Dr. Andy Galpin

This is any athlete that's going to be in sparring or competitions where we're getting a lot of impacts. This is military or special forces or anything like that that is getting low impact repeated exposures or blasts. The more creatine depletion that happens, the worse the damage in your brain that occurs after the second or repeated impact. So right there,

This is any athlete that's going to be in sparring or competitions where we're getting a lot of impacts. This is military or special forces or anything like that that is getting low impact repeated exposures or blasts. The more creatine depletion that happens, the worse the damage in your brain that occurs after the second or repeated impact. So right there,

we can see that if you've had an injury, making sure your creaking stores are replenished as quickly as possible is really important if we're going to continue in that exposure. Now, that's important because many people don't recognize or realize the first injury happened to begin with. Most of them are unreported. Most don't realize it. Hard to diagnose.

we can see that if you've had an injury, making sure your creaking stores are replenished as quickly as possible is really important if we're going to continue in that exposure. Now, that's important because many people don't recognize or realize the first injury happened to begin with. Most of them are unreported. Most don't realize it. Hard to diagnose.

And so prophylactically, it just maybe makes some sense to make sure that you're taking care of business, not necessarily just when you have an injury, but if you even think you're at risk or in high-risk situations or prior to high-risk exposures or competitions.

And so prophylactically, it just maybe makes some sense to make sure that you're taking care of business, not necessarily just when you have an injury, but if you even think you're at risk or in high-risk situations or prior to high-risk exposures or competitions.

All right, good example of this, there's a pretty famous study, I think it was in high school, football players, high school or college, but nonetheless, football players, American football, that is, that did indicate that creatine stores in their brain, I think specifically in the motor and prefrontal cortex, reduced over the course of the season.

All right, good example of this, there's a pretty famous study, I think it was in high school, football players, high school or college, but nonetheless, football players, American football, that is, that did indicate that creatine stores in their brain, I think specifically in the motor and prefrontal cortex, reduced over the course of the season.

Now, this is not a perfect study design, but you can see what this is alluding to. If you're in a situation, again, with repeated head impacts over the course of a season, The number of impacts, in fact, maybe I'll back up quickly. In this particular study, what they did is they filmed the games. And so what they measured is, for each individual player, how many head contacts they had.

Now, this is not a perfect study design, but you can see what this is alluding to. If you're in a situation, again, with repeated head impacts over the course of a season, The number of impacts, in fact, maybe I'll back up quickly. In this particular study, what they did is they filmed the games. And so what they measured is, for each individual player, how many head contacts they had.

But there was an association between those players that had more head impacts, not even necessarily injuries, and the level of creatine reduction in the brain over the course of the season. So again, we're making some assumptions here, but I think it's fair to at least say it's plausible

But there was an association between those players that had more head impacts, not even necessarily injuries, and the level of creatine reduction in the brain over the course of the season. So again, we're making some assumptions here, but I think it's fair to at least say it's plausible

The more impacts on your brain, the more creatine is reduced, potentially the higher risk you are for second impact syndrome injuries. Now, before we go any further with the creatine research, I need to do a quick pause and explain to you what I mean when I say strong evidence or weak evidence. There's no perfect way to do that.

The more impacts on your brain, the more creatine is reduced, potentially the higher risk you are for second impact syndrome injuries. Now, before we go any further with the creatine research, I need to do a quick pause and explain to you what I mean when I say strong evidence or weak evidence. There's no perfect way to do that.

but an easy way to roughly understand is called the strength of evidence scale. So I will abbreviate that and the rest of today's episode by just calling it the SOE, the strength of evidence. This takes into account research design, the quality of the relevant studies, the applicability to patient care, and a number of other factors.

but an easy way to roughly understand is called the strength of evidence scale. So I will abbreviate that and the rest of today's episode by just calling it the SOE, the strength of evidence. This takes into account research design, the quality of the relevant studies, the applicability to patient care, and a number of other factors.

It's up to you ultimately to decide what is an actionable level of evidence or not. Some people that are maybe suffering from a brain injury consider a study in animals to be enough, and others wanna see a randomized controlled trial in humans. That's not for me to decide, that's up to you, but I do wanna share with you where the level of evidence is, and you can make your choice from there.

It's up to you ultimately to decide what is an actionable level of evidence or not. Some people that are maybe suffering from a brain injury consider a study in animals to be enough, and others wanna see a randomized controlled trial in humans. That's not for me to decide, that's up to you, but I do wanna share with you where the level of evidence is, and you can make your choice from there.

So the SOE is on a scale of one to five. A score of one is the best. That is the highest score possible. This means we see consistent results across multiple studies. You've seen it in both randomized control trials as well as systematic reviews and so on and so forth. A score of say four or five would be the opposite. That would be our lowest score.

So the SOE is on a scale of one to five. A score of one is the best. That is the highest score possible. This means we see consistent results across multiple studies. You've seen it in both randomized control trials as well as systematic reviews and so on and so forth. A score of say four or five would be the opposite. That would be our lowest score.