Dr. Wood’s Favorite Supplement (Better Brain Fitness podcast)


Welcome to Better Brain Fitness, hosted by doctors Josh Turknett and Tommy Wood. In this podcast, we will explore the frontiers of how to keep our brain fit and healthy so that we can perform at our best and do the things we love for as long as possible. Let’s go.

Welcome to another episode of Better Brain Fitness. I’m once again joined today by my co-host, Dr. Tommy Wood. Hello, Dr. Wood. Hello. So, today’s episode we have a question that Tommy will be fielding. As we mentioned in the prior episodes , that’s the format for these podcasts.

So if you yourself have a question you would love for us to answer, please feel free to submit it to us. You can click the link in the show description or go to brainjo.academy/questions.

All right, our question from today comes from Josh at Brainjo, who says [00:01:00] so I’ve heard a lot about creatine for body building and muscle fitness.

Is there any evidence for brain benefits? That’s a good question. Tommy, what do you, what do you think about creatine?

It is a great question, and I will say that creatine as creatine monohydrate is probably my single favorite supplement for the brain. And it’s . Probably the best studied supplement of all the supplements that exist.

You know, probably hundreds of studies at this point. And, our question writer is correct in that it has a long and storied history as part of body building and strength sports, and that’s because of how creatine works. So we’ll, kind of give a little biochemistry.

People may have heard of something called ATP, [00:02:00] adenine triphosphate. That’s like the main energy currency in our cells, and it’s regenerated generally in the mitochondria. And although it can be done in other ways. And when we do anything, any task that requires energy in a cell, in general, the way that we power that is by moving around what we call high energy phosphates, of which ATP is one.

And so we take a phosphate off, atp, tri phosphate, we take one, and by doing that we release energy and that goes into whatever process is being done. In order to recycle atp, right, we’ve used it up, and we want to, you know, recycle. One of the ways that we do that in the short term, so particularly for immediate use, we don’t have time to let the mitochondria do it, which requires oxygen and other things.

We have like a buffer system, which is the phospho creatine system. So we have a creatine molecule and creatine is made up of three amino acids,[00:03:00] glycine, arginine. They come together and make creatine and it’s sort of dependent on the methylation system. People may have heard of methylation, that’s really important. This is actually one of the most methylation intensive processes in the body, is making creatine.

And so creatine is phosphorylated we call it. So it has this high energy phosphate on it, and then we use that to replenish atp. And this is really important again for like immediate energy.

So we think about the phosphor creatine system for like sprinting, right? That’s our like immediately available energy. And we take the phosphates off creatine and we put them on ATP so we can regenerate it. So it mainly acts as this energy buffer, but it’s also implicated in a whole bunch of other interesting things, like particularly mitochondrial function – so how well your mitochondria work, either long term or after an injury.

And so creatine has been tested in a whole bunch of different animal models, and has been tested in some clinical trials looking at [00:04:00] it as a neuroprotective agent. And regardless of the brain injury, it seems that creatine, if you have it on board beforehand, is really protective.

So if, we think about creatine as a sports supplement, because it helps buffer this immediate energy requirement, if you’re doing heavy weights for a low number of reps, things that require a lot of strength, then creatine sort of can give you an extra repetition or two, because you have this sort of short term energy.

Now when we think about the brain, over time there’s been a number of really interesting studies that have shown how critical creatine can be to cognitive function in other aspects of brain health.

So probably one of the most interesting ones is creatine’s effect on mood. So, if we look at how much creatine people are eating, and this is what we call nutritional epidemiology and it’s fraught with a whole [00:05:00] bunch of problems because people don’t really tell you when you ask them what they eat, they don’t really tell you what they actually eat. But it seems that sort of at a, at a, a societal level, those who consume more creatine in the diet, they have overall a lower likelihood of depression, or better mood.

And creatine can come from the diet. So it’s particularly in muscle tissue, and it particularly comes from animal products. So meat and fish. Fish in particular are actually the best source of creatine. So salmon has nearly one gram for every hundred grams of salmon. So salmon is nearly 1% creatine.

And then smaller fish, things like sardines, herring, it’s even higher. It’s maybe four or five grams per hundred grams. You maybe lose a little bit of that in the cooking, but you’ll still get most of it there. So those who are eating a lot of sea seafood are probably getting a reasonable amount of creatine in their diets.

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Then when you turn to sort of stronger quality evidence, there were two randomized control trials where they took individuals who had depression and they put them on some kind of antidepressant, like a ssri. And they found that in those who didn’t respond, if they then added creatine on versus a placebo, creatine significantly improved depression symptoms.

So randomized controlled trial data, suggesting that this is, sort of powerful in terms of mood. Then, we also [00:07:00] know, and this is probably most interesting to our listeners here that creatine significantly improves memory. And there was a recent metaanalysis that just came out last year where they looked at 10 randomized controlled trials, and they found that creatine significantly improved particularly memory. That’s what was tested in most of those studies. And if you look at, say, mouse data, if you give them creatine, it seems to improve mitochondrial function, particularly in the hippocampus, which we know is directly related to memory.

So, especially memory seems to be improved by creatine, and there are two different ways that you can supplement with it, you can either take a higher dose for a short period of time. So 20 grams a day is very common for a week. That’s what people might call a loading dose. However, you don’t need to take a loading dose.

You can just take a lower dose, something like five grams per day. And then in studies, if they take a lower dose, they just give it for a little bit longer, like six weeks. And then you can see a significant effect. In the meta-analysis, they [00:08:00] particularly showed that those who are older saw more benefit from creatine.

And this could be because, maybe in those who are older, there’s already some decline in function, so there’s more to recover. But equally, I think as people get older, they often tend to eat less. We know that it’s people may be consuming less protein, less animal products, so they may be eating less creatine as well.

And there are other randomized controlled trials that show that the benefit of creatine may be greater in those who have less creatine in diet, particularly vegetarians or those who are fully plant-based. So that may be a group where this is particularly important.

Other things that I like about creatine is that it can improve other aspects of cognitive function. So, one nice study they did in athletes, they looked at athletes who are forced to have a normal amount of sleep, or were sleep deprived. And in those who were sleep deprived the next morning, if they took a normal dose of creatine, five grams, they showed a significant retention [00:09:00] of this was a skill-based sport, so it acutely improved skills after sleep deprivation in a similar manner to caffeine.

And so we know that as we get older, there are these multiple things to sort of stack up in terms of cognitive function and brain health and that increase our risk of cognitive decline, and that is problems with sleep, problems with mood, and then we have, you know, the actual problem itself, problems with memory and creatine helps with all of those.

And then sort of the, I guess the, the final part is, I talked right at the beginning about multiple different types of brain injury that seems to be protected by creatine and one contributor to cognitive decline is acute brain injuries. And these could be early in life, concussions, traumatic brain injuries, and they happen anytime either a sport or falls as you get older.

And we know that creatine is significantly neuroprotective in studies of acute traumatic brain injuries. And then also strokes. And those can be big [00:10:00] ischemic strokes, but they could also be small, you know, micro strokes, which contribute to something called vascular dementia. So as you get older, there’s an increasing likelihood that some other thing will happen to your brain and we have a pretty good idea that having more creatine on board is gonna protect against that as well, and you’ll recover better and and maintain more function afterwards.

So, for all of those reasons, I think everybody with a brain should take creatine. The dose, like I said, probably most people, something like five gram, three to five grams a day, if you buy creatine, monohydrate, it should come in the form of something called CreaPure. You’ll be able to see that on the side.

It’s made by one company in Germany and it’s what we call white labeled. So one company makes it and then everybody puts their label on it. And it’s exactly the same thing. If it’s not Crea pure, it probably comes from some unregulated factory somewhere else in the world that I would, I would not take that.

But Crea Pure is the sign that you want. And that’s what, that’s what most people will sell. It’ll come with a scoop and you just take [00:11:00] one scoop a day. Those who are eating a lot of meat and fish. So say you eat a tin of sardines every day, you’re probably getting almost all of that dose.

However, it’s a super low risk supplement. So, even though I eat quite a lot of meat and fish, I still take five grams every day. And they’ve done studies in Parkinson’s Disease where they did a loading dose and then they gave a maintenance dose. I think in that study they gave four grams per day for two years.

They saw no negative side effects. It’s incredibly safe. The two things maybe that you need to think about. When you first take creatine, it can sort of go into your cells and take a little bit of water with it. So make sure you’re drinking, you’re well hydrated, particularly as you start to take it, especially if you’re taking a loading dose.

And then another thing is that it can increase the level of creatinine, which some people . Use as a marker of kidney function in the blood. So just be warn that if you’re getting blood tests done by your doctor and they’re looking at that marker, it may increase. It’s not because your kidneys are failing.

And that’s what people have [00:12:00] said previously, that’s just not true. It’s because, creatine, when it’s recycled, it occasionally releases or it turns into this compound called creatinine, which you then pee out. So it’s just the process of you metabolizing the creatine, but other than that, incredibly safe.

Probably recommend it to almost everybody for all of those reasons that I listed. I think that’s everything. Any follow up questions our quesionter? Well, I’m gonna guess that Josh has a few follow up questions, so I’ll speak for him.

But that was great. So, one question that you’ve kind of touched on this already, is there an upper limit? Can you overdo it?

I don’t think so. Certainly there were, at this point, no safety concerns. So say if you took 30 grams a day for a very long period of time, there’s certainly no need to do that , I think it’s unlikely that there are significant downsides because that kind of dose is even 30 grams a day, which is much more than most people would need for more than a week if they were trying to do this, this loading dose, and a loading dose of that amount [00:13:00] can significantly increase brain creatine within a week that, that study’s been done, as well.

So say you’re gonna take 30 grams day, that’s the equivalent of eating three or four cans of sardines a day, maybe, right? That’s a lot of seafood, but it’s, it doesn’t, if you think about it in terms of sardines, it doesn’t seem particularly excessive. So I think the likelihood of downside, even at those very high doses for long periods of time, but just not needed, right?

People used to think you would have to do this big loading dose and then a maintenance dose, but almost all the studies suggest that just taking a lower dose for a longer period of time. Another question that used to come up because creatine was in the body building world, and in the body building world, a lot of the supplements you take are supplements that you have to cycle, particularly because they’re hormone related. You don’t have to do that with creatine.

Yeah, I would, I would imagine since it kind of first gained traction in the body building community, I would imagine people tested much higher doses, and as far as I know, there aren’t like major reports of toxicity from it.

I think there have [00:14:00] been in those who do the kind of exercise that maybe makes them dehydrated, there are certainly some kind of niche case reports of athletes who have pushed themselves way beyond the limit of their tolerance, been very dehydrated, plus taking large doses of creatine.

There’s a possibility that that may exacerbate the risk because it’s sort of making the effect of dehydration worse. But I mean, I don’t think anybody listening to this is gonna be anywhere near that. Right. That, that kind of scenario. Right. And yeah, the only thing I’ve personally ever noticed is the hydration thing.

Yeah. The need for a little bit more of when you’re starting it. Yeah, I, I remember, so the first time I ever used it was years ago. And I remember like when I first noticed it kicking in, and I was doing pull-ups and it felt like magic. One day I could do whatever, you know, six, and then I just grabbed the bar and I was like, what is going on? It is like this extra reservoir. But more recently as I’ve used it, I [00:15:00] noticed an impact on sort of just my overall energy levels. Do you notice that as well? I can notice that if I stop taking it for a little bit, I’ll notice that. And then when it kind of kicks in, I can say I just feel like my reservoir for just what I want to do day to day is, is bigger.

And that may be partly cognitive too, where you’re less cognitively drained after, just in the same way that you’re less drained after five reps of pullups or whatever, than you would be, you’re kind of less, less drained from writing or any other cognitive activity. Anyways, that’s my kind of take on it.

I expect that to, to be the case. All of those things, regardless of which tissue you’re using, they’re finite resources.

Right. There aren’t many times when I’m not . Taking it, so I don’t often notice the difference. One other thing that I was gonna say, people may ask like, when, when should I take it?

It depends on when people like to take their supplements. I generally take mine in the morning or before bed, depending on what it is.

The other option is to see if you are doing workouts, you might wanna take it after your workout. There’s a small amount of [00:16:00] evidence that says that if you’re gonna take creatine for like performance, physical, performance enhancement, it’s slightly better to take it after exercise.

Again, that effect is quite small. I personally take it in the morning, cause if I take it, I tend to exercise later in the afternoon. If I take it close to bed, I feel more energized when I’m trying to go to sleep. So I, I take it first thing in the morning.

And does it matter if you have an empty stomach, full stomach?

Again, there seems to be some link between like creatine uptake and insulin signaling. So again, like a small amount of evidence that may be better to take it with a meal. But I don’t, and again, the timing thing and, and what you take it with, I think the overall effect of that is, is minimal.

The important thing is to just take it for long enough relative to the dose that you’re taking in order to see a benefit.

Well, we have the two extremes. I usually take mine after I finish my breakfast, and it seems to work fine. So, yeah, either way I think is good.

I think the the main thing for me personally is remembering to take things right? And so how, however [00:17:00] you structure that into your day is probably the most important thing.

Well, that’s great. Even though we don’t like promoting Silver Bullets, it’s as close to one as we have right? Maybe relative to some of the other things, you’re not gonna improve a whole bunch of stuff unless you are stimulating the tissue, right?

We’ve talked so much about cognitive demand, you’re not . Sleeping, all this other kind of stuff. But, in terms of things that. Can have very low risk with a number of benefits, this is certainly something I’d have on my list.

And I think even in the way you’ve described how it works, it’s really in many ways amplifying those other things we’re already doing.

Yeah. You know what I mean? It’s serving as kind of a booster to all the other stuff we’re already doing. So you want, you want to have both as we’ve talked about a lot, and I think this is a really good example of that.

Okay. Well thanks again . Josh for that question. Again, if you guys have questions out there, we’d love to hear from you.

And you can click the link in the show notes or go to [00:18:00] brainjo.academy/questions. All right, that’s it for this episode. Thanks, Tommy. Thanks everybody. Bye-bye bye.

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