The BEST Way to Use CREATINE to Build Muscle (Science Explained) ft. Max Coleman and Daniel Plotkin

Hey, everybody, it's Max Coleman and Daniel Plotkin here with Built with Science podcast. And today Danny boy and I are going to be discussing the one, the only, the supplement that you should be taking, creatine. We're going to talk about everything you need to know about the supplement from literally what it is, how you should probably be using it, some common misconceptions regarding creatine use, the safety and efficacy of taking creatine, and we'll even touch on some stuff and some benefits outside of the stuff that we really care about, like strength and hypertrophy. Right. But first, Denny boy, why don't you go ahead and tell us what creatine is?

What, what?

Define creatine. Talk about what the functions are in the body and. Yeah, go ahead and take it away.

Yeah. So creatine is a compound that's essentially just three amino acids. Methionine, arginine and glycine. And it's the body's quick energy. So it's stored in the cytosol of the muscle cell. And then when you do something like sprint or bench press or anything that requires a lot of quick energy, the creatine phosphate molecule donates that phosphate to ADP to make ATP, which you might have learned in biology, sort of powers all the functions of our body. So that phosphate from creatine allows the phosphates on ADP to continue to do their work. So very simply, it's just our body's quick energy source that allows us to keep doing fast stuff like lift weights, sprint, jump, and anything that would be less than 15 seconds or so and very high intensity.

Cool. So like a one rep max bench press would be something that uses almost exclusively phosphocreatine for its energy source, right?

Yeah, probably like 95%. Yep.

Okay, cool. And then where does this phosphocreatine come from? Is this something that we already have in our body already anyway, or is it something that we have to eat or get from sunlight, like vitamin D or some crazy stuff like that?

Yeah. So it's synthesized mostly in the liver. So our body produces it in the liver. Well, initially in the kidney, then the liver, and then it gets stored in the muscle cell. So we're already producing creatine and storing it ourselves. And we'll get into later on why we need to supplement it if we're already creatine.

Well, let's get into it right now. So if, if your body's already producing creatine, Right. Your body already has this thing in its muscles that it's using for energy already. I. What's the, is there a reason that people feel the need to supplement with creatine?

Yeah. So in order to get the maximal benefit from creatine, your stores need to be topped out. And it seems like our body is not prioritizing keeping our stores topped out. So supplementing it all it does is just allow for our stores to be fully saturated. So that way we have enough creatine around to have the maximal benefit. So it's like having a cup that's 75% full. If you are thirsty, you know, and all you're gonna have is that one cup, top that cup out before you go and do things. So.

Okay, cool. So is, is there a difference then between I guess, the creatine that we kind of already synthesized in our kidney and liver versus the stuff that we're like taking in powder form? Like, is there any difference between those two things?

No.

Yeah.

So that's one of the reasons why we're more confident about its safety. That a lot of the time when something is produced in the body and you take it in in the same exact form, you can be a little bit more confident that it's not really messing you up, it's not going to poison you. Not to say that things that, you know, our body doesn't produce are automatically bad, but we can be more confident that it's not bad when our body already produces it.

Cool. So this is something that is already naturally produced in humans and animals? Probably. Do you know if it's outside? I don't know actually, I don't know if it's outside of mammals. Like, okay, it's something that's produced. Okay. But as far as that's concerned, like with producing it, is that something that people like our, our plant based friends should be worried about? Like are, are we getting creatine in labs from animal sources or is that, is there, are they getting it from animal muscles, for instance, and then producing it in a lab or is there some other means by which they get it?

No, they synthesize it from the individual amino acids. So it's, it's a vegan product. People who are vegan don't need to worry about it not being ethically sourced. So that's, that also brings us to the fact that it is in meat. So if you're consuming an inordinate amount of meat, then you could get the creatine that you need, but you would need to eat a ton of meat in order to get there. So probably best to Supplement.

Okay, cool.

We can get to details of that now or later. Up to you.

Yeah, yeah, exactly. Like. Go ahead. Yeah. Tell us how we should be using the product, how we should go about using creatine. Is there. I mean, I know that the common thing that's thrown around is you probably should be taking one scoop, which is about 5 grams a day of creatine. Is that pretty straightforward? That's all we need to worry about, five grams a day, and it'll cover all our problems. Or is there. Is there more nuance there?

Yeah. So for the most part, if you just decided to take 5 grams a day in perpetuity, then you would probably cover all, if not most, of your bases. There. There are some things to talk about in terms of saturating your creatine stores a bit more quickly by doing a loading phase. So what we talked about initially was that we want to get our creatine stores saturated. So there's a quicker and a slower way to go about doing that. You can either take 20 grams per day for seven days and finish topping out your stores very quickly, and that would be 5 grams in four doses per day for seven days. And you wouldn't have to worry about topping out your stores after that. You would just take 3 to 5 grams on an ongoing basis after that moment. Or you can do the slower way, where in about 30 days you'd have your creatine stores topped out if you just took 5 grams a day. So those are the two main ways to go about doing things. But you can for sure adjust based on any sort of symptoms that you're feeling. So let's say in the rare case you're getting some gastrointest. Gastrointestinal distress, from those higher doses, you might get a little bit higher or a little bit quicker saturation from doing 10 grams a day. So two doses of 5 grams, so it's not an either or thing. You can be a little bit more aggressive, but not so aggressive that you get gastrointestinal distress. So you can modulate your supplementation in that loading phase at whatever pace you want and just realize that if it's a little bit higher doses, you'll get saturation a little bit quicker. If you go the more conservative route and go 5 grams a day, it'll probably take about a month to top out your stores.

Is there any benefit to doing it quicker? Like, so, for instance, what I heard was there's a quick way and a slow way and they get you to the same road. They get you to the same goal. Right. Just one road is a little bit shorter than the other, but that shorter road seems to have some sort of negative consequence. Right. Like otherwise, wouldn't just everyone be doing it quickly as opposed to slowly? I mean, I, I personally, I know that I would want results quicker rather than slower. So is there a reason why I, like, I shouldn't be doing a loading phase?

Yeah, so as I mentioned, there are some. It is few people that get gastrointestinal distress from higher amounts of creatine. So in that case, if you feel that symptom, you can always titrate down. There's also. So in terms of why you would go about doing this, there's not a really strong rationale for performance for loading creatine because the small amount of time where you're able to do a couple of more reps in the gym from getting a quicker creatine saturation probably doesn't matter in the grand scheme of things. But there are some practical reasons why you might want to do a loading phase. So the two main things that I consider when deciding whether I want to do a loading phase in an individual is one, if that person has never taken creatine before, that loading phase allows them to get a quick water retention and get that weight fluctuation out of the way. So that way they can have more affinity to whether they're gaining or losing weight if they're on a cutting or bulking cycle. And two, which I think is really important is there are some non responders to creatine. So seeing that weight fluctuation in a shorter amount of time can make you more confident that you're a responder. And if you did it over the 30 days, you might hesitate to say, depending, especially if you're bulking, you're like, oh, is this actually coming from the quick water retention from that loading phase or is it just that I bulked a little too quickly?

Yeah. So you, you, you mentioned weight gain as, that, as a, as a way for determining if you're a, a responder or not to creatine. Right. So what typical ranges of weight gain are we talking? So like for instance, like, let's say I do a loading phase and in a week I put on a pound of, of not necessarily tissue, but just weight in general. Right. Can I be pretty confident that I'm responding to creatine or should I be putting on like five pounds in that first week that I'm doing a loading phase?

Yeah, it definitely does vary. And the amount of saturation that you were at previously probably matters a whole lot. So I'd say a pound, you can be relatively confident, especially if that pound cons persists. But 2 to 4 pounds is typically the average seen in studies. But anywhere from 1 to 5 pounds, I would say, is like a range that I would consider to be normal for outcomes from saturation. And you mentioned vegans. I think you would expect higher amounts of increases in weight because of the fact that they're eating no meat. So they're not getting their creatine from the meat sources. So they probably. And they do this has actually been shown, have on average less creatine saturation. So they would likely benefit more from creatine supplementation.

Cool. So all our vegan listeners and friends out there make sure you're taking creatine because you guys probably need it more than your omni omnivorous and carnivorous counterparts. Okay. So loading sounds like it's a pretty good idea, assuming that you can handle it. It's good for both telling you if you're gonna be a responder to creatine or not. And it's good at telling you getting your. We stabilize out pretty quickly as opposed to wondering if. If that weight increase is caused by just maybe eating a little bit too much. And the creatine is kind of hard to separate those out. Right. So it. Maybe you can tell me if I'm wrong, but if your, if your stomach can handle the gastro, if, if you don't experience any gastrointestinal, like, distress while doing a loading phase, it's probably, it's probably worth doing or it's not gonna hurt you at the very least, right?

Yeah, I, I'd agree with that for sure.

Cool. And then as far as like, after the. You do the loading phase, right, for those first seven days, for that first week, you recommend going straight back down to like 5 grams or. I've heard some stuff about relative doses for creatine. So, like, you know how similar to like. No, we don't just tell people to eat 150 grams of protein. Right. We tell people to eat an amount of protein that is, you know, in some way or not linked to the. The amount of body weight or lean mass that an individual has. Should we doing something like that for creatine or. Or is it pretty safe to just say 5 grams a day after your loading phase is pretty. Is pretty good?

Yeah, I think it makes sense that an individual with more muscle mass would have more room for creatine, so to speak. So I think for the Vast majority of individuals, 5 grams would cover their bases. But if 5 grams wouldn't cover your bases, you'd probably know it. You're probably a freak in terms of the amount of size that you have. So I think that as long as your pocket can handle it and it is a relatively cheap supplement, go with a little bit higher amounts if you're a larger individual. And the thing that the number that's usually used in the literature is. 0,1 gram per kilogram of body weight. So you can use that figure to really guide you. I wouldn't expect an amount higher than that to help you. So if you're worried about it, go with that figure. But for the vast, vast majority of people, I would just stick to that 5 gram amount. And for many people, 3 grams just to maintain saturation would actually be enough.

Okay, cool. But it's, it's, it's a pretty cheap product just in general, so it's not gonna hurt you both financially or physiologically or in health ways and all taking a little bit more. Okay, cool. So maybe worth. It's definitely not gonna hurt you and you may, you may be getting something else out of it. Speaking of, you know, just other ways of using creatine, there's a bunch of different types of creatine on the market. Like I know there's creatine hcl, there's like an estroethyl creatine that you can take. But. Or is the, do you have a preference for which creatine form is the best for improving performance in the gym?

Yeah, the most well tested and the most bioavailable creatine is creatine monohydrate. So I wouldn't waste money on any of the other ones just cuz when compared head to head, none of them have produced better outcomes. Some of them have been equal and many of them have been worse. And none of them even come close to how cheap creatine monohydrate is. So not only is it the best, but it's also the cheapest. So definitely just go with creatine monohydrate and don't worry about any of the cool jargon that people use in order to make other creatine sound great in terms of making claims about their solubility or their ph or anything like that. Just don't worry about it, don't get fooled. Just buy creatine monohydrate.

Cool. And then I've seen some products like, I know there's a lot of like hand energy drinks for instance, that they're like free workout energy drinks with a ton of caffeine. And they also say that they have creatine in them. Like do you think that that's a good place to be getting your creatine from?

I do not think that. So if the creatine is already in an aqueous solution, so if it's in water, then the breakdown of creatine is actually pretty high, especially if it's left on a shelf for a while, which most of the time it is. So I would definitely stick to powdered forms of creatine where you just swish them up in some water and then gulp them down as opposed to getting it from an already made solution. Definitely stick with the powders.

Okay, cool. And then, and the powder is just cool anyway. Cuz one, you get to carry around a bunch of white powder with you and two, you can dry scoop it, which you know, everyone knows that dry scooping is the, the, the quick to get a bunch of friends to think you're really cool. Okay, cool. So you know, probably, it's probably worth taking a relative dose loading phase is probably worth doing if you can handle it. The type, stick with monohydrate. Don't drink the stuff that's already in a can. What about timing? Is there any particular, you know, with protein, like they say it's probably good to eat a bolus of protein relatively close to training. Is that the same with creatine or is that something that we can just. Is it kind of similar to protein than that? You know, the kind of. The daily amount is what you really need to worry about and timing probably isn't a huge factor.

Yeah. So based on the mechanism of topping out your creatine stores, timing is definitely not a huge factor. There was one study that had a really small benefit to timing creatine before a workout, but I don't make anything of that just yet. I think the vast, vast, vast majority of the benefits are gonna come from just saturating those stores. So find a consistent time where you can take creatine and stick with that time. The one thing that I will mention is that the one supplement that does seem to have a negative interaction with creatine is caffeine. So separating out your creatine and caffeine doses is probably a good idea. So if you take, if you work out consistently in the morning, maybe take your creatine in the evening or vice versa, and then you cover your bases. I don't know that there's strong enough evidence to say this, like Definitely don't do it. It's gonna be horrible. But there's enough evidence to say if you wanna be on the safe side, just separate them. There's not a huge upside. And on that same topic, a lot of the time pre workouts will have creatine and caffeine in them. And I think this is an issue for two reasons. One, if you're trying to maintain your creatine stores, you want to take them every day. And if you're not taking your pre workout every day, which most people don't, even if you take it every time you train, you'd have to TR to take that dose every day. And the second issue is the one that we just mentioned, that caffeine and creatine is in there at the same time. You literally can't separate them. So I would try to, if you're being on the safe side, choose a pre workout formulation that doesn't have creatine in it, it just has caffeine in it. That way you can take them separately.

Cool. And then I, I'm den. I'm sure you can relate to this but like oftentimes the, the most common thing I hear with, with creatine supplementation from clients or is that it literally just a matter of forgetting to take it? So I think that finding the time of the day for you that is just the most convenient and that may be with your pre workout, it's probably still worth doing because it's better to just take the creatine anyway, even if there may be a negative interaction with caffeine as opposed to just, you know, not taking the creatine at all. But if you want to know what I do every night, I drink my, my Metamucil, which is a fiber supplement and I mix in some creatine there and then I drink. I try to front load most of my caffeine use earlier in the day. We usually record these podcasts in the mornings, so that usually that's kind of like my safeguard for making sure that they don't, they don't negatively interact with one another. Okay, cool. So I think we've got a pretty good basis for how to go about it. Don't worry about timing. The cheapest is the best, which is really great for monohydrate and then loading. If you can handle it, do it relative dose. If it's, it's, it's not gonna hurt you. But three to five grams a day is probably pretty safe, right? Okay, cool. We know what creatine is. We know how to use it. Now let's talk about what creatine isn't. Some common misconceptions regarding creatine and boy, there are a ton of them. There are a lot of people who think that creatine is a drug or something that is, it can be really dangerous for you. So do you want to touch on that, Danny? Some of the, some, some of the things that people worry about that they probably shouldn't be worrying about when it comes to creatine supplementation.

Yeah. So let's cover the steroid one. So creatine isn't a steroid, it's just a three amino acid. Steroids have a specific structure that creatine doesn't resemble at all. So creatine is not a steroid in terms of other things that people talk about. Balding is a huge one that people mention. Will creatine cause hair loss? There was one study in rugby pit rugby players that found higher DHT levels which is associated with hair loss from creatine supplementation. But one, they didn't measure hair loss specifically, so that's obviously a big caveat. And two, based on the analysis of the study, their DHT levels started at lower amounts and increased to amounts that were within the physiological range. So not something that you would consider to be an abnormality. With that being said, it's not something to totally dismiss. We don't have direct evidence showing that creatine does not cause hair loss. So I know Grant Tinsley at Texas Tech, Dr. Grant Tinsley at Texas Tech is or was working on a study pre Covid and I'm not sure what happened with that. I know it got put on hold. I don't know if it got restarted. My professor at my lab knows him, so I can probably get an update on that. I hope it happens because in order to get the answer, we want direct evidence. So we can't say with utter confidence that it doesn't. We could just say there's no evidence to show that it does.

Okay, so people making claims about creatine causing hair loss. It's not necessarily guaranteed. Not true, but it's just a very baseless claim, at least at this point in time. That.

Exactly. Yep.

Cool. So it's not causing any hair loss, which clearly is not causing a lot of hair loss. I've been 18 every day for like three years now. Case of one, there's not a very good solid evidence there. But anyway, not causing hair loss, not a steroid. But is it unhealthy in other ways? Like so I've, I've heard some people talk about how it can be like really, really dangerous for like kidney health and liver health and stuff like that. Have you heard or seen anything in regards to that?

Yeah, so there's pretty good evidence that it does no harm to either of those organs. There's actually studies looking at people that have been taking them for as long as we have and looking at all kinds of markers of kidney and liver health. And there's no differences between people who otherwise who did, did or did not take creatine for very, very long periods of time. I think there's one study that looked at people taking it for, I think it was five years, three years, but a very long time. So there's no indication that it has any negative effects for the kidney or the liver. With that being said, if you have an illness that, like kidney failure or something like that, definitely consult with your doctor before supplementing creatine because it does need to be processed in those organs. So if you already have an illness, definitely consult with a doctor. But in healthy individuals there's no indication that it has any negative effects, health effects, fools or any organ for that matter.

Oh good. Okay. And is it like a, is it like a dose makes the poison? So like if I, you know, for instance, like were you telling people to take.01 grams per kilogram or like around 5 grams? But if, if for instance, someone was taking like doing a loading phase and taking 20 grams a day, like would that be any more like deleterious to their health or is it pretty safe even through a wide range of, of dosage?

Yeah, even with those higher ranges they've looked at all kinds of health markers during the loading phase and saw no issues. Even so there's individuals that have trouble that actually can't synthesize creatine. Their genetic defects in their ability to synthesize creatine. So they have huge issues, developmental issues. And they take really, really, really high doses of creatine in order to help those developmental issues. Their ability to walk, their cognitive ability. And they don't receive even at doses of like they do it by body weight, but they're really, really high doses. Cuz it's the relative dose per kilogram of body weight is higher. I want to say like 60 grams of creatine is not uncommon in these people and they don't report side effects and their parents don't report side effects of the creatine itself. So I'm very confident in saying that even pretty high doses of creatine are not gonna be deleterious.

Cool. Cool. And then another common thing that I hear about creatine is that it can be really dehydrating. So it can be. It can be something that causes, like, chronic dehydration, especially during that loading phase. So is it something that people need to worry about? Should people be drinking more water when they start supplementing creatine or anything like that? Or is this also just overblown?

Yeah, I think that's also overblown. I think creatine, as we mentioned, draws water into the cell, so if anything, it's hydrating. But if you have some gastrointestinal distress, then obviously some dehydration can happen from that. But overall, I definitely wouldn't worry about getting dehydrated by creatine. With that being said, you want to have the water around in order to, you know, sort of pull it into the cell. So getting adequate water or drinking an adequate amount of water is definitely not a bad idea. You should do that when consuming creatine, but it's not gonna dehydrate you or anything like that.

Cool. And just a top disclaimer. You should be drinking a normal amount of water all the time anyway. Just trust your kidneys. Unless you had a doctor tell you your kidneys are unreliable, only drink a.

Normal amount of water if you are consuming creatine. You heard it here first.

Otherwise, drink three gallons a day. It's the. Actually, the. It's been studied as the most anabolic way to. To increase your 1R bench press in three weeks. Okay. All right. So I've also heard people that are worried about taking creatine because they're trying to lose weight, and they're worried that while they're trying to lose weight, while they're doing all this, like, extra work, you know, cardio, cutting their calories, whatever it may be, they're worried that taking creatine is gonna offset that because of any weight gain. So is that something that people, especially people on, like, fat loss phases, should they be worried about supplementing with creatine? Like, is that something they should be concerned with?

Yeah, I don't think that they should be concerned with that because the weight is obviously not getting added to fat tissue. But in order to have an affinity toward how much weight you're losing. We spoke about this earlier. Doing the loading phase and getting that out of the way is probably not a bad idea, but definitely not something that you need to worry about, because as long as you're being consistent with your calorie deficit, you'll find out pretty quickly that you're losing fat. I wouldn't not take it and waste those gains just because you're on a fat loss diet. Even if you're gonna go the slow way and not load.

Yeah. And if anything, it's probably gonna help you on your cut. Cause I mean, it's, it's providing these ergogenic aids. So if anything, it's just gonna make the cut even better, right?

Yes.

So now on the opposite end of the spectrum of people thinking that it's like this deleterious health, horrible steroid drug, there are people who say that it's the greatest supplement of all time and it's the only supplement that works. And it'll, it'll make these incredible steroid like changes to your performance and physique. Is that true too or is that kind of overblown?

Yeah, I think the magnitude of effect, especially in some spheres is sometimes overblown in terms of it is the only supplement that works and it's extremely effective. It is effective, but the magnitude of effect is not night and day. It's not like you're gonna take it and then you turn into Superman in the gym. You know, a few extra reps is what you generally expect, which can compound to good results. But it's not something that is gonna be a game changer. There's plenty of people who don't take it and you know, create awesome physiques and sometimes forget to take it and don't get back on. Like if, if it had an inordinate effect that was super noticeable, then I think that wouldn't occur. So in terms of people just, they stop taking it and sort of forget about it type deal. But it is definitely the most tested and the mo. The supplement that's consistently been shown to be the most effective. So I'd say it is probably the king. If you wanna, if you wanna assign king, queen, that's probably creatine as king and then a couple of others underneath it as, as queen. So I definitely would reach for it as one of the first supplements to take when you're trying to augment gains. But it's definitely not steroid like benefits.

Cool. And then so I kind of forgot to touch on this earlier, but now that we're talking about steroid, like comparing it to steroids is creatine something that's worth cycling? So like, you know how like people on steroids, they'll, they, they'll have periods of time where they're using more steroids than less or no steroids. And. And there are periods of no steroid use. Is that something we should be doing with creatine? Like, we should have periods of the year where we're taking high doses and then come off or taper off and then go back on, or is it something we just do all the time?

Yeah, you just continue to take a maintenance dose. There doesn't seem to be a sensitivity issue, like with anabolic steroids, when you want to resensitize yourself and things like that. So I've been taking creatine, I think, now, for nine years straight, and I think you just said three years straight, and I just stayed on a maintenance dose and was totally fine. There's no issue with doing that. And I believe there's also some data with looking at whether there'd be issues with synthesis afterward. And there weren't issues. So not something to worry about.

Just not like testosterone, where your body's gonna stop endogenously producing it after you take it.

Exactly. With high dose of testosterone taken over time, you definitely have that issue. But with creatine, you would definitely not have that issue. Yep.

Sweet. Sweet. Okay, so with some of those con, like, common misconceptions out of the way, let's touch on those performance benefits. Right. Let's talk about what you can expect to see from taking creatine. Right, so let's start with strength. Like, what is, like, a reasonable increase in strength? Like, is it. Am I gonna take. Start taking creatine and then add 30 pounds to my bench press as an advanced lifter? Like, is that gonna happen in the first loading phase of the week? Like, what magnitude of difference are we expecting to see here with strength?

Yeah, I mean, you just ran a meta analysis on this, so you could probably speak to this a bit more, especially on the hypertrophy side, but a few percentage points. Generally speaking, for most of the outcomes, it's not night and day, but small things compound over time. So if you can even increase your bench by five pounds, then you'd be probably bigger, faster, stronger in, you know, three months from now, six months from now. So scoffing at a few percentages is probably not something great to do. A few percentages over time, especially in a trained individual, is probably a really good thing. A lot of people sort of use, like, raw numbers alone, and I think you can get in trouble with that because let's say you take an untrained individual and then you put them on creatine and you say, oh, they increase by this much. Percentage due to creatine? No, they increased by that percentage because they were getting stronger due to lifting. Plus creatine helped them. So it's a lot of the time, it's actually hard to tease out exactly the magnitude of effect. But yeah, when you compare between groups, it's a few percentage points. And it's not something that's going to be like you go in the gym after the loading phase and you're 30.

Pounds and people are coming up to you and going, what did you start taking? How can I get my hands on that? Yeah, so I think, I think the best way of putting is this is a small but substantial increase in the amount of strength that you're gonna see. So it's, it's, it's meaningful and it's definitely something that will help you over time, but it's just maybe not as much as, as some people may claim it to be and certainly not as much as like steroids. Right. And then Danny boy, you kind of alluded to this. Yeah. My, my, my dear friend Ryan Burke actually just ran a meta analysis that I was help. I was fortunate enough to be able to help creatine's effect on hypertrophy directly. So we have a ton of research on creatine, hundreds of study on creatine, which in our field in exercise science is like unheard of to have that many studies on a single topic or a single supplement. Right. And we had a lot of evidence showing that it's really, really good for muscle growth. Right. And we even had a couple of meta analyses which for those of you who don't know what meta analyses is the top of the hierarchy of knowledge. Right. It's just, it's a compound of a bunch of different studies or a compilation of a bunch of different studies all looking at something very similar. In this particular instance, we were interested in looking at creatine supplementation on direct measures of hypertrophy. Right. So there's a lot of studies out there in, in fact, there's a good bit of meta analysis out there looking at creatine supplementation on just lean tissue increases in general. But the issue with that, obviously is that creatine increases water content in the body. So that can kind of conflate some of these lean tissue measures. Right. We won't de. Delve too deeply into that. So we wanted to run a study looking at direct measures. So people were either using ultrasound or, or MRIs to look at the actual size differences between muscles. Right.

And the resulting is, you were looking at specific Sites. So instead of looking at, all right, they gain this amount of muscle in total, you're looking at only studies that said, all right, how much muscle did they gain in the quadricep or one specific quadricep or the calf muscle? Not how much did they gain in total amount of tissue.

Exactly. Yeah, exactly. So there was a lot of studies that were using, like, dexa, for instance, or just other body composition methods to. To use that as a proxy for muscle growth. So they would say, like, oh, these people put on, like, three pounds of muscle in their legs or something like that, or. Or three pounds. They're saying three pounds of muscle, but really it's three pounds of lean tissue. And there's issues with that. So, yeah, we were like, well, let's see how many extra centimeters in the biceps these people are getting from taking creatine. Right. And the results were a bit shocking to people, which is kind of interesting to me, because they weren't that surprising at all. So we found 10 studies, ultimately, that met our inclusion criteria. Right. And they ranged from, like, six to 52 weeks long. They. We had four studies that were done in, like, younger individuals and six that were done in older individuals, some in females, some in males. We had two studies in there that were untrained and eight that were on untrained. Right. Basically, full defect size for all outcomes was about 0.11. So, like, for those of you who don't know, effect sizes are kind of quantifiers are qualified at 0.2 is considered small. I believe 0.5 is considered moderate, and 0.8 or higher is considered like, a strong, substantial finding. Right. And we found 0.11, which is extremely small. Right. So it is essentially like almost trivial differences in hypertrophy, direct hypertrophy measures. Right. However, when you break that down a little bit further, you see kind of a difference between younger and older populations. Right. So for older populations, we saw an effect size of like.06. And that can be considered trivial. I mean, there's almost no differences between taking creatine and not taking creatine, assuming that you're lifting weights. Right. But for younger populations, so people in the, like, 18 to 35 age range. Right. We found an effect size of 0.23. Right. When given those cutoffs that I was just talking about, that's a small effect. Right. So especially in younger populations with hypertrophy directly being measured, there does seem to be a small but pretty substantial increase in the amount of muscle you're able to build if you're Using creatine versus not using creatine. Like I said, this ultimately surprised a lot of people, which was kind of confusing to me because we already knew that creatine had pretty modest benefits for muscle growth anyway. And then this was just kind of further saying, like, yeah, they're pretty modest benefits, but they certainly are there. So me personally, the results of this meta analysis are not going to keep me from taking creatine. Hopefully it's not taking. It's not keeping most people from taking creatine. Again, like we were talking about earlier, it's definitely not hurting anything. It's super cheap, and if anything, it does seem to be making a small but substantial difference. So hypertrophy and strength definitely seem to benefit a lot, or not a lot, but substantially from taking. Taking creatine. I don't know if there's anything I missed there with regard to hypertrophy, is there? Or if there's anything that you would like to add to that, Danny boy?

No, I think that's good. I think one thing especially important to mention older individuals is that functional outcomes are super important in this population. So even if they don't get a night and day muscle size benefit, just small amounts of strength benefits can help them in their daily tasks like getting up from a chair and doing, you know, activities of daily living. So even if it's not a crazy amount of muscle gain, it could still matter for their life, which is, you know, arguably. Arguably more important. I need to couch that statement, you know.

Yeah, jury's still out.

Yeah, exactly. I think we need a study on that. Anything. We need a meta on that quality of life from being able to get up from a chair versus liking what you see in the mirror, which is being jacked. Yes.

What's more important than 60 years old, being able to get out of bed or looking like you can bench 3? 15. Yeah, like we said, journey's still out. Yeah. Okay, so give it. It's kind of a really good segue, actually. So you were talking about how, yeah, maybe older adults aren't gonna see this huge, like, hypertrophic benefit from taking creatine, but they still see a pretty substantial strength increase. And then maybe, just maybe, there are some improvements from creatine supplementation outside of strength and hypertrophy that may be really good for older individuals. You want to touch on those at all?

Yep. So I think the biggest one that would be useful to older individuals is probably the benefits on bone. So there was a recent large study that looked at three grams of creatine. For two years that found that there was no benefit to supplementation for older individuals. But they, one, were taking a pretty low dose, 3 grams per day, and two, they were not resistance training. There's two other studies that showed a benefit in bone. Although it was a very modest benefit, There was a benefit in bone, and they were taking higher doses. So they were taking about 8 grams or 9 grams per day, and they were resistance training in tandem. So compared to placebo, creatine had better indices of bone regain. So I think what we could take away from that is that we have preliminary evidence that, one, if you're gonna take creatine as an older adult, make sure you're lifting weights in order to get the benefit to bone. And two, it seems that higher doses for bones specifically make sense. So I want to couch this statement and say the studies that I've seen haven't actually looked at function, which I think would be the next step. So just because you see small changes in bone indices doesn't necessarily mean that's going to create less breaks in the future or more function, doing tasks of daily living and so on. So I think having those studies would be super important. But since it's so low risk and since we're seeing the signal, I think it makes a whole lot of sense to veer on the side of caution. And if you're an older adult, take that higher dose and lift those weights and get that benefit.

Yeah, and I kind of want to piggyback off that. Not just older adults, Anyone who's taking creatine. This. This supplement is completely worthless if you're not. Well, okay. If you're a healthy individual who's just trying to get big and strong, this supplement is completely worthless if you're not taking it in tandem with resistance training. So it's not like steroids. And we've said this, like, four times now on the pod. So it's not like steroids, where if you just take it, you'll just start growing muscle and strength. You have to take it in conjunction with resistance training. That's where you actually see that the. The gold mine that is creatine. Right. Okay. So it's good for bone health and it's. It's good for muscle growth and stuff like that. I've heard some stuff about some cognitive benefits of creatine. I know that creatine is utilized in the brain, but I. I don't know necessarily what exactly those cognitive benefits are. I know that they're talked about pretty often in these circles, but what Cognitive benefits are people seeing from creatine?

Yeah, there's a, a decent amount of growing evidence that it is beneficial for cognition. So there's studies looking at memory recall. They have, have all types of games that they have them play and they perform better on them. Memory recall, I would say, is obviously a super useful one. Some of the game type stuff is sort of reminiscent of like Parkinson's disease and whatnot, where, like, just because you get better at doing a specific puzzle or something like that doesn't necessarily mean that it's going to change your quality of life or enough cognition to actually matter for life's daily tasks or your work and so on. But I think there's enough of a signal there to say, all right, there's something going on with cognition, with creatine, so why not get that? If you're already trying to get jack of creatine, you could actually be getting some extra benefits for cognition, some extra benefits for bone. There's some evidence in neuro, neurodegenerative diseases that's coming out slowly. There's some evidence in concussion. So it seems like when you get a concussion acutely, the energy metabolism of the brain is messed up to the point where you're not metabolizing glucose as well in the brain. So having creatine around or other substrates that aren't glucose could actually save the brain from degenerating due to the concussion. More evidence is needed for that in humans, but there's some promising mouse and ferret data on that. So there's a ton of evidence that's going to come out slowly in other areas. I know there's some evidence in pregnancy that there's some benefits to the fetus and the mother. So definitely not our area of expertise. But we just want to point that out because it is a new frontier where there seems to be benefits outside of muscle that could be real and, and why not know about them when you're already taking them to get jacked?

Cool. Yeah. So it's a really cool side effect. Like it's really like getting jacked and strong is, is great and all. And it's cool that this other stuff that we don't care about like Parkinson's and, and pregnancy and cognitive shit is also maybe getting a benefit from, you know, creatine is okay. So we kind of have touched on this already. Vegans, vegetarians, omnivores, carnivores. Do you think there's any differences there between the benefits you see there? So, like, I know we talked about how Creatine stores in the muscle are probably lower for individuals on like a vegetarian or vegan diet as opposed to like an omnivorous diet. But does that mean that like omnivores. Well we definitely know this about omnivores. We definitely can still benefit from taking creatine. But like carnivores for instance, cuz that's like a really popular diet these days. It's just exclus exclusively coming from especially red meat is really popular. Which red meat for those of you don't know, has a pretty high concentration of creatine already in it. Which makes sense, right? We're eating muscles and we mostly store creatine in our muscles. Right. Does that. But basically does that mean that carnivores can skip creatine supplementation? I mean is there any reason for carnivores to be taking creatine?

Yeah, so as mentioned for vegans and omnivores there's definitely a benefit and probably a stepwise benefit because obviously one is getting no creatine, one is getting some. So let's quantify these numbers a little bit. For red meat, 1 kg. So 2.2 pounds has about 4 and change grams of creatine last time I looked. So if you're eating over two pounds of red meat then you probably are good. You know, you, you don't need to supplement with creatine. So carnivores might actually get away with not supplementing creatine and be totally fine with that being said, you know, it's a cheap supplement. And then if they want to make sure that they're topping out their stores on days that they're not eating that much red meat, cuz they, they could be eating fish and chicken which have lower amounts of creatine. So I'd say all of them probably benefit. Carnivores least likely to benefit and may just want to, you know, have creatine around just on days where they're not eating as much red meat or take like 2 grams a day or something like that. But yeah, there's probably a step wise where carnivores maybe they'll benefit, but probably not. Omnivores and vegans definitely benefit because I don't know very many people who are just slamming more than two pounds of beef every day.

Yeah, it's also, I know it's pretty, it's pretty common in fatty fishes as well. It's found in pretty high concentration in fatty fishes. So maybe our pescatarian friends who are eating a tremendous amount of salmon throughout the day are probably chilling as well. But I do know that, or at least I've, I've. I've heard that cooking meat can actually have an effect on the creatine in that, in the, in the, the creatine source of that meat. So even if carnivores are eating like two pounds of, of of red meat a day, it's possible that that's still not getting them all the four to five grams, the four and change grams of creatine. So even then, unless you're eating that beef raw, unless I'm just misunderstanding the denaturing of creatine from cooking, it's probably even still not a bad idea to supplement with it.

Yeah, I'm not sure about that. I have to, I'd have to look at that. But yeah, it's probably not a bad idea, that's for sure. There are some carnivores that just eat it raw. So I think you're mischaracterizing that community, which is, you know, a bit insensitive of me.

Yeah, sorry. My, my dearest apologies to Liver King and all of his followers. It was really rude of me to say something like that. Okay, so basically it sounds like there's not really a population that shouldn't be taking creatine because, like, even carnivores may stand to benef. Benefit from it. So that with that being said, like, are there any concerns with creatine? Like, is there a reason that someone maybe shouldn't be taking creatine? But aside from like, having the naturalistic fallacy, like, like being a big part of their identity, like, is there, is there some reason why an individual should pause before taking creatine outside of obvious, like you're, you have liver or kidney issues, that you should consult your doctor first.

Yeah, I don't think that there is one. Although I can think of some niche scenarios where it might make sense to either cycle off of creatine or not start taking creatine. So weight class, sports, so powerlifting, some bodybuilding, unless if they're open class. No, but anything where you have to be a certain weight, maybe even gymnasts, they'd probably benefit from being on creatine while they're training. But then for competition, they can cycle off of creatine, get to that lower body weight while holding onto that muscle tissue, and then be able to perform at a lower weight class while hopefully retaining all of the strength necessary to do that one. Rm. But then it gets a little bit more complicated in things that require you to flex for a really long time. So I think about this and I don't really have a good answer. If you cycle off of creatine to make a weight class for bodybuilding, but you need to flex on stage for really long periods of time, which one's giving you more benefit? That's a decision that the person's gonna have to make on an individual basis and see and experiment and find out what works best for them. I'd say that's probably not the majority of our audience. So.

Competitive bodybuilders? Yeah. Unlikely. Yeah. I also, there's. There's something to be said about, like, if you're a bodybuilder and you're. And you're trying to make weight, you. You might fall into this ideology that stopping creatine is going to lead to a drier look, right? Because you are decreasing water content. But the caveat to that is that you might be losing water content where you kind of want water content for bodybuilding, which is to say that that water that you're losing is not subcutaneous. It's coming from the muscle itself, which is like the shit that makes you look full and dope on stage. So that's another thing. It's something that you'd have to experiment with yourself, but it's definitely something to consider if you're thinking about doing that. So essentially, though, Jenny Bo, outside of some pretty, like you said, niche circumstances, there's really not a huge downside or maybe even any downside to taking creatine at all. And there's. It's seemingly only all of the benefits that we've been talking about for the last hour. So I personally don't see a reason why almost any population outside of very specific population shouldn't be taking creatine. Agree? Disagree.

Definitely agree. Yeah.

Cool. All right, let's tie all this together and get these people out of here. Right. So basically, what is creatine? It's just an. It's a naturally occurring protein conglomerate. Right. I don't know what, what would you call. It's not a protein? Tell me. Come on, my physiology friend.

I would just call it a compound. I think you can get more technical into, into what it. What it is from a chemical structure, but it's definitely not a protein because the way it's put together the amino acids and how many amino acids and so on is not protein, like, but I would call it a compound. So continue from correctly using the term compound and then we can inform our listeners without any sort of misconceptions.

Yeah. This, this quick little bow tie for our summary didn't work out as I thought it was going to. Yeah.

So it's obviously cut.

We can use that protein like compound, so.

Protein? No, no, no, don't say that.

Protein like compound. Nitrogen containing protein like compound that contains amino acids not held together by polypeptide bonds. So it's not technically a protein. Okay. All right. Seems to have a lot of benefits in the body. It's already produced in the body by the liver and kidneys and stored in the muscles. But it's probably a good idea to supplement with creatine to help fill out those stores. Right. You don't want a 75% full cup. Right. Loading creatine is probably a good idea if you're, if you're client or you yourself can handle it. It doesn't give you any GI distress. You're probably fine taking anywhere from 3 to 5 grams a day, but a relative dose of 0.1 gram per kilogram a day is certainly not gonna hurt. You stick with monohydrate in its powder form. You're chilling. Don't worry about the time of day you take it. As long as it's a time that is, you can take consistently. And it's not gonna. You're not gonna forget when to take it. Right. It's not a drug. It's not gonna hurt you. It's not gonna cause hair loss. It's going to give you only probably some pretty substantial but small benefits to strengthen hypertrophy. And there's a bunch of other benefits to it as well that we're not super, super confident on. But at the very least, we can say we have preliminary data saying that there is benefit to like, bone health and other cognitive things as well, and seemingly no side effects. So creatine is definitely worth taking for almost all populations. And yeah, I think that's a pretty good summary for creatine, I think. Danny Boy, thank you so much for walking us through this. I think that's a really good explanation of what it is and how it should be used. You got anything else you'd like to add before we close it out?

Good man. They need to hire you for those, like, quick speaking type commercials. Okay. Thank you so much for listening.

Yeah. And if there's another topic you guys want covered by Danny Boy and myself, then make sure to comment below. And thank you guys so much for tuning in.

So.