What can you take or do to reduce headache? And in order to address this, we're going to start first with the headaches associated with head hits and traumatic brain injury, because it turns out there's a surprising and very useful approach to doing that. But this same approach also can help offset and treat headache in other conditions as well.

Meaning not just for headaches caused by traumatic brain injury, but also headaches caused by sudden onset tension headache or migraine headache, or even perhaps, again, perhaps cluster type headaches. So the first substance that I'd like to highlight that has been shown to significantly reduce the intensity and or frequency of headaches is creatine.

Now, creatine, as many of you know, is something that people supplement and take. Most often, creatine is discussed in the context of muscle performance, not just for people who weight lift, but for people who do endurance exercise. And it's often been said that five to 10 grams per day of creatine monohydrate, depending on how much you weigh, five to 10 grams per day of creatine monohydrate can increase creatine phosphate stores in muscles, can bring more water into muscles, can make you stronger, can increase power output, and that is all true.

That is all completely true. We discussed this in the Huberman Lab Podcast with Dr. Andy Galpin when he was a guest on the Huberman Lab Podcast Standard Series. And we discussed this extensively in an upcoming episode from Dr. Andy Galpin in his special six-part guest series where he is a guest on the Huberman Lab Podcast, but where really he's the one doing the majority of the teaching.

That series covers everything from strength, hypertrophy, endurance. And there's an episode on supplementation where we go deep into the discussion about creatine. Now, in that discussion, and again now, we highlight the fact that creatine, while most often discussed online and in the media as a supplement for sports performance, for the reasons I just mentioned, actually has far more data behind it.

That is laboratory studies exploring the role of creatine in the clinical setting. So I'd like to highlight a paper from that literature now that will make very clear as to why creatine is interesting and in fact, very effective for treating headache, in particular, headache caused by head hits or traumatic brain injury.

The title of the paper is "Prevention of Traumatic Headache, Dizziness, and Fatigue with Creatine Administration." Now, keep in mind, this is a pilot study. It was performed in humans. So when you hear the words preclinical, that is if you hear there was a preclinical study on blank, that means almost always that the study was performed on animal models, mice, rats, primates, et cetera.

A clinical trial is something that's carried out on humans. And a pilot study means that the study was carried out on humans, but on a fairly small cohort, a fairly small group or limited number of subjects. Nonetheless, if the data are robust, as it is in this case of this paper, I think it's worth paying attention to.

So in this study, what they looked at was creatine administration. So what they did is they had people ingest a certain amount of creatine, I'll tell you in a moment, in fluid, so it could be taken in water or milk, with or without food, doesn't really matter what time of day.

They had people take creatine. Why would they have people take creatine after traumatic brain injury? And in particular for people that are suffering from headache, dizziness, fatigue, et cetera. The reason is that neurons, nerve cells, rely very heavily on the regulation of calcium in order to generate those action potentials to communicate with one another.

So it doesn't matter if it's a motor neuron, a sensory neuron, or a modulatory neuron, they all generate action potentials or something similar to it. And calcium is important for that process. Calcium becomes dysregulated after traumatic brain injury in a number of different ways, in particular in ways that impact the energy production systems of cells that are related to ATP, adenosine triphosphate.

For those aficionados out there that want to look it up, you can simply look up calcium, ATP, and neurons, and you can learn about that cycle. Creatine can be stored in muscles as we talked about before, but creatine, and in particular, the phosphorylated form of creatine, which is the readily available fuel source form of creatine, can also be stored in brain tissue.

And it is actually quite prominently stored in the forebrain, the area where the real estate of your brain just behind the forehead, which is involved in planning and action and understanding context. So it's very important for cognition. It's important for personality too, but it's important for a number of different aspects of life that have to do with making plans, being able to focus very intensely on your work, et cetera, or on anything for that matter, all functions that become heavily disrupted in people who have traumatic brain injury and concussion.

Creatine's ability to communicate with the calcium and the ATP system was the motivation behind this study. That is, the authors hypothesized on the basis of preclinical data in animals that by increasing creatine stores within the brain, not just in the muscle, but in particular within the brain, that the availability of creatine would allow for better cognitive function in general.

Now, they didn't look at cognition specifically in this paper, but they did look at the other aspects, that is the bad stuff associated with TBI. And they had people supplement with creatine at a level that is much higher than the typical level that people supplement with creatine simply for sports performance.

So as I mentioned before, most people, if they supplement with creatine for sports performance, they take creatine monohydrate, typically five grams per day, sometimes 10 grams per day if they're about 100 kilograms or greater in body weight. 100 kilograms is approximately 220 pounds. So the dosage that was used for supplementing creatine in this study to address the potential impact of creatine on headache, dizziness, and fatigue was quite a bit higher than the dosages used simply for muscle performance.

In this study, they had people take a dose of 0.4 grams of creatine monohydrate per kilogram of body weight. So for somebody that weighs 100 kilograms or 220 pounds, that would be 40 grams of creatine per day. And if someone weighs half that much, they would take 20 grams of creatine per day.

And they did that over a period of six months. And we know that when you take creatine over and over day to day, that there's a buildup of creatine stores both in the muscles and within the brain tissue. And what they found as a consequence of this creatine administration was really striking and I think quite exciting.

They found a very significant decrease in the frequency of headache in people that were supplementing with creatine as opposed to the controls. Now, keep in mind that this is a pilot study, but the effects are very dramatic. They found a very statistically significant decrease in the frequency of headache in people that were taking creatine.

In fact, if you look at the controls and you see that they're basically getting headache at a frequency of 90% or more after TBI, the reduction in headache frequency is down to about 10 or 12% in the people taking creatine. So that's quite a dramatic effect. And if you look at the other measures they took, keep in mind, again, this is a pilot study, so a limited number of subjects, but again, the results are very impressive.

What they found is that the number of people experiencing dizziness was significantly reduced in people supplementing with creatine as was the number of people experiencing fatigue, kind of acute fatigue and chronic fatigue. Again, not chronic fatigue syndrome per se, but chronic fatigue, which was in this study defined as a general sense of bodily weakness and even mental weakness.

Mental weakness is a little bit hard to quantify, but they were very careful to distinguish between cognitive and mental fatigue versus physical and somatic fatigue. They acknowledged that both of those occur in TBI or post-TBI, that headache is quite frequent. Basically, the takeaway of this study is that for people experiencing headache, dizziness, and fatigue due to TBI, and perhaps, and I want to underline perhaps because it hasn't really been explored yet, but perhaps headache, dizziness, and fatigue due to other conditions, symptoms, or causes of headache, creatine monohydrate supplementation might be, again, might be an excellent candidate for people to try.

Why do we say that? Well, first of all, creatine monohydrate is relatively inexpensive. It's considered safe at the dosages used in this study and certainly for sports performance as well. And there are very few other compounds that have been shown to have as significant an impact on headache over the long-term as has creatine monohydrate in these studies of people with TBI.

It's also important to highlight the fact that many, many people suffer from TBI, as I mentioned earlier, and as now, there are very few treatments for TBI. You tend to get the basic advice coming back, and again, I think it's excellent advice. You know, get proper amounts of sleep, get exercise, but don't get another traumatic brain injury.

That's obvious, but you'd be surprised how many people go right back to work because they have to. And, you know, we have to be sympathetic to the fact that many people just can't stop working or go on disability. So many people have to go back to work. That could be sport or it could be other kinds of work where they are then subject to perhaps getting more TBI.

Maybe they're getting less rest as a consequence and stress. Obviously, stress is a confounding issue for TBI, but sleep, exercise, sun, nutrition, all of those things, proper social connection, are what people are encouraged to do when they have TBI, but there have been very few compounds, in particular, very few over-the-counter compounds that are known to be safe that have shown efficacy in dealing with TBI.

So I think that while this is a pilot study and we can consider it preliminary, I think it's important enough and the effects were dramatic enough that people with headache, and in particular people with TBI, ought to consider supplementing with creatine in order to deal with their headaches. And of course, I eagerly await other studies exploring the role of this high dosage of creatine, or I should say relatively high dosage of creatine monohydrate for offsetting headache.

Meanwhile, I think there are a number of people out there suffering from headache who might consider using creatine monohydrate in an exploratory fashion and seeing whether or not it helps offset their headaches. Keep in mind, of course, anytime you're going to add or remove anything, supplement or otherwise from your treatment, your nutrition, et cetera, I do suggest that you consult with your physician, in particular, if you have chronic headaches.

I don't say that to protect me, I say that, of course, to protect you. (upbeat music) (upbeat music)