The TriDoc Podcast, triathlon and health in one place · Dr. Jeff Sankoff

Ep. 178: Cutting through the creatine hype and From Cross Country to Caribbean: Embrace Your Inner Roller Skier!

·1 hr 7 min·4 clips

The highest creatine intake tracked with a 31% lower depression risk in women.

1. The TriDoc Podcast episode pairs a creatine evidence review with Silas Eastman’s plan for roller ski racing on Saba. 2. Jock Sankoff hosts as an emergency physician, triathlete, triathlon coach, and multiple Ironman finisher, while Griffin McMath joins as a naturopathic doctor and host of the Fast Talk podcast. 3. The episode asks whether creatine is useful for endurance athletes and whether it has any role in cognition, depression, or recovery. 4. Jock says creatine monohydrate and creatine hydrochloride are both discussed because the supplement is widely promoted despite practical issues like chalky texture and large dosing. 5. He explains that creatine is converted to phosphocreatine, supports ATP production, and is most relevant in anaerobic efforts rather than aerobic exercise. 6. Jock ties the supplement’s reputation to bodybuilding, where studies show gains in muscle mass, muscle definition, and repeated anaerobic strength efforts. 7. Griffin notes that athletes and non-athletes alike keep asking about creatine because it is being discussed across endurance sports, nutrition, and longevity circles. 8. Jock reviews meta-analyses in trained populations and says creatine does not improve endurance performance and may even trend negative because of extra body mass. 9. He points to soccer studies where 20 to 30 grams per day improved anaerobic output but left aerobic performance unchanged. 10. The pair distinguish between sprint-heavy sports and triathlon, where aerobic metabolism dominates and added weight can hurt watts per kilo. 11. Griffin says the supplement’s popularity often comes from visible gains in type 2 muscle fibers and from a human tendency to generalize bodybuilding results to other sports. 12. Jock says the evidence still does not support creatine as a way to help runners, cyclists, or triathletes podium in endurance events. 13. The conversation shifts to cognition with a 2024 systematic review of 16 studies and about 500 participants, where creatine did not reverse neurocognitive decline. 14. Jock notes that dosages in those studies ranged from 0.3 grams per kilogram per day to 20 grams per day, which makes standardized conclusions difficult. 15. Griffin adds that some clinicians recommend creatine after concussion or TBI, but Jock says the data were too preliminary to include as proof. 16. Jock then cites a 2025 observational study of US adults showing higher dietary creatine intake was associated with a 31% lower depression risk, especially in women. 17. Griffin frames that finding as a possible entry point in a complex depression loop rather than a standalone cure, and Jock agrees that diet and mental health may interact. 18. The medical mailbag sounds conversational and skeptical, with Jock repeatedly weighing study design, dosing ranges, and real-world athlete tradeoffs. 19. Listeners interested in endurance nutrition, creatine, and off-season cross-training for triathlon will get the most from it. 20. Listeners wanting a pure race recap or a short lifestyle chat may skip it.

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