Episode Transcript
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Holly L. Thacker, MD (00:06):
Welcome to
the Speaking of Women's Health
podcast.
I'm your host, dr Holly Thacker, and I am back in the Sunflower
House for a new podcast andthis is going to be a little bit
of a potpourri.
I'm going to talk about somesubstances that I've been asked
(00:28):
a lot about recently in mypractice and I'm the director
for the Center for SpecializedWomen's Health.
I'm a professor of medicine andalso OBGYN and reproductive
biology and I run our specialtywomen's health fellowship and I
see midlife women's health formenopausal risk assessment,
(00:52):
hormone therapy, osteoporosisand anti-aging, and we started
this podcast back in 2023because we wanted to get some of
our great content out to busypeople, and I want to dive into
this topic on some of thesesupplements that have really
(01:15):
really been kind of buzzing, andsome of it is, I think, on
social media.
It's really popular to be onInstagram and be an influencer
and put out all this contentabout perimenopause and
menopause, and some of thecontent's good and, I guess,
(01:36):
people thinking and talkingabout their health and being
proactive, and that's our mottohere at Speaking of Women's
Health Be strong, be healthy andbe in charge.
But, that being said, a lot oftimes I think some of these
influencers are selling thingsand I run this nonprofit.
I'm not selling anything.
We just want to get the rightinformation out and I'm so
(01:57):
grateful for supporters andphilanthropists who have
contributed to this nonprofitand anyone can contribute.
Anyone can be a subscriber.
You can go onspeakinginwomenshealthcom and
click that donate button if youappreciate the health
information.
(02:18):
So today I want to talk aboutsome supplements.
Creatine is one of them.
L-carnitine supplementsCreatine is one of them
L-carnitine, taurine and boronand, like I said, you may have
seen social media influencersand wellness blogs kind of
hyping them all up.
So we're going to dive intowhat is fiction and what is fact
(02:40):
, and I want to cut through thenoise.
You're busy.
You've got a lot going on inyour life.
You want to make sure you'remaking good use of your money,
if you are buying anysupplements, and let's talk
about these substances aminoacids, trace minerals and who
might benefit from them and ifit's truly necessary to add them
(03:02):
to your routine.
Now, remember this is notmedical advice.
This is just some healthinformation to empower you to be
strong, be healthy and be incharge.
So I'll start with the one thatI get asked the most about,
which is creatine, and creatineis a compound that comes from
(03:23):
three amino acids arginine,glycine and methionine and
creatine is naturally producedin your body and it's primarily
stored in muscles and your brain.
So what are the benefits ofcreatine?
Well, it's known in part, forits benefits on athletic
(03:47):
performance and muscle massproduction, and I heard about
the interest in creatine from myathletic sons back when they
were competing at pretty goodlevels at high school and also
(04:07):
collegiately.
Stetson Dr, stetson Thacker,who's been on our podcast, who's
my oldest son.
He was actuallya national GotMilk athlete.
His little cute mug with amustache was plastered all over
the place.
He was like one of 23 scholarathletes picked in the country,
and my other two sons, emersonand Grayson, went on to play
(04:31):
college football like theirfather.
So, of course, being young,strong men competing, they were
very much interested in musclemass and athletic performance.
But creatine has been studied toplay important roles in other
parts of our health, not justathletic performance, heart
(04:51):
health, managing type 2 diabetesand injury prevention.
Also cognition and brain health, and I've done a couple of
podcasts related to brain health.
One was in season one, I thinkSeptember 8th 2023, on the mind
(05:11):
diet and the supplement, whichback then was by prescription.
Now it's over the counter,called Serifolin NAC, now
renamed Serifolin Brain Wellness, which has been shown to reduce
brain shrinkage.
It doesn't have any creatine init but it has methylated
vitamins.
A lot of people with the MTHFRmutation don't convert some of
(05:36):
the B-complex vitamins to anactive form that can be used.
That also affect methionine,which affects some of the
neurotransmitters in the brain,and in season three I did
another podcast about anti-agingand brain health.
(05:58):
I've also done several podcastson omega-3s, which seem to be
anti-aging and help with brainhealth.
Now creatine, besides brain andmuscle, also has a role to play
in bone health and of course I'ma bonehead, I'm an osteoporosis
specialist and we have lots ofcontent on treating, preventing,
(06:22):
managing osteoporosis withlifestyle, nutrition and select
medications, includingosteoanabolics or bone building
therapies if needed, and alsoskin aging.
And of course we have a lot ofstuff on skin, because pretty
much most all women care abouthair and skin.
I always just think of it askind of external and peripheral
(06:45):
and not really integral to yourhealth.
But certainly if your skinisn't healthy and your hair
isn't healthy, that many timesreflects nutritional and
hormonal and other deficiencies.
So what foods are rich increatine.
So the body makes about half ofthe creatine it needs each day
(07:06):
by itself and the other halfcomes from a person's diet.
So the creatine rich foods arethings that you probably would
suspect, like meat, fish,poultry and dairy.
So some of the foods that arereally high in creatine are
herring, which is also reallygood for omegas your omega-3s
(07:31):
Pork.
Now, if you heard my podcast onthe foods that are banned in
other countries that areavailable in America, you'll
know that a lot of countries banAmerican pork because of a
growth promoting substance thatis provided to American pork to
(07:53):
make it fattier and bigger.
So I always tell people, ifyou're going to ingest pork
which is rich in K2, by the way,also known as M7, which is one
of the few foods that helpsdrive calcium into the bones and
not the arteries then youreally want to look for one that
doesn't use any extra additivesor antibiotics or injections or
(08:18):
artificial substances topromote growth.
Beef is really rich in creatine.
Grass-fed beef tends to havebetter omega ratios.
Salmon another great option forcreatine and omegas, and is one
of the foods that's rich increatine and not too high in
(08:41):
uric acid.
So if you're plagued with goutor any crystalline diseases.
Elevated uric acid, which a lotof times is not on regular
metabolic panels unless youspecifically ask for it.
Salmon's a really good one.
Lamb, cod, cod's rich inomega-3, chicken, and the dark
(09:04):
chicken has the K2.
And then milk from animals, sothat would include cow's milk
and goat's milk.
So what women are asking me iswell, doctor, should I be on
creatine supplements?
And I find that people likequick fixes, like let's just
swallow a capsule instead ofreally thinking about everything
(09:26):
.
And they are very popularamongst athletes, also those
that don't get enough creatinefrom their diet.
So strict lacto-ovo vegetariansare definitely at risk for not
getting enough creatine.
The supplements do come inpowder form tablets, capsules,
(09:48):
liquids and energy bars.
For athletes, the creatinesupplementation does increase
the energy that is available inmuscles for high intensity
exercise, heavy lifting and soit can lead to improved exercise
performance, and some peoplebelieve that it might also
(10:09):
improve some post-exerciserecovery and injury prevention.
Now, it's very important todrink plenty of water if you're
taking a creatine supplement,and some research shows that
taking it after your workout isactually superior to your
pre-workout for body compositionand strength, and some of these
pre-workouts have the creatinein it and rather than just take,
(10:31):
you know, just like a glob ofstuff that you're not even sure
of.
You really need to look atlabels, bring in the containers,
talk to your healthcare teamabout it.
So most studies show that ifyou use appropriate doses, most
don't find any significant sideeffects for up to five years.
But there are cases ofinterstitial nephritis and I
(10:59):
noticed that my one son'screatinine level really kind of
had jumped up quite a bit andhis physician said to him you
know, are you doing bodybuildingas your source of income?
Is this your livelihood?
He said, well, no, I'm justrecreational now.
And he said, well, that Iwouldn't take it because there
are some rare cases ofinterstitial nephritis, which
(11:21):
you know is a kidney condition,that is, kidney damage, and I
always ask and find out what mypatients are on and when I find
an elevated creatinine level itcan mean impaired kidney
function, it can mean somebodywith a high muscle mass.
There are some geneticdifferences.
Blacks tend to have slightlyhigher creatinines than
(11:44):
Caucasians.
Knowing what your baseline isand comparison is very important
.
And there is a blood test thatyour physician can order, called
Cystostatin C, and that's ameasurement of kidney function
that's independent of musclemass or creatine supplements, so
sometimes I'll have to orderextra tests to evaluate that.
(12:09):
Now, cysticetin C can go up withobesity and I find that some
people who ask me about creatinesupplements are trying to get
some quick, fast weight loss.
And you know weight loss and,um, you know, anything that's
worth doing is worth doing rightand, generally speaking,
(12:34):
there's not easy quick fixes forweight loss, despite all the
ridiculous ads that you mightsee online.
But eating a higher protein,higher fat, low carb diet, which
promotes ketosis and somepeople say mental clarity,
certainly gets a lot morecreatine into your system
without having to spend money onsupplements.
And I don't specificallyrecommend any supplements of
(12:59):
creatine in anyone who haskidney disease, as well as
someone who's pregnant,attempting to become pregnant or
breastfeeding moms, also peoplethat have diabetes and liver
disease and some existing kidneydisease.
I think that further researchis needed.
Now.
Creatine may negativelyinteract with caffeine, meaning
(13:22):
that caffeine can decrease someof the beneficial effects on the
athletic performance, and a lotof athletes and weekend
warriors will take some caffeinein their pre-workout.
So probably for most people,creatine supplements are okay,
but my warning to patients areanytime you take something that
(13:44):
isn't a food and is not a drug,then it's not regulated by the
FDA, and so there could betoxins or other supplements or
things in it.
So I think, rather than justtaking something, you have to
really have a reason and youneed to do it thoughtfully.
So what is L-carnitine?
Well, it's another amino acidand it's found in some foods and
(14:08):
supplements and we haveL-carnitine in virtually every
cell of our body and it plays acritical role in energy
production by turning fat intoenergy.
Now, most women, I know, wantto definitely turn some of their
excess fat into energy.
(14:28):
Now, 95% of your L-carnitine isstored in your muscles.
There is trace amounts in thebloodstream, the liver, the
heart and the kidneys, and mostpeople get a small amount of
L-carnitine from eating animalproducts like meat and dairy.
So what are the benefits ofL-carnitine from eating animal
(14:53):
products like meat and dairy?
So what are the benefits ofL-carnitine, you might ask, and
you have been listening to theSpeaking of Women's Health
podcast.
I'm your host, dr Holly Thacker, back in the Sunflower House,
and we're talking aboutsupplements.
We went over creatine, nowwe're on L-carnitine and we're
going to touch on a few othersubstances.
So part of the potentialbenefits of L-carnitine is it
(15:17):
might contribute to themanagement of certain cardiac
conditions.
It may actually reducearrhythmias and angina,
so-called chest pain, but wedon't have definitive evidence
of its effectiveness inpreventing heart failure or
preventing heart attacks.
Peripheral artery disease Someresearch indicates that
(15:39):
L-carnitine might reduce some ofthe leg pain, the claudication,
some of the leg pain, theclaudication.
It might even improve walkingdistances for some individuals
suffering with intermittentclaudication, which is a symptom
of peripheral artery disease.
Male infertility L-carnitinemight enhance sperm quality and
(16:01):
motility in some men facinginfertility, although it does
not appear to definitelyincrease pregnancy rates.
Now, a big one that affects alot of people is diabetic
neuropathy, and we're going tohave an upcoming podcast on
peripheral neuropathies.
So preliminary studies suggestthat acetyl L-carnitine might
(16:27):
help lessen nerve pain andimprove nerve function in those
people that are suffering withdiabetic neuropathy.
Cognitive health Senile dementiaof the Alzheimer's type, sdat
Some research indicates it mightimprove cognitive function and
possibly slow the progression ofAlzheimer's disease, but
(16:51):
further investigation is needed.
Now, one reason why it'ssomewhat popular is the interest
in weight loss.
Indirectly it could assist inweight loss by promoting that
fat oxidation and increasingenergy expenditure.
But it's probably very modestand it's much more pronounced if
(17:11):
you combine it with a healthydiet and, of course, regular
weight-bearing exercise andmuscle building exercise.
Depression I think a lot ofmood disorders are affected by a
poor diet.
I've seen dramatic improvementswhen people correct their
(17:33):
vitamin D deficiency, their zincdeficiency, improve their
omega-3 to omega-6 fat ratiosand, interestingly, there is
some research that showsL-carnitine can reduce the
symptoms of depression.
Can reduce the symptoms ofdepression.
Now, exercise performanceL-carnitine is marketed as a
supplement to enhanceperformance, but research really
does show mixed results.
(17:55):
So what are some of the foodsrich in L-carnitine?
Well, I think you're seeing apattern here.
It's found in animal products,especially red meat, and it's
kind of ironic that red meat haskind of been demonized.
A lot of foods, for instanceeggs, have been demonized for
their cholesterol.
Well, they have choline, whichis great for the brain, and the
(18:23):
eggs that have omega-3 in them.
If they feed the chicken flax,it's another good source of
omega-3, which so many peopleare deficient in.
So foods that are rich inL-carnitine include beefsteak,
and if you haven't checked outany of our recipes, on Speaking
of Women's Health, we haveseveral good ones, and one of
the ones that I like I thinkit's a flank steak that's got a
(18:46):
marinade with coffee.
That's a good one to check out.
Ground beef good old cow's milk.
Codfish that's coming up againwith creatine and omega-3 and
L-carnitine.
Chicken breast, which tends tobe white meat as opposed to dark
meat.
Oh, and ice cream.
(19:06):
Ice cream is on that list and I, some of you know, I have a
granddaughter.
My oldest granddaughter isArtemis, and I'm planning a
fifth birthday party for her.
In fact it's themed in unicorntheme and we're having an ice
cream truck.
So if her parents or anyonecomplains about ice cream, I
(19:29):
will be sure to tell them thatthere is L-carnitine in these
ice cream cones that the kidsare going to be ordering.
And cheese, cheddar cheese andhard cheese, in particular, now,
the three cheeses that have theK2, which we boneheads really
like to promote because we pushvitamin D, because it's
(19:50):
anti-inflammatory andanti-cancer and bone benefits.
That helps your gut absorbcalcium and we don't like our
patients, if at all possible, tonot be estrogen deficient and
estrogen helps your gut absorbcalcium.
That we want to make sure thecalcium goes where it's supposed
to go into the bone and notother tissues or arteries.
And I did an entire podcast oncheese, another good food that
(20:16):
sometimes has been demonized.
Okay, so let's just say thatyou're a vegetarian or you
really don't want to eat thosefoods.
It still is best to try to getL-carnitine from your diet, but
if you're unable to consume thenecessary L-carnitine levels,
you might need to consider asupplement, and so, generally
speaking, vegetarians and vegansdo tend to have lower
(20:41):
L-carnitine levels and may wantto consider supplementation, and
there's various dosagerecommendations.
Acetyl L-carnitine this form isthought to be best for brain
health and dosages haverecommended and vary between 500
to 3,000 milligrams a day.
Now the L-carnitine L-tartrateis the one that's generally
(21:06):
recommended for exerciseperformance, and doses are a bit
higher a thousand milligrams toeven up to 4,500 milligrams per
day and propionyl L-carnitinemight improve blood flow in
those people with high bloodpressure or related health
conditions, and there was a 2005study that used a dose of two
(21:29):
grams per day.
Another supplement I've seensometimes used in pre-workouts
is red beets red beet powder,because it improves nitric oxide
, and some of my patients withkind of borderline high blood
pressure who don't want to starton medication have taken red
(21:49):
beet gummies or supplements.
Again, in general, I think foodis always best If you do eat a
lot of red beets.
I like red beets, my husbanddoesn't, but I really do.
It can make your stool lookbright red, like you're having
bleeding, and I've had more thanone patient in my practice come
into the office upset thinkingthey're having rectal bleeding,
(22:11):
and they just had a lot of redbeats the day before.
So what are some of the sideeffects of L-carnitine?
It's generally considered safe.
Some people have noticedheartburn or diarrhea or
indigestion or even rarelyseizures.
People have noticed heartburnor diarrhea or indigestion or
even rarely seizures.
So really anything can be toomuch of a good thing.
Just like you can, you canseverely injure yourself by
(22:34):
drinking too much water anddropping your sodium levels.
So if you are going to takeL-carnitine supplements because
maybe you don't think you'regetting enough in your diet, you
should not generally exceedmore than three grams per day,
and our caveat always is be sureto speak with your health care
team or clinician beforestarting any supplements.
(22:56):
Just because they're notprescription doesn't mean you
don't need some medical adviceand supervision.
So now we're going to move on totaurine benefits, foods and
supplements.
What is taurine?
Well, it's a naturallyoccurring sulfur containing
amino acid, and it's found inyour brain, your eyes, your
(23:18):
heart and your muscles, and itis found in certain foods and
the body can even produce it byitself.
Taurine plays an important rolein the body's heart health and
immune system and brain function.
It's involved in blood pressureregulation.
It's very helpful in terms ofhelping to maintain the proper
(23:40):
hydration and electrolytebalance inside your cells.
It's involved in forming bileacid salts, which play a very
important role in your digestion, and it's involved in
regulating important mineralssuch as calcium within your
cells, and most all your calciumis stored in your bones.
(24:02):
Only a small amount is in thebloodstream, which is very
important for cellular processes, electrical conduction activity
in your body, and there aresome people, especially if they
avoid dairy, who don't getenough calcium in their diet.
There are people whose kidneysdon't handle the calcium quite
as well and leak it out throughthe kidneys.
(24:23):
So it's not uncommon for me toorder a 24-hour collection of
urine for calcium to assesssomeone's calcium balance,
because you can't just draw theblood and tell, and only about
half my patients complete thetest, sadly, I hate to say.
And now that I order it, I tellpeople you have 59 days to get
(24:44):
this test done, otherwise theorder goes away and my nurses
are really busy.
If you don't get it done andthe order goes away, they're
probably not going to reorderthat lab until you come back in,
so you know if your physicianor healthcare team really wants
to get an assessment.
Some things just can't be doneby blood and so it is a little
bit of a hassle to collect yoururine.
(25:06):
Now, taurine does support thegeneral function of your central
nervous system and your eyes,and we've had a few podcasts on
eyes, dry eyes, a coupleCataracts with Dr Wagenberg.
If you didn't listen to thatone, most everyone, if you live
long enough, will developcataracts.
Taurine helps with immunesystem health, antioxidant
(25:28):
function and helps support yourvision.
So what foods are rich intaurine?
Well, your body can make it inyour liver from other amino
acids, but certain foods seem tohelp and are generally high
protein foods, like you'd expectMeat, especially the dark meat.
(25:50):
Poultry, seafood, especiallyshellfish, dairy products and
seaweed.
So really, for strictvegetarians, seaweed is kind of
your main go-to.
Now there is taurine in someenergy drinks and it's a very
common ingredient in energydrinks and most research has
(26:13):
shown that taurine in energydrinks is not the problem, but
all the sugar and the colors andthe caffeine, and the safety of
drinking these energy drinksregularly is not clear, but too
much caffeine can make youjittery and be hard on the heart
, can elevate blood pressure,and sugar generally is something
(26:36):
that you really want tominimize in your diet.
Caffeine can increase yourheart rate.
It can increase anxiety.
The American Academy ofPediatrics states that energy
drinks are not appropriate forchildren and adolescents due to
the high levels of caffeine.
Due to the high levels ofcaffeine.
(27:01):
And one thing that concerns meis I have had the experience of
people in my practice being veryconcerned about getting
addicted to kratom, which is anaddictive substance.
I don't think it should be soavailable, but they have these
little bottles of this addictiveliquid like in gas stations and
convenience stores right nextto the energy drinks.
(27:23):
So again, just because you canjust go buy something off the
shelf, or you think it's a food,or you think it's a drink, or
you think it's just some workoutsupplement, you really have to
read labels and be concerned,and it amazes me the number of
people that I see that take alot of different things and
they're not even sure whatthey're taking or they don't
(27:44):
realize they're doubling ortripling up on something.
So really take it seriously andwhen you go in for your visit,
bring in all your supplements.
So most people don't need totake a taurine supplement,
because most people can getenough protein in their diet not
everyone but your body can makeadjustments by creating and
(28:05):
making taurine out of otheramino acids, but if, for some
reason, your healthcareclinician recommends a
supplement.
Generally, the most commondosage range is about 500
milligrams to 3,000 milligrams,and it is becoming a relatively
popular substance for improvingathletic performance, and some
(28:26):
studies put together creatineand taurine, because creatine
can boost energy production andhelp with recovery, while
taurine might also help withmuscle recovery, reducing
fatigue and even helping nervefunction.
But a lot more research needsto be done before routinely
recommending this.
(28:48):
Now, lastly, I'm going to talkabout a very small mineral that
can make a big impact in yourhealth boron, and it's a trace
mineral, and it's involved insupporting your bones, your
brain function.
Boron, and it's a trace mineral, and it's involved in
supporting your bones, yourbrain function and hormones.
So boron's not yet quite thesame household name that
creatine is, but the tracemineral does quietly support
(29:10):
your bones, brain and yourhormones, and it's not
officially classified as anessential mineral, but you
really should know about it andalso know that most people do
get enough boron from aplant-rich diet.
So we've talked a lot aboutcarnivore and the meat and
poultry and seafoods that helpyou so much with creatine,
(29:35):
l-carnitine and taurine thathelp you so much with creatine,
l-carnitine and taurine.
So boron does seem to beinvolved in bone and joint
health.
If you didn't hear my podcaston joint supplements, preparing
for possible joint replacementsurgery and all things
(29:57):
musculoskeletal, go back andlisten to that one.
Boron also seems to affect brainfunction and hormone balance,
making testosterone moreavailable and active.
Boron also seems to help yourbody absorb calcium, magnesium
and phosphorus, which are allkey minerals for strong bones,
and it seems to extend theeffects of estrogen and vitamin
(30:17):
D, both of which are all keyminerals for strong bones, and
it seems to extend the effectsof estrogen and vitamin D, both
of which are very important inprotecting against bone loss.
There have been a few studiesthat have linked boron to
reduced inflammation and lowerrates of osteoarthritis.
Low boron levels may impairbrain function and
(30:39):
supplementation has been shownto improve some memory, focus
and coordination.
Boron seems to help cellularmembranes and enzymatic
functions, which are veryimportant for your neurons that
communicate with each other andhormonal balance In both men and
women.
Boron may increase the freeactive testosterone by lowering
(31:04):
sex-binding globulin levels andmaking more active estrogen can
be very helpful, especially inpostmenopausal women.
It may have some antioxidanteffects.
Boric acid may speed recoveryand we do use boric acid to
(31:27):
actually treat yeast infections.
And you can find thoseover-the-counter vaginal
suppositories, sometimes mixedwith coconut oil suppository,
sometimes mixed with coconut oilProstate protection.
Higher intake may be linked toreduced prostate cancer risk.
So where do you find boron?
Well, it's in many plant-basedfoods fruits, apples you know,
(31:51):
you've heard the statement anapple a day keeps the doctor
away, apple a day keeps thedoctor away.
Pears, raisins, avocado,avocado has a lot of heart
healthy fat in it and also hasmagnesium.
Nuts and legumes.
So the nuts almonds are alsorich in omega-3.
And then the legumes of peanutsand chickpeas, vegetables,
(32:18):
broccoli and broccoli is areally good vegetable.
It has DIM in it, which helpsreduce HPV affecting your cells.
So women who've had abnormalPAPs and HPV, we really like
them to get cruciferousvegetables in their diet.
Other vegetables that haveboron are potatoes, leafy greens
(32:42):
and three drinks coffee, milkand wine.
So most people don't need boronsupplements.
It appears that the safe upperlimit for adults is about 20
milligrams per day.
If you're consideringsupplementation, talk to your
(33:03):
healthcare team first, becausehigh doses can have some side
effects, and I have seen some ofthese expensive bone
supplements.
Women don't want to start onosteoporosis medicines, although
many are very safe andeffective, and you really should
be concerned about not treatingosteoporosis as opposed to
(33:25):
being concerned and exaggeratingthe rare risk with some of
these medications.
And so instead, women turn tothese bone supplements, and many
of them are high in boron, andthey're also high in strontium,
which is a heavy metal thatactually gets deposited into
(33:46):
your bones and falsely makesyour bone density look stronger.
So I do not recommend taking astrontium supplement, and if you
are taking boron and stilleating a lot of a plant-based
diet, you may be taking too much.
So I hope you found this episodehelpful.
(34:06):
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