Dr. Justin Marchegiani sits down with creatine expert Mark Faulkner, co-founder of Con-Cret, to break down creatine HCL vs. creatine monohydrate, why roughly 85% of a monohydrate dose may go unabsorbed, and how creatine supports brain energy, cognition, recovery, and immune function. They explore dosing efficiency, bloating and water retention, food sources, and emerging research on creatine for athletes, healthy aging, and neurological resilience. To work with Dr. Justin, visit http://www.justinhealth.com/free-consultation
Dr. Justin Marchegiani: [00:00:00] Hey, guys. Dr. Justin Marchegiani here. I am here today with Mark Faulkner. Mark's background is in physics and toxicology, and he's an expert in creatine. His website is con-cret.com. Mark, welcome to the show. How are you doing?
Mark Faulkner: Very well, thank you. I'm honored to be here.
Dr. Justin Marchegiani: Excellent. So you're an expert in creatine. Creatine's all the buzz — there are so many different benefits. The research is showing benefits for traumatic brain injury and helping the brain recover, and we know there's a benefit of creatine supporting ADP/ATP in the cell for energy. But there are also things like sleep deprivation, neurological benefits, mood benefits. It also helps bring hydration and electrolyte balance to the muscles. So I want to dive in. Let's talk a little about your background and how you got into being an expert in creatine.
Mark Faulkner: Certainly. It started in forensic toxicology. Another gentleman and I founded a laboratory, and our specialty was athletic drug testing. [00:01:00] Our original team developed the steroid testing program for the National Football League, and we did a lot of performance-enhancement drug testing for professional and amateur athletics — NCAA teams, conferences, et cetera. All along the way, I repeatedly heard athletes say, “Yes, we're using steroids because they help us do our job. We're in the equivalent of multiple car wrecks each weekend.
Dr. Justin Marchegiani: Sure.
Mark Faulkner: And on Tuesday morning we've got to get up and perform again, and steroids help us recover like nothing else does. So if you're taking our steroids away, find us something else that helps us do our job, because this is how we feed our family, and we have a limited time to do it — injuries could happen at any moment.”
Dr. Justin Marchegiani: Right. A couple of years, who knows.
Mark Faulkner: I heard that enough that it kind of haunted me. So when I sold out of the toxicology laboratory, I started working with some sports-medicine researchers on compounds that would be safe, healthy, and legal — since steroids [00:02:00] are not safe, not healthy, and not legal — that would provide the performance enhancement these athletes needed. We looked at all sorts of peptides and amino acid compounds and various conjugations of creatine. Long story short, we made a mistake on a particular peptide batch on January 23rd of 2003. We added the wrong amount of acid catalyst, and lo and behold, this special conjugation of creatine was formed — a kind of concentrated creatine, which is why we later called it Con-Cret, for concentrated creatine. Creatine HCL was what was formed. We knew it wasn't what we were looking for, and we didn't know what it was, so we set it aside, figured out what we did wrong, and went on making the peptide. That peptide didn't end up helping athletes run faster and jump higher, as we'd hoped. But we went back to that [00:03:00] mistaken batch and asked, “What is this stuff?” When we profiled it, we saw a very curious, very interesting form of creatine that had much better stability, solubility, bioavailability, and plasma uptake. After a number of years of research, it turned out to be about as close as you could get to steroids in terms of strength, endurance, and recovery without being a steroid. So we began commercializing it, and it became the number-one specialty creatine among elite athletes for many years. Then we started looking at research for all the other applications of creatine — neurological, immunological —
Dr. Justin Marchegiani: [00:04:00] So it has to do with your immune system, how creatine impacts the cognitive system, the immune system —
Mark Faulkner: Cardiology, everything.
Dr. Justin Marchegiani: That makes sense. Now, the mechanism. You're talking about these guys wanting a steroid-like benefit without the steroid. But what's it doing? We know creatine — phosphocreatine has these phosphate groups, and the cells take ADP and add an extra phosphate to make ATP, the cellular currency of energy. Is that the major mechanism? What else is happening?
Mark Faulkner: Yes, that is the major mechanism.
Dr. Justin Marchegiani: How is that driving healing and recovery? I understand performance — you have more raw material, so you have an extra energy source. But how is that driving healing and recovery? What's it doing to growth hormone?
Mark Faulkner: Well, it does provide strength and endurance when there's performance happening. [00:05:00] A really key part of creatine is that when cells are active, they become fatigued. It can be T cells becoming fatigued fighting to keep us healthy. It can be brain cells becoming fatigued fighting neurological disorders, or just simply thinking. The body uses 20% of the body's creatine just to think.
Dr. Justin Marchegiani: Oh, that's a big one. That's a quote — I want to hit that again. Repeat that line one more time, please, if you don't mind.
Mark Faulkner: Certainly. The brain uses 20% of the body's creatine just to think.
Dr. Justin Marchegiani: Huge.
Mark Faulkner: And so, separate from anything else, the cells get fatigued when they're operating at optimal levels on our behalf. Creatine not only provides the energy for those cells to function when we put them through activities, it provides the cellular energy for those cells to then recover [00:06:00] when we're at rest or rebuilding — whether it's muscle cells, brain cells, whatever the case is. That cellular energy is important not just for performance but for recovery. So when you ask how it's impacting things beyond strength and endurance, it really is a matter of cells recovering and getting ready to do what the body expects those specific cells to do as part of overall body and health function.
Dr. Justin Marchegiani: What's creatine doing to the hormones? I understand 20% goes to the neurological side, but what's it doing to the hormones to help with recovery?
Mark Faulkner: It's symbiotic, because if the cells don't have enough cellular energy, they can't effectively or optimally use any nutrients or hormones as part of overall recovery. [00:07:00] The endocrine system is supported by — and needs — creatine for itself to function. But creatine doesn't actually do anything to the hormones other than support those molecules in performing the functions they're supposed to do.
Dr. Justin Marchegiani: That makes sense. So you mentioned it's helping ATP, helping with phosphocreatine replenishment, and part of the goal is maybe less muscle damage, less soreness, less recovery needed. Can we talk about hydration? People say, “Oh, creatine makes me feel bloated,” but part of that is cellular hydration. Talk to me about what creatine's doing with hydration and electrolytes in the muscle.
Mark Faulkner: Absolutely, and I'll answer in two parts, because [00:08:00] hydration and cellular fluid distribution happen one way with creatine hydrochloride and another way with creatine monohydrate. I'll start with creatine hydrochloride. Creatine that's taken up into the blood compartment gets absorbed — we have an elegant creatine transport and receptor system so that creatine out of the blood gets into the cells. It performs those mitochondrial functions with ATP, ADP, and the phosphates, and in doing so it pulls water into the cells, just the way it's supposed to. It volumizes the cells, keeps the muscle cells well hydrated, so you don't cramp and don't get muscle tears that sometimes happen with strenuous activity when the body becomes dehydrated.
Now, that's also what happens with the creatine from monohydrate that gets into the blood compartment [00:09:00] and is taken up into the cells. The issue with creatine monohydrate — the second fluid-distribution issue I referred to — is that, unfortunately, only about 15% of a creatine monohydrate dose actually gets into the blood compartment to be taken up into the cells and volumize them with water. The other 85% sits in the gut, the small intestine, and the large intestine, and the body has to scavenge fluid from other parts of the body — including pulling tissue moisture back — to flush out that other 85%. That's why some people taking doses of creatine monohydrate experience diarrhea: it's flushing it out. [00:10:00] The body quickly responds and says, “I don't want to keep taking hydration out of muscle cells, so I'll hold water in order to flush out the rest if you give me more doses.” So the body retains what we call redistributed fluids — outside the muscle, subcutaneous, et cetera — and holds that water in reserve, ready to flush the 85% on the next dose. That's where people experience puffiness. Not all, but the majority. There was a Princeton group that did a study, in the Journal of Cardiology [⚠️ verify journal] last year, that demonstrated about 80% of people who take higher doses of creatine monohydrate experience puffiness, bloat, or water retention. [00:11:00] That's the body trying to hold water so it doesn't dehydrate other cells while it flushes the unabsorbed creatine monohydrate.
Dr. Justin Marchegiani: So explain that one more time — why is the body holding the excess water on?
Mark Faulkner: Because it wants to flush the unabsorbed creatine monohydrate out of the body without taking fluids out of functioning cells as much as possible.
Dr. Justin Marchegiani: What percent of creatine do we absorb?
Mark Faulkner: It depends on the dosing form. With creatine monohydrate, there's a Journal of Pharmaceutics article from 2018 [⚠️ verify] that demonstrated with tagged creatine monohydrate in the mammalian body that about 15% was taken up into the blood compartment and the other 85% was excreted. [00:12:00]
Dr. Justin Marchegiani: 15 — one-five. Got it.
Mark Faulkner: Right. So 85% the body needed to flush and excrete. The plasma uptake of creatine hydrochloride is much higher, so you can take smaller doses, have more absorbed, and deliver more to the cells on those small doses than on a large dose of monohydrate. Both deliver creatine to the blood compartment — it's just a matter of molecular efficiency.
Dr. Justin Marchegiani: And what's the reason such a small percentage — 15% — gets absorbed? Is it the type of creatine?
Mark Faulkner: It's that creatine monohydrate's biochemical activity in the body is just such that it's a simple molecule, but a bit of a clumsy molecule. It's kind of like the difference between making a phone call on a rotary phone versus a digital smartphone. [00:13:00] [⚠️ unclear audio — speaker says “old digital smartphone” but context clearly means “old rotary phone”] Both are effective at making the call, but the smartphone is a newer technology with more efficient operations. Or the difference between a sedan, a station wagon, or a minivan versus a Lamborghini in terms of getting you from point A to point B. Both can do the job — it's just a matter of which does it more efficiently or quickly.
Dr. Justin Marchegiani: Okay. So we get 85% not absorbed with creatine monohydrate — the cheaper type. We have a couple of other creatines. I didn't realize you created the creatine hydrochloride — that's news to me. So creatine HCL is more soluble in water, so less bloating, so I imagine there's less water uptake with that. Plus we have micronized [00:14:00] creatine monohydrate, which breaks down better, and buffered creatine — Kre-Alkalyn — which is more pH-neutral and tends to be less bloating. There's also creatine magnesium chelate and creatine nitrate. You don't hear as much about those, but those are the big ones. Do those other chelates of creatine change the hydration or absorption?
Mark Faulkner: It changes it some. None of them are as well absorbed as creatine hydrochloride. There have been attempts with different conjugations to improve absorption over the years, but creatine hydrochloride was very surprising — extraordinary in terms of solubility and plasma uptake. I'll comment on creatine nitrate: a lot of people think it might help nitric oxide, but I haven't seen any studies indicating [00:15:00] that increases in nitrates or nitrites through that conjugation have any impact on nitric oxide, which of course affects vessel dilation. And I'm always a little concerned about too much nitrites or nitrates orally ingested. As for the buffered creatine — Kre-Alkalyn — it's really just creatine monohydrate powder mixed with a buffering powder, like a magnesium phosphate, to change the pH from neutral to more alkaline, with the idea that it helps the creatine not cyclize into creatinine. That's all true, except that as soon as you drink it, [00:16:00] you introduce that buffered solution into the gastric juices, which are hydrochloric acid. You're not going to buffer the stomach — as soon as it hits, the stomach acids neutralize the alkalinity, and you're left with creatine monohydrate. So from my scientific perspective, the data on Kre-Alkalyn is not very impressive. Micronized creatine, I think, is improved solubility over standard monohydrate.
Dr. Justin Marchegiani: And that's just a smaller particle size — same thing, just smaller.
Mark Faulkner: Yes. So you have some improved absorption, but I've not seen much data on it, [00:17:00] and it doesn't come anywhere close to the milligrams-per-milliliter solubility of creatine hydrochloride. The key thing about any conjugation of creatine is that if it's not in solution, it won't get in the bloodstream. Creatine has to be in solution to be taken up into the blood compartment.
Dr. Justin Marchegiani: So regular creatine monohydrate is at 15% absorption. Micronized monohydrate — does that go up at all from 15?
Mark Faulkner: It goes up a little. I haven't seen specific data, but just a guess based on the solubility data I've seen on micronized monohydrate — it could probably increase it by 50% or so.
Dr. Justin Marchegiani: So now it's at what — 15 to 25-ish? [00:18:00]
Mark Faulkner: Somewhere around 20–25% uptake.
Dr. Justin Marchegiani: So if I'm taking 10 grams of micronized creatine, you're only getting in about 2.5?
Mark Faulkner: If it's micronized, yeah. If it's regular creatine monohydrate at 10 grams, you're probably getting around 1,200 to 1,500 milligrams — so 1.2 to 1.5 grams into the blood compartment, and the rest, roughly eight-plus grams, gets flushed.
Dr. Justin Marchegiani: Got it.
Mark Faulkner: When you look at it on a per-dose basis, I actually think creatine hydrochloride is a better value. Think about a 10-gram dose: out of a kilo, you get 100 doses. A dose of creatine hydrochloride is 750 milligrams. [00:19:00] Even if you double that to 1.5 grams, at 750 milligrams you're getting about 1,300 doses out of that kilo instead of 100, or if you take double, 650 to 700 doses. If you drop monohydrate to five-gram doses, you get 200 doses. But 200 versus 600 to 1,300 doses — on a per-dose basis, creatine hydrochloride ends up favorable, [00:20:00] and it usually doesn't cost three to six times more than monohydrate.
Dr. Justin Marchegiani: Is there a reason there's no more soluble version needed?
Mark Faulkner: There hasn't needed to be, because it's so extraordinarily soluble. If you put a dose into an aqueous solution, it has 100% solubility — it just disappears into it.
Dr. Justin Marchegiani: So if we were doing 10 grams, we're getting seven to eight grams absorbed?
Mark Faulkner: But you don't need to do 10 grams of creatine hydrochloride. You can deliver more creatine to the cells, including the brain, on a low dose of HCL. Literally 1.5 grams of creatine hydrochloride could be very similar to the creatine the cells get on a 10-gram dose of monohydrate.
Dr. Justin Marchegiani: So you see studies talking about higher doses — that the first five grams of creatine goes to the muscles, and after that you start to get some neurological benefits. But that five grams is really counting on maybe 800 to 1,000 milligrams getting absorbed.
Mark Faulkner: That's correct. There was a great study out of the Journal of the American Nutrition Association (JANA) [00:22:00] this past fall by Dr. Sergey Obukh [⚠️ verify spelling], who is probably the world's top creatine researcher. For the first time, he showed that low doses of creatine hydrochloride — 750 milligrams to 1.5 grams — delivered more creatine to the brain than the large 10-to-20-gram doses of monohydrate reported in other studies. He showed significant brain energy-metabolism improvements and brain creatine increases on those low doses, [00:23:00] peer-reviewed and published. When you compare those results to the cognition studies involving 10 to 20 grams of monohydrate, it's significant that a low dose can deliver as much or more creatine to the brain as a very high dose of monohydrate. And a 10-to-20-gram dose of monohydrate isn't very sustainable for many people — it's expensive at that amount, and it can cause increased side effects: bloat, water retention, diarrhea. It's tougher to get 20 grams down daily. Even broken into four or five-gram doses, the discipline to take four doses a day versus popping one or two scoops to get 0.75 to 1.5 grams of HCL [00:24:00] — the sustainability of the routine is challenging at those high doses.
Dr. Justin Marchegiani: What does the data say? I pulled up a study — creatine monohydrate versus creatine hydrochloride, maybe 50 people — and it showed similar results for each. With better absorption you'd think — this is a five-gram dose —
Mark Faulkner: Is that the Brazilian Olympic athlete study?
Dr. Justin Marchegiani: Let me pull it up.
Mark Faulkner: There's a good study out of Brazil that looked at Olympic athletes — a head-to-head comparison of creatine monohydrate and creatine hydrochloride. What they demonstrated was kind of what I said earlier: both deliver creatine to the blood compartment.
Dr. Justin Marchegiani: This is the 2025 one — Journal of the International Society of Sports Nutrition. [00:25:00] 31 male and female, given five grams over eight weeks. They had some benefits — I'm just looking at the results here.
Mark Faulkner: The one I was referring to is an athlete head-to-head on Olympic athletes. Both forms supported strength improvement, which is what you'd expect. The difference is that the Brazilian athletes all reported their BMI improved with creatine hydrochloride — their lean muscle mass improved along with the strength. Happy to send you that study. [00:26:00]
Dr. Justin Marchegiani: Fat percentage decreased only with the HCL.
Mark Faulkner: That's exactly right. It was a well-done study, and it indicated that the creatine delivered to the blood compartment by either monohydrate or HCL both help the cells with strength. It's just a matter of how much you have to take of either one to get those amounts of creatine to the muscle cells or any of the other cells.
Dr. Justin Marchegiani: So here's how I read this. [00:27:00] This study used five grams of creatine a day. They needed to go that high because the monohydrate only absorbed a smaller percentage — maybe they only got one gram. But we could have gone a lower dose on the creatine HCL and still had the same benefit?
Mark Faulkner: That's correct. It's a dosing-efficiency situation. The places where that makes the most difference are in medical indications — patients with neurodegeneration, immunology issues, cardiac issues, or other things where the attending physician or nurse practitioner wants to use creatine as part of stabilizing that person's health and making their cells as resilient as possible. It's easier to keep patients on a low dose of anything than a high dose. [00:28:00] Patient compliance and treatment sustainability are pretty significant. There was a study called CREST-E, conducted by the NIH on Huntington's disease — a neurodegenerative disease that's kind of like Alzheimer's on steroids; it strikes younger and progresses faster. That study used creatine monohydrate, dosing 20, 30-plus grams to try to get therapeutic effects, and it was not successful. People say creatine monohydrate is the most studied form, and the most studied dietary supplement — true, because it's been around longest — but they neglect to say it also has the most failed studies, CREST-E being one. Whereas longitudinal case studies on Huntington's patients [00:29:00] using creatine hydrochloride have shown positive therapeutic outcomes at lower doses. In fact, these patients, who from diagnosis would normally expect to perish in three to five years, are out over 10 years with no disease progression — which is really significant for a neurodegenerative disease as tragic and dreaded as Huntington's. [⚠️ strong disease-outcome claim — see Safety Review #2]
Dr. Justin Marchegiani: So the absorption's better — I get that. Why are there so many fewer studies?
Mark Faulkner: Simply because it hasn't been around as long as monohydrate, so people haven't known to use it in studies. There was a group out of Kansas that did a nice Alzheimer's study with creatine monohydrate. [00:30:00] I think it's fair to say that next time they do an Alzheimer's study, rather than dosing elderly patients with 20 grams of monohydrate, they'll try creatine hydrochloride at lower doses to improve the dosing regimen. You are seeing more come out. There was a menopause study last year with creatine hydrochloride that showed really impressive results. There's a sarcopenia study going on now. There's some oncology work showing that creatine hydrochloride — because it can get more creatine to the brain than monohydrate — positively impacted chemo brain fog, and was able to buffer some of the cardiomyocyte damage that happens from certain chemotherapies. [⚠️ oncology — see Safety Review #3] So more studies are taking place with creatine hydrochloride now that people understand the dosing efficiency. [00:31:00] There's a TBI/concussion study going on right now — the first phase will probably be published in the next 60 days — showing interesting synapse protection in cases of traumatic brain injury; the second phase will look at other markers and behavior observations. It's about 30 years behind monohydrate, but it's gaining momentum in academic study.
Dr. Justin Marchegiani: That makes sense. Talk to me about price difference — how is creatine hydrochloride different from micronized monohydrate? And to back up, you mentioned brain fog with chemo, or brain health with TBI. [00:32:00] I've even seen brain improvement with sleep deprivation. What's the mechanism — is it just providing fuel for the mitochondria in the brain?
Mark Faulkner: Exactly right. Our optimal performance and recovery are all dependent on cellular energy, and the rate-limiting molecule on cellular energy is creatine. If the body has optimal stores, the cells function better and, importantly, recover better. I had to go to Spain, then China, then come back — all in less than a week and a half. I was jet-lagged coming and going, or should have been. But I'd take two to three grams of creatine hydrochloride — a higher dose, not 0.75 to 1.5 — before the trip, after the trip, [00:33:00] at each leg along the way, and I never had jet lag. With monohydrate, people are usually taking 10 or more grams to avoid jet lag. They're both doing the same thing; the concentrated creatine just accomplishes it with a lower dose. What's happening is the cells become fatigued less and recover faster.
Dr. Justin Marchegiani: Are you the major distributor for creatine hydrochloride, or is this catching on in other places?
Mark Faulkner: Creatine hydrochloride is the most patented creatine in history — we were awarded eight patents. Those patents have now expired, because we've been doing this for 20 years and that's how long patents [00:34:00] last. So there are some sources in China bringing creatine hydrochloride into the market, but we're proud that we're the only American-made creatine of any form. Most creatine in the world comes from China. There's a little under the CreaPure brand, or CreaVitalis, out of Germany — but that's maybe 5 to 10% of the market. We make ours outside Omaha, Nebraska, where the molecule is synthesized. On pricing: micronized creatine is probably $10 to $15 a kilo before it's processed into a retail product; the German CreaPure [00:35:00] is in the $15 to $18 range. Our concentrated creatine HCL is probably in the $25 to $30 range — so roughly 50% more, maybe double, compared to the micronized. But you have anywhere from three to seven times more doses out of a kilo, so cost per dose ends up below those, especially at higher gram doses of monohydrate. We never recommend more than about 1.5 grams.
Dr. Justin Marchegiani: That makes sense. What are some of the lesser-known benefits — and can you get enough creatine from food? I've seen you get about 0.5 grams of creatine per pound of grass-fed beef. [00:36:00] Is it the same absorption in meat — still that 85% lost?
Mark Faulkner: Dietary creatine is very well absorbed by the body, so yes, you can get it. Herring has a fair bit; red meat and beef have creatine; chicken and pork to a lesser degree. Vegetables and fruits typically have very little. The key thing about dietary creatine is it needs to be eaten as is — if you cook it, you destroy the creatine pretty significantly. So if you're going to eat red meat, you really need it medium-rare or rare; if you cook it much, you lose a lot.
Dr. Justin Marchegiani: Even medium-rare, you've lost something, right?
Mark Faulkner: You do — probably at least 10, maybe 20%, in a medium-rare steak. [00:37:00] But your body makes about a gram a day. The average person needs about two grams a day for cells to function well. So if your body's making a gram, you need about another gram through diet or supplementation. If you're vegan or vegetarian, you definitely need another gram.
Dr. Justin Marchegiani: About two pounds of grass-fed meat could get you close if you're not overcooking it.
Mark Faulkner: That's right, but most people aren't eating two pounds of grass-fed beef a day. That's why the latest statistics are that about 65% of American adults are low in creatine — they don't have optimal stores, which is why supplementation is so important for most Americans. And there are unexpected benefits. It's amazing how much our health depends on creatine. [00:38:00] What most people don't understand is that our T cells — immune cells that fight against cancer, viruses, bacteria — absolutely depend on creatine for their cellular energy. If a killer T cell comes up against a cancer cell, it knows it needs to target it. Cancer cells thrive on glucose and other common energy molecules, and our T cells are smart enough to know, “I don't want to compete by scavenging for glucose in order to be at my strongest.” So the first thing a T cell does when it sees a cancer cell, a virus, or a bacterium is armor up with more creatine itself. [⚠️ cancer + immune — see Safety Review #1] It's like a soldier going into battle wanting to carry more ammo. [00:39:00] There was some beautiful work out of UCLA by Dr. Lily Yang [⚠️ verify] showing that if you give a T cell enough creatine — many American adults don't have optimal stores — the T cells take up as much as the body has and go fight, because they've got to fight for us. But the problem is they run out of fuel. They become exhausted and can't keep fighting successfully, and then the cancer cell has the opportunity to overcome that T-cell immune-defense response and proliferate, often coalescing into a tumor. [00:40:00] So I think people underestimate our immune system. Yes, creatine's important for muscle strength and energy, and for cognition — but it's also the molecule we need for maximum immune strength.
Dr. Justin Marchegiani: I didn't think of it from an immune standpoint. So when immune cells are under stress, they compensate with more receptor sites for creatine?
Mark Faulkner: Absolutely. They armor up with more creatine receptors so they can take on more, because they know they'll need that fast-regenerated energy to be successful in their attack on a bad cell.
Dr. Justin Marchegiani: So being a vegetarian could really impact your immune system if you're not getting natural forms of creatine.
Mark Faulkner: That's true. Now, I'll say there are a lot of benefits to a vegan or vegetarian diet in terms of antioxidants [00:41:00] that help naturally downregulate oxidative stress — and oxidative stress is what creates a fertile environment for all sorts of diseases. So they naturally have a lower level of systemic inflammation, and their body will upregulate its creatine production. But the body never makes all the creatine it wants and needs, because it expects some to come from your diet. So a vegan or vegetarian can supplement and have terrific clinical outcomes with a little supplementation. And if someone takes a lot of creatine — eating or supplementing — the body downregulates how much it's making. [00:42:00] It never goes to zero, and if you stop, it regulates itself back up. It's not like the endocrine system, where if somebody's taking steroids, the testosterone slot shuts down and doesn't come back.
Dr. Justin Marchegiani: So there's no negative feedback loop, is what you're saying.
Mark Faulkner: That's correct. It's very elastic in terms of its recognition of dietary creatine intake.
Dr. Justin Marchegiani: So who can benefit? Athletes have done creatine for a long time — it makes sense for recovery and muscle performance. It makes sense for seniors, who aren't getting enough protein as they age. The original protein recommendation was about 0.35 grams per pound of body weight, which probably isn't enough. So who can benefit from extra creatine, and what would those benefits be? [00:43:00]
Mark Faulkner: Great question. I'll answer in a macro way first, then get more specific. There's a group right now — the Global Creatine Network — working with the World Health Organization to establish RDIs, recommended dietary intakes of creatine, for all age levels. [⚠️ verify WHO/RDI claim] So who can benefit from creatine? Everyone. The reason the World Health Organization is leaning into this is that they believe a significant contributor to the increase in global disease over the last several decades is low creatine intake and the body not having enough to fuel the immune system. So to combat the global [00:44:00] increase in chronic diseases, recommendations are coming — for the elderly, to maintain muscle mass and neurological function and to ward off dementia; for menopausal women with significant symptoms, including menopausal brain fog, fatigue, and mood swings, which creatine has been shown to positively impact; for anyone stressing their body with strenuous exercise; and even down to infants and toddlers. There's a study that demonstrated, under doctor's care, with small doses of creatine, that infants' [00:45:00] skull circumference — head measurements — grew more in the creatine-supplemented group, meaning their brains were developing more rapidly. So creatine for pregnant women, nursing women, infants, toddlers, adolescents, adults. [⚠️ pregnancy/infant dosing — see Safety Review #5] Within three to five years there will be creatine recommendations for all age groups, because the medical community globally sees creatine as that important and that lacking in many diets. The benefits would be stronger immune systems, better resistance to disease, [00:46:00] better neurological resilience, and impact on mood and behavioral health — especially when combined with medically assisted treatment for mental wellness. And for the elderly, sarcopenia and muscle wasting: if you can preserve muscle as we age, you decrease fall risk. So many elderly lose quality of life when they fall and break a hip and never get out of a wheelchair again, with massive cost to the healthcare system. So there are benefits for all age groups.
Dr. Justin Marchegiani: Makes sense. You mentioned endogenous creatine — you make about one gram a day. And the building blocks to make creatine in the body are arginine, glycine, and methionine, correct?
Mark Faulkner: That's [00:47:00] right.
Dr. Justin Marchegiani: And methionine you largely get from muscle meat, so if you're vegan, vegetarian, or not getting a complete protein source, methionine could easily be missed. To max out that one gram per day of creatine made endogenously, you need enough amino acids. So lower-protein diets — you see kwashiorkor in third-world countries, where you get the bloated belly from fluid issues — that's all low protein. So if we have low protein, that one gram of creatine goes down a lot.
Mark Faulkner: That's absolutely accurate.
Dr. Justin Marchegiani: Where are you most excited about the newer data on creatine? I always thought of it as muscle recovery, but now I'm seeing cognitive benefits for memory, benefits for people under stress or jet lag, and the sleep-deprivation studies [00:48:00] where they give people creatine, sleep-deprive them, and they perform as well as a non-deprived control group. Those cognitive studies are compelling. What are you excited about?
Mark Faulkner: Right now, the most excited I am is about this TBI/concussion study out of the University of Nebraska Medical Center. The early data shows there appears to be pretty significant prophylaxis against traumatic brain injury when someone is taking a therapeutic amount of creatine. I happened to be on a flight last week wearing a creatine shirt, and a guy in the aisle looked at me and said, “Oh, I like that product.” I said, “So do I.” [00:49:00] He said, “Our team uses it.” I asked what kind of team, and he said, “We have a professional bull-riding team.” When the seatbelt sign turned off, I went up and asked him to tell me more about how they use creatine with their bull riders. He said, “Professional bull riders get injured a lot — at least a third of the injuries are concussions. We've been tracking concussion protocols this past year, dosing our bull riders with the concentrated creatine hydrochloride. [00:50:00] For the first time, we went through an entire season with zero concussions.” [⚠️ “zero concussions” — see Safety Review #4] That's profound, because so many athletes at all levels have to exit a sport because of repeated concussions and severe TBIs — you look at the quarterback from Miami, Tua Tagovailoa [⚠️ real public figure — see Safety Review #7], or friends with hockey or soccer players who love the sport but have to stop because of concern for long-term mental wellness and early onset of dementia or memory loss. The negative trajectory from TBIs and concussions — possibly being able to mitigate, prevent, or lessen it — is something I'm extremely excited about. That's going to be beautiful data to review when published. [00:51:00] The idea that bull riders wouldn't get concussions, that a lacrosse, hockey, football, or soccer player could avoid those cranial injuries — that would be a tremendous bit of goodness.
Dr. Justin Marchegiani: Explain the mechanism. I understand that with an injury there's mitochondrial damage, and we're trying to upregulate the mitochondria, so this fuel helps. But how does it prevent it? The trauma's there — the brain ricochets inside the skull.
Mark Faulkner: It's preventing it because the neurons are starting from greater resilience and strength. It's like the difference between getting punched in the stomach unexpectedly — it really hurts — versus [00:52:00] expecting it and having a chance to flex.
Dr. Justin Marchegiani: Resiliency.
Mark Faulkner: A neuron flex-state and resiliency. It's the same neuron resilience we've seen in those positive clinical outcomes for Huntington's, Alzheimer's, and other case studies in neurodegeneration. When neurons are more resilient, they don't get damaged as easily or as much. I'll add that there is some damage that happens when you have a TBI, but not only does it appear to be lessened — those cells with optimal creatine stores also have the chance to regenerate and heal faster. One observation in this study [00:53:00] is that the animals in the placebo group that went through the concussion protocol acted concussed — like a human who has to be in a dark room. The ones in the creatine hydrochloride treatment groups, after the concussion protocol, were running around like nothing happened.
Dr. Justin Marchegiani: Wow. So it sounds like this should be a first-line thing for every athlete, every football player, anyone in high-risk physical activity — boxers, et cetera. What's the dose — are we talking 20 to 30 grams a day?
Mark Faulkner: No. That's the beauty. It would take 20 to 30 grams or more of creatine monohydrate to try to accomplish those outcomes. With creatine hydrochloride, the human equivalent of these doses is standard dosing — [00:54:00] 0.75 grams, 1.5 grams, three grams, in that range. Very low doses, in order to efficiently get the creatine to the brain to make the neurons more resilient.
Dr. Justin Marchegiani: So if you need two grams a day and your body makes one, we're adding one to two on top of that?
Mark Faulkner: Depending on your activity level — with strenuous exercise you take more. Your body needs that extra gram a day. If you're eating enough to get half a gram, you need to supplement about another half gram of net creatine into the blood compartment. But for strenuous exercise or something else going on, you need more. That's why for strenuous exercise we say take, on top of the roughly 0.75 grams a day for optimal health, [00:55:00] another 0.75 grams per 100 pounds of body weight about an hour before you work out — then you have all the cellular stores of creatine you need for strength, endurance, and recovery.
Dr. Justin Marchegiani: It takes about an hour to get into your system so your mitochondria can access the fuel.
Mark Faulkner: Yes — creatine usually peaks in the bloodstream about an hour after you take it.
Dr. Justin Marchegiani: So for brain and neurological benefits, with monohydrate you've got to be in that 20-to-30-gram level. With HCL, because 80%-plus gets into your bloodstream, you only increase it maybe two grams — about three to four grams total?
Mark Faulkner: I wouldn't even go that high. For TBI, you're probably closer to one and a half to three grams at most.
Dr. Justin Marchegiani: And preventatively, one to one and a half would be enough, and then [00:56:00] if you had an issue you could go higher afterward?
Mark Faulkner: That's right. I take about 1.5 grams of creatine hydrochloride a day. If I were to suffer a TBI or a concussion, I'd probably immediately up my doses — it can't hurt you [⚠️ absolute safety claim — see Safety Review #4] — to the six-to-12-gram range, just to make sure I was giving the cells every bit of creatine they could possibly use.
Dr. Justin Marchegiani: So you're definitely a creatine hydrochloride guy — you made that clear. Where's the best place to get it? You have your website — want to give that to listeners again?
Mark Faulkner: Sure. It's con-cret.com, C-O-N hyphen C-R-E-T dot com. It's available on Amazon and at Walmart, and soon, I think, at Target, CVS, and Kroger. And of course GNC and Vitamin Shoppe [00:57:00] as well.
Dr. Justin Marchegiani: And you co-founded this in 2003?
Mark Faulkner: Yes. We started Vireo — Vireo is a Latin word for health — that's the parent company, founded in 2002 to formalize the research projects around creatine, peptides, and amino acids. The Con-Cret creatine hydrochloride was discovered in 2003.
Dr. Justin Marchegiani: And then I've got to bring this up, because it comes up now and then. A study back in 2008–2009 talked about DHT increases due to creatine, and there's a connection with hair loss. I know there was a 2025 study that came out and debunked it — a 12-week study; they didn't see any increase in DHT/testosterone ratio, and they didn't see any hair loss. I want your take on the DHT–hair-loss connection with creatine.
Mark Faulkner: The latter [00:58:00] study is the one to pay attention to. The previous study that opined a relationship between creatine and increased DHT was not well designed. I would not have any concern. Your hair, skin, and follicle cells require creatine to function well. There is no repeated evidence of a creatine and DHT increase.
Dr. Justin Marchegiani: In the newer study they actually did trichogram tests, looking at exact follicle count, and they looked at DHT levels.
Mark Faulkner: The first study didn't look at enough other markers that might explain the fluctuation in DHT. To assign it to creatine consumption was irresponsible. [01:00:00] And that data has never been able to be replicated.
Dr. Justin Marchegiani: In this newer study, the T-to-DHT ratio did not change — which I think was the mechanism they were looking at in the previous study. I always like to understand the mechanism. Are there any studies showing creatine can increase testosterone at all?
Mark Faulkner: No. The body has an elegant biochemical choreography, and one of the things you don't want to mess with very often, or very much, is the endocrine profile. If you do, there are usually ripple effects, and most aren't positive. At the forensic toxicology laboratory we had, we regularly saw [01:01:00] people fluctuating their testosterone levels who had advanced cardiac plaquing, gonadal atrophy, gynecomastia, and fat deposits. The body's fragile balance of hormones is something you don't often want to mess with. Creatine doesn't interact with or exacerbate hormone issues, positive or negative. Your whole body works better if it has optimal stores of creatine, including your endocrine system. But we're not aware of any drug interactions, contraindications, or hormonal complications associated with creatine, since it's a [01:02:00] natural molecule to the body.
Dr. Justin Marchegiani: Very good. What's the point of creatine loading — is it because absorption is so low? And is it necessary with all types of creatine?
Mark Faulkner: I'll start with: it's not necessary, for any type of creatine. When creatine first came on the market, people thought it was kind of like a steroid. With steroids you cycle them because your body can't take them for very long and you get negative side effects, so you'd be on, then off. The idea was, “If this is muscle-enhancing, we ought to load, then back off.” The point was to flood the body initially with enough creatine to saturate the muscles faster. But you'll saturate the muscles with creatine of any form over time. [01:03:00] If you load with 20 grams a day for a week or two, most people get significant side effects — bloating, diarrhea, puffiness, water retention. If you're an offensive lineman who wants strength and bulk, maybe you load monohydrate. But if you're a running back, wide receiver, or cornerback who wants strength and leanness — like that Brazilian study showed, you could get strength and leanness with creatine hydrochloride. So monohydrate is strength and bulk; hydrochloride is strength and leanness. I'm not a fan of loading. You don't need to load creatine hydrochloride at all, and I don't even think you need to load monohydrate. [01:04:00]
Dr. Justin Marchegiani: Best dose for the average person?
Mark Faulkner: For creatine monohydrate, the standard five-gram dose is a good daily dose for optimal health, because you're delivering somewhere around 700 milligrams of creatine to the bloodstream out of that 5,000-milligram dose. For creatine hydrochloride, a standard daily dose of 750 milligrams — 0.75 grams — to 1.5 grams is just fine.
Dr. Justin Marchegiani: And if you want a neurological or cognitive benefit, probably double that?
Mark Faulkner: Exactly. For cognition with monohydrate you're in the 10-to-20-gram range, and for creatine hydrochloride — for trauma, TBI — like the jet-lag dosing I talked about earlier, probably in the two-to-three-gram [01:05:00] range.
Dr. Justin Marchegiani: Very good. Last question from me — is there anything important we didn't hit that you wanted to touch on? Did we get all the big stuff?
Mark Faulkner: I think you did. You covered it very well.
Dr. Justin Marchegiani: You mentioned peptides. Without making any medical claims, are there any valuable peptides you see out there, and what would be some of the big benefits?
Mark Faulkner: The disclaimer first: I'm not a peptide expert. We've done some research on peptides, and there are a few I'm interested in. My concern with peptides right now is that many billed as oral peptides never make it through the gut — they get destroyed in the gastric juices — so for most of them you're not going to see the claimed benefit. There needs to be a lot more study. The IV-delivered versions, [01:06:00] probably the most effective form of dosing a peptide, I'm concerned about because many aren't made under an FDA drug-quality program. I get concerned about the SQF or GMP status — safe quality foods or good manufacturing practices — because I've been in this industry long enough to know there are some shadowy figures and activities. We used to see, in the forensic-tox world, lots of counterfeit or black-market items sold as steroids or performance enhancement, where people filled vials with all sorts of compounds that weren't what was on the label. So the quality control in that area [01:07:00] has to advance, with more academic studies, before I get comfortable making any peptide recommendations. There's a lot of exciting science yet to unfold, but it's still in its infancy.
Dr. Justin Marchegiani: Is there any one that stands out with compelling data behind it?
Mark Faulkner: The most compelling peptide I've seen — with good safety data and therapeutic positive clinical-outcome data — is one called ethyl alpha guanidomethyl ethanoate [⚠️ verify name/spelling], “alpha-G” for short. It impacts systemic inflammation, and the data on systemic inflammatory downregulation is very impressive. So that's the peptide I'm most excited about. [01:08:00]
Dr. Justin Marchegiani: Very cool. Anything else you want to leave the listeners with today?
Mark Faulkner: Just gratitude for having me and this topic on. It's been enjoyable, and I hope your listeners come away with a little more information about creatine. And I'll say one last thing: I like to describe creatine as the most important supplement people can take. People roll their eyes — “Of course you'd say that, you're a creatine guy.” But no — it's the most important because all the other important supplements — protein, vitamin D, fish oil, magnesium — are wonderful and important, but none of them matter much if the cells don't have enough energy to use those nutrients. [01:09:00] And since creatine is the rate-limiting molecule on cellular energy, that's why it's the most important. Foundationally, it has to be there for the cells to use those other nutrients effectively.
Dr. Justin Marchegiani: Makes a lot of sense. Thanks so much, Mark. I'll put Mark's information down below, and we'll put some links to some of the studies we talked about. Hopefully you guys enjoyed today's podcast — if you did, we'd love to see your comments below. Mark, what's your site one more time?
Mark Faulkner: C-O-N hyphen C-R-E-T, con-cret.com.
Dr. Justin Marchegiani: Excellent. All right, Mark. Thanks so much. Take care, everyone. Bye now.
Mark Faulkner: Thank you.
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