Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
The Supplement Showdown: Creatine, L-Carnitine, Taurine, and Boron
The wellness industry thrives on convincing us we need the latest supplements for optimal health. But do those trendy powders and pills pushed by social media influencers actually deliver results? In this eye-opening episode, Speaking of Women's Health Podcast Host Dr. Holly Thacker cuts through the marketing noise surrounding four popular supplements dominating online conversations: Creatine, L-Carnitine, Taurine, and Boron.
As Director for the Center for Specialized Women's Health, Dr. Thacker brings evidence-based clarity to the supplement conversation. She explains how these compounds naturally function in our bodies, what foods provide them naturally, and who might genuinely benefit from supplementation.
This podcast delivers exactly what modern health consumers need—straightforward information that cuts through marketing hype and empowers us to make smarter wellness decisions. Remember: when it comes to your health, knowledge truly is power!
Welcome to the Speaking of Women's Health podcast. I'm your host, dr Holly Thacker, and I am back in the Sunflower House for a new podcast and this is going to be a little bit of a potpourri. I'm going to talk about some substances that I've been asked a lot about recently in my practice and I'm the director for the Center for Specialized Women's Health. I'm a professor of medicine and also OBGYN and reproductive biology and I run our specialty women's health fellowship and I see midlife women's health for menopausal risk assessment, hormone therapy, osteoporosis and anti-aging, and we started this podcast back in 2023 because we wanted to get some of our great content out to busy people, and I want to dive into this topic on some of these supplements that have really really been kind of buzzing, and some of it is, I think, on social media. It's really popular to be on Instagram and be an influencer and put out all this content about perimenopause and menopause, and some of the content's good and, I guess, people thinking and talking about their health and being proactive, and that's our motto here at Speaking of Women's Health Be strong, be healthy and be in charge. But, that being said, a lot of times I think some of these influencers are selling things and I run this nonprofit. I'm not selling anything. We just want to get the right information out and I'm so grateful for supporters and philanthropists who have contributed to this nonprofit and anyone can contribute. Anyone can be a subscriber. You can go on speakinginwomenshealthcom and click that donate button if you appreciate the health information.
Holly L. Thacker, MD:So today I want to talk about some supplements. Creatine is one of them. L-carnitine supplements Creatine is one of them L-carnitine, taurine and boron and, like I said, you may have seen social media influencers and wellness blogs kind of hyping them all up. So we're going to dive into what is fiction and what is fact, and I want to cut through the noise. You're busy. You've got a lot going on in your life. You want to make sure you're making good use of your money, if you are buying any supplements, and let's talk about these substances amino acids, trace minerals and who might benefit from them and if it's truly necessary to add them to your routine. Now, remember this is not medical advice. This is just some health information to empower you to be strong, be healthy and be in charge. So I'll start with the one that I get asked the most about, which is creatine, and creatine is a compound that comes from three amino acids arginine, glycine and methionine and creatine is naturally produced in your body and it's primarily stored in muscles and your brain.
Holly L. Thacker, MD:So what are the benefits of creatine? Well, it's known in part, for its benefits on athletic performance and muscle mass production, and I heard about the interest in creatine from my athletic sons back when they were competing at pretty good levels at high school and also collegiately. Stetson Dr, stetson Thacker, who's been on our podcast, who's my oldest son. He was actuallya national Got Milk athlete. His little cute mug with a mustache was plastered all over the place. He was like one of 23 scholar athletes picked in the country, and my other two sons, emerson and Grayson, went on to play college football like their father. So, of course, being young, strong men competing, they were very much interested in muscle mass and athletic performance.
Holly L. Thacker, MD:But creatine has been studied to play important roles in other parts of our health, not just athletic performance, heart health, managing type 2 diabetes and injury prevention. Also cognition and brain health, and I've done a couple of podcasts related to brain health. One was in season one, I think September 8th 2023, on the mind diet and the supplement, which back then was by prescription. Now it's over the counter, called Serifolin NAC, now renamed Serifolin Brain Wellness, which has been shown to reduce brain shrinkage. It doesn't have any creatine in it but it has methylated vitamins. A lot of people with the MTHFR mutation don't convert some of the B-complex vitamins to an active form that can be used. That also affect methionine, which affects some of the neurotransmitters in the brain, and in season three I did another podcast about anti-aging and brain health. I've also done several podcasts on omega-3s, which seem to be anti-aging and help with brain health.
Holly L. Thacker, MD:Now creatine, besides brain and muscle, also has a role to play in bone health and of course I'm a bonehead, I'm an osteoporosis specialist and we have lots of content on treating, preventing, managing osteoporosis with lifestyle, nutrition and select medications, including osteoanabolics or bone building therapies if needed, and also skin aging. And of course we have a lot of stuff on skin, because pretty much most all women care about hair and skin. I always just think of it as kind of external and peripheral and not really integral to your health. But certainly if your skin isn't healthy and your hair isn't healthy, that many times reflects nutritional and hormonal and other deficiencies. So what foods are rich in creatine. So the body makes about half of the creatine it needs each day by itself and the other half comes from a person's diet. So the creatine rich foods are things that you probably would suspect, like meat, fish, poultry and dairy. So some of the foods that are really high in creatine are herring, which is also really good for omegas your omega-3s Pork.
Holly L. Thacker, MD:Now, if you heard my podcast on the foods that are banned in other countries that are available in America, you'll know that a lot of countries ban American pork because of a growth promoting substance that is provided to American pork to make it fattier and bigger. So I always tell people, if you're going to ingest pork which is rich in K2, by the way, also known as M7, which is one of the few foods that helps drive calcium into the bones and not the arteries then you really want to look for one that doesn't use any extra additives or antibiotics or injections or artificial substances to promote growth. Beef is really rich in creatine. Grass-fed beef tends to have better omega ratios.
Holly L. Thacker, MD:Salmon another great option for creatine and omegas, and is one of the foods that's rich in creatine and not too high in uric acid. So if you're plagued with gout or any crystalline diseases. Elevated uric acid, which a lot of times is not on regular metabolic panels unless you specifically ask for it. Salmon's a really good one. Lamb, cod, cod's rich in omega-3, chicken, and the dark chicken has the K2. And then milk from animals, so that would include cow's milk and goat's milk.
Holly L. Thacker, MD:So what women are asking me is well, doctor, should I be on creatine supplements? And I find that people like quick fixes, like let's just swallow a capsule instead of really thinking about everything. And they are very popular amongst athletes, also those that don't get enough creatine from their diet. So strict lacto-ovo vegetarians are definitely at risk for not getting enough creatine. The supplements do come in powder form tablets, capsules, liquids and energy bars. For athletes, the creatine supplementation does increase the energy that is available in muscles for high intensity exercise, heavy lifting and so it can lead to improved exercise performance, and some people believe that it might also improve some post-exercise recovery and injury prevention.
Holly L. Thacker, MD:Now, it's very important to drink plenty of water if you're taking a creatine supplement, and some research shows that taking it after your workout is actually superior to your pre-workout for body composition and strength, and some of these pre-workouts have the creatine in it and rather than just take, you know, just like a glob of stuff that you're not even sure of. You really need to look at labels, bring in the containers, talk to your healthcare team about it. So most studies show that if you use appropriate doses, most don't find any significant side effects for up to five years. But there are cases of interstitial nephritis and I noticed that my one son's creatinine level really kind of had jumped up quite a bit and his physician said to him you know, are you doing bodybuilding as your source of income? Is this your livelihood? He said, well, no, I'm just recreational now. And he said, well, that I wouldn't take it because there are some rare cases of interstitial nephritis, which you know is a kidney condition, that is, kidney damage, and I always ask and find out what my patients are on and when I find an elevated creatinine level it can mean impaired kidney function, it can mean somebody with a high muscle mass.
Holly L. Thacker, MD:There are some genetic differences. Blacks tend to have slightly higher creatinines than Caucasians. Knowing what your baseline is and comparison is very important. And there is a blood test that your physician can order, called Cystostatin C, and that's a measurement of kidney function that's independent of muscle mass or creatine supplements, so sometimes I'll have to order extra tests to evaluate that.
Holly L. Thacker, MD:Now, cysticetin C can go up with obesity and I find that some people who ask me about creatine supplements are trying to get some quick, fast weight loss. And you know weight loss and, um, you know, anything that's worth doing is worth doing right and, generally speaking, there's not easy quick fixes for weight loss, despite all the ridiculous ads that you might see online. But eating a higher protein, higher fat, low carb diet, which promotes ketosis and some people say mental clarity, certainly gets a lot more creatine into your system without having to spend money on supplements. And I don't specifically recommend any supplements of creatine in anyone who has kidney disease, as well as someone who's pregnant, attempting to become pregnant or breastfeeding moms, also people that have diabetes and liver disease and some existing kidney disease. I think that further research is needed.
Holly L. Thacker, MD:Now. Creatine may negatively interact with caffeine, meaning that caffeine can decrease some of the beneficial effects on the athletic performance, and a lot of athletes and weekend warriors will take some caffeine in their pre-workout. So probably for most people, creatine supplements are okay, but my warning to patients are anytime you take something that isn't a food and is not a drug, then it's not regulated by the FDA, and so there could be toxins or other supplements or things in it. So I think, rather than just taking something, you have to really have a reason and you need to do it thoughtfully. So what is L-carnitine? Well, it's another amino acid and it's found in some foods and supplements and we have L-carnitine in virtually every cell of our body and it plays a critical role in energy production by turning fat into energy. Now, most women, I know, want to definitely turn some of their excess fat into energy.
Holly L. Thacker, MD:Now, 95% of your L-carnitine is stored in your muscles. There is trace amounts in the bloodstream, the liver, the heart and the kidneys, and most people get a small amount of L-carnitine from eating animal products like meat and dairy. So what are the benefits of L-carnitine from eating animal products like meat and dairy? So what are the benefits of L-carnitine, you might ask, and you have been listening to the Speaking of Women's Health podcast. I'm your host, dr Holly Thacker, back in the Sunflower House, and we're talking about supplements. We went over creatine, now we're on L-carnitine and we're going to touch on a few other substances.
Holly L. Thacker, MD:So part of the potential benefits of L-carnitine is it might contribute to the management of certain cardiac conditions. It may actually reduce arrhythmias and angina, so-called chest pain, but we don't have definitive evidence of its effectiveness in preventing heart failure or preventing heart attacks. Peripheral artery disease Some research indicates that L-carnitine might reduce some of the leg pain, the claudication, some of the leg pain, the claudication. It might even improve walking distances for some individuals suffering with intermittent claudication, which is a symptom of peripheral artery disease. Male infertility L-carnitine might enhance sperm quality and motility in some men facing infertility, although it does not appear to definitely increase pregnancy rates. Now, a big one that affects a lot of people is diabetic neuropathy, and we're going to have an upcoming podcast on peripheral neuropathies. So preliminary studies suggest that acetyl L-carnitine might help lessen nerve pain and improve nerve function in those people that are suffering with diabetic neuropathy.
Holly L. Thacker, MD:Cognitive health Senile dementia of the Alzheimer's type, sdat Some research indicates it might improve cognitive function and possibly slow the progression of Alzheimer's disease, but further investigation is needed. Now, one reason why it's somewhat popular is the interest in weight loss. Indirectly it could assist in weight loss by promoting that fat oxidation and increasing energy expenditure. But it's probably very modest and it's much more pronounced if you combine it with a healthy diet and, of course, regular weight-bearing exercise and muscle building exercise. Depression I think a lot of mood disorders are affected by a poor diet. I've seen dramatic improvements when people correct their vitamin D deficiency, their zinc deficiency, improve their omega-3 to omega-6 fat ratios and, interestingly, there is some research that shows L-carnitine can reduce the symptoms of depression. Can reduce the symptoms of depression. Now, exercise performance L-carnitine is marketed as a supplement to enhance performance, but research really does show mixed results.
Holly L. Thacker, MD:So what are some of the foods rich in L-carnitine? Well, I think you're seeing a pattern here. It's found in animal products, especially red meat, and it's kind of ironic that red meat has kind of been demonized. A lot of foods, for instance eggs, have been demonized for their cholesterol. Well, they have choline, which is great for the brain, and the eggs that have omega-3 in them. If they feed the chicken flax, it's another good source of omega-3, which so many people are deficient in.
Holly L. Thacker, MD:So foods that are rich in L-carnitine include beefsteak, and if you haven't checked out any of our recipes, on Speaking of Women's Health, we have several good ones, and one of the ones that I like I think it's a flank steak that's got a marinade with coffee. That's a good one to check out. Ground beef good old cow's milk. Codfish that's coming up again with creatine and omega-3 and L-carnitine. Chicken breast, which tends to be white meat as opposed to dark meat.
Holly L. Thacker, MD:Oh, and ice cream. Ice cream is on that list and I, some of you know, I have a granddaughter. My oldest granddaughter is Artemis, and I'm planning a fifth birthday party for her. In fact it's themed in unicorn theme and we're having an ice cream truck. So if her parents or anyone complains about ice cream, I will be sure to tell them that there is L-carnitine in these ice cream cones that the kids are going to be ordering.
Holly L. Thacker, MD:And cheese, cheddar cheese and hard cheese, in particular, now, the three cheeses that have the K2, which we boneheads really like to promote because we push vitamin D, because it's anti-inflammatory and anti-cancer and bone benefits. That helps your gut absorb calcium and we don't like our patients, if at all possible, to not be estrogen deficient and estrogen helps your gut absorb calcium. That we want to make sure the calcium goes where it's supposed to go into the bone and not other tissues or arteries. And I did an entire podcast on cheese, another good food that sometimes has been demonized. Okay, so let's just say that you're a vegetarian or you really don't want to eat those foods.
Holly L. Thacker, MD:It still is best to try to get L-carnitine from your diet, but if you're unable to consume the necessary L-carnitine levels, you might need to consider a supplement, and so, generally speaking, vegetarians and vegans do tend to have lower L-carnitine levels and may want to consider supplementation, and there's various dosage recommendations. Acetyl L-carnitine this form is thought to be best for brain health and dosages have recommended and vary between 500 to 3,000 milligrams a day. Now the L-carnitine L-tartrate is the one that's generally recommended for exercise performance, and doses are a bit higher a thousand milligrams to even up to 4,500 milligrams per day and propionyl L-carnitine might improve blood flow in those people with high blood pressure or related health conditions, and there was a 2005 study that used a dose of two grams per day. Another supplement I've seen sometimes used in pre-workouts is red beets red beet powder, because it improves nitric oxide, and some of my patients with kind of borderline high blood pressure who don't want to start on medication have taken red beet gummies or supplements. Again, in general, I think food is always best If you do eat a lot of red beets. I like red beets, my husband doesn't, but I really do. It can make your stool look bright red, like you're having bleeding, and I've had more than one patient in my practice come into the office upset thinking they're having rectal bleeding, and they just had a lot of red beats the day before.
Holly L. Thacker, MD:So what are some of the side effects of L-carnitine? It's generally considered safe. Some people have noticed heartburn or diarrhea or indigestion or even rarely seizures. People have noticed heartburn or diarrhea or indigestion or even rarely seizures. So really anything can be too much of a good thing. Just like you can, you can severely injure yourself by drinking too much water and dropping your sodium levels. So if you are going to take L-carnitine supplements because maybe you don't think you're getting enough in your diet, you should not generally exceed more than three grams per day, and our caveat always is be sure to speak with your health care team or clinician before starting any supplements. Just because they're not prescription doesn't mean you don't need some medical advice and supervision.
Holly L. Thacker, MD:So now we're going to move on to taurine benefits, foods and supplements. What is taurine? Well, it's a naturally occurring sulfur containing amino acid, and it's found in your brain, your eyes, your heart and your muscles, and it is found in certain foods and the body can even produce it by itself. Taurine plays an important role in the body's heart health and immune system and brain function. It's involved in blood pressure regulation. It's very helpful in terms of helping to maintain the proper hydration and electrolyte balance inside your cells. It's involved in forming bile acid salts, which play a very important role in your digestion, and it's involved in regulating important minerals such as calcium within your cells, and most all your calcium is stored in your bones.
Holly L. Thacker, MD:Only a small amount is in the bloodstream, which is very important for cellular processes, electrical conduction activity in your body, and there are some people, especially if they avoid dairy, who don't get enough calcium in their diet. There are people whose kidneys don't handle the calcium quite as well and leak it out through the kidneys. So it's not uncommon for me to order a 24-hour collection of urine for calcium to assess someone's calcium balance, because you can't just draw the blood and tell, and only about half my patients complete the test, sadly, I hate to say. And now that I order it, I tell people you have 59 days to get this test done, otherwise the order goes away and my nurses are really busy. If you don't get it done and the order goes away, they're probably not going to reorder that lab until you come back in, so you know if your physician or healthcare team really wants to get an assessment. Some things just can't be done by blood and so it is a little bit of a hassle to collect your urine.
Holly L. Thacker, MD:Now, taurine does support the general function of your central nervous system and your eyes, and we've had a few podcasts on eyes, dry eyes, a couple Cataracts with Dr Wagenberg. If you didn't listen to that one, most everyone, if you live long enough, will develop cataracts. Taurine helps with immune system health, antioxidant function and helps support your vision. So what foods are rich in taurine? Well, your body can make it in your liver from other amino acids, but certain foods seem to help and are generally high protein foods, like you'd expect Meat, especially the dark meat. Poultry, seafood, especially shellfish, dairy products and seaweed. So really, for strict vegetarians, seaweed is kind of your main go-to.
Holly L. Thacker, MD:Now there is taurine in some energy drinks and it's a very common ingredient in energy drinks and most research has shown that taurine in energy drinks is not the problem, but all the sugar and the colors and the caffeine, and the safety of drinking these energy drinks regularly is not clear, but too much caffeine can make you jittery and be hard on the heart, can elevate blood pressure, and sugar generally is something that you really want to minimize in your diet. Caffeine can increase your heart rate. It can increase anxiety. The American Academy of Pediatrics states that energy drinks are not appropriate for children and adolescents due to the high levels of caffeine. Due to the high levels of caffeine.
Holly L. Thacker, MD:And one thing that concerns me is I have had the experience of people in my practice being very concerned about getting addicted to kratom, which is an addictive substance. I don't think it should be so available, but they have these little bottles of this addictive liquid like in gas stations and convenience stores right next to the energy drinks. So again, just because you can just go buy something off the shelf, or you think it's a food, or you think it's a drink, or you think it's just some workout supplement, you really have to read labels and be concerned, and it amazes me the number of people that I see that take a lot of different things and they're not even sure what they're taking or they don't realize they're doubling or tripling up on something. So really take it seriously and when you go in for your visit, bring in all your supplements. So most people don't need to take a taurine supplement, because most people can get enough protein in their diet not everyone but your body can make adjustments by creating and making taurine out of other amino acids, but if, for some reason, your healthcare clinician recommends a supplement. Generally, the most common dosage range is about 500 milligrams to 3,000 milligrams, and it is becoming a relatively popular substance for improving athletic performance, and some studies put together creatine and taurine, because creatine can boost energy production and help with recovery, while taurine might also help with muscle recovery, reducing fatigue and even helping nerve function. But a lot more research needs to be done before routinely recommending this.
Holly L. Thacker, MD:Now, lastly, I'm going to talk about a very small mineral that can make a big impact in your health boron, and it's a trace mineral, and it's involved in supporting your bones, your brain function. Boron, and it's a trace mineral, and it's involved in supporting your bones, your brain function and hormones. So boron's not yet quite the same household name that creatine is, but the trace mineral does quietly support your bones, brain and your hormones, and it's not officially classified as an essential mineral, but you really should know about it and also know that most people do get enough boron from a plant-rich diet. So we've talked a lot about carnivore and the meat and poultry and seafoods that help you so much with creatine, l-carnitine and taurine that help you so much with creatine, l-carnitine and taurine. So boron does seem to be involved in bone and joint health. If you didn't hear my podcast on joint supplements, preparing for possible joint replacement surgery and all things musculoskeletal, go back and listen to that one.
Holly L. Thacker, MD:Boron also seems to affect brain function and hormone balance, making testosterone more available and active. Boron also seems to help your body absorb calcium, magnesium and phosphorus, which are all key minerals for strong bones, and it seems to extend the effects of estrogen and vitamin D, both of which are all key minerals for strong bones, and it seems to extend the effects of estrogen and vitamin D, both of which are very important in protecting against bone loss. There have been a few studies that have linked boron to reduced inflammation and lower rates of osteoarthritis. Low boron levels may impair brain function and supplementation has been shown to improve some memory, focus and coordination. Boron seems to help cellular membranes and enzymatic functions, which are very important for your neurons that communicate with each other and hormonal balance In both men and women. Boron may increase the free active testosterone by lowering sex-binding globulin levels and making more active estrogen can be very helpful, especially in postmenopausal women. It may have some antioxidant effects.
Holly L. Thacker, MD:Boric acid may speed recovery and we do use boric acid to actually treat yeast infections. And you can find those over-the-counter vaginal suppositories, sometimes mixed with coconut oil suppository, sometimes mixed with coconut oil Prostate protection. Higher intake may be linked to reduced prostate cancer risk. So where do you find boron? Well, it's in many plant-based foods fruits, apples you know, you've heard the statement an apple a day keeps the doctor away, apple a day keeps the doctor away. Pears, raisins, avocado, avocado has a lot of heart healthy fat in it and also has magnesium.
Holly L. Thacker, MD:Nuts and legumes. So the nuts almonds are also rich in omega-3. And then the legumes of peanuts and chickpeas, vegetables, broccoli and broccoli is a really good vegetable. It has DIM in it, which helps reduce HPV affecting your cells. So women who've had abnormal PAPs and HPV, we really like them to get cruciferous vegetables in their diet. Other vegetables that have boron are potatoes, leafy greens and three drinks coffee, milk and wine.
Holly L. Thacker, MD:So most people don't need boron supplements. It appears that the safe upper limit for adults is about 20 milligrams per day. If you're considering supplementation, talk to your healthcare team first, because high doses can have some side effects, and I have seen some of these expensive bone supplements. Women don't want to start on osteoporosis medicines, although many are very safe and effective, and you really should be concerned about not treating osteoporosis as opposed to being concerned and exaggerating the rare risk with some of these medications. And so instead, women turn to these bone supplements, and many of them are high in boron, and they're also high in strontium, which is a heavy metal that actually gets deposited into your bones and falsely makes your bone density look stronger. So I do not recommend taking a strontium supplement, and if you are taking boron and still eating a lot of a plant-based diet, you may be taking too much.
Holly L. Thacker, MD:So I hope you found this episode helpful. Please be sure to subscribe to Speaking of Women's Health or anywhere that you listen to podcasts anywhere that you listen to podcasts and give us a follow. Give us a five-star rating if you would and share our podcast. We just don't want you to miss this great information, because we've got a lot more empowering, evidence-based conversations coming your way, because, when it comes to your health, knowledge is power and we want you to be strong, be healthy and be in charge and stay tuned.
