TODAY’S DOSE OF HONESTY

The energy- and longevity-boosting supplement you’ve probably never heard of.

If you search this supplement online, you will find MANY ads targeted to customers (mostly male) looking to up their sports performance and/or build serious muscular strength. Truth is, it actually holds many potential benefits for women—especially older women. It’s called creatine, and it’s one of the most studied supplements in the world of nutritional science. And I take it every day.

Creatine is a compound produced in our kidneys, brain, pancreas, and liver from the reactions of certain amino acids, and it’s the primary generator of the body’s major energy molecule, adenosine triphosphate, or ATP. ATP is a tiny but mighty battery for our cells, fueling our body at its most basic levels to keep us alive and moving. In physiological terms, creatine powers muscle strength and function, but also has significant positive effects on bone health and brain (cognitive and psychological) function. 

Here’s more: Extensive research on creatine suggests it may reduce the risk of ischemic injury (injury caused by impaired blood supply) to the heart and brain and offer overall life-prolonging benefits. The majority of research on creatine to date has been done with men (not a surprise), but there IS data that supports its use and benefits in women—and, in particular, women over 50 or who are peri- or post-menopausal. 

As I mentioned above, your body produces creatine, and it’s also found in red meat and fish. But nearly 99% of the creatine we ingest is excreted from our bodies in our urine, so consuming it as a supplement can increase your body’s stores. Here's what you need to know about creatine supplementation.

The dosage: Decades of scientific study suggests that a daily consumption of 3-5 grams of creatine monohydrate is safe for a healthy individual, although some studies have indicated that higher doses (8-10 grams a day) might be necessary for bone and brain benefits, particularly in older adults. Creatine monohydrate is the most well-studied form of the supplement (which is what I take), so any other forms just don’t have the science to back up claims about superiority. You can buy creatine monohydrate as a powder, pill, and liquid, but the powder is what’s assimilated most quickly into the body. It can be mixed in yogurt or smoothies but dissolving it in very hot beverages like coffee may affect its absorption.

The possible negative side effects: There are not many concerning side effects when the dosage is fewer than 5 grams. A review of more than 500 peer-reviewed studies done by the National Institutes of Health (NIH) found that, in controlled research studies and when taken in recommended doses, there is no increased risk of kidney problems in healthy individuals. Similarly, another NIH review of the scientific evidence did not support risks of hair loss, edema (retention of water weight), or gain of fat mass with creatine use. Some people may experience bloating or GI side effects, but that usually does not occur at a dosage of 5 grams or fewer daily. As always, make sure to discuss creatine supplementation with your healthcare provider.

The potential benefits: The vast majority of studies done on women and on men and women over age 50 show that creatine only works to increase lean muscle mass, strength, and bone density IF combined with resistance training/weightlifting exercise. In other words, there is no magic bullet where your bones and muscles are concerned—you need both diet AND exercise! The data on improvement in mood, cognitive function, and brain health is slightly more difficult to evaluate due to the subjective nature of many of these studies, but there is still good evidence to suggest that the benefits outweigh any risks. 

The question of which brand to choose. Since supplements are not subject to the same pre-market scrutiny and surveillance in the U.S. as medications are, there’s no way to ensure that what you’re buying is pure and contains what the package says it does. A published NIH study that evaluated 175 brands sold on Amazon found that only 30% contained functional ingredients with creatine monohydrate and 21% contained blends of different forms of creatine. Only 8% of products were third-party certified. Many experts recommend getting a brand sourced from Germany, which is considered to have the gold standard for creatine manufacture. Honestly, I take what’s conveniently available to me, because there’s no way to know for sure whether one brand is better than another.

Bottom line: In my opinion, the overall benefits from creatine supplementation—in an amount no greater than 5 grams per day—outweigh the risks, which is why I take it.

SYMPTOM SOLUTIONS

Experiencing hair loss? Here’s what to steer clear of

So many factors can contribute to hair loss: family history, stress, entering menopause, a host of medical conditions—and, quite often, their treatments. Believe me, I’ve been through it, so I know. It feels like you’ve simply lost control of something that defines you, which can be downright frightening. The good news on this front is that there has been much more research in the past decade or two into the root causes of hair loss, which has led to more and more effective treatments. If you are experiencing hair loss, your first step is to find a qualified medical professional who can help you chart your course. The next (and equally important!) step is all about how you care for your hair. While medications may be necessary, there is much YOU can do to alleviate the problem.

Hair loss is so common—in fact, a recent survey we conducted with a large group of TODAY’S AJENDA subscribers (to which over 70% responded!) revealed that hair loss was one of the top three topics you want to read more about. I’m here to deliver! We’ll be covering hair loss a lot in upcoming issues of this newsletter; today, I want to talk about the stuff you should leave on store shelves. Because when it comes to corralling this thing, what you DON’T do is as important as what you do. Here are a few of the more notorious items/ingredients to avoid when shopping.

In grocery aisles:

Simple carbohydrates. Simple carbs—such as white bread and rice, bagels, cookies, etc.—can increase production of sebum, an oily substance on the scalp. Some sebum is good for your hair but too much causes inflammation, which is bad for hair health. Sugary foods also increase insulin production, which can lead to poor blood flow in the scalp and may result in hair loss.

Fried foods. This includes microwaveable items that have been previously fried.  Fried foods may also stimulate overproduction of sebum. For the sake of your hair, it’s best to stick to fresh, unprocessed foods.

Alcohol. Excessive alcohol use—more than one drink per day for women or two drinks per day for men—has been linked to hair loss. Heavy drinking can interfere with absorption of nutrients important for hair health, such as protein and zinc.

In hair product aisles:

Products with DMDM hydantoin. Formaldehyde-releasing preservatives like DMDM hydantoin help to keep beauty products from spoiling. While this chemical is found naturally in small, safe amounts in many foods, formaldehyde-releasing ingredients can cause hair loss at higher levels. Several over-the-counter products, including shampoos, conditioners, and keratin treatments (think Brazilian blowouts) have been associated with hair loss, some of which have even been involved in class-action lawsuits. All offenders contain DMDM hydantoin. Do not use any hair product that contains this chemical.

Products that may leave a residue on your scalp. Scalp buildup can lead to inflammation and hair loss. This requires using your good judgment: If a product leaves a waxy film on your hair, it’s probably leaving buildup on your scalp too, so stop using it.

Products that contain powder. Most dry shampoos, texturizing powders, and styling powders contain starches or other ingredients that absorb oil and grease from your scalp. If you don’t wash them out thoroughly, these powders can build up on your scalp and hair strands over time and may contribute to hair loss.

Products with alcohol. It’s bad inside and out: Shampoos, styling products, and leave-in conditioners that contain alcohol can dry your hair and scalp, leading to hair breakage and loss. Check ingredients labels. If alcohol is one of the first on the list, skip it. If you can’t find an alcohol-free or mostly free product, ask your stylist or hair-care medical professional to recommend one.

Products containing sulfates: You’ve probably heard about sulfates in shampoos. Some forms—like sodium lauryl sulfate—have been associated with significant scalp irritation, especially in people with sensitive skin. If sulfates cause enough irritation, they may contribute to hair damage and hair thinning for some people. If you have sensitive skin, you may benefit from trying a sulfate-free shampoo. 

Stay tuned for more info on hair loss treatment/prevention in upcoming issues of TODAY’S AJENDA!

COMMUNITY

“What is BRCA? Does everyone needed to be tested for it?”

Good breast cancer-related question. I asked our Core Expert, oncologist Dr. Elizabeth Comen, to weigh in.

There are two specific genes that “BRCA” refers to—BRCA1 and BRCA2. Certain mutations in BRCA1 and BRCA2 can increase the risk for breast cancer as well as other cancers, depending on the mutation. These mutations can be inherited from your mother’s side and/or your father’s side of the family. For example, if your mother carries a BRCA1 mutation, you have a 50% chance of carrying it as well. Importantly, men can also inherit BRCA mutations, which can increase their risk of breast cancer and, potentially, other cancers like prostate or pancreatic cancer as well.

So, when thinking of family history and who should get tested for BRCA mutations, it’s important to recognize that these mutations can be passed down by both your mother and father’s side. Overall, about 1/400 people will have a BRCA mutation, but this risk can be much higher (1/40) in other populations, such as Eastern European Jewish ancestry. Moreover, BRCA1 and BRCA2 are not the only mutations associated with an increased risk of breast cancer and other cancers. Genetic testing most often includes analyzing beyond just BRCA1 and BRCA2 mutations and is done with a simple blood or saliva test. 

Should everyone be tested for BRCA mutations? Current medical guidelines do not suggest this for the general public. When considering genetic testing, it’s essential that you talk to your doctor about your specific family history of any type of cancer on both sides of your family—including beyond your immediate family—and what tests may be appropriate for you and your family members.

Our Core Expert

Elizabeth Comen, M.D., is a medical oncologist with Memorial Sloan Kettering Cancer Center and an assistant professor of medicine at Weill Cornell Medical College. She is the author of the newly released book All in Her Head: The Truth and Lies about What Early Medicine Taught Women About Their Bodies and Why It Matters Today. Buy it here. @drelizabethcomen

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ABOUT DR. JEN

In her roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—shares the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has written several books, including the best-selling The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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