the things that you would expect if you're preserving the health of cells better by supporting their energy system, like

A (20:54)

uva, UVB damage as well, potentially.

B (20:57)

So all of those, you know, the face is getting a lot of exposure to sun. It's not covered. Other parts of our body can be covered. And as a result, we do know that these UV rays will cause DNA damage, which can lead to mutations, which makes the cells suffer in a variety of ways, including their ability to produce energy. And a lot of it has to do with getting too much sun at once. So if you get a little bit of sun Exposure and you develop a light tan and you never get too much from what your body can handle. That is a really good practical guideline for what you should try to achieve. And like, I live in Austin, Texas, it gets quite hot here. So I look to try to develop very slowly a light T as it gets hotter and hotter so that I am more resistant to getting sun exposure just by living in Texas during the summer months. So it's not complete sun avoidance. But, you know, I do wear a sunscreen every day and also try to get a little sun exposure.

A (22:01)

So you mentioned 95% of creatine will find itself in the cell and 5% will go elsewhere. Where, or outside the cell. Where else is it going?

B (22:12)

Yeah. So creatine was originally named creos, which means flesh. So it was first identified in 1830, and it was. Because that's where it was originally found. And so when there's an analogy that I have created which has been useful for me, so visualize a sloped concrete plane. And there are holes in that concrete, and you're sitting at the top, and you've got two glasses of water, and you pour the first glass down this concrete slope. But all of that water goes into the first couple of holes, right? It fills those up and none makes it to the later holes. Now you have a second glass of water and you pour that down and it rolls past those full holes and it can get to the other ones. Think of that like your muscles. Your muscles take in all of the creatine that you first. If you're taking three or five grams per day, it's going to go to the muscles. And this is why conversations around taking a higher dose, somewhere up to 10 grams, has become popular, because we think that it has a greater chance of getting into the brain. And that is another area that has become quite interesting because the data shows that it does seem to have an impact on cognitive performance, especially during times of stress. And these types of stress is not things that are so unfamiliar, like super high levels of stress that few people ever experience regularly. We're talking about everyday stressors, things that we experience weekly. And the way that creatine is working is it's not a stimulant, at least for the brain or anywhere, but it is buffering energy supply. So when your body is working really hard to maintain its ATP levels, which is the currency of energy in the body, and it's having a hard time keeping up with the demand, creatine comes in and instantly offers its phosphate group to resynthesize ATP so you can keep energy flowing. And the way to physically imagine this or interpret this effect is going back to the gym. So people who regularly take creatine or they load with it, they take it for a little while, let's say seven days, they might notice that if they were doing a set of weights, let's say bicep curls, that they could only do for eight days repetitions with creatine on board, they can now do two more repetitions. Right. It has preserved your ability to maintain energy under conditions where you're really challenging energy supply. How does that apply to other parts of the body? Well, we're now knowing, we now know that it applies to other areas too long thinking durations, periods of sleep deprivation, even hormonal fluctuations during menopause or menstruation and perimenopause menopause. And the real, a real big one that we don't have all the answers for now is during healthy aging. So can we support healthy aging with having creatine on board so that we can maintain a better energy supply? And we know that energy constraints are one of the components of us deteriorating as we get older. And so I think we're going to see a lot more creatine research as a health span promoting supplement.

A (25:30)

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B (28:42)

So what types of stresses are we talking about? These are everyday things and we don't oftentimes think of them as stressful. But imagine you are going to work and in your workday you're trying to focus and you're getting interrupted with emails, you've got meetings, you're getting random phone calls and yet you have this project that is in the background. You're having to switch your focus. You're feeling a sense of stress because what you want to be working on is getting constantly interrupted and that is causing a little background stress. It is now 3 o' clock in the afternoon and you're feeling the effects of the fatigue of constantly having to task switch and your brain is not performing as well as you would like it to and that's adding additional stress because now you finally have a moment where you have an hour window where you're not interrupted. And guess what? Your brain isn't performing very well to actually get your work Done. What does that mean? That means that you can't leave work as long, you know, as early as you would like, or you have to go back to work after you go home and feed your family and take care of other responsibilities. These types of everyday stresses are real. It's what most of us are dealing with. And so the idea is that can creatine support you in those moments that actually help preserve your energy supply so that you can actually perform better when you do have that moment, when you can actually get your work done? That is just one very quotidian way in which creatine might be helping you in a real tangible fashion.

A (30:20)

Fantastic. I wanna. I wanna get into some of the mechanisms around how creatine works on energy. So you mentioned healthy aging. You mentioned one of the, you know, qualities or characteristics of aging is some of these energy constraints with some of the stressors that you outlined.

B (30:38)

Yeah.

A (30:39)

When we think about creatine in muscle, certainly it is usually using the phosphocreatine system. Walk us through how that works with lifting, specifically, because I think that'll give people a grasp of how it's working in the muscle. And then maybe to your earlier point around how it has effects on the brain, how that energy system might be the same or different in different systems in the body. So walk us through the mechanistic way that it works in muscle and how it might be working differently in other. In other areas of the body.

B (31:13)

So I'll talk about what creatine fundamentally is. It's a complex that has three amino acids, arginine, glycine and methionine. And most of creatine in your cells is bound to phosphate, so it is in your cells as phosphocreatine. I mentioned this a moment ago. Let's go back to the fundamentals of energy. So the currency of your cell for energy is ATP, that is adenosine with three phosphates. And when there is some sort of reaction that needs to have energy for it, then ATP will donate one of its phosphates to fuel that reaction. And a very interesting aspect of ATP that a lot of people don't know is that about 95% of your ATP in your cells is bound to magnesium. The reason why is that phosphates carry this heavy negative charge, and it's such a heavy negative charge that it makes it hard for enzymes to interact with them. So that energy is sitting there but can't be utilized. And magnesium carries a slight positive charge. And when it binds to the ATP complex, it makes it so that that your ATP is a lot more accessible to the enzymes that need to use it to do work. So that is an important point about ATP in general. But as you're using ATP, it donates a phosphate and it becomes ADP or adenosine diphosphate. And then it'll get resynthesized. And the body is trying to maintain that. And every individual cell will undertake about 10 million ATP reactions per second. So you are actually rebuilding your entire body weight in ATP every single day just from how many reactions it is fueling. That's how many. It's a staggering number. Where does creatine come into play when your body has a hard time maintaining the level of ATP? It's getting utilized. It's getting over and over and it's, it can't quite keep up.

A (33:30)

Up.

B (33:30)

Phosphocreatine will instantaneously donate its phosphate to resynthesize ATP so it can keep energy flowing. And so the best way to think of creatine is not as a source of energy, but as a buffer of energy flow. And that's where we're just realizing all the different places where it can help. Because the original identification of where it was useful was in a very clear state where there's an energy deficit. You're working out so hard and ballistically that your body can't keep up with energy. And then that leads to fatigue and a drop off of performance. Think of, think of sprinting. Very intuitive, very clear. You start at the start line, the gun goes, you work as hard as you possibly can, and you're getting towards the finish line and you're slowing down, right? You just can't quite keep up that same pace of energy. And that's where having creatine on board would make you be able to maintain your fastest pace for a little bit longer. And that was the original understanding. Like, wow, this could really help Olympic athletes. This could be the difference between winning a gold medal and not even making the final race. And that's exactly where it's been proven. And just to kind of close the loop on that, since that first identification of its utility for sports performance, it has been now the most studied ergogenic or sports enhancing compound ever. It's been studied a million different ways in different populations. It is consistent, it's reliable, and it always shows a very impressive effect. Then there's some additional interesting benefits of, well, it's adding to intercellular hydration. Does that actually improve the ability of the cell to undergo protein synthesis? Do you actually have a better training response on a cellular level in response to the now greater stimulus that you can provide from training because you're doing a couple extra reps. And so the overall effects of creatine on sports performance have been complicated in a good way. We understand that it's very robust in terms of the effects that it's having, but that's where the understanding of how it was supporting energy started. Since that time in an athletic context, researchers have now looked, well, what about in endurance sports? Eventually you fatigue there. Might creatine be used in that context to resupply energy when energy demand is starting to exceed what the body continued to produce? And yes, there's evidence there. And then also again in places where like in sleep deprivation, that's a, a really classic way to stress the brain. So when you don't get enough sleep, then you still have to maintain a high degree of energy production the next day, even if you're not thinking very hard. The brain is just active, even in its default state. And you add to that having to think hard and now you're even worsening the situation. Other things that take place when you're in a sleep deprivative state is that the brain acidity goes up, ammonia levels rise, and all of those lead to the very identifiable feeling of sleep loss is miserable. You don't feel good, it's hard to focus, it's hard to do. Planning. Even the smallest things can take forever or be inaccessible to you. And this is, I think some of the most impressive research in on creatine in the brain is there's been now been multiple studies. There's three that I usually will talk about where they've taken one group was a group of older people and they were given three hours of sleep only. And then they were given a fairly high dose of creatine. So think about 25 grams for 155 pound person, so larger than your typical amount. And what we saw was that there was a preservation of normal skill, so the reaction time stayed normal, meaning that it didn't degrade from what their baseline performance was, their planning ability. You'd expect it to.

A (37:48)

You'd expect it to.

B (37:48)

Yeah, absolutely. The other, the next study by Terry McMorris was really interesting. They took a group of elite rugby players and they gave them three hours of sleep. And in the placebo group, just like you said, Stephanie, they showed reliable decrements in performance. They were actually testing their rugby skills at which they were expert. And they were terrible in every way. Their passing ability, decision making, all sorts of Ways that their skills were interrogated showed a reliable significant drop off, except in the creatine group. Group. The creatine group showed again this buffering effect. They didn't have any decrement in their performance. They were performing as well as they were at their baseline, which is when they were tested prior to the sleep deprivation. That's remarkable. And then those two studies were 2007, 2011. And then more recently there was another study by a researcher named Nejad, this is out of Germany, and he showed very similar cognitive preservation. So again, similar degree of sleep loss, similar amount of creatine. Given this time, it was 0.35 grams per kilogram. So you would scale that up to whatever your body weight is. And what was most interesting about this study is that they showed the mechanism of why creatine seems to be helping so much under these conditions. And the reason why. So yes, they saw the same preservation of skill is that because of the increased acidity and because of the increased ammonia, it allows more creatine to get into the brain. It's like the brain becomes a sponge for creatine when it's stressed out. It's looking for a crutch to help it perform when it is suffering, when it's under conditions that are not at all optimal. And that is probably why we see such a powerful immediate effect of creatine during situations of stress. So translate that to everyday situations of, well, me and my family are traveling to Europe and we've got a layover and we're going to be up for 30 hours before we get to our hotel. But then we're renting a car and at a time where we would, or, you know, I'm the, the dad is going to be driving the family. I would be actually at my biological timing when I'm most sleepy. That has very serious consequences. I'm in a new country, right? And so having creatine on board during periods like that can help preserve cognitive skills, which is a safety concern. What about people that are doing shift work and they have to be up for 35 hours and they're performing first responder important level tasks? It could be incredibly important there and then just the everyday. I don't know why, but I slept terribly last night and I've got an important day in front of me and creatine has absolutely become something for me that I rely on. There's nothing even close for me in terms of rescuing that terrible brain performance day after I've gotten just not enough sleep. And that can be because I woke up in the middle of the night and I couldn't go back to sleep or for whatever reason I woke up, a dog was barking. So I Woke up at 5 and now I'm missing a couple hours more sleep than I would have gotten. And so creatine can really help under those situations too.

A (41:17)

Well, I wish that we had this conversation last week because my son, I just was traveling with my son for a soccer tournament for his, for his football team. Football team. As he wants me to say, not soccer. He's like, okay, called football mom. I'm like, all right, okay. So we were traveling and him and his teammates not calling anyone out, but in case they're listening, but they were all out like partying until like midnight. And then there was one day where they had the next day, the next morning they had an 8am game. And I wish I was able to let him listen to this because I would have loaded him up with creatine. He typically does take creatine, but not before a game. And I think this is my, this is gonna be my proposal for him. So if you are. So if you have kids in, you know, they're playing competitive whatever, this can be useful for that. I also think if you're just. I, I know a lot of women, certainly the perimenopausal menopausal transition as their kids are getting older. It's almost like an opportunity to get back to themselves. So you see a lot of women taking up tennis and paddle ball, pickleball, padel or like getting into hydrox competitions and stuff. So I think that this is also a really good use case for it as well.

B (42:27)

Yes, 100%. And I'm, I'm quite curious to have to see more research in young adults that are in their, like that are going through puberty. Right. That is a time that of intense energy demand. Pile on that. With multiple sports, the stress of school, imperfect sleep. In modern times, because, Gwen, young people go through puberty, they have a shift in their circadian timing and means that they naturally want to stay up later, but they still need more sleep than an adult because they're growing. But then you now have their biological circadian timing has shifted, so they're just not sleepy and it's one o' clock at night and all their friends are up and they're texting each other and the parents are yelling, go to bed. And you just described that, but they can't naturally sleep in. And the reason why we think this is a hypothesis is that the first adult Responsibility in a hunter gatherer tribe was for the young, these young people to stay up late to watch the tribe. There's something called the sentinel hypothesis, which I find fascinating, and that was created by Frederick Snyder. And what he'd noticed across a lot of different species is that in an unplanned fashion, there is always members of the group who are up, who are awake, and that is to watch out. Because during sleep, that is a time of profound vulnerability. You could get attacked. Right. So having somebody up is actually useful. And a friend of mine, David Sampson, studied the Malagasy in Madagascar. It's one of the surviving hunter gatherer tribes. And he found a study of them over 30 days that there was somebody awake 99% of the time. So think about younger people staying awake later, but then having to sleep in later. Old people are getting up at 4am but going to bed early.

A (44:31)

Right.

B (44:31)

You have people who have insomnia that are waking up for two hours in the middle of the night. Right. And these things are unplanned, and they can occur and shift and change at different times in your life. And so we try to fit everybody into the exact same schedule all the time. So going back to children who are going through puberty, a time of intense, energetic need, and yet we're also not getting the same amount of sleep because of the biological tendency to stay up late. But also school times that are. Or soccer times that are starting at, you know, we gotta get up at seven because the game starts at eight. And so that is another reason why creatine might be useful for, in the context of modern life for young people.

A (45:15)

And I made a note here, I wanted to come back to it. You said, you know, creatine is for younger individuals and older individuals. Do we have any evidence around? Is there an ideal time to start taking creatine? Like, are we. I mean, at the extreme, I'm sort of being salacious here, but are we putting it in. In baby bottles? Like, what is. You know, and. And I'm not recommending that as a joke, but is there. Is there a time where we might think, hey, at this intense phase of growth, where maybe we start seeing, you know, prepubescence with, with girls, where we are starting to see some of those secondary sex characteristics developing, or we're starting to see growth spurts, where we're seeing lots and lots of, you know, elongation of, of the long bones? Let's say, is that a time where we want to be giving the body a little bit of that extra buffer that you were mentioning.

B (46:05)

I think you can make a very plausible argument that every phase of life should require a certain amount of creatine for optimal performance. What is that amount? How would you scale it down to the body size and then have. Imagine a additional factor, sex, an additional factor for the energetic demand of that moment. Like are these demands continuous or do they have fluctuations? Do we need to complicate it that much and just give everybody an adequate supply? Probably that's the answer.

A (46:41)

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B (47:48)

I'll talk a little bit about like where, where does creatine naturally come from? Because I think a lot of people don't quite know your body makes creatine. So it'll make one or two grams a day. And the way that it makes that is it, it starts by making it in the kidneys and two thirds of the molecule is finished there and then it is completed in your liver and then it enters into circulation. And so cells don't make creatine locally like in the cell. It's made in that way, it's outsourced and then it gets into circulation and then cells have creatine, something called the creatine 1 transporter and they pull the creatine in and a lot of cells have that. So that is a good way to think about it. So we make about one or two grams, but then we have dietary sources as well. And the dietary sources are pretty much animal based only. So you get a good amount of creatine from red meat, from fish, salmon is high, herring is high, less in pork and chicken, but it's still a good source. And you really have a negligible amount of creatine, virtually none in plant sources. So people that are vegetarian and vegans have. They have to rely entirely on their endogenous synthesis. And so they are likely running a persistent creatine deficit without supplementation. Now, those are kind of average numbers, but if we look at hunter gatherer levels of meat intake during hominid evolution, if you just. Of course, it hasn't been studied directly, like how much creatine did hunter gatherers get? But what you can do is infer how much creatine they likely were getting based off of the estimates of meat consumption levels. And it is not implausible to think that hunter gatherers were consuming 5 to 10 grams of creatine per day. Which is really interesting when you compare that to the data that shows such profound benefits in the body at those levels.

A (49:47)

Fantastic. Are there any populations where we would think they do? People do not need to be supplementing with creatine.

B (49:57)

So I think that people that have a high meat diet, so people that might be following a paleo diet or even a carnivore diet, are certainly in the category of people who would benefit less from supplementation. But there's still a reason potentially for supplementation, and that is to take a boost of creatine during periods of sleep deprivation or high stress, where you might get a little extra benefit there, or maybe not because you're actually taking in a high amount of creatine anyway. So one complication that we should consider, which is, I think a reasonable evaluation of the literature, is that people who are undergoing these studies where they do sleep deprivation and they show that a high dose does really well. These are not people that are optimistic, minimized for their daily creatine. These are people that may probably creatine naive most often. And so the high dose shows this extraordinary benefit. But I would imagine in a group of people that are eating a very high amount of meat and not supplementing, that they would do better in response to stress and sleep deprivation than the other group that is in more of a normal diet and certainly better than vegans and vegetarians. And they might have less of a benefit in response to supplementation, but that's don't have crystal clarity on that. But you could certainly say if you're having a very high meat diet, you might not need to take creatine daily or take less and then just reserve it for those moments where you have extra stress and then see how you feel like you, you'll. I notice how I feel when I take creatine when I'm sleep deprived. And so a person can intuit whether or not they're getting additional benefit under those conditions if they fit one of those dietary groups.

A (51:47)

I also will push back on my own question. I'll be devil's advocate to myself and say that I think even if you are somebody who is having a meat heavy diet, let's say I think that just the aging process, because our stores naturally, I think that they naturally decrease. And if you're a woman, I think it's even more important for you to be making sure that your supplementation is on point. Would you agree with that, disagree with that? How would you work through that?

B (52:17)

So the, there are some changes in creatine intake mostly with age. So the changes that we see have a lot to do with changes in diet. And the differences that we see with women have a lot to do with diet as well. There are some interesting differences between men and women that are worth noting. But they're also, a lot of these things can be made up with just consuming more meat or consuming more supplementing with more, depending on like, I totally respect if somebody wants to maintain a, a lower meat diet and higher vegetables. So if you're, let's say a pescatarian and you have fish a couple times a week, there's lots of reasons why people will make that. You just stand to benefit more from supplementation, even more, I should say. But yeah, women synthesize about 20 to 30% less than men, but they also lose less. So there's less turnover and there's also less muscle mass. And so you know what you, what we do know is that muscle loading, so creatine loading which loads up the muscle tends to equalize the amount of creatine between the sexes. But just so we know, like a standard change in muscle creatine levels is once you start to supplement for omnivores, it'll increase muscle creatine about 20%, at which point there is no additional benefit for muscle. But if you're a vegetarian or vegan, you will reliably see a 40% increase in muscle creatine storage scores. So that's double the benefit, which means that they stand to feel it even, even more.

A (54:00)

Yeah. Why, why do women synthesize less? What is the mechanism there? I'm just making notes on what you said. What is the. Why do we make less?

B (54:07)

So some of it has to do with hormones, which is, it's, it's Pretty fascinating how the changes in female hormones over the course of the month have an impact on all aspects of creatine. So, for example, when estrogen is dominating, you will see an increase in. So creatine kinase is the enzyme that will both break down phosphocreatine, so it's donating its phosphate and keeping energy supply going. It also has an impact on the creatine transporter. Remember, that's how creatine gets pulled in from its surroundings, so it upregulates the transporter and it even has an effect on the enzymes that are involved in the synthesis or the manufacturing of creatine internally. And so all of those things change in the opposite direction when progesterone is dominant. And that is why during the luteal phase, women might describe like, everything feels hard, you're running through sand, and energy feels slow down. It just, it's. You have all sorts of physically, you don't feel as strong, mentally you don't feel as strong, there's a real deficit irritability, you know, you don't recover as well. And so that the hormone cycle for women is one that is affecting how creatine is being synthesized, absorbed, and utilized in cells. And that is changing month to month. And then, of course, changes during the these major life transitions through perimenopause and menopause. And it's actually one of the reasons why I think creatine might have a disproportionate benefit for women. And don't get me wrong, I think that men experience so much benefit as well, and then women just have this extra benefit on top of that. And that's why I've been enjoying talking about creatine for women, because I think it really could be we have to make a lot of choices in life and prioritize. There's so many different supplements that have interesting data behind them, but you want to be able to really focus on, okay, what, where should I be spending my money with? If resources and time are limited, and I think creatine is an area that requires real significant investigation so that you're benefiting from this because energy is foundational to life, and if you can support energy in any way in a healthy way, and creatine does it in a very unique way, then it's worth your time and attention to know why it's good and then also give it a try and see how it benefits you.

A (56:38)

So if I can just synthesize this and recap what you just said, it seems that estrogen has a Positive overall effect in synthesis and the ability of creatine kinase to allow for the degradation of creatine in the phosphocreatine system, as well as allowing for that creatine 1 transporter. So for muscle cells and other cells like to be able to pull creatine into the cell, which usually is much more. You know, we have estrogen dominant in the first half of our cycle, right. We see that apical rise in estrogen as we're preparing for ovulation. And then as you mentioned, progesterone. One of the roles of progesterone is to actually inhibit estrogen, right. So it's like down girl. So it will inhibit estrogen receptors and there's also a negative feedback feedback loop on the brain. So as you are now inhibiting estrogen, your ability to synthesize creatine and for all those other things, the creatine 1 transporter, the creatine kinase, to sort of do its job, it's going to be, we'll say, attenuated. So like it's gonna, it's gonna be pulled down a little bit.

B (57:40)

That's exactly right. And I'll mention one additional factor. So the way I described creatine kinase, anything that is like a kinase is an enzyme. It's bidirectional. So not only is it involved in breaking down phosphocreatine so that the phosphate can continue ATP supply, but it also then resynthesizes it. So now you finished your sprint and you're taking your resting and your body's trying to get its energy stores back up so you can have a repeat performance again. Something very intuitive that we can feel. Creatine kinase is also involved at rebuilding phosphocreatine for your next sprint, lift, while, whatever.

A (58:19)

So if you are a woman listening to this show, you're someone who started training, maybe because you're listening to the show or you're in midlife and you're trying to feel good in your body. When do we want to be taking creatine? Do we want to be taking it before we exercise? Maybe with a pre workout, intra workout, after? Does it matter? What is the optimal time? If there is any based on research, or is it just you have to just remember to take it and take it when you take it and that's it?

B (58:49)

Yeah, it's a really good question because we obviously want to maximize the benefit of anything that we are doing. On the other side of that, we don't want to endure unnecessary complication because we know that when you Complicate something, it becomes harder. You didn't get the timing perfect, you forgot. And therefore your overall behavior with that thing, in this case creatine actually degrades and you're not taking it as consistently. So the question is, is it better to just take it consistently or should we really focus in on timing? Does it make an extraordinary benefit? Well, yeah, there is evidence that taking it with certain nutrients, something that will stimulate insulin, can cause a little bit of, of a difference. But we, we just wrote a blog on this, on the Qualia Life blog, and there were some really cool studies that were shown that gave a pretty clear answer to the study. So it was within the same person. So it's a within person design. And they had one person do training where they took 5 grams of creatine before working out. And they had, then they gave a washout period. And then a week later they had them do 5 grams of creatine after the workout. And they wanted to see was there any difference. And the result was no, that they ended up in the exact same place either way. And so this then says that probably this plus other evidence shows that just taking it probably in the morning because it can have an effect on alertness is probably the best time. So find a time where you can be really consistent with your creatine ingestion. Maybe pair it with a behavior that you regularly do. This is good knowledge from behavioral sciences. And then take your creatine at that time every day. Or if you forget sometime that morning. My friend Tommy Wood has a saying, don't major in the minors. Sometimes we can complicate things so much that we forget the bigger picture idea. So make sure you get your 5 grams of creatine per day. Some people may want to try 10. And we also should talk about how much creatine to take at once, because that is.

A (61:09)

Yeah, I want to talk to you about loading. Yeah, yeah, yeah. Okay. I actually like the AM as a general suggestion, because I think. Or the morning, because I find that it's usually when people are going to take supplements anyway. Right. I, as much as I try to split things up through the day, I end up just taking most of my stuff in the morning. There's a couple of examples where maybe I'll take something later on in the evening, but for the most part, like 95% of my supplements are done first thing in the morning. Because I'm thinking about it, I'm like, okay, I'm gonna, I'm, I'm getting water in the morning. I'm thirsty. And what do I take with my water? I take my supplements. So I think that it's, it's for most people just anchoring it to something that you're already doing, like habit stacking it with something that you're already doing as you make your coffee, get your supplements out and you know, take your supplements. I think that's, that's the best way to go because otherwise it's just one more thing on your to do list and the likelihood of you forgetting it if it's not anchored to anything is extraordinarily high.

B (62:08)

That's absolutely right. And so do yourself a favor. I love the, your, your usage of habit stacking. Do it when you are most likely to do that routine because we try to like we, we batch our routines and then we move on with our day. Then you're thinking about other things, things you might keep a container on your desk. So now we have like, there's also the complication of loading. Is that even necessary? And then also taking higher doses like we've talked about for specific purposes and some considerations around that. Because remember what I said in the beginning that creatine is a hydrophilic water loving molecule. It pulls water to it. And so if you were to put 20, 25 grams in a glass and drink it down, it might go right through you. So you do not want to try that when you don't know your own body's reaction to creatine. And instead when you do load, you want to take 5 grams and then wait half an hour, an hour and then take another. That's what I typically do because I take 10 grams a day, I'll take 5 grams and then I'll wait a little bit, I'll take another five and that seems to work well for me. And if I am sleep deprived, I'll take five and then I'll wait, wait a half an hour, take another, you wait a little bit. My body seems to do better with that approach than to try to take it all at once.

A (63:32)

So if you're sleep deprived, the recommendation is 10 grams or is it higher than that?

B (63:37)

Well, there isn't, there isn't a particular recommendation. What there is is evidence. Or what was the dose used in the particular studies and the dose used at least in the last study by Naja had was 0.35 grams per kilogram body weight. So you would take a different amount than me. Right. So we'd have our own dose depending on our body size. Maybe that's overkill. And maybe if you're taking 10 grams a day, you can cut that amount in half, right? There's a lot of unanswered questions.

A (64:08)

Well, because there's going to be a certain amount of satur, is there not going to be like an upper limit of saturation?

B (64:13)

Yeah, there is. So what we see in the muscles is typically around a 20% increase in muscle stores. And then in the brain, we've seen increased levels in the frontal cortex and other areas that tend to be around 5 to up to like 16% increase. So not quite as much as the, you know, 20 to 40% that you see in omnivores and vegans. It's less and it might take longer and it might require higher daily doses. So remember that analogy of like pouring the water down the slope? So if you take 5 grams and all of it is just repleting your muscles, your muscles take it in first and there's nothing left over. The argument for the 10 grams a day is exactly that. So that you're actually, it's. You're taking enough where your muscles are pulling in all that they're going to. It's now saturated and there's more left over and that can get into the brain.

A (65:08)

The other thing I wanted to maybe make sure that we touch on, which we haven't yet is the formulation around creating. So my understanding is that the most robust literature around creatine comes from creatine monohydrate. But I have seen other formulations. Like I've seen, Is it hcl? What am I thinking of? I've seen other formulations of creatine. So when we're thinking about formulations, what is your opinion in terms of what we should be looking for in a product that is going to be giving us some of the benefits that we've been talking about today?

B (65:42)

Yeah, you're right. Creatine comes in different forms, and the most common form commercially and also in research is something called creatine monohydrate is the reference, the standard reference. So pretty much everything that I've talked about in terms of what has been studied is studying creatine monohydrate. And so, to be fair, given the fact that the preponderance of evidence is on creatine monohydrate doesn't mean that other forms might not show unique effects. It's just that the effects that have been shown with forms like creatine ethyl ester or creatine hydrochloride haven't really risen to the place where we see some sort of privileged Benefits from them in a particular context or even overall. And so I feel more comfortable personally going with the most standard form that's been most validated, most tested for everything, kidney and brain and everything else. So both safety and efficacy. And you're also not paying a premium for something that hasn't even been shown to be beneficial. More beneficial. Studies that have looked at creatine hydrochloride, that. That, for example, or even ethylester, if they show any benefits, they didn't have creatine monohydrate as a comparator. So we don't know that they're performing any better than the gold standard.

A (67:10)

Right.

B (67:10)

So.

A (67:11)

Right. Okay. Yeah.

B (67:12)

I'm. Hey, I hope that we find that creatine, I don't know. Hydrochloride has this unique benefit that now gives us a way to create a cooler formulation of both. But at the moment, we don't have that information. That information doesn't exist as far as I'm aware of. So why not go with what we know best?

A (67:34)

And do we think that there's a better or an optimal way to take it? So do we want to be taking it with things like electrolytes or magnesium, like you were mentioning before, phosphorus, which those of you who remember from high school bio, minus three is the charge. Right. So magnesium is plus one. So do we want to be taking it with other electrolytes? Is that ideal? Or can we take monohydrate by itself? You know, when there's that outfit that you keep reaching for over and over again, the one that's soft enough to sleep in, but put together enough to answer the door and somehow right for everything in between those two things. That is what Cozy Earth's bamboo jogger sets are. They are made from viscose from bamboo, so it's lightweight, breathable, and the kind of soft that only gets better with time the more you wear it. It has a taper fit with a relaxed waistband and just enough structure to feel intentional. I use it for my morning coffee, my afternoon errands, my evening wine. It just goes wherever my day goes as well. And the clogs, these lakehouse clogs. Guys, I feel so pampered when I wear them. I am in the kitchen in the morning with them, the backyard in the afternoon, and on the couch at the end of the day. Cozy Earth clogs are built for all of it. It is a cushioned footbed, soft interior, and an easy slip on sil silhouette that feels like the right choice every time you reach for them. They're supportive enough to stand in, but cozy enough to forget that you're wearing them this spring. Give yourself the kind of comfort that lives with you all day long, not just in the moment that you get home. Head over to cozyearth.com and use my code better for an exclusive 20% off your order. And if you see a post purchase survey mention that you heard about Cozy Earth right here on the Better podcast

B (69:28)

you can take monohydrate by itself. All the forms of creatine that we've studied have just studied that when Qualia sat down to say, all right, well how would we optimize? We did create a formula, but the goal wasn't to unnecessarily complicate. We always have the vision of like, all right, if you're going to be supporting this entire system and the system is contributing to free flowing energy supply, are there any ways that we might optimize? So if you look at some of our other products, there's a lot of ingredients because it's doing. We have more opportunities to support the whole system in doing that particular task. For creatine, it's actually we felt it was pretty simple and that is where our formula ambition started. And so we have two different forms of creatine. So there's one is called optic creatine and this is creatine monohydrate. But it is micronized. So that means that the particle of creatine monohydrate is much, much smaller, which means it dissolves better. And that has very practical benefits because a lot of people who take creatine will know if you put 5 grams into a jar and you stir it up, a lot of it will settle to the bottom and then, you know, you're getting, I don't know, two thirds of what you put in the glass and it's gritty for some people, the grittiness ends up leading to them stopping taking it. That matters. And so the micronized creatine means it dissolves much, much better, which means it tastes better actually too because you don't have to add masking agents like some creatine that I was taking before we came out with our product and had very heavy sweetener in it, which I found awful. And the only reason I'm was continuing to take it was just to finish what I had bought and I was going to buy something different. So that's one and, and there could be some absorption benefits to that too, but that is less proven. But the practical aspect of it tasting better and Dissolving better is, and that's most of the creatine that is in that version. The second version is called creatine Magna power, and that is creatine that is bound to elemental magnesium. So you're getting 40 milligrams of magnesium with every dose of, of qualia creatine. And you're exactly right. We go back to the argument for how are we going to support our body in energy creation and energy utilization and the whole maintenance of the system. And we know that, that less than half of the United States is meeting the daily recommendation for magnesium. And so that was an opportunity where we felt, hey, we can help with that situation. And, and then it's also matters directly. So there's this form that's out there. It's pretty cool. And let's make sure that if we're supporting energy, that we're also now concurrently supporting magnesium to help that. And I love that idea. And by the way, we don't have frank deficiencies of magnesium, but like I said, 50% of the United States is insufficient. And yet meeting the recommended daily intake is probably not even close to optimal. So there is evidence that double the amount of magnesium is closer. You still see increasing, you see benefits at that level beyond the standard recommendation. And so there is room for more magnesium in our, in our life. And then the third ingredient, so the third out of three is the addition of 250 milligrams of sea salt. So sea salt is sodium and magnesium. And one thing that we know is that the creatine 1 transporter uses sodium and chloride to help get more into the cells and into the, into the body. So the idea was, all right, well if we're going to be taking creatine, can we get more into the body and then ultimately where it needs to be going into your cells. And while we certainly have enough sodium in our diet, and that's not a problem. But Stephanie, you said, yeah, sometimes I just like to take it first thing in the morning. And so you're not taking, you might not have like you might be taking it with a meal where you have sodium in it. And so the addition of this small amount is supporting it when your body is actually getting it into the body. And so we felt that was really an optimal version of creatine. Tastes good, absorbs well, gets into cells well, supports the energy system in multiple ways. And that was our formulation.

A (73:58)

Thinking, well, I, you know, in full transparency, I hide the creatine from my husband, the qualia creatine, because he finds it and, like, I, I need to hoard it for myself. And one of the things that I. One of the things I really love about Qualia is this idea. You know, it comes back to that habit stacking that we were talking about. It's like you are, if you are somebody who is going to be training, let's say you're lifting weights or you're going to play pickleball or tennis or whatever, you're going to be sweating more. If you are, you are likely deficient in magnesium to. If you are, you know, the bottom 50% of Americans, as you mentioned, or just, you know, your food is not being grown in soil that's like, super nutrient rich anymore. So I think that magnesium is one of those, like, essentials that everybody should be taking. So I think that it's a really smart heart combination of all of those things. Your salt needs increase the more active you are. Magnesium is. Your magnesium needs are kind of always there. And I would argue, you know, it goes up as you age because we are, you know, increasingly just destroying our soil. It's a conversation for another time. But, yeah, so I love, I love Qualia's R D behind this and just this idea of making it really simple so you don't have to take three different things. You just take the creatine and now you have a magnesium hit and you have a sea salt hit, which I think is. Which I think is brilliant. So, yeah, I love all your formulations, but the creatine, like I said, I hide it. I have a special little area in my pantry that I, I know that my husband doesn't go in. So that's where my quality creatine lives. Yeah, smart.

B (75:25)

Good. I, Yeah, I really, you know, I'd been a fan of the company for a long time. I've taken Qualia Mind, which is their nootropic or cognitive supporting product, for almost a decade. And I joined the company last year as their chief health officer. So I do a lot of communication, talking about what are the different areas that we are trying to affect, how do we even create our formulations, why do we think it's helpful? And so we are as much an education company as we are a formulation company. Those are the different ways that we try to help the world. World be healthier. And what's so cool about supplemental products is that you can embed a lot of knowledge into something that has a relatively easy form factor for adherence. You know, it's easier to take a scoop of creatine than it is to Go do two hours of Zone two training, you know, like. And so because of that, there's a lot of good that can be done. We were just talking about magnesium. We could easily do a podcast of Equal Link, talking about all the cool stuff related to magnesium. And we're now helping everybody who's listening have a greater appreciation of how, when, why they should be taking magnesium, different ways to get it, all the reasons they should. And that's awesome. Like, I. I get really motivated by that. Like, scientists do experiments, and right now I'm not doing experiments. So I have a background as a scientist, but I have Optus to work as a scientific communicator because I think that area had been underappreciated for a long time. And that gets into a pretty complex discussion around our healthcare system and society, where it was like, well, it didn't matter what people know, because your doctor is going to just prescribe. They have to do all the thinking and you just have to follow their orders. And that is too limited in terms of what a real healthcare system should look like. We have a role, all of us, in our own healthcare process, probably more important than any other expert on your team. So what you know matters because it is helping you set your direction for what you're going to be trying to do. And so that's why I think getting good information out there, talking about the adz and doing your awesome podcast is absolutely needed in today's world. So I'm glad to sit in this chair and have conversations like we're having, because I think we can do a lot of good.

A (77:52)

And so if you have a woman, let's say, who's been listening to this, maybe she started creatine, fell off the bandwagon for whatever reason, or she's never taken creatine before because of some of the fears that we've been talking about today. And she's now decided, after listening to this, that she's going to start her journey. How would you recommend she start? And what would be the length of time that you would anticipate before she starts noticing? Maybe even just some of the performance benefits in the gym or her endurance capacity or her. Her cognitive function? Yeah.

B (78:24)

So everybody respond. People are better and worse at being able to be really in tune with their body. Some people can really notice actual changes, and other people not as much. And it might have to do with how closely you've paid attention and intuitive, like how, well, how familiar or familiar are you with your own body performing in the gym. If you're a seasoned athlete, you're going to likely know how creatine is helping, like right away. To go back to your question, how should you start? Well, it's common for people to start by doing a loading phase. And that's where you would take 20 grams a day for five to seven days. And then you go down to three to five grams a day. And you maintain that that has been the standard practice for decades. And it comes out of the athletic literature. If you just take three to five grams a day, you will end up in the exact same place that you would have if you had loaded in terms of muscle. But maybe that higher dosing is also important to get into the brain. Again, there's more research needed there to interrogate that specific question, but that is why more and more people are taking 10 grams per day now. Is that you again, think of it. It gets all the first five grams get going to the muscle, and then you have now an extra supply that can get it into other tissues because there's, it's, it, it's, there's still some circulating. So that's, that's kind of like where we started. What's true, like, you can actually just take 5 grams a day for, for three weeks and you're going to be in the same place as those who loaded. It's really like, how quickly do you want to experience those benefits? And then there's. Well, but maybe we should be taking more anyway because it's probably getting into more tissue because the creatine hungry muscles are taking all of it first. And I think that's a fair description. But what I would say is for those who are just getting started with it is start light. Let's say you took 10 grams and you had GI issues. You might say, creatine's not for me, never doing that again. Wouldn't that be a tragedy? So let's focus on what the priority should be, which is regular, consistent usage at a dose that's supporting all of your body tissue. And so what I would say is start at 2 or 3 grams a day, see how you're doing. I did fine. All right, you go up to five, do it for a couple days, and then I'll do a split dose, do five, and then wait an hour and do another five. Okay, did fine. And then just maintain that. So I do like five or ten a day. So I always do five in the morning and sometimes I forget doing it the second time. And I just am not concerned by that. Like, I definitely remember to take the Another five if I feel like I'm not performing that well. But I don't know, I don't worry about it too much. Like, sometimes my day just moves on. I'm performing fine and that's okay. Yeah.

A (81:35)

I would also say to just as someone who spent 20 years in the clinic, is that once you start feeling better, you actually forget your baseline. Most people, we would do something called the visual analog scale, which is just like on a scale of 1 to 10, you know, on this line where how much pain are you in, let's say for headaches or back pain or whatever it was. And within two months usually. Actually, I would reevaluate patients every month. And they were down to like a. They're like, I feel great. You know, And I would. On their, you know, on their reevaluation day, it's like, how you doing? Good.

B (82:07)

Yeah.

A (82:08)

No, nothing's really changed. And then we look at some of the questions, visual analog scale, and they've gone from like a six or a seven to like a three. I'm like, well, that's. That's a really big change. So I think that there is a tendency, and I say this with love, I just think that there is a tendency for the human mind to forget pain. Right? Like, you can start getting up in the morning with more energy, and it's subtle enough that, you know, it just happens gradually over time. That you don't just like spring out of bed one day and be like, wow. Yeah, I guess it was that. It was that, you know, one week of creatine loading. That's the last one that did it. You know, it's like this very slow, gradual change that happens. So I would just counsel anybody who is listening. If you really want to make sure that something is working for you, take a snapshot. Like, do a before, you know, take a snapshot of your energy now, how you're sleeping now, what your performance is like. If you're tracking any of that at the gym, you know, how many steps you're taking in a day, how long you can sprint before tiring out. Like, these are all really useful metrics for you. Because then in a month, once you've saturated the cell, however you've done it, you've done the 20 day, 20 grams, then you've dropped it down, or you did 5 grams for the whole month, whatever, at the end of that month, you were going to be fundamentally different. But the tendency for the human brain to forget pain and discomfort is so high that in a month, I mean, if I asked you now, Dan, I'm like, what were you doing a month ago? Like, no clue. You know, like, I have no idea where I was. I was traveling somewhere maybe, maybe, you know, we don't remember what we were doing. We don't have documentation. And so it's really hard to track changes. So this is just my data brain, years of charting and charting and charting and charting with patients. It's like you need to. What you measure, you manage, essentially, right? What you measure, you manage. So if you are measuring your pain, your energy, how much endurance you have, how much and you know all of these different components of life, you'll really be able to evaluate whether the variable that you've manipulated, in this case increasing creatine, is working for you.

B (84:11)

That is such a great comment. And I have a saying that I developed, which I call the meaningful but invisible. And it is exactly what you're speaking about. When we make changes that take some period of time to. Let's say there was a. A 15% improvement in memory and it took six weeks for that change to occur, you might not recognize that improvement because it took a while. There was a slow process of acclimation to this new state. And while objectively you would every day of the week take that 15% advantage, the fact that it has occurred is not obvious to you. And so I love the idea of finding something objective as a baseline to test, like, do your, you know, take a weight in the gym and do your curls and do. See what you can do at a particular weight and then try again in a week. And that is actually one of the advantages of doing a loading phase because the benefits occur sooner and you might tap in to that faster feedback cycle which would then confirm that creatine is having an effect. And even though you end up in the same place over three weeks with a lower dose, you might not appreciate or see the benefit with the same degree of resolution. So that is actually a reason for doing a loading phase.

A (85:44)

It's the exact same reason why you don't notice when the kitchen counter is clean day after day. But you know, and this is. I'm speaking to my teenagers here, but mom is cleaning up your plates and your glass, your thousands of glasses that you go through. I don't understand how teenagers do this, but, you know, it's. That it's meaningful but invisible. Like, if I didn't clean the kitchen counter at the end of the day, the next day you would. When you come down to have breakfast, you would notice that there's no Room on the counter to put your plate for breakfast. So it's that meaningful. It's like, like I feel like that is like women's work actually. It's like the laundry. We never notice when the laundry's done, but we sure as heck notice when it's not done. Yeah, same thing when the dishes are not put away in the counter. Like we definitely notice when it's not done, but when it is done, it's invisible work. Right. So it's kind of, I mean that's just, that's just hashtag mom life there. I'll just insert my little oh, oh

B (86:35)

yes, I'm living that life. And, and I'll say this too, that this meaningful but invisible delta or the change can occur in both directions. So you could actually experience a decrement in performance and also you've normalized to that if there is a slow loss of performance. Although we tend to notice those more because particularly with things like pain, when pain goes away, you're not thinking about it as much. When pain's there, you're thinking about it a lot. And so that is one of the problems with, with the change, a change in a positive direction where you're no longer thinking about it as much. It's a good thing. It's only problematic when you stop doing the thing that got you there in the first place that was benefiting you and then you might have a reversion back to the place where you're not in as good of a place.

A (87:31)

I am so proud to have been working with Qualia for the years that I have. Not only for the research and development that you put out, but for the education that you put out. Like our conversation today is a really great example of that. And I know that there is an offer for anyone who listens to the show if they want to head over and pick up. Let's say they want to just start with the qualia creatine. They can head over and they can use better at checkout and that's going to give them 15% off. So we want to thank you for that generosity. My final question for you is what is your ideal supplement supplement stack in your own life? What are some. Obviously creatine is going to be part of that. We, we get that that's a non negotiable for you, but what are some of the other things that you make sure that you're taking on a daily basis?

B (88:14)

Yeah. So I am a fan of supplements. I take our Qualia Nad product every day and I love it. I feel it more than other NAD products and I have. Particularly in particular, I've noticed an improvement in my recovery time from exercise, which was something that I had been tracking closely for years because I was dissatisfied with my recovery pace and I was also trying a lot of things. So I was actually in a good place to really understand my body. And I noticed.

A (88:55)

Was it persistent? Sorry to interrupt you. Was it persistent doms? Like, was it persistent like muscle soreness? Like, what was the recovery that you weren't happy about? About?

B (89:01)

Yeah, so it was the feeling that I wasn't ready for my next workout for days longer than I would like. And, and so, yeah, that was really the problem. Not like the heavy, heavy doms, but not feeling fully up to energy. That's been a big factor. Magnesium is one of my favorite supplements overall. I take it in the day, I take it at night. So I take it actually more than once a day and I notice a benefit. So that one has been really positive. And I'm by the way, I'm not just mentioning the Qualia supplements, but this is, this is true. These are the ones that I really appreciate most. And then I actually have a variety of supplements that I take in more of an ad hoc fashion. So we have a great product that doesn't get that much attention and that one is Qualia joint which is really a product largely around controlling inflammation. So if I do, let's say yoga in the morning, I'll do hot yoga and it's good workout. You know, heart rate gets up pretty high due to the heat and also the fact that it's a pretty intense flow, lots of balancing positions and after that is done, I feel great. Great. And then over the course of the day I'll get stiffer and stiffer before bedtime and then I can wake up and be a little stiff and achy the next day. So I will take a double dose of qualia joint 12 hours after working out because you don't want to take something that is going to squash reactive oxygen species and inflammation immediately after training because those signals are part of what you've generated to facilitate adaptation. They're important in you getting more fit. So you wait 12 hours and then I take inflammation controlling products like Qualia joint and also take some fish oil and pro resolving mediators which actually shut down the inflammation process. So it's like an off switch for inflammation. And I do that combination about 12 hours after working out and that's had a huge, huge impact on how I feel. So I'll wake Up the next day, and I'll feel like I'm 20 years old. It's awesome.

A (91:26)

I think we're gonna get you back on the show for another deep dive on the joint health and on the nad, because I have to say, once you are over 40. So I agree with you. When I take the nad, I definitely feel it. I get kind of the tingling, like, my wrists and my. My ears go red a little bit. So I definitely feel. I'm like, oh, yeah, it's working. But with the joint specifically, I think that once you're over 40, like, that's really where we start to see a lot of breakdown. We see breakdown in what I like to call the jtl, you know, joints, tendons, and ligaments. And I really feel like you. You notice a difference when something's working, if your joints are feeling better or they're feeling worse because you know how you feel.

B (92:09)

Yeah.

A (92:09)

Like, a lot of women will say, oh, gosh, I did something weird with the deadlift. Now my back. Back's a little achy or lunging weird. Now my knee. I tweaked my knee. You really feel the difference when your joints are not feeling well. And then, of course, the contrast when they start to feel better again. So.

B (92:24)

Yeah.

A (92:24)

Yeah. I love the joint product as well. I know we didn't talk about it all today, but that's one of. That's probably like my nad and the joint, like those are. And. And the creatine. Yeah, those are like, my top three. I love, love, love them.

B (92:36)

I love that.

A (92:37)

Okay, so we had nad, magnesium, and then you said add hormones, hawk joint, fish oil, and PRMs. Anything else?

B (92:43)

So then I will take on occasion. I actually tried to mix up my phytonutrients. I think that phyto. So phytochemicals, there's this, you know, in nature, there are 80,000 edible plants, and hunter gatherers would consume 20 to 30 different plant types in a day and over 700 different types in a year. And each one, each plant has many different types of phytonutrients. So things like polyphenols and olive oil. And that is an entire pharmacopoeia in nature. And even if you have a healthy diet, today, we're eating a limited set of phytonutrients. So I think that you could argue in a way that there is a phytonutrient deficiency. And on modern diets. Right. If you go to the grocery store, what are you buying? You're buying broccoli and carrots. And tomatoes, potatoes, and they're all good. But it's a limited amount of foods that we manufacture through agriculture and make widely available. And so I think that's an argument for supplements, that supplements can help you get access, particularly ones that are well designed to a whole range of phytochemicals that we don't have naturally in our diet, but have been a part of human diets in the past. And they're not essential, meaning that we like essential nutrients are ones where we have a frank need, like magnesium. Right. And you can't just have more copper and it's enough for your magnesium, you have to have magnesium that makes it essential. Phytonutrients are not essential. But what we do see is that diets that have very low amounts of phytonutrients and those that have like what we consider an optimal amount have a significant impact on health span and longevity. It can be like a 20 year gap. So they, they are having a really important effect on our health. And so we've now created an argument for how supplements of products that we then will assemble into a joint formula or something that is clearing senescent cells, we kind of create them for targeted purposes. But what we're really doing is tapping in, in to these natural levers that we're getting less access to today. And so to answer your question, I will then mix in. This is more complicated than what most people will want to do, but I'll look at what did I eat today and I might then selectively add a couple more nutrients that might support my diet overall. And so that's a black belt level type of supplement program. So I actually have a pretty rich supplement shelf. But those things then become conditional, periodic, seasonal and the foundational ones stay pretty much the same.

A (95:32)

Fantastic. Dan, it has been wonderful chatting with you today. Thank you so much.

B (95:36)

Thank you so much for having me on. It was an absolute delight to chat with you. This has been great and I appreciate your time.

A (95:46)

Awesome. All right, friends, welcome to the after party. After we have gone on this wonderful nerd safari on creatine. I hope that you feel a little bit better if you are someone who has been chronically sleep deprived. Hello, Midlife. Hello. Waking up at 2am for no reason. Now we have a solution for it. And maybe if there's been some hesitation on creatine causing bloating or hair loss or any of those things, those have been addressed. And as a woman, we understand maybe a little bit more after listening to the show why taking creatine is so essential for normal function. For me, I think that there was a couple of really big highlights or aha moments. First of all, I think that, you know, in the, I think it was the 1970s or 1990s that the global supply of creatine was 1kg, which to me is absolutely wild. And then you can sort of see the explosion rate from there. But I think what was really interesting to me was that even when even like train, like these rugby players that he was mentioning, when they gave them three hours of sleep, but they gave them 25 grams of creatine, that their reaction times like so they're obviously well trained individuals that their reaction times in the skill of rugby, so something that they're used to doing was preserved. I really, really love that. And I mentioned in the show, like, if only I had had this conversation two weeks ago when I was traveling with my son's, it would have been like a completely. I would have completely approached their late night shenanigans a little bit differently for the game the next day. So. And just for you, right, if you are someone who, for whatever reason you have a big day and you can't sleep, you're nervous or you know, sleep is, is trash for whatever reason, knowing that there's an alternative rather than just taking the sugar, the coffee, the energy drinks that are sort of going to crash your nervous system anyway and take you away from your body composition goals, like we know creatine is a great alternative to that. So that was really great, really awesome for me as well. And then the other thing that I really liked was the meaningful but invisible that was towards the end of the conversation. But as he was talking, I was like, man, isn't that just what women do all the time? We have, we meaningfully but often invisibly contribute to our own lives, to the lives of people that we love all around us. But I think that it's important if you are going to be starting something like creatine to track how you feel right now. I know nobody likes to do the before. Everybody hates the before. They hate the before picture, they hate the before, you know, snapshot of symptoms. But it's really important when you're looking back to see how far you've come. Because even though right now in this moment you might feel like garbage, I promise you, taking something like creatine specifically over the long term, even if you're just doing like a 3 to 5 gram dose a day, you are going to feel significantly different in a month. And it would be just really wonderful validation just for you personally to see how far you've come in just four short weeks. And then that that sort of reinforces the behavior which at the end of the day is kind of what we're after. Right. It's like in the same way that exercise like the more you exercise, the more you sort of want to exercise. Like it has the self reinforcing behavior. Taking something like creatine and understanding how far you've come also can be reinforcing if you're doing it correctly. All right, so I hope, if anything that this conversation has convinced you to take creatine. And if you want to try the creatine from Qualia Life, you can head over to to qualia life.com better that's the name of the show and you're going to get 15% off of your purchase. I would highly recommend starting with creatine. I was telling you before, that is probably my favorite. I hide it from Giovanni, my husband, but that's probably my favorite supplement that we take. So if you are finding this podcast useful to you in any respect, maybe you're getting information that you wouldn't otherwise get in your everyday life or access to work world class experts. Let us know what you think. Leave us comments on Spotify, leave us comments on YouTube, leave us comments on Apple podcasts or wherever you consume this show. My team scours the Internet to make sure that we are providing value and we want to always over delight and over deliver. So until next time, my dear Betty, I bid you adieu. I hope you enjoyed today's episode. And now I must give you the obligatory legal and medical disclaimer. This podcast, Better with Dr. Stephanie, is for general information only. The advice and recommendations we discuss do not replace medical, chiropractic or any other primary healthcare provider's advice, treatment or care in the consumption of this podcast. There is no doctor patient relationship and the use and implementation of the information discussed are at the sole discretion of the listener. Please take this information to your primary healthcare provider to make the best choice for you. Remember, I am a doctor, but I am not your doctor and these episodes are meant for educational purposes only.