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Creatine Can Raise Creatinine—Why It Doesn’t Mean Kidney Damage (Ask for Cystatin C)

This episode explains that creatine supplementation commonly raises serum creatinine on blood tests, which can falsely suggest reduced kidney function because creatinine is used to calculate eGFR. The script breaks down the biology: increased muscle phosphocreatine from supplementation leads to more creatinine production, while kidneys may still be filtering normally. It describes how this can trigger unnecessary repeat testing, medication changes, or specialist referrals if supplement use isnt disclosed. Cited randomized controlled trials show creatinine rises with creatine, but other kidney markers—especially cystatin C—remain normal, including in a two-year study; creatinine also returns to baseline after stopping. The key advice is to tell clinicians you take creatine and use cystatin C or direct testing when kidney function is in question, with caution for those with pre-existing kidney disease.

00:00 Creatine Blood Test Trap

01:09 Creatine to Creatinine Explained

02:56 Why eGFR Looks Worse

04:12 Real World Misdiagnosis Spiral

05:58 What Studies Actually Show

08:36 Safety Caveats and Kidney Disease

09:07 What to Tell Your Doctor

09:43 Cystatin C and Final Takeaways

11:00 Wrap Up and Disclaimer

Gualano, B., Ugrinowitsch, C., Novaes, R. B., Artioli, G. G., Shimizu, M. H., Seguro, A. C., Harris, R. C., & Lancha, A. H. (2008). Effects of creatine supplementation on renal function: A randomized, double-blind, placebo-controlled clinical trial. *European Journal of Applied Physiology, 103*(1), 33–40. [https://doi.org/10.1007/s00421-007-0669-3](https://doi.org/10.1007/s00421-007-0669-3)

Robinson, T. M., Sewell, D. A., Casey, A., Steenge, G., & Greenhaff, P. L. (2000). Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function. *British Journal of Sports Medicine, 34*(4), 284–288. [https://doi.org/10.1136/bjsm.34.4.284](https://doi.org/10.1136/bjsm.34.4.284)

Bender, A., Samtleben, W., Elstner, M., & Klopstock, T. (2008). Long-term creatine supplementation is safe in aged patients with Parkinson disease. *Nutrition Research, 28*(3), 172–178. [https://doi.org/10.1016/j.nutres.2008.01.001](https://doi.org/10.1016/j.nutres.2008.01.001)

**This video is for informational and educational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this content. Dr. Adrian Laurence provides general health information and does not establish a doctor–patient relationship through this video or any related content.**

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Why “Normal” Cholesterol Can Miss Heart Attack Risk (ApoB Explained)

Family and lifestyle medicine doctor Adrian explains why many people who later have heart attacks previously had “normal” LDL cholesterol: the standard test measures how much cholesterol is inside LDL particles, not how many particles are circulating. Because LDL particle size varies, two people can share the same LDL-C while one has many more small, dense particles, increasing plaque and inflammation risk. He cites evidence from the Framingham Heart Study and hospital data showing many coronary artery disease patients present with acceptable LDL levels. He argues apolipoprotein B (ApoB), with one ApoB molecule per atherogenic particle, directly counts particle number and predicts cardiovascular risk even after accounting for LDL-C, and notes guidelines recognize ApoB as a target, especially in diabetes, high triglycerides, or metabolic syndrome.

00:00 Normal LDL Myth

00:59 What LDL Measures

01:34 Particle Size Problem

02:10 Evidence It Fails

02:50 Hospital Reality Check

03:49 ApoB Explained

04:28 ApoB Beats LDL

05:38 Who Should Test

06:25 Lowering ApoB

07:10 Key Takeaways

07:53 Final Wrap Up

Cromwell, W. C., Otvos, J. D., Keyes, M. J., Pencina, M. J., Sullivan, L., Vasan, R. S., Wilson, P. W. F., & D'Agostino, R. B. (2007). LDL particle number and risk of future cardiovascular disease in the Framingham Offspring Study: Implications for LDL management. *Journal of Clinical Lipidology*, *1*(6), 583–592. https://doi.org/10.1016/j.jacl.2007.10.001

Johannesen, C. D. L., Langsted, A., Nordestgaard, B. G., & Mortensen, M. B. (2024). Excess apolipoprotein B and cardiovascular risk in women and men. *Journal of the American College of Cardiology*, *83*(23), 2262–2273. https://doi.org/10.1016/j.jacc.2024.03.423

Sachdeva, A., Cannon, C. P., Deedwania, P. C., Labresh, K. A., Smith, S. C., Dai, D., Hernandez, A., & Fonarow, G. C. (2009). Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines. *American Heart Journal*, *157*(1), 111–117.e2. https://doi.org/10.1016/j.ahj.2008.08.010

**This video is for informational and educational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this content. Dr. Adrian Laurence provides general health information and does not establish a doctor–patient relationship through this video or any related content.**

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Common Anticholinergic Medications Linked to Higher Dementia Risk (Benadryl, Sleep Aids, Bladder Drugs)

Family doctor Adrian explains that anticholinergic medications—commonly used for allergies, sleep, anxiety, bladder control, nausea, and more—block acetylcholine, a key brain chemical for memory and learning, and long-term use has been linked in multiple large studies to higher dementia risk. He highlights common examples including diphenhydramine (Benadryl and many OTC sleep aids like Nytol/Unisom), hydroxyzine, oxybutynin, and older antidepressants like amitriptyline, noting risk is highest with higher dose, longer duration (including 3+ months), and especially when multiple anticholinergics are combined. Older adults (over 60) and those with memory concerns or family history may be most at risk. He advises not stopping prescriptions abruptly, reviewing all prescription and OTC products, asking a pharmacist to assess overall anticholinergic exposure, and discussing lower-risk alternatives with a doctor.

00:00 Hidden Dementia Risk

01:00 How Anticholinergics Work

02:18 Common Drugs Involved

03:26 Stacking Raises Risk

04:26 What Studies Show

05:40 Who Is Most Vulnerable

06:42 What To Do Next

07:29 Big Picture Brain Health

08:45 Pharmacist Conversation

08:56 Wrap Up

Dmochowski, R. R., Thai, S., Iglay, K., Enemchukwu, E., Tee, S., Varano, S., Girman, C., Radican, L., Mudd, P. N., & Poole, C. (2021). Increased risk of incident dementia following use of anticholinergic agents: A systematic literature review and meta-analysis. *Neurourology and Urodynamics*, *40*(1), 28–37. https://doi.org/10.1002/nau.24536

Pieper, N. T., Grossi, C. M., Chan, W.-Y., Loke, Y. K., Savva, G. M., Haroulis, C., Steel, N., Fox, C., Maidment, I. D., Arthur, A. J., Myint, P. K., Smith, T. O., Robinson, L., Matthews, F. E., Brayne, C., & Richardson, K. (2020). Anticholinergic drugs and incident dementia, mild cognitive impairment and cognitive decline: A meta-analysis. *Age and Ageing*, *49*(6), 939–947. https://doi.org/10.1093/ageing/afaa090

Zheng, Y.-B., Shi, L., Zhu, X.-M., Bao, Y.-P., Bai, L.-J., Li, J.-Q., Liu, J.-J., Han, Y., Shi, J., & Lu, L. (2021). Anticholinergic drugs and the risk of dementia: A systematic review and meta-analysis. *Neuroscience & Biobehavioral Reviews*, *127*, 296–306. https://doi.org/10.1016/j.neubiorev.2021.04.031

**This video is for informational and educational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this content. Dr. Adrian Laurence provides general health information and does not establish a doctor–patient relationship through this video or any related content.**

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