CREATINE FOR MUSCLE HEALTH
AND WEIGHT LOSS
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Episode 257:
Show Notes
In this episode of The Real Health and Weight Loss Podcast, Dr Mary Barson and Dr Lucy Burns, both doctors and metabolic health experts, focus on creatine supplementation. They explain why creatine stands out from most other supplements, highlighting its strong evidence base, affordability, and low risk. The discussion covers what creatine is, how it works in the body, who might benefit from it, and practical advice for safe and effective use.
What is Creatine:
- Creatine is a compound produced naturally in the liver, kidneys, and pancreas from three amino acids (arginine, glycine, methionine). Most creatine is stored in skeletal muscle as creatine phosphate, serving as a rapid energy reserve. Smaller amounts are found in the brain, heart, and other tissues.
Dietary Sources:
- Creatine is present in animal-based foods such as steak, chicken, and dairy. People following vegetarian or plant-based diets may have lower creatine levels, making supplementation more relevant for them.
Role in the Body:
- Creatine is essential for regenerating ATP, the main energy carrier for cells, especially in muscles. Supplementation supports muscle health, particularly when combined with resistance or strength training. It may also provide cognitive benefits, such as improved short-term memory and mental clarity, though more research is needed for long-term effects.
Who Benefits Most:
- Creatine supplementation can be especially helpful for people with muscle disorders like muscular dystrophy, as well as for the general population engaged in strength training. Women may experience greater benefits than men, possibly due to lower baseline creatine levels or dietary differences.
Supplement Quality and Dosage:
- Creatine supplements are synthetically produced—there is no such thing as "organic" creatine. The best choice is plain creatine without added caffeine, sugars, sweeteners, or unnecessary vitamins. The recommended dose is about 3 grams per day, which is sufficient for most people.
Side Effects and Safety:
- Side effects are rare and mild, such as gastrointestinal discomfort or bloating. Weight gain may occur but is due to increased muscle mass and water retention, not fat gain. Myths about kidney harm are unfounded when creatine is used at recommended doses.
Evidence-Based Advice:
- The hosts urge listeners to be cautious of marketing claims and stress the importance of evidence-based use. Creatine earns their "tick of approval" when used as directed and in combination with exercise, especially for women and those on plant-based diets.
Conclusion:
- Creatine is a well-researched, low-risk supplement that can support muscle and possibly brain health when combined with strength training. Always use plain creatine and consult a healthcare professional for personalised advice
Episode 257:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:12) And this is the Real Health and Weight Loss podcast!
Dr Mary Barson (0:21) Hello, lovely listener, and welcome to this fabulous podcast. Dr Mary here, and I am joined by my gorgeous college, colleague, Dr Lucy. How are you, fabulous?
Dr Lucy Burns (00:35) I am fabulous and collegey and collegial. Collegial? Yeah, I'm all of those. Thank you so much for asking.
Dr Mary Barson (00:42) I love that we don't have to be perfect because that's an impossible idea. Apparently, even when you're doing simple things like introducing people.
Dr Lucy Burns (00:51) Yeah, like speaking.
Dr Mary Barson (00:53) Speaking. It's a bit of a problem for a podcaster, but look, I'll rally. And I think things will improve.
Dr Lucy Burns (01:00) Well, I think you're doing it. And again, you know, progress, not perfection.
Dr Mary Barson (01:05) Totally, totally.
Dr Lucy Burns (01:06) Yes. Good. Excellent. Well, I'm wondering if part of the tongue-tied is because you don't drink caffeine.
Dr Mary Barson (01:13) I don't drink caffeine. Caffeine doesn't like me. It doesn't matter how much I like caffeine. It doesn't like me. In June last year, I got a blood patch to treat a CSF leak, and ever since then, I've been vulnerable to getting high pressure in my brain. Like, I'm good. I'm fine. If I drink coffee, I get blurred vision, a headache. I feel tired and I need to lie down, which is usually the exact opposite of the effect people want from coffee. So I can't blame not having a coffee on my inability to say colleague versus college today. But how about you, Lucy? How are you this morning?
Dr Lucy Burns (01:50) Yes, I'm awesome. Feeling great. Excellent. And speaking, not in tongues. I'm excited about today's topic because, you know, we dabble in supplements. Well, we've dabbled in supplement series. We've done lots of podcasts on popular supplements and tried to present, you know, pros and cons. And overall, most supplements haven't been given a tick of approval. Most of them seem to promise the world and deliver very little. Most of them seem to be expensive and with potential risk. But today, we seem to have a supplement that is probably a bit cheaper and seems to have a low risk. And in fact, you know, I've started taking it. So we dive into the world of creatine.
Dr Mary Barson (02:40) Yeah. And I think one of the nice things about creatine is that it's been around a long time. So we've got fairly long-term data about its safety risks and benefits. So I think it is, it's a good one to chat about.
Dr Lucy Burns (02:55) So I thought we'd, first of all, just so people know their words. Some people get mixed up with the word creatine and creatinine because they kind of sound a little bit the same. And in fact, there's only two letters difference, but creatine is a supplement. And then creatinine is something that we will measure in your blood as part of your renal function. So I like to just sort of use it.
Dr Mary Barson (03:20) That's right. So, and, and we'll talk about renal function and creatine in a bit, because there's a lot of, there's a bit of myths and, um, and misunderstandings about that. But yes, we are talking about creatine, not creatinine.
Dr Lucy Burns (03:33) Indeed. So let's start with, you know, what is creatine?
Dr Mary Barson (03:37) Creatine, it's a compound that we make. Our body makes it, and we synthesise it in our liver, in our kidneys, in our pancreas. We sort of get three different amino acid building blocks, and we mush them together, and we make creatine. And creatine is mostly stored in our muscle, our skeletal muscle, as creatine phosphate. And it acts as a wonderful quick energy reserve for our muscles. That's where most of our creatine that we make goes. We also have a little bit in our brain, heart, and other tissues. Creatine is also, is particularly helpful for our brain health as well. But mostly when we talk about the benefits of creatine, we are talking about the benefits to our muscles, which—our muscles are extremely important for our function and for our metabolic health.
Dr Lucy Burns (04:28) Yeah, absolutely. So, you know, as always, we always say, well, where do you get creatine from? So we can certainly get creatine from our food. And as you mentioned, it's stored in muscle. So in animal muscles—so, you know, steak and chicken, et cetera. And actually, I wasn't sure about cheese. I had to go look cheese up, but it is actually in milk, in dairy. So, you know, assuming your cheese is made from dairy, then it will have creatine in it. And I have to make that assumption because, you know, these days, cheese is made from things like cashews, but yeah. So I think that we need to recognise that you can certainly, you don't have to get it from a supplement. You certainly can get plenty in your diet, but there does seem to be evidence for supplementing, or as, you know, topping it up—which is really what a supplement should be. It should be a top-up, shouldn't it? Not a replacement. Not a replacement.
Dr Mary Barson (05:24) Compliment a whole food diet, not replace a whole food diet.
Dr Lucy Burns (00:29) Exactly. Exactly.
Dr Mary Barson (05:31) So we definitely get creatine from our food. If we're eating those delicious animal foods, there is evidence showing that creatine can be a bit lower in people who are on a vegetarian and plant-based diet. So that's something—something to be aware of. And it's really important. I mean, we do need it. Creatine has a really important job in helping regenerate the ATP, which is how our cells make energy. They're like the batteries that power every single cellular function. And it's really important. It's our primary energy carrier. And creatine has this really important role in energy production and energy storage for our muscles. And it's really good for our muscle health. So having a good amount of creatine on board is really helpful. And there's evidence that having extra—topping up with supplementation—can be useful for muscle health. And so we could talk about some of the potential benefits. We've talked about how it's made, how we make it ourselves, but we also get it from our food or from supplementation, where we store it, where we use it, and the potential benefits of creatine.
Dr Lucy Burns (06:49) Yeah. So, I mean, again, the thing, I guess, that sparked my interest is that there's some really good evidence that creatine may be helpful for muscular dystrophy. So, you know, hello, anyone with muscular dystrophy, put your hand up. Oh, actually, people with muscular dystrophy can't put their hands up. So luckily I can make a joke about that, having muscular dystrophy.
Dr Mary Barson (07:08) Yeah. It's totally okay.
Dr Lucy Burns (07:11) Yeah. But yeah. So for me, I went, oh, okay. Because the thing for me is that I actually can't do strength training. So it's like, well, you know, we bang on a lot about strength training, and for people that can't do it because you have a muscle disorder, it's a little bit like—so I thought, well, this is going to be helpful. But the benefits of supplementing with creatine, this is for people without muscular dystrophy. Again, it's like everything that we say: you can't, you know, you can't just take an antioxidant and that absolves you of all the oxidation. You can't just take creatine and suddenly you're going to build muscle. You actually still have to build the muscle. You still have to move the muscle. You still have to lift the weights. But by supplementing with creatine, it enhances that, and it potentially improves recovery, which I think is also really helpful.
Dr Mary Barson (08:08) Yes. And interestingly, the relative improvement with creatine seems to be better in women, looking at the studies, compared to men. And this might be because women have lower baseline creatine levels, and it might be that we're eating less meat. I'm not sure exactly why women tend to have lower creatine levels, but it benefits us a bit more than it benefits men, which is interesting.
Dr Lucy Burns (08:34) Yeah. Yeah, absolutely. I think the thing is, again, it's, you know, it's three little amino acids — arginine, glycine, methionine. They're made in a factory, so there is no organic creatine. It is a processed product. Like we're not going to pretend that you can buy, you know, organic grass-fed creatine. You can't. It's made by a chemical reaction that mushes these three amino acids together. So the things I guess that we would be looking for then in a supplement is making sure that that's all that's in it. Like you don't need to then get a supplement that's got a whole heap of other stuff in it that doesn't necessarily add to it. In fact, I was just looking that one of the benefits is around brain and cognition, and some people will use it as a little energy boost in the afternoon for their brain. So if you've got that sort of brain fatigue in the afternoon, some people will take their creatine then and, you know, anecdotally there's reports that it's helpful. But interestingly, there are supplements out there that pair it with caffeine, but there are studies showing that when you combine creatine with caffeine, it reduces the effect of the creatine.
Dr Mary Barson (09:51) Yeah. And caffeine's not my friend anyway, as we were previously discussing. So yes, I think, yep, you want to be careful what you mix it with. And also check that it doesn't have sugar or nasty sweeteners or, you know, extra B vitamins that you may not necessarily need, because we have mentioned this before — that B vitamin toxicity is a real thing and possibly under-recognised and relatively quite common. So you've got to be cautious and careful with your supplementation. We like to give it the same respect that we would give medications.
Dr Lucy Burns (10:25) Yeah, absolutely. And marketing is all around the, you know, it'll be marketed as like an energy something or other, and it'll have, you know, creatine and it'll have caffeine. It might have some sort of guarana something or other in it as well. And B, lots of Bs, you know, super boost and all of these weird things. And yeah, they're not necessarily harmless. So yeah, I agree with you Miss.
Dr Mary Barson (10:51) Just be cautious. Yeah. And you don't want to be having big spikes of caffeine in the afternoon, because that will affect your sleep as well. But there is evidence that creatine can be helpful for that cognitive function, that it can improve short-term memory, attention, mental clarity, and animal studies in particular looking that it may be helpful for neurodegenerative disorders. I think it's very much a watch this space — can’t make any broad sweeping statements about that yet, but it is interesting to look at. And I think we should keep looking at that.
Dr Lucy Burns (11:22) Yeah, absolutely. So one of the things that's helpful about creatine is it's freely available. You can buy it anywhere. You can buy it in the supermarket, given it's made in a factory. We don't need to worry necessarily about the quality because they're all the same. So you're just looking for straight-out, plain old-fashioned creatine with no bells and whistles. And you don't even need very much, like it's three grams a day. It comes in a tiny, tiny little scooper that you just sprinkle out. So, you know, there's not a lot of evidence for more than that in standard people. Again, sometimes studies are done on athletes and weightlifters and people training for the Olympics and all of that. But, you know, we're just talking, you know, your bog-standard person — three grams a day is enough, combined with some really good strength training, resistance training muscles, and essentially lifting weights.
Dr Mary Barson (12:24) Yes. Yep. Stress those muscles out and the creatine will help you get stronger. You're going to get stronger anyway if you stress those muscles out, but the creatine might be helpful if it's something you wanted to explore. It also has a flow-on effect to your bones. As you stress out your muscles and they get stronger, you're also stressing out your bones and they are getting stronger. I think we should talk about some of the potential risks of creatine. I'm pleased to say that it doesn't seem that there are many. Some people report gastrointestinal discomfort, and some people can get minor side effects like bloating or stomach pain. If that's happening to someone, they potentially could split the dose — just have smaller amounts twice a day rather than a bigger amount all at once. But like you said, it's not a big dose anyway, or it might just not be for everyone. I mean, not everybody can tolerate everything. Interestingly, when I first read this, I was like, what? I did a little double take and I'm like, oh, okay, yeah, it makes sense. Weight gain — but not fat gain — is one thing that people experience. So weight gain is typically due to the increased muscle mass, which is fabulous. And it also actually increases water retention within the muscles — the muscle cells themselves — which is not necessarily a bad thing either. The muscle cells get bigger with water as well. But it's not fat accumulation. So if people start creatine and they gain weight on the scales, that doesn't mean they're gaining extra fat. So this is something to be mindful of. And certainly, there's a lot of thought that it could be dangerous to kidney health. However, long-term studies show that it's not dangerous to kidneys if taken at the recommended doses. So I think following the instructions on the bottle is really important. And taken at recommended doses, there have been no signs of harm to the kidneys or overall function.
Dr Lucy Burns (14:23) Yeah. Like, it's a teaspoon. It's not a truckload of stuff. More is not better. Three grams a day — it's a little, you know. People go, well, how will I take it? You can sprinkle it on your yogurt. You know, it's reasonably tasteless. You can put it in a drink if you want to. You can just add it into cauliflower mash. You can do whatever you want. It's simple. So I'm quite excited about the fact that, because every now and then I feel like, oh my God, we're such naysayers. No supplements do we like. That's right. That's it. But I guess it's just trying to cut through the marketing noise and give you guys some, you know, evidence-based. And again, you and I, Miss, as people that read papers, know that, you know, not all evidence is created equally.
Dr Mary Barson (15:13) And I was reading studies on creatine that were sponsored by creatine makers. I'm like, okay, putting on my skeptical hat as I read this one. So, yes.
Dr Lucy Burns (15:21) Yeah. Yeah. So I think the summary seems to be that yes, in combination with strength training, creatine is going to be helpful. It's probably more helpful if you're a woman. So yeah, postmenopausal women, you should certainly give it a crack. Combine it with your strength training, though. Don't just take it and stop strength training. It's probably good for cognition. So thinking, and again, you get to decide that. You'll notice straight away whether your thinking is better, and it may have long-term benefits, but there's no evidence yet for that. And it seems that the only side effects occur when people take too much. That's it. So creatine gets a tick from us.
Dr Mary Barson (16:01) Yep. Gets a tick. Yep.
Dr Lucy Burns (16:04) Good. All right. Lovely. So that's it for us this week. We will be back with another episode of the Real Health and Weight Loss Podcast. If you like this, if you feel like giving us a rating, that would be awesome. You can just go to Apple or Spotify, go down and fill in the stars. Hopefully you give us five. That'd be nice. What it does is it just helps them push the podcast out for other listeners, and Apple go, oh, these people must be good. People rank them. So yeah, if you feel like giving us a rating, we would be extremely grateful.
Dr Mary Barson (16:33) Really does help. We would love that.
Dr Lucy Burns (16:36) All right. Bye for now.
Dr Lucy Burns (16:41) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
