FoundMyFitness Podcast Episode #100: The Optimal Creatine Protocol for Strength, Brain, and Longevity with Dr. Darren Candow, Ph.D.

Release Date: March 31, 2025

In this landmark 100th episode of FoundMyFitness, host Rhonda Patrick, Ph.D., engages in an in-depth conversation with Dr. Darren Candow, one of the world's foremost experts on creatine, muscle physiology, and aging. Dr. Candow, Professor and Director of the Aging Muscle and Bone Health Laboratory at the University of Regina, Canada, brings over 140 peer-reviewed publications to the discussion, shedding light on the multifaceted benefits of creatine supplementation beyond its well-known role in enhancing athletic performance.

1. Introduction to Creatine and Its Evolving Role

[00:00 - 04:17]
Rhonda opens the episode by outlining creatine's expansion from a supplement exclusive to athletes aiming for increased strength and power to a nutrient with potential benefits spanning cognitive function, bone health, cardiovascular health, and mental health conditions like depression. She emphasizes creatine's burgeoning role in areas such as sleep deprivation, muscle and bone preservation in aging populations, and metabolic health.

Notable Quote:
"Most people associate creatine with strength and power, but its effects extend far beyond that."
— Rhonda Patrick, [00:00]

2. Creatine’s Impact on Resistance Training and Muscle Health

[04:17 - 12:13]
Dr. Candow delves into creatine's fundamental role in resistance training, explaining how it enhances ATP production, thereby allowing for higher intensity and volume during workouts. This, in turn, leads to greater physiological adaptations like increased lean body mass and muscle performance.

Key Points:

• ATP Maintenance: Creatine supplementation helps sustain ATP levels during high-intensity exercise, delaying the onset of muscle fatigue.
• Training Volume and Strength: Enhanced ATP availability allows for more repetitions and sets, leading to greater strength gains over time.
• Type 2 Muscle Fibers: Creatine aids in the recruitment of type 2 fibers, which are crucial for explosive power and are typically lost with aging.

Notable Quote:
"From creatine supplementation, it really maintains ATP or adenosine di triphosphate. So if you have more ATP longer, you can exercise at a higher capacity, a higher intensity, and that delays the utilization of other energy systems."
— Dr. Darren Candow, [05:28]

3. Supplementation Strategies: Dosage, Loading Phases, and Forms

[23:30 - 31:26]
The discussion transitions to optimal creatine supplementation protocols. Dr. Candow outlines traditional dosing strategies, including the loading phase (20 grams/day for seven days) followed by a maintenance phase (2 grams/day). However, he introduces newer approaches that challenge the necessity of a prolonged loading phase, suggesting that a two-day load followed by 2 grams/day may suffice for muscle saturation.

Key Points:

• Loading Phase vs. Steady Dose: While the loading phase rapidly saturates muscle stores, a consistent lower dose over a longer period can achieve similar saturation with fewer side effects.
• Relative Dosing: Tailoring creatine intake based on body weight (0.1 to 0.14 grams per kilogram) ensures personalized supplementation.
• Forms of Creatine: Monohydrate remains the gold standard due to its proven safety and efficacy, though alternatives like creatine hydrochloride (HCL) are available for those experiencing gastrointestinal issues.

Notable Quote:
"The loading phase was designed for athletes to really rapidly sort of fill up the room, if you will, from a skeletal muscle perspective. After that, you can reduce it as little as 2 grams a day."
— Dr. Darren Candow, [23:30]

4. Recovery, Inflammation, and Anti-Catabolic Effects

[14:12 - 16:37]
Creatine's role in enhancing recovery and reducing inflammation is explored, particularly in endurance athletes who undergo prolonged physical stress. Dr. Candow explains that creatine exhibits anti-catabolic and anti-inflammatory properties, which can aid in faster recovery post-exercise and potentially mitigate muscle breakdown in stressful conditions.

Key Points:

• Anti-Catabolic Effects: Creatine may reduce protein breakdown markers like leucine oxidation in males.
• Inflammation Reduction: In endurance events, creatine supplementation attenuates the rise in cytokines, markers of inflammation.
• Broader Recovery Benefits: While resistance training shows limited inflammation, high-intensity continuous exercises like CrossFit benefit significantly from creatine's anti-inflammatory properties.

Notable Quote:
"It really seems to speed up the recovery after every set, but also in between contractions as well."
— Dr. Darren Candow, [09:36]

5. Creatine and Bone Health

[27:48 - 34:26]
Dr. Candow discusses creatine's dual role in bone health, both directly by energizing osteoblasts (cells responsible for bone formation) and indirectly by reducing osteoclast activity (cells that break down bone). While creatine does not directly increase bone mineral density, it helps preserve it, particularly in critical areas like the hip.

Key Points:

• Osteoblast Activation: Creatine provides energy to osteoblasts, potentially enhancing bone formation.
• Osteoclast Inhibition: Acts similarly to bisphosphonates by reducing bone resorption.
• Clinical Trials: At least 15 studies indicate anti-resorptive effects, though no studies have conclusively shown increased bone mineral density.

Notable Quote:
"Creatine is probably the one that will be number one when people select it, even probably more than caffeine nowadays from an exercise training perspective."
— Dr. Darren Candow, [12:13]

6. Creatine and Brain Health: Cognitive Function and Stress

[38:48 - 58:46]
One of the most exciting areas discussed is creatine's impact on brain health. Dr. Candow explains that while the brain automatically synthesizes creatine, supplementation can enhance cognitive function, especially under metabolic stress such as sleep deprivation, jet lag, or traumatic brain injury (TBI). Higher doses (up to 20 grams/day) during acute stress periods can significantly improve memory and cognition.

Key Points:

• Brain Bioenergetics: Creatine boosts the brain's energy capacity, aiding in cognitive tasks and reducing brain fog.
• Metabolic Stress: Under conditions like sleep deprivation or TBI, creatine supplementation can mitigate cognitive decline.
• Neurodegenerative Diseases: While prevention remains a primary focus, ongoing studies are investigating creatine's therapeutic potential in conditions like Alzheimer's and depression.
• Mental Health: Creatine shows promise as an adjunct treatment for depression by increasing brain energy metabolism and reducing inflammation.

Notable Quote:
"When we look at the totality of emerging evidence, it's split. Some studies don't see any effect, but the ones that do are in a population where they're either mentally fatigued, sleep-deprived, or during times of aging."
— Dr. Darren Candow, [39:12]

7. Special Populations: Vegans, Children, and Pregnant Women

[57:07 - 87:06]
Dr. Candow emphasizes the importance of creatine supplementation for populations with limited dietary intake, such as vegans, who do not consume creatine-rich animal products. Additionally, he advocates for creatine use in children and touches on its potential benefits during pregnancy, although he calls for more research in these areas.

Key Points:

• Vegans and Vegetarians: Supplementation is crucial as dietary creatine is negligible in plant-based diets, potentially enhancing muscle performance and cognitive function.
• Children: Safe supplementation can improve agility, coordination, and muscle mass without adverse effects, though more extensive studies are needed.
• Pregnancy: Preliminary data suggest potential benefits for fetal brain development, but comprehensive human trials are required to confirm safety and efficacy.

Notable Quote:
"For the vegans watching, keep in mind you're not getting any [creatine], and that's why supplementation could be considered."
— Dr. Darren Candow, [37:36]

8. Addressing Myths and Misconceptions

[89:44 - 100:30]
Dr. Candow systematically debunks several myths surrounding creatine supplementation, including fears of fat gain, muscle cramps, dehydration, baldness, and kidney damage. He provides evidence-based clarifications to reassure listeners of creatine's safety and efficacy.

Key Points:

• Fat Gain: Contrary to popular belief, creatine can aid in fat loss by increasing lean body mass and energy expenditure.
• Muscle Cramps and Dehydration: Creatine actually enhances muscle hydration, reducing the likelihood of cramps.
• Baldness: The alleged link between creatine and hair loss is unsubstantiated, with no direct evidence showing causation.
• Kidney Health: Elevated creatinine levels from supplementation are often mistaken for impaired kidney function, but they reflect normal creatine metabolism. Numerous studies confirm creatine's safety for the kidneys and liver in healthy individuals.

Notable Quotes:
"We have not shown in a single study that increased bone mineral density."
— Dr. Darren Candow, [32:33]

"From a clinical perspective, creatine does not adversely affect renal, liver or cardiovascular cells."
— Dr. Darren Candow, [94:45]

9. Best Practices for Creatine Supplementation

[85:30 - 89:16]
Dr. Candow offers practical advice for optimizing creatine intake, including microdosing to mitigate gastrointestinal issues, taking creatine close to workout times for enhanced muscle uptake, and combining it with protein for synergistic effects. He reaffirms monohydrate as the preferred form and emphasizes the importance of third-party testing to ensure supplement purity and safety.

Key Points:

• Microdosing: Splitting the daily dose (e.g., 1.5 grams in the morning and evening) can reduce GI distress.
• Timing: Consuming creatine pre or post-exercise can enhance muscle uptake due to increased blood flow during workouts.
• Combination with Protein: Pairing creatine with protein sources like whey can amplify muscle performance and lean mass gains.
• Supplement Quality: Opt for pure creatine monohydrate, preferably third-party tested brands like Creapure, to ensure efficacy and safety.

Notable Quote:
"Start with three grams, one and a half morning and evening, then move it up to five, two and a half, then move it up to nine. But then I say three, three and three. Then eventually you're sort of getting tolerated."
— Dr. Darren Candow, [86:25]

10. Future Directions and Ongoing Research

[100:15 - End]
Looking ahead, Dr. Candow highlights emerging research areas where creatine shows promise, including vascular health, cancer rehabilitation, and metabolic disorders like type 2 diabetes. He underscores the need for more comprehensive studies to fully understand creatine's potential in these domains.

Key Points:

• Vascular Health: Preliminary studies suggest creatine may improve endothelial function, beneficial for cardiovascular health.
• Cancer Rehabilitation: Ongoing research explores creatine's role in supporting muscle mass and function during cancer treatments.
• Metabolic Disorders: Creatine may enhance glucose disposal and energy metabolism, offering benefits for individuals with type 2 diabetes.

Notable Quote:
"There is a lot of potential there, it's not overwhelmingly convincing I think because bone takes a long time to turn over. But this is interesting."
— Dr. Darren Candow, [31:26]

Conclusion

This comprehensive episode elucidates the extensive benefits of creatine supplementation across various aspects of health, from muscle and bone strength to cognitive function and mental health. Dr. Candow's expert insights, coupled with robust scientific evidence, debunk longstanding myths and provide clear guidance on optimal creatine use. For anyone considering creatine supplementation, this episode serves as an invaluable resource for understanding how to harness its full potential safely and effectively.

Overall Notable Quote:
"Creatine definitely has the potential. It kind of has a lot of potential for a lot of things. But without protein, you know, those two need to be there."
— Dr. Darren Candow, [35:02]

For more detailed insights and further studies on creatine, visit FoundMyFitness.com and explore the dedicated resources section.