Question: Is it safe to take creatine when nursing?If you felt fatigued and you took the creatine and all of a sudden that started reversing, then you either felt fatigued because you had low creatine synthesis, or you felt fatigued because you had a methylation problem. Those aren't mutually exclusive. If you're not methylating well, the most sensitive thing that will happen is you'll synthesize less creatine. But I mean it could have gone beyond creatine. It could have been that you're synthesizing less creatine, and you're not regulating your dopamine properly and things like that.

But certainly, you're addressing a methylation issue/a creatine deficiency issue. I don't know the exact cause and effect scenario that would lead to ovulation, but it makes sense that you ovulate. Think about the regulation of fertility, the whole thought process of the body's regulation of fertility. All of it comes down to energy. It comes down to the fact that when you get pregnant, you're investing -- I don't remember what the numbers are off the top of my head -- something like 50,000 kilocalories in the pregnancy. Then in lactation, you're investing another I think thousand kilocalories a day or something like that. The whole hypothalamic regulation of sex hormones and thyroid hormone is all regulated by leptin and insulin as signals of long-term and short-term energy status.

Insulin and leptin are hormones. Endocrine hormones are between tissues. But what happens at the cellular level is I think it's very plausible that something that's happening at the cellular level and the recognition of what those hormones mean to communicate that energy is present, sufficient for fertility is going to be ATP dependent. If you're missing creatine, then you're going to have a drop in the power of the ATP signal and the recycling of the ATP. This is the basis for why creatine is used for muscular power, but it's also the basis for why creatine is used to use energy in producing stomach acid or to communicate or to transmit light and dark signals through your eye to your brain to make vision. All over the place, creatine is super important to the cellular utilization of energy. My guess is it's correcting a response inside the cell to the leptin and insulin.

In terms of safety in breastfeeding, I don't think there's any evidence one way or another. It's probably safe because you could get this from meat, and there's no evidence of harm. But if you wanted to be hyper careful, I don't think you need to do this, but if you wanted to be like super, super careful, what I would do is divide the 5 grams over three or four meals evenly on the basis that there are very, very trace amounts of byproducts of high-dose creatine. Five grams will cause extraordinarily tiny amounts of toxins that appear in the urine. I mean, not toxins at the level that we're talking about, but I doubt it's a risk. But if you wanted to be hyper careful, divide the dose up evenly. 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/30/ask-anything-nutrition-march-4-2019

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