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Creatine N=1: Muscle Gains and Brain Games

I’ve been into weight lifting for about 20 years now. I started when I was a teenager in high school mainly because my high school baseball coach and the school’s weight lifting coach were the same person. Getting fitter and stronger was a necessary part of just getting better.

I grew to really love working out. I legitimately just felt better on days that I exercised. It also helped to have the testosterone of a teenager and young adult where really minimal training led to bigger biceps almost overnight!

But despite two decades of strength training, I never really got into the cycle of using supplements to enhance my training efforts. I didn’t have any philosophical stance against supplementation, it just wasn’t something I wanted to do for the extra money that I would use to spend on it. My main goal for exercise more about feeling good than about aesthetics, so why bother?

Fast forward to 2017, and I’m going through my stack of interesting papers about traumatic brain injury and neurodegenerative diseases when this guy shows up:

Creatine and Its Potential Therapeutic Value for Targeting Cellular Energy Impairment in Neurodegenerative Diseases

It’s been well known that creatine provides performance enhancing benefits for sport and training by improving the ability for muscles to use energy. Thousands of studies generally support this effect on muscle [Source]. It is known.

It Is GIF - It Is Known GIFs

Apparently creatine through it’s action on cellular mitochondria has therapeutic potential to help the brain.

Image result for whoa meme

Therapeutic potential is cool and all, but lots of things have biological potential. Was there any supporting data that showed supplementing with creatine could affect the brain? If it could, then it’s possible that just taking a cheap supplement like creatine could help with age related muscle loss on top off addressing some of the cognitive decline we all experience as we get older.

So what’s out there?

Creatine appears to preserve cognition during periods of neurologic decline and neurolgic stress. A randomized trial of creatine vs placebo on healthy adults under laboratory controlled oxygen deprivation with some striking results. [Source] While the placebro group tanked across multiple cognitive tests with oxygen deprivation, the creatine group not only showed reduced decline, but actually showed slight improvement in 2 domans of cognition.

Cognitive scores under oxygen deprivation. Creatine in black compared to placebo in white.

Creatine supplementation has also shown an ability to mitigate some of the cognitive effects of sleep deprivation, bipolar depression, and possibly traumatic brain injury. While creatine has shown promise in animal models of Parkinson’s Disease, it has been largely ineffective in improving quality of life in patient’s with PD.

But what about healthy individuals? The results get a little more fuzzy here. Studies have shown improved cognitive performance in healthy vegetarians and healthy aging populations, but results in healthy young adults were unremarkable.

So it looks like creatine has good upside for helping the brain during metabolic distress or metabolic decline, but young healthy people has slight or no difference.

N=1 with Dr. Chung

So that brings us to our current experiment. Being creatine ignorant all my life, I wanted to see what kind of physical, mental, and cognitive effects we might have by just taking 8 grams per day.

Here are some baseline physical numbers:

  • Weight 185 lbs
  • Bench Press: 225 lbs
  • Back Squat: Recent 310 lbs, lifetime 315 lbs
  • Deadlift: Recent 365, lifetime 400 lbs

For cognitive testing, I used a platform that we test in our office called Cambridge Brain Sciences and an app called Brain EQ.

Brain EQ:

Brain EQ App Pre-creatine scores and averages

Cambridge Brain Science Tests

Cambridge Brain Science Cognitive Test. Pretty average, but those years of teaching people Stroop makes me pretty good at Double Trouble

Mostly pretty average scores. Though taking these tests are humbling and make you feel like an idiot frequently.

In particular, I didn’t feel great about my spatial processing and my memory scores. No matter who you are, it never feels good to be on the bottom end of the bell curve, even if that curve is still average.

Ouch. I’m not as good at navigating space as I thought

So we had our baselines and now we did our creatine protocol.

I basically took 8 grams per day of Metagenics Creatine Monohydrate.

Kept my workouts and diet the same and I intentionally avoided any cognitive training to avoid a practice effect from baseline to followup. No other interventions done for roughly 4 weeks.

Results

Alright, so let’s see what happened.

Physical Numbers:

  • Weight: 192 lbs
  • Bench Press: 235 lbs (10 lb increase)
  • Back Squat: 325 lbs (10 lb increase)
  • Deadlift: 365 lbs (no change)
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So far so good

How about the cognitive scores?

BrainEQ: Mostly unchanged. My reaction time and speed on rapid scanning improved slightly, but I did worse on other scores.

Post Creatine: Brain EQ Scores some what worse except speed tests.

Cambridge Brain Sciences: Improved on 7 scores with 2 being a lot better. Did slightly worse on 5 scores.

7 Scores improved with 2 showing large improvement. 5 Scores worse.

The scores that improved the most naturally came from the tests I did worst on.

The Bad Scores that jumped up.

So What Does It All Mean?

Overall, most of the cognitive scores seemed to be the same. Many scores improved and some decreased but only one score appeared to show a statistically significant difference.

The scores that seemed to improve the most happened in the tests that I did poorer than expected so there was room for a regression to the mean.

My physical strength numbers were substantially better and I can only really attribute creating to the change. I’ve tried maxing out my back squat numerous times in the past 3 years, getting over 315 has always seemed like it was really out of reach.

Overall it looks like my short experience with creatine fits with what’s in the scientific literature so far

Being someone who is mostly cognitively normal, the literature seems to show that creatine doesn’t really change much in terms of cognitive scores.

However, in conditions of increased mental stress or potential nutrient deficiency, creatine seems to have the ability to buffer the cognitive decline in stressful brain states.

This might include:

  • Traumatic brain injury
  • Aging
  • Sleep deprivation
  • Post-exercise/exertion fatigue

Since creatine doesn’t appear to have much downside in patients with healthy kidneys, there seems to be a space where taking a daily dose of 5-8g/day can have some benefit in building the storage and availability of creatine for stressful events.

Final Thoughts

Some final thoughts. Overall I felt really strong and pretty good mentally during the experiment. However, it may be coincidental or not, I did have some digestive unrest and my bowel movements were noticeably decreased.

I’ll run the experiment again under similar conditions and again with high fiber plant heavy diet and see if this offsets some of those digestive effects.

Concussion and Eye Movement Series Part 1: Anti-Saccades

Eye movements have become an important diagnostic for patients with neurological disease and dysfunction. It’s one of the reasons we have invested into using extremely sophisticated eye tracking technology so that we can asses and manage patients effectively with traumatic brain injuries.

This will be the first in a series of posts about eye movements that are commonly affected with concussion. The first eye movement we’ll discuss is called anti-saccades.

What’s A Saccade?

In order to know what an anti-saccade is, we have to know what a regular saccade is. A saccade is a fast eye movement that takes your eyes from one target to another. Saccades are the eye movements we use to explore the world around us. They are also eye movements that react very quickly to new things in our environment. These can be a movement in the background, a flashing light, a loud noise, or a touch on our skin.

When we perceive there’s something in our environment that needs our attention, we use saccades almost like a reflex to direct our brain’s attention toward that new stimulus.

What’s an Anti-Saccade

An anti-saccade is a concept developed to see if someone can consciously inhibit a desire to look at something new. During an anti-saccade, we would have you fixate on a central target, and when a new target comes up, we ask you to move your eyes in a spot opposite to where the new target appeared.

The anti-saccade test


Antisaccades require our brain 🧠 to ignore a new stimulus and to create a plan to move the eyes 👀 to a mirror location.

This task requires higher level brain activity because our brains are wired to look at new stimuli. Specifically it requires a functioning prefrontal cortex (PFC).

In patients with concussion, their ability to perform Anti-saccades is compromised where they make frequent eye movements towards the new target, or they take a long time to move their eyes in the opposite direction. This indicates problems with a function called response inhibition. It’s the ability for our brain to stop doing something we don’t want it to do.

This requires a part of our brain called the pre-frontal cortex. Specifically, the dorsolateral prefrontal cortex. We’ll just call it the PFC for short. The PFC is what allows us to inhibit a desire to do something that may be inappropriate.

We need our PFC to stop ourselves from making inappropriate reactions. It’s one of the main differences between an adult brain and a child’s brain is that our PFC keeps us from having meltdowns when something goes wrong.

Parents of toddlers, you guys know what I’m talking about.


So when we take a hit to the head and our PFC goes down, we can have responses that aren’t appropriate. This might mean an emotional outburst, or problems controlling wreckless behavior like uncontrolled gambling. A viable PFC is critical for that and for keeping our bodies from over reacting to stress.

This provides us a meaningful way to assess PFC activity and gives us an way to improve PFC activity using eye movement therapies.

Not only can anti-saccades be used to assess the functionality of someone’s PFC. It can play a role in helping someone rehabilitate their PFC or other aspects of the brain connected to it.