#100 The Optimal Creatine Protocol for Strength, Brain, and Longevity | Darren Candow, PhD
Dr. Darren Candow, a leading creatine researcher, discusses creatine's broad benefits beyond muscle, including cognitive function, bone health, recovery, and mental health. He covers optimal dosing strategies, different forms, and debunks common myths.
Deep Dive Analysis
17 Topic Outline
Creatine's Fundamental Role in Exercise Performance and ATP
Creatine's Impact on Muscle Strength, Power, and Recovery
Creatine's Anti-Catabolic Effects and Sex Differences
Natural Creatine Production, Dietary Sources, and Supplementation Needs
Creatine Dosing Strategies: Loading, Maintenance, and Higher Doses
Creatine's Role in Bone Health and Osteoporosis Prevention
Creatine's Cognitive Benefits for Stressed and Aging Brains
Creatine for Traumatic Brain Injury, Concussion, and Sleep Deprivation
Creatine's Potential for Depression and Neurodegenerative Diseases
Creatine's Benefits for Vascular and Cardiometabolic Health
Creatine for Injury, Surgical Recovery, and Sedentary Individuals
Creatine Safety and Benefits Across the Lifespan: Children and Pregnancy
Creatine Monohydrate: The Gold Standard and Managing GI Issues
Creatine Timing, Cycling, and Interaction with Caffeine
Debunking Common Creatine Myths: Fat Gain, Cramps, Kidney Damage, Baldness
Creatine's Impact on Homocysteine and Pairing with Protein
How to Choose a High-Quality Creatine Supplement
6 Key Concepts
Phosphocreatine
Phosphocreatine is a molecule that helps maintain adenosine triphosphate (ATP) levels during exercise. By increasing phosphocreatine stores through creatine supplementation, the body can sustain higher intensity exercise for longer, delaying the reliance on slower energy systems.
Type 2 Muscle Fibers
These are fast-twitch muscle fibers responsible for explosive power and strength, which are unfortunately lost as we age. Creatine supplementation specifically enhances the recruitment and ability of these fibers, leading to improved performance, especially in later sets of resistance training.
Sarcoplasmic Reticulum
This is a specialized endoplasmic reticulum in muscle cells that stores and releases calcium, crucial for muscle contraction. Creatine speeds up the uptake of calcium into the sarcoplasmic reticulum, which can improve muscle relaxation time and the overall ability of muscle proteins to contract.
Anti-catabolic Effects
Creatine exhibits anti-catabolic properties, meaning it helps reduce the breakdown of tissues. This includes decreasing protein breakdown in muscles (e.g., leucine oxidation) and inhibiting osteoclast activity, which is responsible for bone resorption, thereby preserving bone density.
Blood-Brain Barrier Resistance
The brain has a protective blood-brain barrier that is highly resistant to creatine uptake from the bloodstream. Specific glial cells called astrocytes, which filter substances into neurons, lack creatine transporters, making it challenging for supplemental creatine to significantly increase brain creatine stores without higher doses or longer duration.
Creatinine
Creatinine is a non-enzymatically metabolized byproduct of creatine and phosphocreatine, which is filtered and excreted by the kidneys. Elevated blood creatinine levels due to creatine supplementation can be misinterpreted as kidney dysfunction, leading to a false positive for impaired kidney filtration rate.
9 Questions Answered
Creatine increases the ability to produce and maintain ATP during exercise, delaying the use of slower energy systems. It primarily enhances muscle strength, endurance, and power by maximizing the recruitment of Type 2 muscle fibers and speeding up calcium uptake for muscle contraction.
While the body produces 1-2 grams of creatine daily and it's found in animal foods, supplementation is considered conditionally essential. Vegans, in particular, benefit greatly as they get no dietary creatine, and older adults may also need more due to reduced natural stores.
A standard dose of 5 grams per day will saturate muscle stores in about 21 days without a loading phase. A loading phase rapidly saturates muscles but can cause water retention. Higher doses (e.g., 10 grams/day) may be beneficial for bone and brain health over time.
Yes, creatine has anti-catabolic effects on bone, reducing bone mineral density loss, especially around the hip, and may increase osteoblast activity. For the brain, it can improve cognition, memory, and recovery, particularly when the brain is metabolically stressed (e.g., sleep deprivation, aging, TBI).
Creatine monohydrate can cause temporary water retention and mild GI irritation, especially with high doses or without food. It does not cause kidney damage; elevated creatinine levels are a normal metabolic byproduct. It also does not increase body fat or cause baldness, and it can actually help with muscle hydration.
Creatine monohydrate is the gold standard due to its proven safety and efficacy. Other forms have not shown superior benefits. Timing is generally irrelevant, but taking it in close proximity to exercise (before or after) may enhance muscle uptake due to increased blood flow.
High doses of caffeine (over 250 mg) may blunt creatine's cellular effects by opposing its role in calcium dynamics within muscle cells. It's recommended to separate intake by at least two hours if consuming high caffeine.
Research suggests creatine is safe for children, improving health, agility, coordination, and muscle mass without adverse effects. While more large-scale human trials are needed for pregnancy, current evidence suggests no issues, and it may support fetal development, especially in vegans.
To avoid GI irritation, micro-dose creatine (e.g., 2.5 grams twice a day) and take it with food, especially with carbohydrates. This helps increase absorption and reduces rapid passage through the GI tract.
34 Actionable Insights
1. Daily Creatine for Broader Health
Take creatine daily, even on rest days, to ensure continuous saturation of muscle stores and to maximize potential uptake into bone and brain tissues for broader health benefits.
2. Creatine Dosing for Brain & Body
Consider taking at least 10 grams of creatine daily, as studies suggest this dose can significantly increase brain creatine content and benefit muscle and bone.
3. Inform Doctor About Creatine
Always inform your doctor if you are taking creatine supplements, as it can elevate blood creatinine levels, which might otherwise be misinterpreted as kidney dysfunction.
4. Use Creatine Monohydrate (Creapure)
Prioritize creatine monohydrate, specifically ‘Creapure’ from Germany, as it is the gold standard due to extensive research, high purity, and GRAS status.
5. Combine Creatine with Weight Training
For optimal bone health, prioritize weight training, plyometrics, or any weight-bearing exercise, and then consider adding creatine supplementation to your regimen.
6. Creatine Supplementation for Vegans
Vegans, who get almost no dietary creatine, should strongly consider supplementation with third-party tested, vegan-based creatine to ensure adequate intake.
7. Take Creatine with Food (GI Relief)
To prevent GI tract irritation, always take creatine with food, as this can improve absorption and reduce rapid passage through the digestive system.
8. Separate Creatine and High-Dose Caffeine
Avoid combining creatine with high doses of caffeine (over 250mg) due to potential cellular interference; if consuming both, separate intake by at least two hours.
9. Daily Creatine for Contact Sports
Individuals participating in contact sports should take creatine daily as a preventative measure, as pre-existing creatine stores can accelerate recovery from concussions.
10. Creatine Dosing for Children
For children, a creatine dose of 2-3 grams per day or 0.1 grams per kilogram of body weight is considered viable to support development.
11. Increase Creatine for Acute Stress
During periods of metabolic stress, sleep deprivation, or jet lag, consider acutely increasing your creatine intake to 20 grams per day to help offset inflammation and cognitive decline.
12. Choose Third-Party Tested Creatine
When choosing creatine supplements, always opt for third-party tested products to ensure purity, safety, and efficacy.
13. Combine Creatine with Protein
Combine creatine with protein (e.g., whey protein) for a potentially superior effect on muscle performance and lean body mass, especially in post-exercise meals.
14. Creatine for Females (No Loading)
Females should consider creatine supplementation, starting with 2-3 grams daily without a loading phase, to avoid water retention concerns while still gaining benefits from exercise.
15. Creatine Loading for Brain Health
To potentially improve brain creatine stores and cognitive function, especially under stress, consider a loading phase of 20 grams of creatine per day for at least a week.
16. Standard Creatine Dosing
Consider supplementing with 3 to 5 grams of creatine per day as a standard recommendation for muscle benefits.
17. Daily Creatine (No Loading)
You can take 2 to 3 grams of creatine daily without a loading phase, which will saturate muscles in about 30 days, avoiding rapid water retention or GI issues.
18. Gradual Creatine Dose Increase
Gradually increase your creatine dose over time, starting with 3 grams (1.5g morning/evening), then to 5 grams (2.5g morning/evening), and eventually to 9 grams (3g three times a day) to build tolerance.
19. Creatine Timing Around Exercise
While timing isn’t critical, consider taking creatine within an hour before or immediately after exercise to potentially maximize uptake due to increased blood flow and muscle contraction.
20. Split Dosing for Less Water Retention
To minimize water retention, split your daily creatine dose (e.g., 3 grams total) into smaller, separate doses throughout the day (e.g., 1.5 grams in the morning and 1.5 grams in the evening).
21. Creatine for Muscle Hydration
Creatine can help superhydrate muscles, potentially decreasing the chance of muscle cramping or dehydration, especially during intense exercise or in hot weather.
22. Mix Creatine with Food (Practical)
Mix tasteless creatine powder directly into food, such as yogurt or a meal, for easy consumption and to potentially improve absorption.
23. Avoid Multi-Ingredient Creatine Blends
For reliable creatine effects, choose pure creatine monohydrate rather than multi-ingredient blends (e.g., pre-workouts) where the efficacy of creatine may be diluted or untested.
24. Creatine Saturation Time (5g/day)
Expect it to take approximately 21 days to fully saturate your skeletal muscles when taking 5 grams of creatine per day.
25. Heat Does Not Degrade Creatine
Do not be concerned about heat degrading creatine when mixing it into hot liquids like coffee or tea, as the caffeine molecule is the more likely source of potential interference.
26. Creatine Dosing by Body Weight
Consider a relative creatine dose of 0.1 to 0.14 grams per kilogram of body weight daily (e.g., 7-9 grams for a 70kg person) to potentially benefit the whole body.
27. Minimum Creatine Dose (Microdosing)
When microdosing creatine, ensure each dose is no less than one gram, as smaller amounts may not enter the blood rapidly enough.
28. Creatine Benefits Without Exercise
Even without exercise, creatine supplementation can still accumulate in muscles and provide benefits, though at a slower rate than with exercise.
29. Creatine Dosing for Multiple Workouts
If you work out twice a day, consider taking creatine twice a day, ideally in close proximity to each exercise session.
30. Long-Term Creatine for Bone
While 8 grams is the lowest effective dose shown for bone, 5 grams of creatine taken consistently over a long period may still provide benefits for skeletal health.
31. Creatine Not a Drug Replacement
Understand that creatine supplementation, even with weight training, will not replace pharmaceutical interventions like bisphosphonates for severe bone conditions like osteoporosis.
32. Research Creatine Brands
Do your homework on creatine brands, ensuring they are certified safe, third-party tested, and ideally pharmaceutical grade, to avoid questionable products.
33. Low-Dose Caffeine with Creatine
Low doses of caffeine (under 250mg, like a normal cup of coffee) are unlikely to interfere with creatine’s effects, but consistent daily combination with very high doses might blunt benefits.
34. Potential Creatine for Pregnancy
While more research is needed, experts suggest creatine may have potential benefits during pregnancy for fetal development and maternal brain bioenergetics, especially for vegan mothers.
7 Key Quotes
If you were to choose one thing why creatine has been so effective, it's improving muscle strength.
Dr. Darren Candow
The more stressed the body is, it seems to come to the rescue more.
Dr. Darren Candow
The brain is very resistant... it says, you know what? Circulation, we don't need creatine in the blood. We're making our own.
Dr. Darren Candow
If it doesn't do that, it's probably not creatine.
Dr. Darren Candow
I argue, including the fetus, why someone couldn't take creatine if we're already producing it. It's not like caffeine, a drug effect.
Dr. Darren Candow
Creatine monohydrate's bioavailability is near 100%. ... How can you get more than 100%?
Dr. Darren Candow
Make sure if you're on creatine supplementation, tell your doctor because it's logical that your creatinine in the blood will be elevated. That's just from the metabolism of the supplement.
Dr. Darren Candow
2 Protocols
Rapid Muscle Saturation (Loading Phase)
Dr. Darren Candow- Take 20 grams of creatine monohydrate per day.
- Continue for 2 to 7 days.
- Follow with a maintenance phase of 2-3 grams per day.
Managing Creatine GI Irritation
Dr. Darren Candow- Start with a lower daily dose, such as 3 grams.
- Divide the daily dose into smaller, more frequent servings (e.g., 1.5 grams in the morning and 1.5 grams in the evening).
- Take creatine with food, especially with carbohydrates, to increase absorption and reduce rapid GI transit.
- Gradually increase the dose as tolerated.