What are the consequences if you have to make your own creatine instead of getting it from your diet?
“Almost universally, studies have shown poorer vitamin B12 status in vegetarians,” because they don’t take adequate vitamin B12 supplements, which leads to elevated homocysteine levels. This may explain why vegetarians have recently been found to have higher rates of stroke. You can see this in the graph below, or at 0:30 in my video, “Should Vegetarians Take Creatine to Normalize Homocysteine?”
Of course, eating plant foods is only one of many ways that vitamin B12 deficiency can occur. Even nitrous oxide (laughing gas) can cause vitamin B12 deficiency in just two days, due to recreational use of whipped cream can gas (I recently learned about the “whip pit”).
When researchers gave vegetarians and vegans just 50 micrograms per day of cyanocobalamin, the most stable vitamin B12 supplement recommended, their initially elevated homocysteine levels normalized to a safe level of less than 10 mmol/L within just 1-2 months. The same impressive results were seen when taking just 2,000 micrograms of cyanocobalamin once a week, as you can see in the graph below and at 1:15 in my video.
But that’s not always the case. In another study, taking 500 micrograms a day as a regular B12 supplement, either sublingual chewable or swallowable, did not normalize homocysteine within a month, as shown at 1:24 below. Presumably, had participants continued on it, levels would have continued to drop, just as in the 50 micrograms a day study.
If I’m eating a plant-based diet, taking vitamin B12, and my homocysteine levels are still too high (above 10 mmol/L), is there anything else I can do? Inadequate folic acid intake can also increase homocysteine, but folic acid comes from the same root as the leaves. It’s found in beans and leaves and is concentrated in green leafy vegetables. If you’re eating beans and green leafy vegetables, taking vitamin B12, and your homocysteine levels are still too high, I’d recommend experimenting with taking 1 gram of creatine a day and retesting your homocysteine levels in a month to see if it helps.
Creatine is a compound that is naturally produced in the human body and is primarily involved in energy production in muscles and the brain. It is also naturally produced in the bodies of many other animals. So when we eat those muscles, we also get their creatine through our diet. We need about 2 grams of creatine a day, so meat eaters get about 1 gram from their diet, and the rest is produced from scratch in the body. In rare cases, there are birth defects that cause people to be born without the ability to produce creatine, in which case they must get it from their diet. Otherwise, our bodies are able to produce as much creatine as they need to maintain normal concentrations in our muscles.
As you can see in the graph below and at 2:54 in my video, cutting out meat reduces the amount of creatine floating around in your bloodstream.
However, the amount of creatine in the brain remains the same, as shown in the graph below and at 2:57. This indicates that dietary creatine does not affect the amount of creatine in the brain, because the brain produces all the creatine it needs. Although vegetarians have lower creatine in their muscles, this does not seem to affect athletic performance, as both vegetarians and meat eaters respond to creatine supplementation with similar increases in strength output. If vegetarians had insufficient creatine in their muscles, they would probably see an even greater increase. So it seems that what happens when you eat meat is that your body no longer needs to produce as much. What does all this have to do with homocysteine?
As you can see in the video below and at 3:36 in my video, in the process of making creatine, our body produces homocysteine as a waste product. Normally, this is not a problem because our body has two ways to detoxify: using vitamin B6 or using a combination of vitamin B12 and folic acid. Vitamin B6 is found in both plant and animal foods and is rarely deficient. However, vitamin B12 is found primarily in animal foods, so people who eat plant foods and don’t take supplements or eat foods fortified with B12 can end up with levels of vitamin B12 that are too low. Also, as mentioned above, folic acid is concentrated in plant foods, so people who don’t regularly eat green leafy vegetables, legumes, and folic acid-fortified grains can have low folic acid. Without this escape route, homocysteine levels can get too high. However, if you eat healthy plant foods and take a vitamin B12 supplement, your homocysteine levels should be fine.
If you start taking creatine supplements, you can expect your homocysteine levels to go down because your body doesn’t have to make homocysteine from scratch and it produces it as a by-product, but you won’t know until you test it.
This is the 11th in a 12-video series exploring stroke risk. If you missed the last two, check out “Vegetarians and Stroke Risk Factors: Vitamin B12 and Homocysteine?” and “How to Test for Functional Vitamin B12 Deficiency.”
The creatine angle was new to me. I have long been concerned about homocysteine levels getting too high among people with inadequate vitamin B12 intake, but didn’t know there was a potential mechanism for lowering it other than the B vitamin. We’ll see if that comes to fruition in the final video of this series, “Efficacy and Safety of Creatine for High Homocysteine.”
