How Creatine Can Help with Concussion & Traumatic Brain Injury

00:00:00.000 | [Silence]

00:00:02.560 | What can you take or do to reduce headache?

00:00:06.360 | And in order to address this, we're going to start first

00:00:08.640 | with the headaches associated with head hits

00:00:10.400 | and traumatic brain injury,

00:00:12.260 | because it turns out there's a surprising

00:00:14.380 | and very useful approach to doing that.

00:00:17.720 | But this same approach also can help offset

00:00:21.840 | and treat headache in other conditions as well.

00:00:23.960 | Meaning not just for headaches

00:00:25.500 | caused by traumatic brain injury,

00:00:26.740 | but also headaches caused by sudden onset tension headache

00:00:30.840 | or migraine headache, or even perhaps,

00:00:33.620 | again, perhaps cluster type headaches.

00:00:35.400 | So the first substance that I'd like to highlight

00:00:37.760 | that has been shown to significantly reduce the intensity

00:00:41.500 | and or frequency of headaches is creatine.

00:00:45.360 | Now, creatine, as many of you know,

00:00:47.620 | is something that people supplement and take.

00:00:49.880 | Most often, creatine is discussed

00:00:53.280 | in the context of muscle performance,

00:00:54.760 | not just for people who weight lift,

00:00:55.960 | but for people who do endurance exercise.

00:00:58.120 | And it's often been said that five to 10 grams per day

00:01:01.320 | of creatine monohydrate, depending on how much you weigh,

00:01:03.280 | five to 10 grams per day of creatine monohydrate

00:01:05.720 | can increase creatine phosphate stores in muscles,

00:01:08.800 | can bring more water into muscles, can make you stronger,

00:01:10.960 | can increase power output, and that is all true.

00:01:13.640 | That is all completely true.

00:01:14.640 | We discussed this in the Huberman Lab Podcast

00:01:16.720 | with Dr. Andy Galpin when he was a guest

00:01:19.040 | on the Huberman Lab Podcast Standard Series.

00:01:21.960 | And we discussed this extensively in an upcoming episode

00:01:25.440 | from Dr. Andy Galpin in his special six-part guest series

00:01:30.440 | where he is a guest on the Huberman Lab Podcast,

00:01:33.000 | but where really he's the one doing

00:01:34.440 | the majority of the teaching.

00:01:35.900 | That series covers everything

00:01:37.060 | from strength, hypertrophy, endurance.

00:01:38.480 | And there's an episode on supplementation

00:01:40.160 | where we go deep into the discussion about creatine.

00:01:42.760 | Now, in that discussion, and again now,

00:01:45.320 | we highlight the fact that creatine,

00:01:47.840 | while most often discussed online and in the media

00:01:50.960 | as a supplement for sports performance,

00:01:53.400 | for the reasons I just mentioned,

00:01:55.360 | actually has far more data behind it.

00:01:57.840 | That is laboratory studies exploring the role of creatine

00:02:00.800 | in the clinical setting.

00:02:02.320 | So I'd like to highlight a paper from that literature now

00:02:04.240 | that will make very clear as to why creatine is interesting

00:02:07.240 | and in fact, very effective for treating headache,

00:02:09.680 | in particular, headache caused by head hits

00:02:11.360 | or traumatic brain injury.

00:02:12.520 | The title of the paper is "Prevention of Traumatic Headache,

00:02:15.560 | Dizziness, and Fatigue with Creatine Administration."

00:02:18.480 | Now, keep in mind, this is a pilot study.

00:02:20.600 | It was performed in humans.

00:02:21.940 | So when you hear the words preclinical,

00:02:23.700 | that is if you hear there was a preclinical study on blank,

00:02:26.560 | that means almost always that the study was performed

00:02:29.100 | on animal models, mice, rats, primates, et cetera.

00:02:32.720 | A clinical trial is something that's carried out on humans.

00:02:35.120 | And a pilot study means that the study was carried out

00:02:38.400 | on humans, but on a fairly small cohort,

00:02:40.840 | a fairly small group or limited number of subjects.

00:02:44.560 | Nonetheless, if the data are robust,

00:02:46.120 | as it is in this case of this paper,

00:02:48.320 | I think it's worth paying attention to.

00:02:50.020 | So in this study,

00:02:50.860 | what they looked at was creatine administration.

00:02:53.100 | So what they did is they had people ingest

00:02:55.300 | a certain amount of creatine, I'll tell you in a moment,

00:02:57.940 | in fluid, so it could be taken in water or milk,

00:02:59.840 | with or without food,

00:03:00.780 | doesn't really matter what time of day.

00:03:02.920 | They had people take creatine.

00:03:04.520 | Why would they have people take creatine

00:03:05.840 | after traumatic brain injury?

00:03:07.840 | And in particular for people that are suffering

00:03:09.960 | from headache, dizziness, fatigue, et cetera.

00:03:12.680 | The reason is that neurons, nerve cells,

00:03:16.040 | rely very heavily on the regulation of calcium

00:03:19.680 | in order to generate those action potentials

00:03:21.520 | to communicate with one another.

00:03:22.720 | So it doesn't matter if it's a motor neuron,

00:03:24.060 | a sensory neuron, or a modulatory neuron,

00:03:25.740 | they all generate action potentials

00:03:27.100 | or something similar to it.

00:03:28.320 | And calcium is important for that process.

00:03:30.860 | Calcium becomes dysregulated after traumatic brain injury

00:03:34.820 | in a number of different ways,

00:03:36.320 | in particular in ways that impact

00:03:38.940 | the energy production systems of cells

00:03:41.400 | that are related to ATP, adenosine triphosphate.

00:03:43.900 | For those aficionados out there that want to look it up,

00:03:46.100 | you can simply look up calcium, ATP, and neurons,

00:03:48.420 | and you can learn about that cycle.

00:03:50.780 | Creatine can be stored in muscles as we talked about before,

00:03:54.200 | but creatine, and in particular,

00:03:55.600 | the phosphorylated form of creatine,

00:03:57.520 | which is the readily available fuel source form of creatine,

00:04:02.520 | can also be stored in brain tissue.

00:04:05.240 | And it is actually quite prominently stored

00:04:07.400 | in the forebrain, the area where the real estate

00:04:09.560 | of your brain just behind the forehead,

00:04:11.280 | which is involved in planning and action

00:04:13.680 | and understanding context.

00:04:15.040 | So it's very important for cognition.

00:04:17.120 | It's important for personality too,

00:04:18.880 | but it's important for a number of different aspects of life

00:04:21.020 | that have to do with making plans,

00:04:22.380 | being able to focus very intensely on your work, et cetera,

00:04:25.380 | or on anything for that matter,

00:04:27.220 | all functions that become heavily disrupted

00:04:29.700 | in people who have traumatic brain injury and concussion.

00:04:32.540 | Creatine's ability to communicate

00:04:35.540 | with the calcium and the ATP system

00:04:38.060 | was the motivation behind this study.

00:04:39.420 | That is, the authors hypothesized

00:04:40.860 | on the basis of preclinical data in animals

00:04:43.200 | that by increasing creatine stores within the brain,

00:04:47.460 | not just in the muscle, but in particular within the brain,

00:04:51.180 | that the availability of creatine would allow

00:04:54.140 | for better cognitive function in general.

00:04:56.620 | Now, they didn't look at cognition

00:04:57.820 | specifically in this paper,

00:04:58.980 | but they did look at the other aspects,

00:05:01.020 | that is the bad stuff associated with TBI.

00:05:03.980 | And they had people supplement with creatine

00:05:06.380 | at a level that is much higher than the typical level

00:05:09.340 | that people supplement with creatine

00:05:11.180 | simply for sports performance.

00:05:12.960 | So as I mentioned before, most people,

00:05:14.960 | if they supplement with creatine for sports performance,

00:05:17.060 | they take creatine monohydrate,

00:05:19.460 | typically five grams per day, sometimes 10 grams per day

00:05:22.260 | if they're about 100 kilograms or greater in body weight.

00:05:25.780 | 100 kilograms is approximately 220 pounds.

00:05:30.580 | So the dosage that was used for supplementing creatine

00:05:32.880 | in this study to address the potential impact of creatine

00:05:37.380 | on headache, dizziness, and fatigue

00:05:39.980 | was quite a bit higher than the dosages used

00:05:43.300 | simply for muscle performance.

00:05:44.820 | In this study, they had people take a dose of 0.4 grams

00:05:49.780 | of creatine monohydrate per kilogram of body weight.

00:05:53.340 | So for somebody that weighs 100 kilograms or 220 pounds,

00:05:56.220 | that would be 40 grams of creatine per day.

00:06:00.020 | And if someone weighs half that much,

00:06:01.540 | they would take 20 grams of creatine per day.

00:06:04.060 | And they did that over a period of six months.

00:06:06.420 | And we know that when you take creatine

00:06:08.020 | over and over day to day,

00:06:09.420 | that there's a buildup of creatine stores

00:06:11.100 | both in the muscles and within the brain tissue.

00:06:13.580 | And what they found as a consequence

00:06:15.020 | of this creatine administration was really striking

00:06:17.280 | and I think quite exciting.

00:06:18.820 | They found a very significant decrease

00:06:21.820 | in the frequency of headache

00:06:23.560 | in people that were supplementing with creatine

00:06:25.660 | as opposed to the controls.

00:06:27.400 | Now, keep in mind that this is a pilot study,

00:06:29.500 | but the effects are very dramatic.

00:06:31.420 | They found a very statistically significant decrease

00:06:34.740 | in the frequency of headache

00:06:36.660 | in people that were taking creatine.

00:06:38.500 | In fact, if you look at the controls

00:06:40.300 | and you see that they're basically getting headache

00:06:42.420 | at a frequency of 90% or more after TBI,

00:06:46.380 | the reduction in headache frequency

00:06:48.140 | is down to about 10 or 12% in the people taking creatine.

00:06:52.140 | So that's quite a dramatic effect.

00:06:53.980 | And if you look at the other measures they took,

00:06:56.540 | keep in mind, again, this is a pilot study,

00:06:58.540 | so a limited number of subjects,

00:06:59.940 | but again, the results are very impressive.

00:07:02.620 | What they found is that

00:07:04.060 | the number of people experiencing dizziness

00:07:07.340 | was significantly reduced

00:07:08.900 | in people supplementing with creatine

00:07:10.340 | as was the number of people experiencing fatigue,

00:07:13.420 | kind of acute fatigue and chronic fatigue.

00:07:15.360 | Again, not chronic fatigue syndrome per se,

00:07:17.660 | but chronic fatigue, which was in this study

00:07:20.380 | defined as a general sense of bodily weakness

00:07:22.540 | and even mental weakness.

00:07:24.700 | Mental weakness is a little bit hard to quantify,

00:07:27.060 | but they were very careful to distinguish

00:07:29.460 | between cognitive and mental fatigue

00:07:31.220 | versus physical and somatic fatigue.

00:07:33.540 | They acknowledged that both of those occur in TBI

00:07:36.340 | or post-TBI, that headache is quite frequent.

00:07:39.300 | Basically, the takeaway of this study

00:07:40.660 | is that for people experiencing headache,

00:07:42.700 | dizziness, and fatigue due to TBI,

00:07:45.620 | and perhaps, and I want to underline perhaps

00:07:47.460 | because it hasn't really been explored yet,

00:07:48.940 | but perhaps headache, dizziness, and fatigue

00:07:52.020 | due to other conditions, symptoms, or causes of headache,

00:07:57.020 | creatine monohydrate supplementation might be,

00:08:00.300 | again, might be an excellent candidate for people to try.

00:08:03.140 | Why do we say that?

00:08:03.960 | Well, first of all,

00:08:05.340 | creatine monohydrate is relatively inexpensive.

00:08:07.860 | It's considered safe at the dosages used in this study

00:08:11.200 | and certainly for sports performance as well.

00:08:15.120 | And there are very few other compounds

00:08:18.960 | that have been shown to have as significant an impact

00:08:21.560 | on headache over the long-term

00:08:24.500 | as has creatine monohydrate

00:08:26.140 | in these studies of people with TBI.

00:08:28.360 | It's also important to highlight the fact

00:08:29.860 | that many, many people suffer from TBI,

00:08:32.700 | as I mentioned earlier,

00:08:33.700 | and as now, there are very few treatments for TBI.

00:08:38.260 | You tend to get the basic advice coming back,

00:08:40.420 | and again, I think it's excellent advice.

00:08:42.180 | You know, get proper amounts of sleep, get exercise,

00:08:44.580 | but don't get another traumatic brain injury.

00:08:46.260 | That's obvious, but you'd be surprised

00:08:48.900 | how many people go right back to work because they have to.

00:08:51.260 | And, you know, we have to be sympathetic to the fact

00:08:54.100 | that many people just can't stop working

00:08:55.900 | or go on disability.

00:08:57.660 | So many people have to go back to work.

00:08:59.340 | That could be sport or it could be other kinds of work

00:09:00.980 | where they are then subject to perhaps getting more TBI.

00:09:04.700 | Maybe they're getting less rest as a consequence and stress.

00:09:07.100 | Obviously, stress is a confounding issue for TBI,

00:09:10.620 | but sleep, exercise, sun, nutrition, all of those things,

00:09:14.680 | proper social connection,

00:09:16.140 | are what people are encouraged to do when they have TBI,

00:09:18.860 | but there have been very few compounds,

00:09:20.180 | in particular, very few over-the-counter compounds

00:09:22.780 | that are known to be safe

00:09:24.220 | that have shown efficacy in dealing with TBI.

00:09:26.540 | So I think that while this is a pilot study

00:09:29.540 | and we can consider it preliminary,

00:09:31.500 | I think it's important enough

00:09:33.260 | and the effects were dramatic enough

00:09:34.960 | that people with headache,

00:09:36.380 | and in particular people with TBI,

00:09:38.100 | ought to consider supplementing with creatine

00:09:40.820 | in order to deal with their headaches.

00:09:42.380 | And of course, I eagerly await other studies

00:09:45.140 | exploring the role of this high dosage of creatine,

00:09:48.300 | or I should say relatively high dosage

00:09:49.700 | of creatine monohydrate for offsetting headache.

00:09:52.140 | Meanwhile, I think there are a number of people out there

00:09:54.580 | suffering from headache

00:09:56.160 | who might consider using creatine monohydrate

00:09:59.180 | in an exploratory fashion

00:10:00.860 | and seeing whether or not it helps offset their headaches.

00:10:03.020 | Keep in mind, of course,

00:10:04.060 | anytime you're going to add or remove anything,

00:10:06.460 | supplement or otherwise from your treatment,

00:10:08.900 | your nutrition, et cetera,

00:10:09.820 | I do suggest that you consult with your physician,

00:10:12.020 | in particular, if you have chronic headaches.

00:10:13.860 | I don't say that to protect me,

00:10:15.020 | I say that, of course, to protect you.

00:10:17.380 | (upbeat music)

00:10:19.960 | (upbeat music)

00:10:22.540 | [MUSIC PLAYING]

How Creatine Can Help with Concussion & Traumatic Brain Injury | Dr. Andrew Huberman

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