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长期以来，肌酸被认为仅仅是举重运动员的专属补充剂。然而，最新的研究表明，其益处远超乎人们的想象，对骨骼、大脑健康甚至整体身心状态都有积极影响。作为肌酸研究领域的专家，Candow将深入探讨肌酸的诸多益处，以及如何安全有效地利用。

肌酸的魔力：能量的源泉

肌酸的核心作用在于维持三磷酸腺苷（ATP）的水平。ATP是所有细胞的能量货币，为身体活动提供动力。肌酸通过延长ATP的维持时间，从而提升运动表现，对身体多个系统产生积极影响。

肌酸的广泛益处：从肌肉到大脑

• 肌肉增长与力量提升: 肌酸补充剂结合力量训练，能显著提升肌肉力量、耐力、爆发力和功能性，并增加瘦体重（约1.4公斤）。虽然增加肌肉质量并非其主要益处，但通过改善高能磷酸代谢，间接促进肌肉增长。即使不进行力量训练，单独服用肌酸也能增加水分潴留和瘦体重，但要真正增加肌肉，力量训练必不可少。肌酸的服用时间并不关键，但在训练前后服用效果最佳。
• 骨骼健康: 对于老年人来说，肌酸结合力量训练，能有效减缓骨质流失速度，增强下肢骨骼强度，降低骨折风险。每日剂量至少8克，持续一年以上效果更佳。对年轻人而言，肌酸对骨骼的益处并不显著。
• 耐力提升: 肌酸并非只对无氧运动有效。研究表明，也能改善耐力运动员的敏捷性、平衡性和恢复能力，减少运动后的炎症反应。这主要归功于肌酸对肌肉损伤和炎症的抑制作用。
• 大脑健康与认知功能: 肌酸对大脑生物能量学有积极影响。在睡眠不足、缺氧、时差反应、抑郁症和焦虑症等情况下，能帮助维持大脑功能，改善认知能力，尤其是在进行高强度脑力活动或睡眠不足时。一些研究表明，肌酸甚至可能对神经退行性疾病（如阿尔茨海默病）具有潜在的益处，但这方面仍需更多研究。Candow个人每天至少服用10克肌酸，切实感受到其对认知功能的积极影响。
• 情绪与心理健康: 肌酸可能对情绪和心理健康有益，尤其对患有临床抑郁症或焦虑症的人群，能改善情绪，提升自我效能感，但需在专业医生的指导下使用，并结合其他治疗方法。

肌酸的安全性与服用方法

多年来的研究表明，肌酸的安全性极高，没有证据表明会损害肾脏或导致脱发。当然，如有任何健康问题，请务必咨询医生。

• 剂量: 对于肌肉增长和力量提升，每日3-5克即可；对于骨骼和大脑健康，则建议每日8-10克甚至更多。可以采用加载阶段（每日20克，持续5-7天）快速达到饱和，但并非必须。
• 服用时间: 服用时间灵活，但建议在训练前后服用。
• 最佳形式: 肌酸一水合物是目前研究最充分、安全有效且价格低廉的最佳形式。
• 与其他物质的搭配: 肌酸可以与蛋白质、水、电解质或果汁一起服用，增强效果。少量咖啡因（如普通咖啡或茶中的咖啡因）不会影响肌酸的效果。
• 水分摄入: 服用肌酸不需要额外补充大量水分，但建议多喝水以维持血浆容量。

结语

肌酸并非万能药，但它是一种安全有效、多功能的补充剂，能为健康带来诸多益处。 结合科学的训练和健康的生活方式，肌酸能帮助我们提升运动表现，增强体魄，并改善大脑和整体身心健康。 记住，在开始任何补充剂计划之前，都应咨询医生或注册营养师的意见。

• 00:00 简介
• 00:25 为什么肌酸是有史以来研究最多的补充剂
• 01:45 肌酸对身体有什么作用
• 05:45 为什么要补充肌酸
• 07:30 典型的肌酸剂量
• 09:35 肌酸和睡眠不足
• 12:36 肌酸和肌肉生长
• 16:16 如何以及何时服用肌酸
• 18:51 肌酸与力量和能量
• 20:26 肌酸和减脂
• 21:26 肌酸和骨密度
• 24:21 肌酸和耐力
• 29:11 肌酸和大脑衰老
• 37:06 需要一直服用肌酸吗
• 38:21 肌酸对肾脏和脱发安全吗
• 43:51 服用肌酸时需要多喝水吗
• 44:46 最佳肌酸类型
• 48:16 肌酸和心理健康益处

00:27 肌酸的好处不仅限于肌肉，还包括骨骼、大脑等方面，甚至可能有助于缓解睡眠不足、缺氧、时差反应、抑郁症和焦虑症等问题。

01:43 肌酸对人体有多方面益处，包括肌肉、骨骼和大脑等。

02:26 肌酸有助于维持ATP水平，ATP是所有细胞的能量货币，肌酸对所有细胞（包括肌肉、骨骼和大脑细胞）都有益。

02:53 肌酸通过维持ATP水平更长时间来促进运动表现，并对骨密度、抑郁症、焦虑症和睡眠等方面有益。

03:21 肌酸的益处已从单纯的肌肉增长扩展到对大脑和整体健康的影响。

03:47 全球约有3500万人服用肌酸，预计未来10年将增至3.5亿人，这与其大量的循证研究和安全性有关。

04:04 肌酸提高肌肉中肌酸储存量，从而更有效地循环利用ATP。

04:23 肌酸通过维持细胞能量来改善运动表现，通过增加卫星细胞、生长因子和减少氧化应激来促进肌肉生长和恢复。

04:47 肌酸具有合成代谢和抗分解代谢作用，改善耐力运动员的恢复能力。

05:11 肌酸的主要作用是提高运动能力，可增加约1.4公斤的瘦体重。

05:31 肌酸补充剂能提高肌肉力量、耐力和爆发力。

05:56 补充肌酸会增加肌肉中的肌酸储存量，从而产生上述效果。

06:22 肌酸的摄入不足是限制肌酸储存量的主要因素，素食者对肌酸补充剂的反应最好。

06:36 素食者对肌酸补充剂的反应最好，而肉食者反应最差。

07:02 素食者对肌酸补充剂的反应最好，因为他们的肌肉中肌酸含量本来就较低。

07:31 对肌酸补充剂无反应的人通常是体内肌酸含量本来就很高的人，或者经常食用大量红肉的人。

07:58 通常人们使用多少剂量的肌酸来完全饱和肌肉？

07:58 肌酸的快速饱和方法是采用加载阶段，每天服用20克肌酸一水合物，持续5-7天，但2-3天即可达到饱和。

08:18 肌酸加载阶段可能导致胃肠道不适和体重增加。

08:47 肌酸加载阶段并非必需，每天3克肌酸即可在约一个月内使肌肉饱和。

09:07 肌酸的每日剂量为3-5克，足以获得肌肉益处；更高的剂量可能对骨骼和大脑有益。

09:25 每日3-5克肌酸足以获得肌肉益处，但可能不足以获得骨骼和大脑益处。

09:44 肌酸的剂量取决于体重和肌肉量。

09:59 最近进行肌酸加载阶段，每天服用28克肌酸，以改善睡眠不足带来的影响，并观察到了一些益处。

10:17 一项德国研究表明，每天服用28克肌酸可以改善睡眠不足状态下的认知能力。

10:30 研究表明，一次性服用大量肌酸可以增加大脑中的肌酸含量，从而改善睡眠不足状态下的认知能力。

10:57 肌酸可以改善大脑生物能量，这解释了它对睡眠不足、缺氧等问题的益处。

11:26 肌酸可能有助于缓解时差反应和睡眠不足，尤其对大学生和夜班工作人员有益。

11:48 大脑对肌酸的吸收比肌肉慢，因此可能需要更高的剂量。

12:52 肌酸与肌肉力量和耐力有关。

13:14 肌酸能提高肌肉力量、耐力、爆发力和功能性，并能改善恢复能力。

13:31 肌酸能增加瘦体重和肌肉尺寸，并提高肌肉力量、耐力、爆发力和功能性。

13:51 肌酸具有抗炎作用，能减少蛋白质分解，从而改善恢复能力。

14:17 肌酸的抗炎作用能改善恢复能力，尤其对每天进行高强度训练的运动员有益。

14:32 服用肌酸可以增加多少肌肉？

14:32 服用肌酸并进行力量训练，可以增加约700克肌肉。

14:57 肌酸的主要益处是提高肌肉力量和耐力，而不是增加肌肉质量。

15:14 肌酸主要通过改善高能磷酸代谢来提高肌肉力量和耐力。

15:42 即使不举重，服用肌酸也能增加肌肉吗？

16:08 单独服用肌酸会增加水分潴留和瘦体重，但需要进行阻力训练才能增加肌肉。

16:34 肌酸的服用时间无关紧要，但在训练前后服用效果最佳。

17:47 肌酸可以与水、电解质、果汁或食物一起服用，也可以与蛋白质一起服用以增强效果。

18:14 肌酸可以与蛋白质一起服用，以增强其效果。

18:17 肌酸与咖啡因的混合使用需要谨慎，过量咖啡因可能会影响肌酸的效果。

18:43 少量咖啡因（如普通咖啡或茶中的咖啡因）不会影响肌酸的效果。

19:10 肌酸对力量和爆发力的影响似乎最大。

19:10 肌酸对力量、耐力和爆发力的影响最大，尤其是在训练后期。

19:31 肌酸能加快训练组间的恢复速度，从而提高训练效率。

19:57 肌酸在训练初期和后期对肌肉力量和耐力的影响不同。

20:16 肌酸能维持高能量水平，从而提高训练效率和身体成分。

20:45 一项研究表明，服用肌酸会导致脂肪减少。

21:22 服用肌酸并进行力量训练，可以减少少量体脂，并可能不会改变体重。

21:44 肌酸对骨密度有何影响？

22:09 肌酸对老年人的骨骼有益，但需要配合力量训练，每日剂量至少8克。

22:30 肌酸能减缓老年人的骨质流失速度，并能增强下肢骨骼强度。

22:48 肌酸对老年人的骨骼有益，但对年轻人的骨骼益处不明显。

23:09 肌酸不能增加骨矿物质密度，只能减缓骨质流失速度。

23:28 肌酸对年轻人的骨骼益处不明显，但对老年人有益，因为它能减缓骨质流失速度。

23:53 年轻时增加骨密度比老年时更容易。

24:16 肌酸能间接促进骨密度增加，因为它能增加肌肉质量，从而增加对骨骼的牵引力。

24:44 肌酸对耐力运动有何影响？

25:10 肌酸能提高耐力运动员的敏捷性、平衡性和恢复能力。

25:37 肌酸能减少耐力运动后的炎症反应，并改善恢复能力。

26:05 肌酸对各种耐力运动都有益，包括铁人三项和马拉松等。

26:08 肌酸主要通过减少肌肉损伤和炎症来改善耐力运动的恢复能力。

26:35 肌酸对老年耐力运动员尤其有益，因为它能减缓肌肉分解和改善骨密度。

26:45 一项2023年的荟萃分析发现，服用肌酸会略微降低最大摄氧量。

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00:00

For a long time, we thought creatine was just for people who lifted weights, and we've clearly shown now that creatine has beneficial effects for not just muscle, but we can talk about bone, brain, and some of the really popular things out there. The more creatine in the brain, the brain can actually function at a higher level, and or during times of sleep deprivation, hypoxia, jet lag, depression, clinical anxiety, maybe it's coming to the rescue. Dr. Darren, welcome to the show.

00:27

Thank you so much for having me. Pleasure to be here. Yeah, I'm excited to have you. And, you know, creatine is one of the most researched supplements of all time. And you've done like a lot of research and studies on creatine. So you're pretty much one of the best people to talk with, talk to when it comes to creatine. So I'm excited to have you on the show and discuss all things creatine. Yeah, happy to be here. There's lots to talk about, so I'm sure, yeah.

00:53

Yeah. So maybe we can start with, you know, I said creatine is one of the most studied supplements of all time. What is like the actual, do you have like any number of like how many clinical trials are there on creatine and what is that kind of the pulse on creatine of what are like some major effects people see? Yeah.

01:12

Yeah.

01:28

females, older adults. We're actually looking at clinical populations. And so today it'll be exciting to look at not just muscle, but we can talk about bone, brain, and some of the really popular things out there. We could even talk about pregnancy and some of the new emerging areas of that. So it's really exciting. Yeah.

01:43

Right. So yeah, you mentioned brain, muscles, bones. There's some aspects of like sleep architecture as well. So what is, why is it like, sounds like a miracle molecule. So like, why is that? What does creatine do to your body when you ingest it?

02:00

Yeah, like it was discovered in the 1800s. And of course, we all remember back to our own high school biology or physiology that creatine is sort of helps maintain ATP. So adenosine triphosphate or the energy currency of all our cells. And keep in mind, a lot of people think just muscle, but no, all our cells and bone and brain use ATP for existence and longevity. And sure enough, when you look at all this emerging data, there's a common denominator that

02:26

creatine either through supplementation or through the diet or how we naturally produce it in the body, it seems to maintain ATP levels longer when we're doing activities of daily living or more importantly exercise. So that might allow the person to exercise at a higher volume and we think that's one of the main driving forces. But yeah, as you point out, in the last probably 20 or 30 years, now we're starting to have some beneficial effects on bone density for clinical populations.

02:53

And from the neck up, it's really emerged. We're now talking about depression, anxiety, sleep. We just published a paper last year on getting a little bit more sleep. What about those susceptible to head trauma, athletes, concussion? So there's a lot of emerging areas. And I think the neck up is probably the biggest area we'll focus on, probably for the next 20 or 30 years. So yeah, it's gone from just young males getting bigger, stronger, faster to probably having a global impact

03:21

uh, effort. Uh, I think the last estimate was about 35 million people on the planet take creatine supplementation and, and it's projected to be 350 million in 10 years. So I think with all the evidence-based research there, and of course the safety profile is second to none. Uh, that's why a lot of people are having this new emerging interest in creatine. Yeah. So, uh, you mentioned that helps with ATP production creatine and, uh,

03:47

And you're like, all the cells require ATP. So your muscles contain some creatine, right? And with the higher the creatine stores in the muscles, then you have availability to recycle the ATP more efficiently or for longer. Yeah.

04:04

And I think your viewers would be more familiar with creatine and muscle or exercise performance. And, and yeah, uh, maintaining ATP or energy, uh, of the cell is one of the biggest mechanisms. So the athlete or the individual can maybe do more repetitions, lift a little bit more. Also recovery is a big thing between subsequent workouts.

04:23

But then when you go inside the cell, creatine does seem to work from a sort of multifactorial way. It actually has been shown to increase things called satellite cells or growth factors. And a lot of your listeners would like, oh, wow, these are really important for contributing to protein synthesis. It also reduces things called reactive oxidative species or inflammation. So now we're starting to see evidence that creatine not only is anabolic,

04:47

but also has anti-catabolic or anti-inflammatory properties. And that's why we're now bringing in the endurance athletes. For a long time, we thought creatine was just for people who lifted weights. And we've clearly shown now that creatine has beneficial effects for improving recovery after aerobic exercise. So soccer, tennis, Ironman, triathlon, that has beneficial effects there. So there's a lot of cellular aspects, but

05:11

one of the main driving forces. It allows the person to do more work, whatever that is, training in the gym, whichever, and therefore over time the adaptations can improve. From right off the top of my head, you get an increase of about 1.4 kilograms of lean body mass with creatine, so about 700 grams of muscle, but the

05:31

biggest and most robust area of evidence is improvement in muscle performance. So for those that are taking creatine and exercising, you should expect an increase in muscle strength and or endurance and power. And those are the big ones that's from a muscle perspective come to mind. Gotcha. Yeah. So supplementing creatine increases this creatine stores in the muscles that allows this to happen. What is like

05:56

limiting, not doing it without supplements? Like, is it not getting enough from diet or the body not producing enough of it? Or what is the kind of bottleneck? Yeah, that's an excellent point. So the average omnivore who's consuming a balanced diet has about 80% of their muscles full of creatine naturally. So supplementation can bring it up at maybe 20 to 30 more percent to about 100%.

06:22

But those emphasizing a vegan, vegetarian, or plant-based diet, they have substantially lower amounts in their muscle. So when they take creatine supplementation, they bring those levels up again. So the people who respond the best are vegans by far.

06:36

Those who respond the least or not are all or those on a carnivore diet. They're eating an enormous amount of meat per day and creatine, unfortunately, is only found in animal flesh. So that's going to be red meat or seafood primarily. Poultry has a little bit, but not as much high concentrations of those. So if you're eating red meat and seafood on a daily basis and you take creatine supplementation, you may actually not notice any significant effects there.

07:02

And they would fall into the non-responder category. Whereas the studies that have looked at vegans, picture your muscles only half full of creatine and then you take a supplement. They sort of double the capacity. They really improve from a muscle biopsy or perspective. So there are non-responders, but those are typically those that have been born with a high amount in the body that are eating a lot of red meat or other some modalities affecting it. But vegans really do respond.

07:31

Right. And what are like usual dosages that people would use to fully saturate the muscles? So the most rapid way is what we call the loading phase. And it's probably the most rapid viable way to fully saturate your muscle quickly. That's about 20 grams of creatine monohydrate a day for about five to seven days. In actual fact, you only need to do that for about two to three days and then we think your muscles are full.

07:58

And that is a really exceptional way to saturate your muscle and get the benefits out of that. A little bit of caution, though, for those that are listening. If you do the loading phase, that's where two things can creep in. One is a little bit of GI tract stress or irritation because you're taking so much. The reason being is creatine is osmotic.

08:18

So it likes to take water from the GI tract with it. And so that can cause a little bit of GI issues. The other thing is with the water retention that you typically get with high dose creatine, the number on the scale in the first week may go up a little bit. So a lot of individuals, primarily young females, don't like that. You do not need to do the loading phase. Again, I want to repeat that. You do not need to. You can take as little as three grams a day and that'll saturate your muscle in about a month.

08:47

So a little bit more patience. We use a relative dose, about 0.1 gram per kilogram. So if you're 70 kilograms, that's 7 grams a day. If you're 100 kilograms, like a football player, that's 10 grams a day. But the average daily dose, 3 to 5 grams, is a very viable amount for muscle benefits.

09:07

However, we don't think that's enough for bone and brain benefits. So I think a lot of people have heard of this three to five grams a day. That's probably a very viable amount for skeletal muscle. 95% of your creatine is in your muscle. But if you're saying, hey, I've heard about bone and brain is five grams enough.

09:25

I personally don't think so. I think we need to do a little bit higher dose. Yeah. Yeah. Gotcha. Yeah. It depends a lot on the body weight and how much muscle. Yes. Yeah. Yeah. Yeah. I did also like the loading phase a few, few weeks ago or a month ago, um, where I took 28 grams. I did it for actually another reason. I did it for the,

09:44

sleep deprivation effect so there was a study that 0.35 grams per kilogram which for me is 28 grams that was seen to improve cognition under sleep deprivation and I did notice some benefits for that and you know

09:59

With that protocol, it apparently like saturated my muscle creatine stores as well. So I can reduce my dose and go back to like, yeah, like seven, eight grams for me. Yeah. And that's Ali study from Germany. Very elegant. They use MRS. So it was very cool that 28 grams a day would be way higher than what you need. But in their study,

10:17

the nice thing is after 21 hours of sleep deprivation, you actually were able to have a greater capacity for memory and cognition. So all that study clearly showed is that creatine can accumulate into the brain with one mega dose.

10:30

We don't know if that's a sustainable amount, but if you knew you had to stay up for 48 hours, I think of an emergency doctor or something, you know, a night shift worker and memory and cognition are coming to mind. It clearly shows creatine has the capability to influence brain bioenergetics. And I think that's why we have a lot of good data coming out on sleep deprivation or hypoxia or other types of things with sleep and or memory where creatine is used in the brain, just like our muscle memory.

10:57

And sometimes when our brain is really stressed, it relies on supplementation. Yeah. Yeah. That's a good tip. So like if you're jet lagged, sleep deprived or something like that. Yeah.

11:09

And I use that for university students, final exams, staying up all night. If you're flying from, you know, North America to Europe, overnight flight, your jet lag, uh, going all the way to South Africa, whatever it is, it seems to have that potential to at least get rid of some of the cognitive or impairments, um,

11:26

And we never thought of that before until new emerging data, especially using MRS, which is basically an MRI for the brain to show that creatine can accumulate. It's really slow. The brain is stubborn compared to muscle. We can probably talk about the differences there, but why I think a higher dose might be more viable from a total daily body perspective. Yeah.

11:48

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12:36

I want to start with still the muscle component because that's what people usually associate creatine with. And yeah, bodybuilders have been taking creatine for decades to build their muscle. What is the research about creatine and creatine?

12:52

let's keep it in the like muscle and strength realm right now. So muscle strength, power, kind of this anaerobic performance. What does it say there? Yeah. So the vast majority supports a very favorable effect. So anybody engaged in weightlifting or anaerobic or high intensity sporting events usually benefit from creatine in combination with exercise training. And there's about five main areas that you should expect. So,

13:14

So obviously if you're performing weightlifting as part of your exercise program and taking creatine as little as three grams all the way up to a little bit more, you should get an increase in lean body mass and or muscle size. So that is fantastic for aging and or obviously for exercise performance. The

13:31

The big areas around muscle performance, strength, endurance, and power have also been shown to go up. And also functionality. So we talk about agility, balance, moving quickly for the athletes. So those are all the areas from a muscle performance perspective. The area that doesn't get enough love, so to speak, is the recovery aspect.

13:51

So creatine seems to reduce markers of inflammation. It's been shown in males to reduce protein breakdown or markers of protein breakdown. So that might allow the athlete who's training twice a day or every day to get into the gym or wherever it is and still train at the same intensity. So it has a lot of anabolic promoting effects, but the anti-catabolic or anti-inflammatory ones definitely need to be considered as well. Yeah.

14:17

That's interesting. How much muscle are we talking about? Like how much can you expect to build? Yeah. So the problem with lean body mass, it looks at muscle or sorry, muscles, a component, but it also has organs, you know, blood plasma. So,

14:32

So we think half of the increase in lean body mass is pure muscle. So for example, most meta-analysis suggests 1.4 kilograms of lean body mass greater with creatine in combination with weight training. So at the end of it, if you say 700 grams, I think most people would buy that. We've also shown really small increases in limb muscle thickness. I think though that I would look at muscle mass

14:57

as a secondary benefit of creatine. Where creatine is only essentially a combination of non-essential and one essential amino acid, it does not increase the rates of muscle protein synthesis like essential amino acids do. So it's likely one of the limiting factors. But…

15:14

Since it really improves high energy phosphate metabolism, that's why the most robust evidence is, hey, I'm looking to improve muscle performance. I think creatine would be right up there with caffeine from a muscle performance perspective. When you look at the data, creatine is a little bit superior there. Yeah, that's interesting. And I would imagine that you still need to do resistance training. Like, are you going to build muscle even if you don't lift?

15:42

Yeah. So the, we just published a study a few months ago, clearly showing that creatine by itself will increase water retention and improve lean body mass. But please note for those that are taking creatine without exercise, it's primarily water. Right. You have to perform resistance training to get the muscle accretion or growth effects. There's been a handful of studies showing that you can still get muscle performance benefits without exercise. Right.

16:08

But unlock the totality of that exercise is foundational. And 99% of the studies clearly show that weight training is the most effective modality. Gotcha. Yeah. So, you know, ideally you want to do lifting and consume the creatine while you're doing the resistance training in those phases. Yeah. And that brings up a really important point I get asked. Does the timing matter? The timing of caffeine matters because it peaks in your blood.

16:34

But for those that are weightlifting, this is really important and kind of cool that you can take creatine at any time of the day.

16:40

We don't think there's actually benefits to when you take it. However, in 1992, the seminal study clearly showed that muscle contractions open the doorways to allow creatine in. So I'm a big proponent of taking some of your creatine on a daily basis, either before, during or after exercise. I think around the exercise training session is a great time to do that. So I say in proximal or proximity sessions.

17:04

to exercise. But if you say, Hey, Dan, I can only take my creatine in the morning or at night, it still needs to accumulate. You will get the benefits. So the luxury is take creatine whenever it's consistent for you. I think if you're taking more than five grams, try to take some in close proximity to exercise.

17:22

Gotcha. And, uh, is it, is the difference how you take it like mixed with water or mixed with some, I don't know, electrolytes or juice or food? You can, you can essentially take it any way you want. Muscle contractions will cause an increase in creatine uptake. Carbohydrates will as well, but there's a bit of caution here. The dose needed is around 75 to a hundred grams of carbohydrates. Most individuals don't want that much. Uh,

17:47

But the cool thing is you can combine creatine with protein. Protein is very insulogenic and you get the benefits of protein. And there's been two studies out there showing that when creatine is added to whey protein, you get a greater increase in strength and lean body mass. So for me, for example, I take five grams with my Greek yogurt and protein mixture in the morning. And then I also drink five grams during my workout. That's how I get my daily dose of 10 grams or more on a daily basis. Super convenient.

18:14

And the other area, and we'll talk about myths.

18:17

comes around caffeine. So there's a big thing globally. Should I put my creatine in coffee? And there's important distinctions here. The caffeine molecule and the creatine molecule don't really like each other when caffeine becomes a certain dose. And it has to do with calcium in the muscle. But the average black coffee or tea is less than 80 milligrams of caffeine. The average even medium is less than that.

18:43

The dose of caffeine that has been shown to sort of interfere with creatine is 250 milligrams. So that would be a large coffee, but you'd have to do this on months and months before they interfere. So I think if you're mixing your creatine in coffee or tea, that should be fine. It seems like it's the dose of the caffeine and not the average beverage. And speaking of muscle strength and power. So when I was looking at the research, then the power output,

19:10

It appeared to be like the biggest thing that you see from creatine. Um, yeah. And more so than muscle mass. Yeah. Oh, absolutely. And it seems to have a drive from the neuromuscular recruitment. And when it gets to strength, endurance and power, the interesting thing is it seems to be later on in the session. So for example, if you do four sets of squat or four sets of bench press,

19:31

creatine really seems to come to the age during sets two, three, and four when the body is naturally using energy, doesn't have enough time for the mitochondria to resynthesize it. So creatine supplementation speeds up the rate of recovery between sets that allows a person to exercise quicker. And of course, obviously lack of time is the world's barrier for exercise. So creatine might just help you get to a better workout more efficiently. Yeah.

19:57

Gotcha. So like once in the beginning of the workout, your own body's natural creatine stores are kind of helping with the reps. And by the end of the reps, your subsequent sets, you know, sets three, four, then you're tapping into the…

20:16

the creatine stores from the supplement kind of. That is a hundred percent correct. And that's why we start to see you're always, you're expanding this energy system. That's really tough and delaying, you know, the glycolytic system or even oxidative system. So it just maintains a high energy capacity, allowing the individual to maybe do more reps or weight over time. And of course that leads to improvements in body composition. Yeah. You're a hundred percent correct. Yeah. I actually remember one study where taking creatine and

20:45

resulted in fat loss as well. So usually people associated with like water retention, they look a bit more bloated or puffy. But in that study, they actually saw fat loss. Yeah, we did two meta-analysis, looked at everybody from 18 and above, and it clearly had the same effects. If you combine creatine with weight training,

21:02

you lose two things. Now, they're very small, but they are reductions. You lose a little bit of absolute body fat, about 0.5 kilograms, and about 1% body fat. So for those saying, oh, creatine increases body fat, we don't see any evidence of that. We see the opposite. So if you increase lean mass,

21:22

decreased body fat, there may be a change on the scale or no change at all. But please notice probably having beneficial effects. And if anything, it's driving water and other nutrients into the muscle, which is a really favorable environment. So that's sort of increasing net body water retention. Gotcha. Yeah. What about bone density? So you mentioned that. Yeah.

21:44

Yeah, it's primarily focused on older adults, about 15 and above, and again, in combination with weight training. But this is where the dose is different. The lowest dose shown to have some bone benefits is about 8 grams all the way up to about 12. And then you need to do training for at least a year, if not longer. There's a great group out of Brazil that showed that 1 to 3 grams of creatine a day without exercise for all the way up to 2 years had no bone benefits.

22:09

And my colleague, Dr. Phil Chilabek, has clearly shown that 8 to 10 grams or sorry, 8 to 12 grams for one or two years of weight lifting primarily and adding in walking, it decreased the rate of bone mineral loss around the hip. But we also saw an increase in bone surface area and strength in the lower limbs as well. So, you know, that has application.

22:30

for older adults as we're more prone to falls and a subsequent fracture, maybe the older adult's bones are preserved a little bit more. Um, so again, we don't see a lot of promise in young individuals, probably because their skeleton is healthy, but those postmenopausal females or older males, you know, as we're losing, uh, uh,

22:48

muscle mass and introducing sarcopenia. So the bone benefits seem to be very popular or prevalent in older adults. It has not been shown to increase bone mineral density. So that's really important. It seems to just reduce the rate of loss. But, you know, if you have a history of osteoporosis or osteopenia, that might be interesting for an older adult, especially to take or

23:09

Flip it. What about the younger individuals who never care about bone? You know, when you look in the mirror, they only see body composition. But as we can build up bone at a younger age, especially for young biological females, that might have huge applications for longevity later on in life. So that is an area of merging and more interest for sure. Yeah, like bone density, bone

23:28

is something you want to bank up uh when you're young because it's much easier to build it and much harder to build it uh in your elderly years so yeah it's impossible yep exactly yeah yeah if creating can help you like add a little more bone density and you know the only reliable method to increase bone density is to lift anyway yes you're not going to build bone density without lifting that much right so uh creating might add a little bit more

23:53

And from an indirect way, if you have more muscle, it's pulling on the bone when you're doing activities of daily living. So the extra benefit of having more muscle mass, it's pulling on the bone, causing that stimuli for bone to grow. Look at gymnasts. They have some of the highest bone mineral density and muscle density on the planet. And it's likely because of all the vectors to the bone and or muscle. Well, we never thought about it that way.

24:16

Just having more muscle means that you're carrying more weights around every day, and that stimulates the bone density. Those ligaments and tendons are really activated when you're lifting, and if you have more things pulling on bone, our bone is very stubborn, but it does respond to a lot of variety of forces, absolutely. And another interesting area of performance creating might help, you mentioned these endurance sports, so maybe you can talk about that.

24:44

Yeah, it's kind of come out of nowhere. We used to think, oh, God, if you're an aerobic trained individual, why would you take creatine? And then when you look at all the studies from soccer, swimming to ice hockey to triathlon and marathon, we started to see, yeah, there's improvements in agility balance. And again, it is an energy component of the anaerobic system. So those sports that are intermittent or long duration seems to have some favorable effects.

25:10

The nice cellular data comes from Ironman and marathon training, where those individuals took creatine, the loading phase, five days before they did the long race. And when they measured their blood after they had a reduction in this inflammatory protein, they're called cytokines, they were elevated, but they weren't nearly as elevated compared to placebo. So it was the first lines of evidence to suggest that long-duration aerobic can actually decrease

25:37

incidences of inflammation or improvements in recovery there as well. So that's why now the emergence for pretty much all sporting events, if it's done correctly, can have applications. We're currently running a paper on combat and martial arts. So it's all these different types of sports, but the endurance athletes are there. We put out a big paper two years ago looking just like at endurance athletes. And again, we're starting to see a lot of beneficial effects for those populations for sure.

26:05

So it's mostly reducing muscle damage.

26:08

Muscle damage or inflammation allowing that muscle because aerobic exercise is very catabolic. We don't think resistance training is continuous enough, but if you're going out for a 40K run, you're running hours and hours of very catabolic to your body and therefore creatine can help in the recovery phase. Yeah, and for the aging endurance athlete, creatine might be more important for the bone density benefits than maintaining the muscle mass. Way more important, especially to reduce…

26:35

muscle breakdown as well. Absolutely. Yeah. Yeah. I did notice a meta-analysis from 2023 that found that creatine supplementation

26:45

resulted in a smaller increase in vo2 max than not taking creatine yes so is there anything like related to water retention or increased muscle mass that might hinder some of the vo2 max it was only like a two to four percent yeah decrease or lower than the placebo group so it's not like a significant amount but uh you know maybe for some sports it might be interesting yeah yeah you hit the nail on the head some show a benefit some show nada and those decreases it might

27:11

The theory was that the mass of the person either went up and or a little bit of the water retention might have helped, but the mass of the person might have slowed them down. So that's why I'm a little cautious when we're doing with long duration aerobic individuals that you can titrate the dose up. Maybe the loading phase might be a little bit too acute. Yeah, it's really a good analogy. Yeah, the way I do it is like, you know, my yearly workout plan is, you know, divided into…

27:35

more lifting focus, more muscle and strength focus, and then more cardio focus. So on the cardio focus sections, I'm not taking a creatine or I'm taking just a maintenance dose of three, four grams, maybe something like that. And if I'm focusing on the strength and muscle mass, I take the optimal dose, which for me is this 100 milligrams per kilogram, which for me is eight grams. That's a very good dose. Very good. Yeah. So if you take a smaller dose, you could probably avoid some of the

28:04

Yeah. Or if you want to take the higher thing, we haven't talked about is our lab has six studies currently looking at the micro dosing idea. So I'm interested in now looking at like a higher dose, but

28:15

But sometimes to your issue, some people say it's very tough to take 10 grams at once or 15. What if you take smaller, more frequent dosages throughout the day? Could that accumulate? So we're starting to go, we're going to have data within this year to say maybe 2.5 grams in the morning and 2.5 grams later on. Is it equivalent to taking a five gram dose? And then also does it cause any adverse effects or so it'll be really interesting to see this micro dosing philosophy. Can it be beneficial? Yeah. Hmm.

28:43

Interesting. And would you do it like during the loading phase as well? If you take, let's say 20 grams, would you separate it into multiple doses?

28:51

Yeah. So if you were to do 20 grams, the idea is four by five grams spread throughout the day. I don't know if you could do 10 by two, because that would be very, very tough to do. I think everybody's so busy. The key is what's practical. What can you do to allow someone to do it? Um, but you know, I've taken 10 grams at once. I typically take two fives at least, uh, or a little bit more. Uh, but, uh, you know, in some of those studies, they took the 20, 25 grams all at once and

29:17

uh no adverse effects so it's up to the person subjective that way yeah gotcha um we can move on with the brain then so that's yeah very interesting uh area of research and what i've noticed is that that what is made creating so popular again like this research about uh brain and cognition so uh the brain obviously uses a lot of energy and has a lot of mitochondria and needs a lot of atp so i guess the same uh

29:43

you know, reason that supports energy production in the brain primarily. Yeah, it's so interesting. You know, our bicep gets sore, we rest it and then train other muscle groups. Unfortunately, the brain is working 24 hours a day, even when you don't want it to. So the brain's only about, you know,

29:58

two kilograms, but it occupies about 20% of our daily energy. And that's on a good day. When we're metabolically stressed, which is likely everybody in the world, it's working 24-7. And the interesting thing is when you look at the brain biology, it's similar to muscle with one big difference. Muscle does not make its own creatine.

30:19

So it likes to act as a vacuum and take in as much as possible. The brain is very unique. It has the blood-brain barrier for a very important reason. And the brain actually does synthesize creatine.

30:31

So only until recently have we discovered that, yes, if you take in more dietary creatine or supplementation, it can actually get in through the blood-brain barrier. It's very slow compared to muscle. The blood-brain barrier only has a certain amount of doorways that allow it in. But when you do take supplementation, creatine can accumulate or raise your brain creatine levels.

30:55

And that has massive implications for those with depression, anxiety, head trauma. A common denominator with all these conditions is that their brain creatine levels are reduced. So at the beginning of the podcast, we talked about how important maintaining creatine is to maintain energy. And of course, all our brain cells are

31:11

Our brain bioenergetics rely on that as well. So the idea is the more creatine in the brain, the brain can actually function at a higher level and or during times of sleep deprivation, hypoxia, jet lag, depression, clinical anxiety, maybe it's coming to the rescue. So the whole push here is that maybe in times of metabolic stressors, creatine may come to the rescue of your normal brain

31:37

add to what's already in the brain and sort of have the benefits. And some of the best studies show that creatine really works during mental fatiguing tasks or sleep deprivation. But that five gram dose for your muscle, we think is not nearly as much because if you're taking five grams, most will go to your muscle. You're going to have a little bit left trickling to the brain and

31:57

For me as an academic, I take at least 10 grams a day and I've certainly noticed an improvement in cognition. I was recently in Germany for the Creatine Conference and I took 20 grams a day leading up to it and I certainly noticed a decrease in jet lag. So, you know, a lot of people are starting to say that. And the other big one is we're starting to see the emergence on sleep.

32:19

And a great study we put out last year showing that five grams a day in biological females that were working out, they actually got an increase in additional hour of sleep on the days they worked out. And I think that is really important. I think everybody is sleep deprived or most people I know and most people would do anything to get more sleep and creatine seems to decrease inflammation in the brain, you

32:41

It improves some of the mitochondrial health parameters and therefore maybe the brain can recover quicker. And therefore that might help improve or explain why cognition and memory and tasks of daily living seem to be maintained, even if you've been up for 21 hours of sleep deprivation in some of these studies. So it's very fascinating. Yeah.

33:01

Yeah, in that study where they took the creatine after 21 hours of sleep deprivation, the creatine had similar effects as caffeine. And that was one bowl of Stolz. It was the first one to look and not titrating it up over time. Absolutely. Yeah. But with the brain and cognition, so there's the aspect of neurodegeneration that there's a few studies looking at creatine's effect on cognitive impairment in elderly people, you

33:28

So, and it showed some improvements and benefits. So is it, you know, useful only in the situations where your brain is under more cognitive deficits or under steep deprivation or some trauma, or would the person be expected to gain like, even like a upscale in their cognition, even if they're like even normal with their cognition?

33:50

Yeah, of the 18 studies, about 14 have shown benefits and some were in healthy individuals. So at the end of the day, I think creatine can cause some small beneficial effects to cognition. It seems to really work again if those are metabolically stressed. But I think of the aging population, we put out a meta-analysis and it did improve memory there. So I think that has huge applications.

34:10

Could that translate into Alzheimer's and dementia? We need big studies coming up, but I'm really encouraged with some of the pilot data that is showing there. There needs to be more research in Parkinson's and Huntington's and multiple sclerosis. So those areas are coming. But

34:26

when you add creatine to traditional treatment programs with clinical depression and anxiety, it has very favorable effects there. And there's been one study in Scotland and children with concussion and head trauma, and it seemed to improve the rates of recovery there as well. And a common denominator is that the idea is that it decreases inflammation, allowing the brain to repair itself a little bit quicker. Uh,

34:50

And the reason we know that is when we look at the rodent model in mice and rats, when they were forced to have a concussion, creatine before or after head trauma really seemed to decrease inflammation and improve cortical stability. Obviously, we can't do that to humans, so we use the animal model.

35:08

as a surrogate there, but at least it provided some mechanisms about what's happening. And that's why we think a bit higher dose for those that are playing contact sports or if you're really metabolically stressed. That's why we think creatine should be considered. It certainly has no detrimental effects. Keep in mind, everything we've talked about here, not a single study has ever taken creatine and went the opposite way. If at the end of the day, it's cost effective, it's extremely safe,

35:35

And I wonder why people won't consider it, especially if you're engaged in football, Australian rules, football, rugby, like, you know, you're going to be hitting your head. This might help. And I don't see why someone wouldn't consider it yet.

35:48

Yeah. Well, I think probably most rugby players are already taking creatine for the physical performance benefits. Yeah. Yeah. And they didn't know about the benefits to the brain. Yeah, exactly. Yeah. You're getting auxiliary benefits for the brain, but would they need like a larger dose then because they're so physically active as well and burning it?

36:07

Yeah. So my thought is that if you're active, it doesn't actually require or increase the requirements. However, now, if you're looking at it from a whole body perspective and you're training more often, obviously the five grams would be the minimal amount. I, I, I target five grams of 0.8 grams of protein. I think that's way too low. I think that's enough that you're not going to get any impairments, but if you're an exercising individual or you're getting older or you're sleep deprived, I think a little bit higher. And I, that's why I

36:35

personally take a minimum of 10 grams a day. Mm-hmm. Gotcha.

36:39

And do you like cycle it or do you just take the same dose? Yeah, I've been taking it for a decade. So the idea with cycling is there from a muscle perspective. And we sort of talked about earlier, once your muscles get full, you can reduce that amount to really about two grams a day. But now weight, bone, your immune system, brain, and we're actually starting to see some benefits to the cardiovascular system. Why not take a bit more? And again, we're only talking about 10, 15 grams per

37:06

For those in protein research, we're talking hundreds of grams. This is like a tablespoon at the end of the day. It's very small. The safety profile is exceptional. There's been no adverse effects on the kidney, liver, blood cell count. So again, it's a very, very small amount. Yeah. And how fast would your creatine stores deteriorate if you stop taking it? Yeah.

37:28

Yeah. So if you've saturated your muscle, it takes about four weeks for them to come all the way back down to baseline. We think the brain preserves it a bit more. The estimate is about five weeks. So let's say, for example, you've saturated your muscle and you're going to go to Mexico and land a beach for a full month.

37:45

you can wait the whole month and those levels would come back to baseline. But for those that like the vacation and if you don't want to take your supplement, remember you can find creatine in red meat, white meat, and or seafood. So if you're out for dinner and you have salmon, you're probably getting two to three extra grams in addition to what you're synthesizing. So that's a great way to maintain some of those levels, even when you're on vacation, you know.

38:05

How much salmon? I think more than just a dish, right? Yeah. So one salmon steak would have about one to two grams. An eight ounce sirloin or tenderloin would have about three or four. But if you get a chance to eat more seafood and if you do consume that, it's an easy way to help maintain a little bit extra in your diet. Gotcha. Yeah. Yeah. I actually found that herring is very high. Yes. Very high. Yeah. Yeah.

38:35

You mentioned the safety data. So there's a lot of fear or worry about creatine that it's going to harm your kidneys or make your hair fall out or a lot of problems. So maybe we can talk about like the safety data with the kidneys specifically because…

38:53

That's one of the like biggest fears. Yeah. So last month, Rick Ryder led a big group and they looked at all the studies. It took an enormous amount of work and it's open access and it's published in the Journal of International Society of Sport Nutrition. And they looked at all the data and clearly showed that creatine did not lead to any greater increases on kidney, liver, blood cell count, GI tract. There was no adverse effects. And

39:15

And it makes sense. We naturally are already producing this compound. So our body recognizes it. And if we don't like it, we excrete it down the toilet in something called creatinine. And I recommend a dosage, even all the way up to higher dosages. Creatine has been exceptionally safe. And for those who can see me, I'm bald, but I was going bald before I took creatine. And just two days ago,

39:36

the great group finally came out with a study that looked at creatine and hair loss. And it went all the way back to the rugby study that looked at DHT, which is a hormone. But in this study, they gave five grams of creatine a day for several weeks. They looked at DHT. They looked at

39:52

bound and free testosterone, but they also looked at hair follicle size and number. And in these young, healthy individuals, creatine did not cause an increase in any hormone or hair follicle loss. So for those that is a myth, we busted two big ones. The safety profile is exceptional and we're not seeing any evidence whatsoever that creatine leads to or does cause hair thinning or follicle loss.

40:17

Yeah. Yeah. And that original study from, I think it was 2006 or something, they didn't even look at hair loss. They just saw that they took the creatine, they did a loading phase and then the maintenance phase stopped.

40:33

And then they saw increase in DHT, but they didn't actually look at hair loss. Yeah, exactly. And everybody found it did. Yep. Exactly. Yeah. Yeah. But yeah, this new study that actually, you know, looked at hair growth, didn't see any difference between the creatine and placebo.

40:49

And beyond 18 to 40 years of age, I'd have to look at it. I haven't read the totality, but again, it's just showing that, and I've assessed over a thousand people and not a single person has come to me and said, Hey, whatever you're giving me is causing my hair to thin out. But when they see me, they're like, Oh, you're bald. And then that other creature is bald. And I was like, there's a lot of genetics from mom's side that usually lead them way there. Yeah.

41:13

Yeah, I haven't noticed hair loss from creating either. But I do see a lot of people online saying that they did see some hair loss or hair thinning. So what could that be?

41:26

You know, we don't know. When people say that, I'm like, what other things are you consuming? Is it aging? Is it, you know, there's a lot of variables that play a role there. The DHT, is it cellular? Is it serum? There's so many factors, it's even hard to comment or extrapolate on what's causing it. But again, when you look at some of the prominent researchers, we're all bald. So people say, well, obviously you're bald and you're creating research, so it must be, but that's not how correlations work. Right.

41:55

Right. Yeah. Yeah. And with the kidneys, it's only harmful if you have kidney impairment or kidney damage.

42:03

Yeah, at higher dosages, it can cause the kidneys to work harder. So when you're taking creatine through the diet or supplementation, it gets stored in primarily our muscle. But when you metabolize it, it gets in the form of something called creatinine. And a lot of people say, oh, my doctor checked off that box on my requisition form. I forgot to tell him I was taking creatine and he got really worried that it was causing my kidneys to fail. And no, what it really means is that the metabolism of the supplement

42:29

cause this creatinine to go up a little bit. And if that's the case, it usually indicates that the filtration has gone down or your kidneys are not working properly. So for anybody listening, if you're on creatine supplementation, please let your doctor know that you're taking creatine because then they should expect the creatinine to be elevated and it just would not cause a false positive. Yeah. Hmm.

42:49

Yeah, and with creatinine, it's very responsive to exercise and muscle mass as well. So if you exercise and you have more muscle mass, then that makes your creatinine levels increase as well. Yeah, and dehydration and a high protein diet can also make your creatinine levels there. So again, make sure you tell your doctor, be honest, don't hide anything from them because you don't want to get anxiety with a false proselyt. Yeah, and I like the cistern more because of that. It's not affected by the muscle mass and exercise. Right.

43:18

Yeah, absolutely. Yeah. Yeah. And I actually measured my kidney markers with, between this loading phase and taking eight grams for a few months. And I didn't notice any like significant differences in, in all these markers. Yeah. And I even measure my creatinine every few years. And even at the high dose, I'm still within normal range and

43:37

I might be the most saturated person on the planet. I've been taking so much of it. Yeah. So, but it may, I'm not saying it's not going to cause, but you know, if you do have dialysis or one kidney or any other issues there, make sure you always talk to your doctor to make sure creatine is right for you. Cause you could be on other types of pills, um, you know, hormones or water retention pills for a blood volume. So just make sure creatine is right for you. And we recommend that for any medical condition. Yeah. Hmm.

44:04

You mentioned the dehydration. Do you need to drink more water when you're taking creatine to retain more water in the muscles?

44:14

Yeah. It's a technical myth that you need to, but it's always recommended because ideally you're taking creatine with exercise. So obviously having a little bit more water, not a lot, maybe one or two glasses if you want. It's not necessary, but I usually recommend it to help maintain your plasma volume. And therefore it's a little bit easier to decrease any metabolic symptoms. But creatine is super hydrating. It does not cause muscle cramping. If anything, it super hydrates the muscle. But creatine

44:42

Consuming a little bit more water is fine. The reason some people might urinate on creatine is likely just to the volume. It has nothing to do with the molecule per se. It's usually people are drinking a little bit more water. Gotcha. I guess we can now talk about the different types of creatine. So there's a lot of different types of it, creatine monohydrate, hydrochloride and others. Which one is the better one?

45:07

Yeah, at the top of the mountain is always creatine monohydrate. That's simply creatine linked to water. And everything I've talked about today has been monohydrate based. And the interesting thing is there's a lot of marketed forms of creatine out there. But for the viewers, there's two things you need to really wrap your head around. If it's not a form of creatine, when it gets into the blood, it's not going to get into your cells. So make sure whatever you're taking, it is creatine.

45:33

And second, I would be really cautious against all these other market of forms that say it increases bioavailability or absorption. Monohydrate is near 100%. I know it's been around for so long. A lot of people are wanting something new. I don't think you need to spend your money on something new.

45:51

And also I worry that the safety profile of all these other market reforms and the efficacy are just not there. So why choose something that's not safe and or more effective than monohydrate? I would recommend only monohydrate. Make sure it's third party tested. The world's best is Creapure from Germany, has no impurities, has grass status. And I think if you're looking for a product that has Creapure in it, that's all you need to look for. Yeah. Yeah.

46:18

Yeah, I think it's most of the creatine comes from China and then there's Creapure. There's two creatines out there only. Yeah. And the one from China, we've had some issues with regulation. So Creapure is from Germany. They have plants around the world. It's third-party tested. It has grass status from the FDA. The purity is near 100%. Yeah. Okay. That's good. There's something called Creagenin, I think, as well that I've heard for

46:43

talked about recently. I don't know if you've heard about it, but yeah, supposedly some new form of creatine. Yeah, there's a lot of new ones. There's supposed to be a lipid soluble type of creatine, so it goes through your plasma membrane of the cell quicker, doesn't require the transporter. The only thing that

46:58

that's out there as a derivative that's needed to make creatine. It's called guanidinoacetate or citric acid, GAA. And there's some really good research on the brain there as well. But there's not a lot out there that can be added or replace creatine monohydrate. So for those listening, I would only back creatine monohydrate. I think that's something to consider, yeah. Yeah, it's the cheapest and the most researched one. Cheapest and most effective and safest. So that's important, yeah. Would there be any way to enhance creatine

47:25

its effects or is it already like, you know, perfect? Yeah, it's pretty much perfect. I think, you know, if you're combining it with protein, you get all those muscle potential benefits there. Exercise is great too. And the cool thing is if you want to put creatine in your water bottle and drink it, you shouldn't notice any adverse effects. So it's one of these things that's kind of works itself. You don't have to do a lot of help with it. And the timing is irrelevant. You can take it before you go to bed, whichever it is. Yeah, it's pretty good there.

47:54

What about creating gummies? Yeah, so there is an explosion right now. And the only thing about the gummies is a very viable source. But make sure that there's actually creatine in there. I saw a couple reports on Twitter lately that there's only a few out there. I think Create is one of the only few that actually had creatine in there. There was eight of 10 that were marketed on Amazon and it showed there was nothing in there. So make sure that the product that you're spending a lot of money on actually has creatine in there as well. Yeah.

48:21

Yeah. Yeah. They taste good. They're like candy and that's why kids are loving it and stuff like that. Yeah. Yeah. Yeah. Um, one thing we forgot to mention before was, um,

48:31

Kind of the mood and mental health benefits. So depression and mood disorders. Yes. Yeah. So for those with clinical depression or anxiety, some really good work out of Utah and United States psychiatrists have clearly showed that creatine added to their medication. It could be SSSRIs or methamphetamines or cognitive behavior therapy. Seemed to improve self-efficacy. Mood was one of the biggest ones. And again,

48:57

That was added to their treatment. No studies looked at creatine by itself, and I think those studies will come. But for those that are suffering from clinical depression or anxiety, make sure you talk to your psychiatrist and see if creatine is right for you. As it currently stands, we're seeing all benefits, and there's some really good review articles out there that people can go online to search for the benefits from the brain perspective, from a clinical perspective. Yeah. Hmm.

49:21

Does it interact with any other medications, any contraindications? Yeah, we don't see any contraindications to SSRIs or any other abnormalities. But again, the psychiatry medical doctor in the community would know that as well. There's been a couple of studies on PTSD that might have applications for veterans or first responders. So again, if it improves brain bioenergetics, start thinking of people who might respond. And it has applications for, I think, a lot of people to consider. Yeah.

49:49

Yeah, during the sleep deprivation experiment that I did, I did notice when I took the larger doses of creatine, there was some elevation in my mood as well. So like a bit of a more, not even like happier, but I guess more, you know, even like quirkier or like a bit more funnier, better mood.

50:11

Yeah. And I think even starting out, if you want to start with, you know, two to three, five grams a day, see how you feel and work your way up. And, you know, I'm probably at the point now I'm taking about 10 grams, if not a little bit more, especially when I'm metabolically stressed. And I think 10 grams is a great average viable dose for bone, brain, muscle, and the immune system. Gotcha. Yeah.

50:32

And you've, you've been taking creatine for, you know, several decades. So why did you start? I've been taking it for 25 years. Yeah. Yeah. No adverse effects. And yeah, I was going bald before. Why did you start taking it?

50:47

Yeah, I actually got involved with a great colleague of mine when I was doing my master's degree. And I noticed that a lot of people on Create Team were getting bigger, stronger, faster. And I fully admit that's the main reason. And I noticed in the gym, I was like, wow, my recovery is a lot quicker. I can actually increase weight that I'm lifting and more repetitions.

51:06

And I definitely respond well. And then you start to get in populations that really need it, like the elderly. That's been a big focal point of our research. So the goal is to try to get people to live longer, functional, free of disease. And I think creatine is one little area in a treatment program. Exercise has to be foundational. Protein is the next big thing. Make sure you're taking adequate protein and a little bit of creatine on top of that cake.

51:31

should go a long way. Are you going to increase your dose if you get older or something like that in your 60s, 70s? Yeah, I probably will be up to about 20 grams there and then we'll kind of have an idea about micro dosing or things like that. But hopefully a big expansion, you know, in the next 10 years on creatine and brain health or other areas. And if there is new forms of creatine out that you may not need that total amount, I'm

51:54

I'm all for evidence-based research. And again, if it's backed by science, it's safe, you know, that's where you want to hang your hat and look at peer referee publications. Yeah. Well, yeah, I'm looking forward to what's going to happen with the research, especially in the neurodegenerative realm for the brain health. That's more interesting right now.

52:15

Yeah, because yeah, there's already, already so many studies on the exercise performance and it's like undeniable that it has. You know, if you could have any benefit to Parkinson's or Alzheimer's, that is a global game changer. Uh, that would have enormous magnitude of effects. Yeah. Hmm.

52:31

Yeah. Well, yeah, it's been great talking with you before I ask my last question. Where can people learn more about you and your work? Yeah. I think at Instagram at Dr. Darren Candles is usually the easiest. It's the most popular nowadays. We try to promote creatine and or other health things. So at Dr. Darren Candle on Instagram and that's great. Yeah. Awesome. We'll put the links in the show notes. And my last question is, what's this one piece of advice or habit that you wish you'd adopted sooner?

52:58

uh exercise i think exercise is the foundation of youth um and now as i get older sleep would be a little bit better more sleep quality is good but i think exercise for those that are not please move your body's meant to move and no pill or powder will ever replace exercise for longevity yeah yeah that's definitely good and if you take creatine you get more results then yeah you get a little bit more hopefully yeah but exercise got to be there yeah yeah well uh yeah awesome it was great to talk with you and yeah i'll see you around

53:28

Great. Thank you so much. All right. That's it for this episode. Make sure you check out my new book, The Longevity Leap on Amazon. I'd also appreciate if you share this episode with a friend or family member. Other than that, my name is Seem. Stay tuned for the next episode. Stay empowered.

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引言与嘉宾介绍

• 主持人开场：主持人首先点出肌酸在补充剂界的悠久历史和广泛研究，并强调其认知已从单纯的“举铁伴侣”扩展到更广阔的健康领域。他特别提到肌酸对大脑功能的潜在益处，如在睡眠不足、缺氧、倒时差、抑郁和焦虑等情况下的积极作用。
• 嘉宾介绍：邀请了在肌酸研究领域深耕多年的达伦博士（Dr. Darren）。主持人赞扬了达伦博士在肌酸研究方面的卓越贡献，认为他是讨论肌酸话题的权威人选。
• 达伦博士回应：表达了参与节目的荣幸，并预告了肌酸话题的丰富性和讨论的广度。

第一部分：肌酸的基础知识与重要性

1. 肌酸的发现与核心功能：

   * 历史：肌酸于19世纪被发现，其生理功能的核心在于维持细胞的直接能量来源——三磷酸腺苷（ATP）。

   * ATP的重要性：ATP是所有细胞（不仅仅是肌肉细胞，还包括大脑、骨骼等）进行生命活动和维持功能的“能量货币”。

   * 肌酸如何工作：肌酸（通过膳食摄入、身体自然合成或补充剂）在体内转化为磷酸肌酸，它能快速地将ADP（二磷酸腺苷）重新磷酸化为ATP，从而在能量需求高的活动中（如高强度运动或大脑高负荷运转时）维持ATP的供应。

   * 日常活动与运动：这意味着补充肌酸可以让人在日常生活中保持活力，更重要的是，在运动中能够维持更长时间的高强度输出，或进行更大运动量的训练。

2. 肌酸的普及与研究进展：

   * 全球使用情况：目前全球约有3500万人服用肌酸补充剂，基于其日益被认识到的广泛益处和安全性，预计十年内这一数字将飙升至3.5亿。

   * 研究广度：肌酸是研究最多的膳食补充剂之一，其研究已从最初的年轻男性增肌、增强运动表现，扩展到女性、老年人、临床人群，并探索其对骨骼、大脑、甚至怀孕等新领域的影响。

   * 安全性：达伦博士强调，肌酸拥有首屈一指的安全性记录，这也是其越来越受欢迎的重要原因。

第二部分：肌酸对肌肉的益处——传统认知与科学证实

1. ATP维持与运动表现提升：

   * 机制：肌酸通过维持ATP水平，使得肌肉在高强度、短时间爆发性运动（如举重、短跑）中能持续供能。

   * 具体表现：运动员或健身者可以完成更多的重复次数，举起稍重的重量，或者在间歇性运动中更快恢复。达伦博士特别指出，肌酸的效果在训练后半段（例如深蹲或卧推的第2、3、4组）尤为明显，此时身体自然能量储备下降，线粒体重建ATP的速度跟不上，肌酸的快速供能作用就凸显出来。

2. 肌肉增长与瘦体重增加：

   * 效果量化：结合抗阻训练，服用肌酸平均可观察到约1.4公斤瘦体重的额外增加，其中大约700克被认为是纯肌肉的增长。

   * 细胞机制：肌酸不仅仅是能量供应者，它还能通过多种细胞途径促进肌肉增长：

   * 增加卫星细胞与生长因子：这些是肌肉修复和生长的关键信号分子。

   * 减少炎症与活性氧化物质：运动会产生炎症反应，肌酸有助于减轻这种炎症，从而改善恢复环境。

   * 抗分解代谢：研究表明肌酸能减少蛋白质分解的标志物，这意味着它能帮助保护已有的肌肉组织。

   * 与必需氨基酸的区别：达伦博士指出，肌酸本身并非像必需氨基酸那样直接大幅度提高肌肉蛋白质合成率，其增肌效果更多是间接的，通过提升训练能力和改善恢复环境来实现。

3. 力量、耐力和爆发力的全面增强：

   * 核心益处：这是肌酸最可靠、最显著的益处之一。几乎所有针对力量型运动的研究都证实了肌酸在这方面的积极作用。

   * 与咖啡因比较：从肌肉表现的角度看，肌酸的效果甚至可能优于咖啡因。

4. 运动后恢复的促进：

   * 重要性：这一点常被忽视，但肌酸在减少运动引起的炎症和肌肉损伤方面有明确证据。

   * 实际应用：对于每天训练或一天多次训练的运动员，更快的恢复意味着他们能以更高的质量完成后续训练。

5. 脂肪减少的潜在效应：

   * 研究发现：一些荟萃分析（包括达伦博士团队的研究）显示，在结合抗阻训练的前提下，服用肌酸的人群不仅增加了瘦体重，还观察到轻微的绝对体脂减少（约0.5公斤）和体脂率下降（约1%）。

   * 机制推测：这可能与瘦体重增加带来的基础代谢提升，以及肌酸促进水分和营养物质进入肌肉（创造更有利的代谢环境）有关。这反驳了“肌酸导致发胖”的误解。

6. 抗阻训练的必要性：

   * 关键因素：达伦博士强调，要想通过肌酸实现肌肉增长，必须进行规律的抗阻训练。

   * 单独服用的效果：如果不进行运动，单独服用肌酸增加的体重主要是细胞内水分的潴留，而非肌肉组织的实质性增长。

7. 服用时机与方式：

   * 服用时间：对于肌肉饱和而言，一天中的任何时间服用肌酸都可以达到效果，其效果是累积性的，不像咖啡因那样有明显的即时效应和峰值。

   * 运动相关性：尽管如此，肌肉收缩（即运动时）确实能增加肌酸的吸收和利用效率。因此，达伦博士个人推荐在运动前后（proximal or proximity sessions）服用一部分每日剂量。

   * 混合物：

   * 水：最常见的服用方式。

   * 蛋白质：与乳清蛋白等蛋白质一同服用，有研究显示能进一步增强力量和瘦体重的增加效果，因为蛋白质本身也促进胰岛素分泌，有助于营养物质吸收。达伦博士个人习惯将肌酸与希腊酸奶和蛋白质粉混合。

   * 碳水化合物：大量碳水化合物（约75-100克）可以显著促进肌酸吸收（通过胰岛素介导），但考虑到碳水化合物的量较大，并非所有人都适用。

   * 咖啡/茶：少量咖啡因（如一杯普通咖啡或茶，约80毫克以下）与肌酸同服通常没有问题。只有当单次咖啡因摄入量非常高（如250毫克以上）并长期如此时，才可能因影响肌肉内钙离子动态而轻微干扰肌酸的效果。

第三部分：肌酸的剂量、使用者反应及个体差异

1. 负荷期（Loading Phase）：

   * 目的：快速使肌肉中的肌酸储备达到饱和状态。

   * 方法：通常为每天总共20克（例如分4次，每次5克），连续服用5-7天。达伦博士指出，实际上2-3天的高剂量就足以使肌肉饱和。

   * 潜在副作用：

   * 胃肠道不适：由于肌酸的渗透性（会从胃肠道吸取水分），一次性摄入过大剂量可能导致腹胀、腹泻等。将每日总剂量分多次服用可以缓解。

   * 水分潴留与体重增加：肌酸进入肌肉细胞时会携带水分，导致细胞内水分增加，从而使体重在短期内（主要是第一周）有所上升。这对于一些对体重敏感的人（尤其是年轻女性）可能造成困扰。

   * 是否必需：负荷期并非必需。不进行负荷期，通过较低的维持剂量同样可以达到肌肉饱和，只是时间稍长。

2. 维持期（Maintenance Phase）：

   * 目的：在肌肉饱和后，维持较高的肌酸水平。

   * 剂量：

   * 通用建议：每天3-5克。

   * 相对剂量：更精确的建议是每公斤体重0.1克。例如，一个70公斤的人每天服用7克，一个100公斤的运动员则服用10克。

   * 最低有效剂量：一旦肌肉饱和，理论上每天2克可能就足以维持。

3. 不同膳食习惯人群的反应：

   * 纯素食者/素食者：由于他们的饮食中几乎不含肌酸（肌酸主要存在于动物肉类中），其肌肉基础肌酸水平通常较低（可能只有正常肉食者的一半左右）。因此，他们补充肌酸后，肌肉肌酸水平提升幅度最大，效果也最为显著。

   * 肉食者（尤其是大量食用红肉和海鲜者）：他们的肌肉基础肌酸水平已经较高，补充肌酸带来的额外提升空间有限，因此效果可能不明显，甚至被归为“无反应者”（non-responders）。

   * 肌酸的膳食来源：红肉（如8盎司牛里脊含3-4克）、海鲜（如三文鱼排含1-2克，鲱鱼含量很高）、禽肉（含量较低）。

4. 肌酸储备的消耗速度：

   * 肌肉：停止补充肌酸后，肌肉中的肌酸水平大约需要4周时间才能完全恢复到补充前的基线水平。

   * 大脑：大脑对肌酸的保留能力似乎更强一些，估计需要大约5周时间才能恢复到基线。

   * 度假时的策略：如果短期（如一个月）不方便携带补充剂，可以通过在度假地增加红肉、海鲜的摄入来部分维持肌酸水平。

第四部分：肌酸对骨骼健康的益处——新兴研究领域

1. 主要适用人群：研究主要集中在50岁以上的老年人群体，特别是骨质流失风险较高的绝经后女性和老年男性。
2. 剂量与疗程：

   * 剂量：通常需要比增肌更高的剂量，研究中显示的有效剂量范围约为每天8-12克。

   * 疗程：需要长期服用并结合抗阻训练，至少持续一年，甚至更长时间才能观察到明显效果。一项巴西研究显示，每天1-3克肌酸，不运动，持续2年，对骨骼无益。

3. 主要效果与机制：

   * 减缓骨密度流失：多项研究（如Dr. Phil Chilbeck的团队）表明，高剂量肌酸结合长期抗阻训练（并辅以步行等），能够显著减缓老年人髋部等关键部位骨矿物质的流失速率。

   * 改善骨骼结构与强度：观察到下肢骨表面积和骨骼强度的增加。

   * 非直接增加骨密度：需要强调的是，目前证据表明肌酸主要是“保护”现有骨量，减缓流失，而非直接“增加”骨密度。这对于已有骨质疏松或骨质减少症的人群具有重要意义。

   * 间接作用：肌酸通过增加肌肉量，间接促进骨骼健康。更强壮的肌肉在日常活动和运动中对骨骼施加更大的牵引力，这种机械刺激是维持和促进骨骼健康的重要因素。达伦博士以体操运动员为例，他们通常拥有极高的骨密度和肌肉密度，这与他们训练中骨骼和肌肉承受的多向负荷密切相关。

4. 对年轻人的潜在意义：

   * 骨峰值的建立：虽然年轻人的骨骼通常较为健康，但年轻时期是建立骨量峰值的关键阶段。通过肌酸辅助（结合运动）可能有助于年轻人（尤其是年轻女性，她们未来骨质疏松风险更高）积累更高的骨峰值，从而为晚年的骨骼健康打下更坚实的基础。

第五部分：肌酸对耐力运动的益处——打破传统观念

1. 传统观念的转变：过去认为肌酸主要适用于无氧爆发性运动，对耐力运动益处不大。但近年来越来越多的研究挑战了这一观点。
2. 作用机制：

   * 改善敏捷性与平衡感：即使在耐力项目中，也存在需要快速反应和身体控制的时刻。

   * 提供无氧能量补充：耐力运动并非纯粹的有氧供能，尤其是在冲刺、爬坡或强度变化时，无氧系统也会参与。肌酸能支持这部分能量需求。

   * 减轻炎症与促进恢复：这是肌酸在耐力运动中一个非常重要的作用。长距离耐力运动（如马拉松、铁人三项）对身体是高度分解代谢的，会产生大量炎症。研究表明，在这些运动前后服用肌酸（例如，赛前5天进行负荷期），可以显著降低赛后血液中炎症标志物（如细胞因子）的水平，从而加速恢复，减轻肌肉损伤。

3. 适用运动类型：

   * 间歇性运动：如足球、冰球等，这些运动需要在持续奔跑中穿插高强度冲刺。

   * 长距离耐力运动：如游泳、铁人三项、马拉松。

   * 新兴应用：研究甚至扩展到格斗、武术等项目。达伦博士团队也发表了关于肌酸对耐力运动员益处的综述。

4. 关于最大摄氧量（VO2 Max）的讨论：

   * 研究发现：一项2023年的荟萃分析提到，服用肌酸的个体，其VO2 Max的增幅可能略小于不服用肌酸的安慰剂组（大约2-4%的差异）。

   * 可能原因：主持人推测这可能与肌酸引起的水分潴留或体重轻微增加有关，这些因素可能在一定程度上影响了以相对体重计算的VO2 Max。

   * 实际影响与策略：这种差异非常小，对于大多数耐力爱好者可能不构成显著影响。但对于竞技水平的精英耐力运动员，可能需要更精细地考虑。一种策略是，在更侧重有氧耐力训练的阶段，减少肌酸剂量（如降至3-4克维持量）或暂停使用，而在侧重力量和爆发力训练的阶段则使用最佳剂量。

第六部分：肌酸对大脑和认知功能的益处——前沿与潜力

1. 大脑的能量需求与肌酸的作用：

   * 高耗能器官：大脑虽然只占体重的很小一部分（约2公斤），但其能量消耗巨大，约占每日总能量消耗的20%。大脑持续工作，即使在睡眠中也是如此。

   * 大脑的肌酸代谢：与肌肉不同，大脑能够自行合成一部分肌酸。但研究表明，通过膳食或补充剂摄入的肌酸仍然能够通过血脑屏障进入大脑，尽管这个过程比肌酸进入肌肉要缓慢和困难（血脑屏障的通透性限制）。

   * 补充的意义：补充肌酸可以提高大脑中的肌酸水平，这对于维持大脑的生物能量学至关重要，尤其是在大脑面临各种代谢压力时。

2. 肌酸在大脑健康中的具体应用与机制：

   * 代谢应激状态下的支持：

   * 睡眠剥夺/倒时差：当大脑因睡眠不足或节律紊乱而处于能量匮乏状态时，补充肌酸能帮助维持认知功能。一项德国研究（Ali研究）显示，一次性大剂量肌酸（如0.35克/公斤体重，对主持人是28克/天）在21小时睡眠剥夺后，能显著改善记忆和认知表现，效果堪比咖啡因。达伦博士个人经验是在跨国飞行倒时差时，会将肌酸剂量增加到每天20克，并观察到时差反应减轻。

   * 缺氧：类似睡眠剥夺，缺氧也会对大脑能量供应造成压力，肌酸可能提供支持。

   * 神经退行性疾病的潜力：

   * 老年人认知障碍：荟萃分析显示，肌酸能改善老年人的记忆力。

   * 阿尔茨海默病、帕金森病、亨廷顿病、多发性硬化症：这些疾病往往伴随着大脑能量代谢的紊乱或神经元损伤。虽然尚需大规模临床研究证实，但初步数据和理论基础表明肌酸在这些领域具有治疗潜力。达伦博士对此非常期待，认为如果肌酸能对这些疾病产生任何积极影响，都将是“全球性的游戏规则改变者”。

   * 情绪与心理健康：

   * 临床抑郁症与焦虑症：多项研究（如犹他州的研究）表明，在标准的药物治疗（如SSRI类抗抑郁药）或认知行为疗法的基础上，联用肌酸能够进一步改善患者的情绪、自我效能感，并可能加速治疗反应。目前研究多为辅助治疗，肌酸单独治疗抑郁/焦虑的研究尚待开展。

   * 创伤后应激障碍（PTSD）：也有初步研究探索肌酸对PTSD的潜在益处，可能对退伍军人、急救人员等高危人群有帮助。

   * 脑震荡与头部创伤（TBI）：

   * 机制：研究（尤其在动物模型中）表明，头部创伤会导致大脑肌酸水平下降，并引发炎症反应。在创伤前或后补充肌酸，能够减少大脑炎症，改善皮质稳定性，促进神经元修复，从而加速恢复。

   * 临床应用：苏格兰一项针对脑震荡儿童的研究显示了积极效果。对于参与接触性运动（如橄榄球、拳击等）的运动员，肌酸可能提供一定的神经保护作用。

   * 改善睡眠质量：

   * 研究发现：达伦博士团队去年发表的一项研究显示，每天服用5克肌酸的生理期女性，在进行体育锻炼的日子里，其夜间睡眠时间平均额外增加了约1小时。

   * 可能机制：推测与肌酸减少大脑炎症、改善线粒体健康，从而使大脑能更快恢复有关。

3. 大脑益处的推荐剂量：

   * 高于肌肉益处剂量：普遍认为，要获得显著的大脑益处，肌酸的剂量需要高于仅仅为了肌肉效果的3-5克/天。因为大部分口服肌酸会优先被肌肉吸收。

   * 达伦博士个人剂量：他个人每天至少服用10克，尤其在面临学术压力等代谢应激时会增加。他认为每天10克是兼顾骨骼、大脑、肌肉和免疫系统益处的一个良好平均剂量。

4. 对健康个体认知功能的影响：

   * 研究结果：在18项相关研究中，约14项显示肌酸对认知功能有益，其中一些研究对象是健康的个体。

   * 效果特点：虽然对健康个体认知功能的提升可能不如在代谢应激状态下那么显著，但肌酸仍可能带来一些小幅度的改善，尤其是在进行长时间、高强度的精神疲劳任务时。

第七部分：肌酸的安全性、常见迷思与辟谣

1. 肾脏健康：

   * 普遍安全性：对于肾功能健康的人群，长期服用肌酸（包括高剂量）是安全的，大量研究未发现其对肾脏、肝脏功能或血细胞计数有任何不良影响。

   * 肌酐（Creatinine）水平升高：服用肌酸后，其代谢产物肌酐在血液中的水平会自然升高。这不是肾损伤的标志，而是肌酸正常代谢的结果。重要的是，在进行肾功能检查时，应告知医生正在服用肌酸，以免医生根据升高的肌酐值（传统肾功能指标之一）做出错误判断。

   * 胱抑素C（Cystatin C）：主持人提到胱抑素C是一个不受肌肉量和运动影响的更准确的肾功能评估指标。

   * 已有肾病者：对于已有肾脏疾病或肾功能不全的人，高剂量肌酸可能会增加肾脏负担，应在医生指导下谨慎使用或避免使用。

2. 脱发（Hair Loss）：

   * 迷思的起源：源于一项早期研究（约2006年）观察到橄榄球运动员在服用肌酸负荷期后，血液中双氢睾酮（DHT，一种与男性型脱发相关的激素）水平有所升高。但该研究并未直接评估脱发现象。

   * 最新研究辟谣：达伦博士提到，就在播客录制前几天，一项专门研究肌酸与脱发关系的新研究发表。该研究给年轻健康男性每天服用5克肌酸数周，不仅检测了DHT、总睾酮和游离睾酮水平，还直接观察了毛囊的大小和数量。结果显示，肌酸并未导致任何相关激素的显著升高，也未引起毛囊萎缩或脱发。

   * 个人观察与遗传因素：达伦博士本人秃顶，但他强调自己是在服用肌酸前就开始秃顶了。他认为脱发更多与遗传因素（如母系遗传）相关。他接触过上千名肌酸使用者，从未有人向他报告肌酸导致脱发。

   * 网络传言的复杂性：对于网络上一些声称服用肌酸后脱发的个案，达伦博士认为原因可能复杂，可能与其他生活习惯、衰老、其他补充剂或药物等多种因素有关，难以简单归因于肌酸。

3. 脱水与肌肉痉挛：

   * 错误认知：肌酸常被误解为会导致脱水或肌肉痉挛。

   * 科学事实：肌酸实际上是一种“超级水合剂”（super hydrating），它将水分带入肌肉细胞，增加细胞内水分含量，这反而有助于维持水合状态，并可能减少痉挛风险。

   * 饮水建议：虽然并非强制要求因服用肌酸而额外大量饮水，但鉴于服用肌酸的人通常运动量较大，保持充足水分总是推荐的，这有助于维持血浆容量和整体代谢健康。如果服用肌酸后尿量增加，通常是因为饮水量增加，而非肌酸本身的直接利尿作用。

4. 胃肠道反应：

   * 原因：肌酸具有渗透性，一次性摄入大剂量（尤其是在负荷期）时，可能会从胃肠道吸收水分，导致部分人出现腹胀、轻微腹泻等不适。

   * 缓解方法：将每日总剂量分多次、小剂量服用，可以有效减轻或避免这些反应。

第八部分：不同类型的肌酸与选择

1. 一水肌酸（Creatine Monohydrate）：

   * 黄金标准：这是研究最多、历史最悠久、被证明最有效、最安全且通常最经济的肌酸形式。播客中讨论的所有益处和研究，几乎都基于一水肌酸。

   * 吸收率：其生物利用度接近100%。

   * 推荐品牌：达伦博士特别提到了德国Creapure®品牌的一水肌酸，因其纯度高（接近100%，无杂质）、经过严格的第三方检测，并获得了FDA的GRAS（公认安全）认证。他指出市面上肌酸原料主要来自中国和德国（Creapure®），而Creapure®在质量控制方面有更严格的保障。

2. 其他形式的肌酸：

   * 市场上的多样性：市面上有许多其他形式的肌酸，如盐酸肌酸（Creatine HCl）、乙酯肌酸（Creatine Ethyl Ester）、缓冲肌酸（Buffered Creatine）、液体肌酸等，它们常宣称具有更高的溶解度、吸收率或更少的副作用。

   * 缺乏证据支持：达伦博士强调，尽管营销宣传很多，但目前缺乏足够的、高质量的科学证据来证明这些新型肌酸在效果或安全性上优于传统的一水肌酸。很多时候，它们的价格更高，但益处并未得到充分证实。

   * 胍基乙酸（Guanidinoacetate, GAA）：这是一种肌酸的前体物质，有一些针对大脑健康的研究，但并非直接替代肌酸。

   * 脂溶性肌酸（Lipid-soluble creatine）：理论上可能更快通过细胞膜，但仍处于研究阶段。

   * 核心原则：无论何种形式，最终要在体内转化为肌酸才能发挥作用。

3. 肌酸软糖（Creatine Gummies）：

   * 新兴形式：作为一种更便捷、口感更好的服用方式，肌酸软糖越来越受欢迎，尤其受到年轻人的喜爱。

   * 注意事项：达伦博士提醒，选择肌酸软糖时，最重要的是确保产品中确实含有标示量的肌酸。他提到有报告指出，一些在电商平台销售的肌酸软糖，经检测后发现肌酸含量极低甚至没有。因此，选择有信誉、经过第三方检测的产品至关重要。

第九部分：达伦博士的个人经验、未来展望与最终建议

1. 达伦博士的个人服用史与原因：

   * 长期服用：他已连续服用肌酸长达25年。

   * 初始动机：最初是出于经典的增肌和提升运动表现的目的，他亲身体验到肌酸带来的恢复加快、力量和重复次数增加。

   * 研究焦点转变：随着研究的深入，他的关注点扩展到肌酸对老年人等特殊人群的益处，致力于通过科学研究帮助人们实现更长久、更健康、功能更健全的生活。

   * 当前剂量与未来计划：他目前每天至少服用10克，尤其在面临学术写作等代谢压力较大的时期会增加。他预计随着年龄增长（如到六七十岁），可能会将剂量提高到每天20克左右，并期待微剂量给药等新策略的研究进展。

2. 对肌酸研究的未来展望：

   * 大脑健康领域：他认为肌酸在大脑健康，特别是神经退行性疾病（如阿尔茨海默病、帕金森病）的预防和治疗方面的研究，是最令人兴奋和具有巨大潜力的方向。任何积极的突破都将产生深远的社会影响。

   * 新型肌酸形式：期待有更多基于坚实科学证据的新型肌酸形式出现，可能在特定方面（如大脑靶向性）有优势，或能以更低剂量达到同样效果。

3. 给听众的最终建议：

   * 运动是基石：达伦博士反复强调，运动是保持年轻和健康的绝对基础，任何膳食补充剂（包括肌酸）都无法替代运动带来的益处。身体天生需要活动。

   * 睡眠的重要性：高质量的充足睡眠对于健康同样至关重要。

   * 充足的蛋白质摄入：对于肌肉健康和整体代谢，蛋白质是不可或缺的。

   * 肌酸的角色：肌酸是在健康生活方式（运动、睡眠、营养）基础之上的一个有益的“锦上添花”的补充，它能帮助你从努力中获得更多回报。

总结

主持人感谢达伦博士的精彩分享，并总结肌酸是一种经过充分研究、安全有效的补充剂，其益处已远远超出传统的肌肉增长，扩展到骨骼健康、大脑认知功能、情绪调节甚至对某些疾病的潜在辅助治疗。一水肌酸因其坚实的科学基础和经济性，仍是目前的首选。听众应根据自身需求和目标，在了解肌酸的基础上，结合健康的生活方式，明智地使用肌酸，以期获得最佳的健康效益。

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Edit:2025.05.13

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