The Efficacy and Safety of Creatine for High Homocysteine

The Efficacy and Safety of Creatine for High Homocysteine
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Those on a healthy plant-based diet with elevated homocysteine levels despite taking sufficient vitamin B12 may want to consider taking a gram a day of contaminant-free creatine.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The average blood levels of homocysteine in men is about one and a half points higher than in women. Maybe that’s one of the reasons why men tend to be at higher risk for cardiovascular disease. Women don’t need to make as much creatine as men since they tend to have less muscle mass, and that may help explain the ‘gender gap’ in homocysteine levels. If you remember from my last video, in the process of making creatine, your body produces homocysteine as a by-product. So maybe for people with stubbornly high homocysteine levels that don’t sufficiently respond to B vitamins, perhaps creatine supplementation may represent a practical strategy to draw homocysteine levels down into the normal range.

It seemed to work in rats but in humans, it worked in one study, this one, but didn’t seem to work in another study, this one, or this one…and in this study homocysteine levels were even driven up. So this whole suggestion that taking creatine supplements would lower homocysteine was called into question. But all those studies were done in non-vegetarians, so they were already effectively supplementing with creatine every day in the form of muscle meat, so they were basically just testing higher vs. lower supplementation. Those eating strictly plant-based make all their creatine from scratch, so may be more sensitive to an added creatine source, but there were never any studies on creatine supplementation in vegans for homocysteine lowering … until, now.

They took a bunch of vegans who were not supplementing their diets with vitamin B12, so some of their homocysteine’s were through the roof, a few as high as 50 when the ideal is more like under 10, but after taking some creatine for a few weeks all of their homocysteine levels normalized before, and… after. Now they didn’t really normalize, which would be under 10, but that’s presumably because they weren’t taking any B12. Give vegetarians and vegans vitamin b12 supplements, either daily dosing or once a week, and their levels really normalize in a matter of months, but the fact that even without any B12, you could bring down homocysteine levels with creatine alone suggests—to me at least—that if your homocysteine is elevated on a plant-based diet, meaning above 10, despite taking B12 supplements (and eating greens and beans to get enough folate), well then it might be worth experimenting with supplementing with a gram of creatine for a few weeks and see if your homocysteine comes down.

Why one gram? That’s approximately how much nonvegetarians are not having to make themselves, that’s how much erased vegetarian discrepancies in blood and muscle, and how much has been shown to be safe in the longer-term.

How safe exactly is it? Well one can take a bit of comfort in the fact that it’s one of the world’s best-selling dietary supplements, with literally billions of servings taken, and the only consistently reported side effect has been weight gain, presumed to be from water retention. The only serious side-effects appear to be among those with pre-existing kidney diseases taking whopping doses of like 20 grams a day. A concern was raised that creatine could potentially form a carcinogen known as form N-nitrososarcosine when it hit the acid bath of the stomach, but when actually put to the test this does not appear to be a problem.

Bottomline, doses of up 3 grams a day are unlikely to pose any risk provided high purity creatine is used, and as we all know dietary supplements are not regulated by the FDA and may contain contaminants or not actually contain what’s on the label, contaminants generated during the industrial production. When researchers look at 33 samples of creatine supplements made in the U.S. and Europe, they all did actually contain creatine, which is nice, but about half exceeded the maximum level recommended by food safety authorities for at least one contaminant. The researchers recommend that consumers give their preference to products obtained by producers that ensure the highest quality control. Easier said than done.

Because of the potential risks I don’t think people should be taking creatine supplements willy-nilly, but the potential benefits may exceed the potential risks if, again, you’re on a healthy plant-based diet, taking B12 and your homocysteine levels are still not under 10 I would suggest giving a gram a day of creatine a try to see if it brings it down.

The reason I did this whole video series all goes back to this study, which found that although the overall cardiovascular risk is lower in vegetarians and vegans combined, they appeared to be at slightly higher stroke risk. I went through a list of potential causes, arrived at elevated homocysteine, and the solution? A regular, reliable source of vitamin B12. The cheapest, easiest method that I personally use is one 2500 mcg chewable tablet of cyanocobalamin, the most stable source of B12, once a week.

And then as I detailed in this video, a back-up plan for those doing that and still having elevated homocysteine is an empirical trial of one gram a day creatine supplementation, which was shown to improve at least capillary blood flow in those who started out with high homocysteine levels.

The bottom line is that plant-based diets appear to markedly reduce our risk of multiple leading killer diseases—heart disease, type 2 diabetes, and many common types of cancer, but an increased risk for stroke may represent an ‘Achilles heel’. Nonetheless, they have the potential to achieve a truly exceptional ‘healthspan’ if they face this problem forthrightly by restricting salt intake and taking other practical measures that promote brain artery healthy health. Nonetheless, these considerations do not justify nutritional nihilism. On balance, even strictly plant-based diets offer such versatile protection to long-term health that they remain highly recommendable. Most likely, the optimal strategy is to eat plant-based, along with going out of your way to eat particularly protective foods as I talked about before, regular aerobic exercise, and most importantly taking your vitamin B12. Oh, and try not to huff whipped cream charging canister gas.

Please consider volunteering to help out on the site.

Video production by Glass Entertainment

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The average blood levels of homocysteine in men is about one and a half points higher than in women. Maybe that’s one of the reasons why men tend to be at higher risk for cardiovascular disease. Women don’t need to make as much creatine as men since they tend to have less muscle mass, and that may help explain the ‘gender gap’ in homocysteine levels. If you remember from my last video, in the process of making creatine, your body produces homocysteine as a by-product. So maybe for people with stubbornly high homocysteine levels that don’t sufficiently respond to B vitamins, perhaps creatine supplementation may represent a practical strategy to draw homocysteine levels down into the normal range.

It seemed to work in rats but in humans, it worked in one study, this one, but didn’t seem to work in another study, this one, or this one…and in this study homocysteine levels were even driven up. So this whole suggestion that taking creatine supplements would lower homocysteine was called into question. But all those studies were done in non-vegetarians, so they were already effectively supplementing with creatine every day in the form of muscle meat, so they were basically just testing higher vs. lower supplementation. Those eating strictly plant-based make all their creatine from scratch, so may be more sensitive to an added creatine source, but there were never any studies on creatine supplementation in vegans for homocysteine lowering … until, now.

They took a bunch of vegans who were not supplementing their diets with vitamin B12, so some of their homocysteine’s were through the roof, a few as high as 50 when the ideal is more like under 10, but after taking some creatine for a few weeks all of their homocysteine levels normalized before, and… after. Now they didn’t really normalize, which would be under 10, but that’s presumably because they weren’t taking any B12. Give vegetarians and vegans vitamin b12 supplements, either daily dosing or once a week, and their levels really normalize in a matter of months, but the fact that even without any B12, you could bring down homocysteine levels with creatine alone suggests—to me at least—that if your homocysteine is elevated on a plant-based diet, meaning above 10, despite taking B12 supplements (and eating greens and beans to get enough folate), well then it might be worth experimenting with supplementing with a gram of creatine for a few weeks and see if your homocysteine comes down.

Why one gram? That’s approximately how much nonvegetarians are not having to make themselves, that’s how much erased vegetarian discrepancies in blood and muscle, and how much has been shown to be safe in the longer-term.

How safe exactly is it? Well one can take a bit of comfort in the fact that it’s one of the world’s best-selling dietary supplements, with literally billions of servings taken, and the only consistently reported side effect has been weight gain, presumed to be from water retention. The only serious side-effects appear to be among those with pre-existing kidney diseases taking whopping doses of like 20 grams a day. A concern was raised that creatine could potentially form a carcinogen known as form N-nitrososarcosine when it hit the acid bath of the stomach, but when actually put to the test this does not appear to be a problem.

Bottomline, doses of up 3 grams a day are unlikely to pose any risk provided high purity creatine is used, and as we all know dietary supplements are not regulated by the FDA and may contain contaminants or not actually contain what’s on the label, contaminants generated during the industrial production. When researchers look at 33 samples of creatine supplements made in the U.S. and Europe, they all did actually contain creatine, which is nice, but about half exceeded the maximum level recommended by food safety authorities for at least one contaminant. The researchers recommend that consumers give their preference to products obtained by producers that ensure the highest quality control. Easier said than done.

Because of the potential risks I don’t think people should be taking creatine supplements willy-nilly, but the potential benefits may exceed the potential risks if, again, you’re on a healthy plant-based diet, taking B12 and your homocysteine levels are still not under 10 I would suggest giving a gram a day of creatine a try to see if it brings it down.

The reason I did this whole video series all goes back to this study, which found that although the overall cardiovascular risk is lower in vegetarians and vegans combined, they appeared to be at slightly higher stroke risk. I went through a list of potential causes, arrived at elevated homocysteine, and the solution? A regular, reliable source of vitamin B12. The cheapest, easiest method that I personally use is one 2500 mcg chewable tablet of cyanocobalamin, the most stable source of B12, once a week.

And then as I detailed in this video, a back-up plan for those doing that and still having elevated homocysteine is an empirical trial of one gram a day creatine supplementation, which was shown to improve at least capillary blood flow in those who started out with high homocysteine levels.

The bottom line is that plant-based diets appear to markedly reduce our risk of multiple leading killer diseases—heart disease, type 2 diabetes, and many common types of cancer, but an increased risk for stroke may represent an ‘Achilles heel’. Nonetheless, they have the potential to achieve a truly exceptional ‘healthspan’ if they face this problem forthrightly by restricting salt intake and taking other practical measures that promote brain artery healthy health. Nonetheless, these considerations do not justify nutritional nihilism. On balance, even strictly plant-based diets offer such versatile protection to long-term health that they remain highly recommendable. Most likely, the optimal strategy is to eat plant-based, along with going out of your way to eat particularly protective foods as I talked about before, regular aerobic exercise, and most importantly taking your vitamin B12. Oh, and try not to huff whipped cream charging canister gas.

Please consider volunteering to help out on the site.

Video production by Glass Entertainment

Motion graphics by Avocado Video

Doctor's Note

This concludes my series on stroke risk. If you missed any of the videos here they are:

Now I’m assuming that nearly everyone who’s taking their B12 will have normal homocysteine levels, so these last two videos are just for the rare person that doesn’t, but those on a healthy plant-based diet with elevated homocysteine levels despite taking sufficient vitamin B12 should consider taking a gram a day of contaminant-free creatine (which would be about a quarter teaspoon).

OK, so where do you get contaminant-free creatine? You can’t rely on supplement manufacturers no matter what they say, since the regulation is so lax, so I would recommend going directly to the chemical suppliers that sell it to laboratories and guarantee a certain purity. Here are some examples from some of the largest companies in alphabetical order where you can get unadulterated creatine:

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141 responses to “The Efficacy and Safety of Creatine for High Homocysteine

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  1. Thanks for the great video!

    I would be interested to know whether the piece of advice regarding chemical suppliers for contaminant-free creatine also applies to ther supplements, namely B12, Omega3 and D3.

    Kind regards,

    Vasco

  2. I prefer the older video format with Dr. G only reading a script. It was easier to catch details of the charts and presented research papers in the older format. The older format seems more authoritative to me also.

    The chart at 2:04 does not impress me very much, I guess. If those dots represent individual subjects, it looks to me like

    (a) a few started below 10 (Hcy) and ended up nearly in the same place after supplementation, except a few actually rose to a higher level.

    (b) All but three of the subjects experienced what looks to me like a minor change in Hcy levels by supplementation, some higher, some lower. So, if you started at 20, you pretty much ended up at 20.

    (c) Only the top three subjects made impressive transformations from high levels to much lower.

    To me that’s a buzz killer.

      1. Most people in the world can not afford expensive blood checks for testing their homocysteine levels or expensive urine checks for testing their MMA levels.

        Only wealthy plant-based eaters like James Wilk or Dr Greger might afford to do so.

        1. ab,

          And expensive blood tests aren’t necessary; eat whole plant foods, avoiding animal products as well as processed and prepared foods, and limiting added oil, sugar, and salt, and take a B12 supplement. Also, don’t smoke, don’t drink alcohol (these steps actually save money), and exercise. For the vast majority of us, that’s sufficient to avoid most of the risk for the lifestyle diseases such as cardiovascular disease, strokes, T2 diabetes, obesity, high cholesterol, high blood pressure, certain cancers, etc.

          1. Dr. J.,
            Well said. I’m not much of a tester myself, but do make a good effort to make a strong showing in all the right moves. That, and I find the topic of health to be interesting, a great money saving hobby to have.

                1. For me, the fact that low B12 can cause vision problems and balance problems and brain problems was already enough before the stroke.

                  I ended up with things like pins and needles and little lesions everywhere.

                  25% of the people who stay low develop neurological problems.

          2. Dr J.,

            Those things improve odds.

            I will say that going Whole Food Plant-Based doesn’t always cause cholesterol and triglycerides and blood sugar and homocysteine to normalize and people tend to be lazy about B12.

            Eventually, I will get tested. But I only lost some weight going off of all of it. Yes, I gained it back and lost it again during COVID. But I never got to a normal weight.

            I never really drank or smoked, so maybe I am safe, but I am overweight, so getting tested makes more sense.

            Many people come with health issues like heart problems and diabetes and they probably should keep getting tested to make sure it works.

                1. Judy:
                  No, you don’t need a prescription from a doctor to get most clinical tests done any more. I have used lef for testing a few times and this is what you do the first time:

                  Step 1: You become a member of lef ( The membership fee, I think, is $ 40.)
                  Step 2: you order the test. (The membership fee applies toward your first purchase, whether it be a test or supplements, so your membership is effectively free.)
                  Step 3: you receive an invoice via email.
                  Step 4: you take the invoice to the nearest Lab Corp. facility and they draw blood. ( the nearest Lab Corp facility can be found either on lef website or Labcorp website. Many large hospitals have one.)
                  Step 5. A few days later, you receive the report by email.

                  No need to plead with your doctor to order the test. Depending on your copay, it could even be cheaper.

                2. Judy,
                  Depends on the state. You cannot in the great nanny state of New York, where I live. The claim is people would not know what to order or how to interpret the results.

                  1. Gengo:
                    That’s ridiculous, isn’t it? Ordering a test is not like ordering at an unfamiliar restaurant. Isn’t it obvious that if you want to order a test, you know what it is? And anybody who can read can interprete the re

          1. Interesting comment Caroline: It works like this low Vitamin B12 makes the homocysteine to go up, that in turns makes the cholesterol group to fail.

            It has been said “a fail in homocysteine is far worse than a fail in cholesterol”

            But the drugs company would rather have you on their profit making drugs then for the doctor doing detective work giving you a homocysteine test.

            So long as you die on the correctly given drugs the doctor is in the clear.

    1. Morevover, the epidemiological study quoted in the video is mostly based on vegetarian and not healthy whole foods plant based eaters… and to the extent of 3 per thousand having a stroke:

      “By contrast, vegetarians had 20% higher rates of total stroke (hazard ratio 1.20, 95% confidence interval 1.02 to 1.40) than meat eaters, equivalent to three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke.”
      https://pubmed.ncbi.nlm.nih.gov/31484644/

      It is not a buzz that 3 per thousand unhealthy vegetarian may get a stroke with all the dairy products and oils they consume…

      How then to draw advices for healthy people based on unhealthy vegetarian lifestyles ?

      As already pointed out by Dr Greger, vegetarianism is not healthy plant-based eating (low fat whole foods).

      https://nutritionfacts.org/2018/02/01/plant-based-is-not-the-same-as-vegetarianism/#:~:text=The%20recommended%20plant%2Dbased%20diet,%2Dbased%20nutrition%2C%E2%80%9D%20Dr.

      1. ab, there is no evidence dairy increases the risk of stroke. Quite the contrary The lead researchers that discovered this problem, have a different conclusion:

        ‘Tong suggests the increased stroke risk associated with a vegetarian diet may reflect low blood levels of total cholesterol or a low intake of certain essential nutrients.

        “The higher rate of hemorrhagic and total stroke in the vegetarian/vegan group seems surprising. However, as the authors point out, these findings are not dissimilar to other research from Japan and China linking vegetarian diets with higher rates of stroke. They attribute this to a possible protective effect of some meat products,” said Dr. Jennifer H. Haythe, cardiologist at Columbia University Irving Medical Center.

        Sankara emphasized that further research is needed to understand the reason for this increased risk.

        “One thing that could contribute to this observation may be the fact that vegetarians and vegans are at a higher risk of developing vitamin B-12, vitamin D, and other nutrient deficiencies which could contribute to neurological illness,” Sankara said.

        If the body has a nutrient deficiency it can lead to an increased risk for a variety of health issues.

        “Nutrient deficiencies, especially vitamin deficiencies such as vitamin B-12, and other B vitamins like folic acid (B-9) and B-6, can increase the risk of stroke,” he said.

        “Vitamin D deficiency can also increase the risk of stroke. It’s imperative that vegetarians discuss with their primary care physician, be screened for such deficiencies, and be appropriately treated with vitamin supplements as needed,” he added.

        For optimal health and development, the human brain requires a fat called DHA that can only be found in meat. While plant foods do contain a substance called ALA that can be changed into DHA, very little of it can be converted in the body.

        https://www.healthline.com/health-news/can-vegan-diet-increase-stroke-risk-what-to-know#The-bottom-line

        As for dairy, One cup (240 ml) of whole milk supplies 46% of the DV for vitamin B12. Cheese is also a rich source of vitamin B12.

          1. Hi Marilyn,

            Not sure what you are referring to, but if it is the research study, they are the words of the researchers who made the discovery. Not mine. They dont appear to agree with the claim that ‘oils and dairy’ are responsible for higher stroke risk.

            As for the science, it tells us dairy products are either neutral or protective:

            *Can full-fat dairy do a body good? *

            Subrata Thakar | July 17, 2018 |

            Contrary to popular belief, full-fat dairy products are not directly associated with increasing cardiovascular disease (CVD) and stroke mortality, according to a new study published in the *American Journal of Clinical Nutrition*.

            “Although for decades dairy fat consumption has been hypothesized to be a risk factor for CVD, as well as potentially diabetes, weight gain and cancer, little empirical evidence for these effects existed from studies of clinical events,” wrote Marcia Otto, PhD, of the UTHealth School of Public Health in Houston, and colleagues. “In current years, prospective studies have shown generally neutral or protective associations between self-reported dairy foods and dairy fat consumption with the risk of CVD, diabetes, weight gain and cancers, raising questions about this conventional wisdom.”

            Otto et al. found no significant link between plasma phospholipid fatty acids—pentadecanoic, heptadecanoic and trans-palmitoleic—and death. The researchers specifically assessed dairy fats’ link to heart disease and stroke over a 22-year period.

            “Our findings not only support, but also significantly strengthen, the growing body of evidence which suggests that dairy fat, contrary to popular belief, does not increase risk of heart disease or overall mortality in older adults,” Otto said in a prepared statement. “In addition to not contributing to death, the results suggest that one fatty acid present in dairy may lower risk of death from cardiovascular disease, particularly from stroke.”

            The researchers evaluated 3,000 adults, aged 65 and older. At baseline, the levels of all three fatty acids were measured in the cohort’s blood and remeasured at 6 years and 13 years.

            During the 22-year follow-up, there were 2,428 deaths—including 833 from CVD and 1,595 non-CVD related. There were 1,301 incident CVD deaths.

            Otto et al. found the fatty acids in dairy were not significantly associated with mortality, total incident CVD, coronary heart disease or stroke. The researchers found heptadecanoic acid was associated with a 42 percent lower risk of stroke mortality, compared to extreme heptadecanoic acid concentrations. Heptadecanoic acid was also associated with a higher risk of non-CVD mortality but it was not clearly related to a specific type of non-CVD mortality.

            “Consistent with previous findings, our results highlight the need to revisit current dietary guidance on whole fat dairy foods, which are rich sources of nutrients such as calcium and potassium,” Otto said. “These are essential for health not only during childhood but throughout life, particularly also in later years when undernourishment and conditions like osteoporosis are more common.”

            https://www.cardiovascularbusiness.com/topics/vascular-endovascular/full-fat-dairy-body

        1. Milk is a highly poisonous food for human, Pete. And it is not by chance that we lose the ability to digest it after infancy unless one has a genetic disease preventing it like most european and western people.

          As for strokes, there are many psychological factors that come into account too, like stress. You can not rule out everything with the nutrition glasses.

          1. thanks ab for the interesting heads-up. Actually made me smile :) so it was not in vain .

            1. Milk is a complete food like no other.
            2. Suggesting milk is poisonous is radical, uninformed dogma. It’s like saying the sun is toxic.
            3. Genetically, it’s the opposite to the way you describe. About 10,000 years ago the human genome in Europe and parts of Africa adapted to digesting lactose as adults. Adaptations occur because they deliver a genetic advantage over contemporaries. That’s the opposite of a disease. It effectively means the enzyme lactase continues to be produced into adulthood. However, this is not guaranteed, particularly in those who cease consuming milk for long periods.
            4. Dr Greger has spoken at length about the stroke risk in (specifically) vegetarians. My suggestion was that milk/dairy is not a stroke risk.

            Nothing wrong with you not drinking milk. There’s a lot wrong if you make uniformed choices. I think you are straying into the latter domain.
            Take care…

        2. DHA is available in vegan form. How do you think the fish get it? Your statement about the amount of ALA converted to DHA is unsupportable. It gives a possibly false impression. There are factors that affect ALA conversion to DHA that people should know, but the conversion does happen in otherwise healthy people with proper diets. Since people living far enough inland to not get ocean sourced fish have somehow managed to posses mental faculties throughout history, it seems likely that ALA conversion to DHA is adequate in many people. Supplementation with vitamins D and B12 is recommended for people who eat meat so your statements regarding those vitamins are non-sequiturs. Of course you left out the part of your source that said overall health of vegetarians was superior to meat eaters to the degree that the vegetarian diet would be recommended over meat eating. But that doesn’t help you shill that milk now does it?

          1. Jack,

            The words you are quoting are not mine. They come from the researchers who discovered the link between vegetarianism and stroke. If you have an issue with the findings, you will need to contact them (they usually have a contactable email address). Most likely they will ignore because they will deem you to be biased – and this is inconsistent with reliably establishing scientific fact. But if you have a valid point they may listen.
            I posted the comments in response to an obviously fallacious comment that dairy increased stroke risk. Vegetarianism causes stroke risk, so lets blame dairy, rather than the nutritional shortcomings of an exclusively plant-based diet. My point being, place the onus where it belongs, rather than attempting to find scapegoats. The science tells us that vegetarian diets protect against cardiovascular disease, but place us at higher risk of stroke. More likely dairy consumption decreases this risk, rather than increases it. That is, it delivers some of the essential nutrients that an exclusively plant-based cannot deliver, or can only deliver in a limited amounts. Including D and B12. So my preference is a vegetarian diet with dairy and fish, much like the Mediterranean diet. I dont promote the consumption of meat. Principally because I respect the animal-welfare views of those who are opposed to it. However, I have much less respect for the exaggerated nutritional criticisms, and the unscientific, faddy/fashion ‘cultish’ criticism of dairy. Which (in the main) is a self-reinforcing, extreme reaction to the legitimate concerns of animal welfare advocates.
            Well intentioned perhaps, but one which has evolved into a massive marketing opportunity for various vested interests (book sellers, marketers) who prosper on a phalanx of faux virtuosity.

      1. Dr Greger in this video serie wants to pass the idea that vegan junk food is healthier than meat. But there is clearly no proof about it. It may well be that vegan junk food is more detrimental than meat, as it is not only high in salt but also in oils and additives and is highly processed. And that may be why the vegetarian + vegan unhealthy group has a relatively higher stoke risks than meat eaters in this particular study.

        Neither meat eating nor vegetarian eating nor processed vegan eating is good for health. So there may be no need to seek for supplements in order to prevent strokes when one considers eating a healthy diet.

        This whole serie from Dr Greger is based on a flawed study in which the vegetarian group is in average even more overweight than the meat eaters.

      2. I would say Dr Greger has no peer when it comes to production techniques. It is outstanding. Especially the graphical treatment of studies. But having him hog the screen is a huge mistake. It completely distracts from the very thing he excels at above all others – his graphics.

        1. I guess different strokes for different folks. I actually had the opposite reaction. Moments ago I was reflecting on how much I like the new format. I love seeing his enthusiasm, his smirks and his cracking himself up with his jokes. I can always hit pause and zoom if there’s something I want to drill down on. But I’m good with whichever format they land on… it’s the info that keeps bringing me back.

    2. WaveSurfer,

      To me, it looks closer to 6 or 7 of the patients had a drop.

      I think the point is that they weren’t correcting their B12 and weren’t necessarily eating foods with folate and Creatine isn’t being recommended until after you fail to lower it through B12 and foods from Folate.

      Mentally, I would add in Betaine through beets and maybe lowering coffee before trying Creatine.

    3. I agree the old format was much more readable personable and less in your face more in the literature. You spent more time showing the aspects of the peer reviewed literature and that was more enjoyable and more believable than just having your nice looking face the whole time. Bring back the old format.

      1. Thanks to both you and WaveSurfer for bringing this up. I have mostly stopped watching the videos, as I can barely stand to watch the gesticulating and gyrating. It is very distracting from the message. And the studies are now so small and brief I can’t see the information I want from them. I would love to see the old format come back.

    4. WaveSurfer,

      I read your comment and was curious about your statement. I pulled up the study that graph was taken from. From my reading is seems that the supplementation improved vascular perfusion in all, but in lowering homocysteine the real effects occurred in people with hyperhomocysteine levels. I’m adding the quote from the study: “The main findings of this study are as follows:
      i) In strict vegan subjects, CrS significantly increased the body weight, body mass index, and creatinine levels;
      ii)CrS significantly reduced the plasma homocysteine
      levels and increased folic acid levels only in the group
      of hyperhomocysteinemic subjects;
      iii) CrS was able to increase the perfusion of capillaries in the basal state
      and after hyperemia, which is an effect that was verified in both the normal and hyperhomocysteinemic vegan subjects

    1. Thanks George! Did you see the first sentences saying ascorbic acid interacts with vit E to counter oxidative stress? A little lemon jiuce over a salad that includes a couple of walnut halves might work well…

  3. YOU ACTUALLY WROTE:
    The only serious side-effects appear to be among those with pre-existing kidney diseases taking whopping doses of like 20 grams a day.

    UNTRUE
    ANY creatine supplementation is not recommended for people with kidney issues, even minor, if you talk to a nephrologist. Not some ‘lifestyle physician’ attempting to practice out of his realm of expertise.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421632/

    “The potential side effect of creatine supplementation, kidney damage, was based on case reports only and was associated especially with high doses of creatine supplementation or renal disease [8–10].

    In our case, though the patient was using the recommended doses of creatine monohydrate, he developed renal failure. Furthermore; he also did not have a history of any renal disease or use of any nephrotoxic drugs or herbs. There is less concern today than there used to be about possible kidney damage from creatine, although there are reports of kidney damage, such as interstitial nephritis. Therefore, patients with kidney disease should avoid using this supplement.”

    1. Reality bites, and what was the ‘recommended dose’ the patient took?
      Most of the muscle man websites recommend 20 grams. Far more than the measly 1 gram Dr. Greger is recommending.

    2. What Dr Greger recommends IN CERTAIN CIRCUMSTANCES is quite different than the usual dosage recommended for commercial creatine products. Commercial creatine products are marketed for bodybuilding and have recommended dosages that are initially HUGE, such as 20 grams or more each day for a week on top of the creatine already in the diet of meat eaters.. Dr Greger suggests an amount lower than most meat eaters get in their regular diet. But of course a patient with particular problems should consult a care giver before taking a supplement.

  4. Betaine (trimethylglycine [TMG]) supplementation has also shown to be effective in several studies. As a good methyl donor, betaine re-methylates homocysteine to convert it back to methionine and attenuates homocysteine rises after meals.

    Study: Low Dose Betaine Supplementation Leads to Immediate and Long Term Lowering of Plasma Homocysteine in Healthy Men and Women

    “Furthermore, the increase in plasma homocysteine after methionine loading on the 1st d of betaine supplementation was 16% (P < 0.06), 23% (P < 0.008) and 35% (P < 0.0002) less than in the placebo group, respectively, and after 6 wk of supplementation was 23% (P < 0.02), 30% (P < 0.003) and 40% (P < 0.0002) less, respectively. Thus, doses of betaine in the range of dietary intake reduce fasting and postmethionine loading plasma homocysteine concentrations."

    Study Link: https://academic.oup.com/jn/article/133/12/4135/4687457

      1. ab,

        As I understand it, our gut bacteria do excrete vitamin B12 — but too far down the digestive tract for us to absorb it. So, we poop it out, as do most animals. So increasing B12 production in our gut bacteria wouldn’t be of any benefit to us.

          1. That’s exactly what Dr. McDougall has always said. B12 deficiency is exceedingly rare. I think Dr. Greger missed it on this series and tried to come up with an explanation for something that isn’t there. And then went down the B12 rabbit hole. Yes, dairy and egg eating “vegetarians” eat a terrible diet. I have long ago lost count of the number of people I’ve met who ate the SAD and had a stroke.

            1. Blair,

              I think he explained that people can test normal for B12 but have functional B12 deficiency as evidenced by high homocysteine.

              Dr. McDougall has changed his position on B12 so many times and has reserved a right to keep changing his position on it.

              You are taking one of his theories and acting like it is the only theory that Dr. McDougall has when it isn’t.

            2. UK vegetarian and vegan seem to have particularly unhealthy diets and this may be due to high level of animal activism in this country. Studies showing vitamin B12 deficiency and higher strokes like quoted in Dr Greger’s videos have been made in the UK.

              1. No, AB, the one WebMD was looking at was not the UK study. A Danish study was much, much worse than the UK study. Studies have been done in Germany and Spain and Austria and Czechoslovakia. Vegans who supplement are less likely to be deficient and less likely to be functionally deficient (less likely to have high homocysteine) in so many areas of the world.

                What Dr. Greger pointed out was that vegans and vegetarians should have much better stroke risk benefits than they have and B12 / Homocysteine is one of the reasons they test poorly.

                1. ab,

                  It isn’t just the UK. In meta-analysis where the vegans had lower body weight, lower blood pressure, lower diabetic risk factors, lower lifestyle risk factors, more likely to exercise, less likely to smoke, etc, they expected a much lower stroke risk.

                  There are studies that show that supplementing does affect the endothelial function of vegans and it supplementing affects atherosclerosis.

                  However, metabolic vitamin B-12 deficiency is highly prevalent in vegetarians in Australia, Germany, Italy and Austria, and in vegans (80%) in Hong Kong and India, where vegans rarely take vitamin B-12 fortified food or vitamin B-12 supplements. Similar deficiencies exist in northern Chinese rural communities consuming inadequate meat, egg or dairy products due to poverty or dietary habits. Vascular studies have demonstrated impaired arterial endothelial function and increased carotid intima-media thickness as atherosclerosis surrogates in such metabolic vitamin B-12 deficient populations, but not in lactovegetarians in China. Vitamin B-12 supplementation has a favourable impact on these vascular surrogates in Hong Kong vegans and in underprivileged communities in northern rural China. Regular monitoring of vitamin B-12 status is thus potentially beneficial for early detection and treatment of metabolic vitamin B-12 deficiency in vegans, and possibly for prevention of atherosclerosis-related diseases.

                  You are trying to shut Dr. Greger up and put him down rather than see what you can glean from him.

                2. Vegan are clearly not a reference for healthy eating. Vegan is not healthy nutrition at all. You should keep that in mind. So you can not draw generalizations based on vegan.

                3. Deb, most people participating into those studies are drinking alcohol regularly (even in moderation) and that impacts the gut, the antioxydant status and the vitamin B12 status. Smoking also elevates homocysteine.

                  I didn’t see any study with people having a healthy lifestyle and not drinking alcohol checked for their vitamin B12 and homocystein status versus their stroke risk.

                  Scientist have already difficulties to find enough vegan people (who do not eat or live healthily), so to draw conclusions for healthy eating and living from those studies is not the “best balance of evidence”.

            3. Blair,

              When they have done studies on vegans 92% tested B12 deficient and 2 out of every 3 vegetarians also tested B12 deficient.

              Plus, when vegans are deficient, their homocysteine levels are higher than meat-eaters homocysteine levels and it is when they are given B12 that the homocysteine levels drop lower than meat-eaters.

              The deficiency levels are so high that I feel like that should be the big message. Of course, they can get their B12 from Nutritional yeast if they get a brand that has higher levels in it, like Braggs. But that is cyano B12 in Braggs Nutritional Yeast in the first place.

                1. I see that you do not answer to a simple question: was alcohol consumption taken into account in all those studies about vitamin B12 deficiency ?

              1. I already pointed out that some of the studies on vitamin B12 deficiency was flawed. When you look at the numbers carefully, you see that the deficiency is grossly exagerated and only a minority may suffer from functional deficiency, which may also have confoounding factors like alcohol consumption amongst other things.

        1. Dr. J.,
          Dr. Greger did a video showing a woman researcher who took a small group of people and gave them their own poop, in capsules, and their B-12 levels were fine. I suspect that people have been using manure to fertilize their crops for a long time. Farming, by definition, is a “knee deep in poop experience.” E-coli and cholera? Yes, plenty of it, but something people have lived with for a long time. Drive by a dairy or chicken farm even with the windows up.

          1. Wrong. Farming is based on the deforestation of the Earth. And all the agricultural fields come from very fertile forest soils that are created mainly by the degradation and fermentation of plant by-products (mainly leaves and small branches). Animal poop is actually only a very small part of the soil fertilization process. It is almost negligible and there is no need of animal manure to have great agricultural soils, when one follows the way of nature, the way of the forests.

            There are indeed bacteria in our gut that produces vitamin B12 and actually it has been shown that some of them are also located where one absorbs the nutrients within the intestine, and not only down in our colon. But apparently, the fragile equilibrium of the gut microbiome is impacted by food and alcohol consumption. So it may explain the occurence of vitamin B12 deficiency that has been documented in the scientific litterature.

            Lack of cobalt rich foods (such as in young leafy greens) and of betaine are also potential triggers of vitamin B12 deficiency induced by dysbiosis.

  5. Thank you for this interesting article. One thing that should be considered with people who have high homocysteine despite a healthy/plant based diet is that the MTHFR gene mutation is very common. This is the gene that methylates B12, and, in doing so, helps promote the methyl-B12 mediated metabolism of methionine to cysteine, with homocysteine as an intermediate step. Even in people who are heterozygous for the gene mutation, increase in homocysteine levels are seen. So if supplementing with B12 is not improving the homocysteine level, the simple solution is to take methyl-B12 as a supplement instead of plain B12.

    1. Thanks for bringing some light on the art of nutrition. It balances well Dr Greger’s recommendation on vitamin B12, who favors cyanocobalamin over methylcobalamin.

        1. Greg,

          Methyl B12 was tested on vegans and it failed in a study.

          I have had it fail twice and a few other people on this site had it fail.

          It is not shelf-stable and isn’t as effective as Cyano B12 in studies and may not be complete.

          There is a researcher on PubMed who feels like the Methyl should never be given without Adenosyl B12.

          Eventually, they did tests where they paired 2 of the other types of B12 and they matched Cyano in its effectiveness.

          A researcher recommended if you don’t want to take cyano to take 2 or 3 of the other types.

        2. Greg, it’s important that your mom follow her doctor’s recommendations. They are the ones looking at her lab results.
          Methylcobalamin works great for me.

  6. Consumer Reports top picks for Creatine are BulkSupplements.com Creatine Monohydrate and GNC Creatine Monohydrate

    https://www.bulksupplements.com/products/creatine-monohydrate

    https://www.gnc.com/best-sellers-shop-all/386487.html

    Some research points to Creatine as having cognitive benefits.

    Your Brain on Creatine – https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201202/your-brain-creatine

    Creatine might reduce cognitive decline older people:

    https://www.tandfonline.com/doi/abs/10.1080/13825580600788100

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093191/

    Creatine Supplementation Enhances Corticomotor Excitability and Cognitive Performance during Oxygen Deprivation – https://www.jneurosci.org/content/35/4/1773

  7. Another way to reduce homocysteine levels is to not smoke anything. The carbon monoxide it the smoke drastically increases homocysteine levels.

  8. A diet so healthy that most of the boards now discuss synthetic supplements. So much for whole foods.

    I have found the recent videos rather depressing.

    1. Gillian,

      There are so many people eating Whole Food Plant Based who haven’t normalized their numbers yet.

      Dr. Greger always starts with foods, but normalizing the lab numbers is what this is about.

      1. Ah ? Do you have statistics or a study to show that ? Dr Greger often starts with junk science and flawed studies picturing unhealthy vegetarian lifestyle not whole foods plant nutrition.

        1. One can not blame him entirely though, as good science is very rare and very few people eat healthy diets and even less participate into studies.

        2. ab,

          Dr. Greger tends to present the studies in a way where you can see the progression of logic.

          He uses studies and has 200 doctors who help him with that process. I think he said 200.

          There are many times there are not better studies available yet, so they have to use what they have and I know that gets frustrating.

          As far as the lab numbers of WFPB, there are people like Dr. Lisle who work with people who have said that most people still don’t succeed on WFPB. It is not always easy for people who have health problems to reverse their lab numbers completely. I will look for studies, but I have been here long enough to know that post-menopausal women used to discuss it all of the time.

          Being on the internet, it comes up as a discussion regularly.

          It is so common that I used to have YouTube offer me more people who left things like raw vegan and fruitarian and vegan (which can mean anything, but the people said they were eating the right things)

          Dr. Lisle talking about people failing is the one that sticks with me.

          I am not failing, but it is taking me years to lose weight. It will take maybe 4 or 5 years to succeed in just that one area and I kept refining my diet getting rid of oil and dairy and sodium and sugar but I couldn’t just do it the way people said. I needed Dr. Greger’s How Not To Diet. I needed sleep and circadian rhythms and to be awake in the morning to eat breakfast and to be home from work by 7 pm to eat dinner and not eat late and not have my glycemic response to low glycemic foods be messed up.

          I was back to listening to that audio book tonight and I had briefly gone back more to processed foods during COVID. Partly because of foods not being available at the grocery store for a few months. Tonight, listening to Dr. Greger, I know that increasing fat intake messes up the brain in 5 days and I can bear witness to that.

          Anyway, he can’t put up studies that don’t exist yet. He talked about having 9 fact-checkers in his books and he is doing his best and he is part of a team that is respected by doctors around the world.

          To me, I already know that some of the most serious, most disciplined people on this site didn’t have their numbers improve even after they cleaned up their eating so much that it became perplexing why it wasn’t working.

          There are people on this site who said that they had been eating WFPB for 9 years before their stroke and, yes, I do believe them.

          Some people have a really hard time and many, many others have a real easy time.

          I am glad that you are passionate and that you believe in Whole Food Plant-Based.

          I just know that many, many people make mistakes.

          1. With me, I thought when I went off junk food and processed food and pizza and soda.

            I kept thinking, this will be it.

            I got rid of dairy and cheese and had stopped eating fried foods and stopped eating thing after thing after thing with almost no results.

            Then, I thought, okay, let’s focus on adding in fruits and vegetables, and still not many results.

            I even had stopped having things like vegan chili and guacamole and finally got off the oil-free hummus.

            Right now, I am doing beans and rice and I think I am doing it to see if just eating that will help me lose weight.

            At this point, I have been disappointed so many times.

            I thought for sure when I started doing salad as my main meal for over a year that I would finally lose as long as I stuck to no-oil dressings.

            Discouragement is probably why I finally did do some vegan processed foods.

            It is almost as if I just finally said to myself, “Might as well just eat some Amy’s and Gardein.”

            I messed up my brain again and gained weight on Amy’s and Gardein.

            But reset and lost it back but I have found WFPB to be just as frustrating as when I did try dairy to lose weight and Atkins and the Mediterranean Diet and Moderation and everything else.

            I am enjoying eating beans and rice every day. Those are my comfort foods anyway.

            I did add in a small salad with microgreens so I could keep my broccoli and arugula and beet microgreens and kale and carrots and tomatoes and my pomegranate seeds and my artichoke and mushrooms. Yes, the list is still long, but my salad is microgreens. No longer a big box.

            We will see what happens.

            1. Deb,

              You have mentioned being on vegetables and fruit last year and switching to beans and rice this year.

              Without getting too far into the nitty gritty – a few questions:

              (1) Did you change diets due to of a conscious decision to change for specific reasons – or did you change because of a change in appetite?

              (2) Notice much physiological change? Energy? Anything else ?

              ———————————–

              I have been sending people interested in weight loss to Jeff Novick’s recorded lecture on the topic.

              Very helpful video – you can use the knowledge to lose weight, stabilize, or to gain weight.

              But I warn you – I keep getting angry telephone calls.

              One was angry because he had to buy new pants.

              Another called recently because he had to buy a new belt.

              There’s just no pleasin’ everybody . . .

              Deb.

              All the best –

              Vivamus

              ————————-

              Calorie Density: How To Eat More, Weigh Less and Live Longer
              Jeff Novick, MS, RDN
              https://www.youtube.com/watch?v=0CdwWliv7Hg&feature=youtu.be

  9. What about using NAC (N-acetyl cysteine) to lower homocysteine? I found that creatine supplementation elevates my blood pressure, probably to the increase in water weight in the body. Your thoughts?

  10. Also strongly consider yoghurt (helveticus or greek style). If we can extrapolate, this study (just in) suggests it is superior to both milk and non-dairy protein in reducing cardiovascular and diabetes disease risk. Particularly in the obese, and those on ‘inappropriate’ diets.

    ‘Recent meta-analyses suggest that the consumption of fermented dairy products reduces type 2 diabetes and cardiovascular disease (CVD) risk, although the underlying mechanisms remain unclear’.

    ‘We evaluated whether dairy protein products modulated gut microbiota and cardiometabolic features in mouse models of diet-induced obesity and CVD’.

    Conclusion: ‘Both fermented dairy protein products (Lactobacillus helveticus, or Greek-style yogurt) reduce cardiometabolic risk factors in diet-induced obese mice, possibly by modulating the gut microbiota.

    High-fat/high-sucrose diet – Protein Variables

    1.100% nondairy protein (NDP)

    2. 50% NDP, plus 50% milk

    3. 50% NDP plus 50% Lactobacillus helveticus yoghurt (FMP).

    3. 50% NDP plus 50% Greek-style yogurt (YP).

    Weight Gain

    After 12 wks. = 74% increase in body weight (mice type 1)

    After 24 wks. = 101.5% increase in body weight (mice type 2)

    Findings

    1. L.helveticus and greek style yoghurt modulated gut microbiota, upregulating streptococcus.

    2. In mice type 1:

    compared to non-dairy protein, greek yoghurt increased expression of genes involved in jejunal and ileal immunity and integrity.

    3. In mice type 2:

    compared to milk proteins, greek yoghurt improved insulin sensitivity by 65%
    compared to non-dairy proteins, L.helveticus yoghurt attenuated hepatic inflammation = 2.1-fold, IL1-β = 5.7-fold, INF-γ = 1.7-fold, vascular adhesion molecule 1 (VCAM1) = 1.3-fold
    compared to non-dairy proteins, greek-style yoghurt attenuated VCAM1 = 1.04-fold, intracellular adhesion molecule 1 = 1.4-fold, and decreased circulating adhesion molecules.
    Conclusion

    Both fermented dairy protein products reduce cardiometabolic risk factors in diet-induced obese mice, possibly by modulating the gut microbiota.

    Perazza et al, 2020

    https://academic.oup.com/jn/advance-article-abstract/doi/10.1093/jn/nxaa217/5901459

  11. Well, in this study, vegetarians with inadequate b-12 higher homocysteine had a lower risk of ischemic and Hemorrhagic stroke than those vegetarians with adequate B-12.

    The authors offer this potential explanation as to why their study had different results from the Oxford study

    The strong inverse association between vegetarian diet and hemorrhagic stroke in our study contrasts the results of the recently published EPIC-Oxford study.36 Buddhist vegetarians in our population and the EPIC-Oxford vegetarians differ in alcohol consumption and use of allium vegetables. Nearly 80% of vegetarians in the EPIC-Oxford study drink varying degrees of alcohol but most participants in our studies avoid alcohol (about 6% of nonvegetarians and fewer than 1% of vegetarians were current drinkers at baseline). Alcohol consumption (as measured by γ-glutamyl transferase) has been suggested in a previous cohort study to modify the effect of low serum cholesterol (typical of vegetarians) on hemorrhagic stroke risk.37 The EPIC-CVD case cohort study also found a clear trend between increased alcohol consumption and stroke risk.38 While Western vegetarians use ample amounts of garlic and other allium vegetables, Asian Buddhist vegetarians avoid these vegetables. Allium vegetables are major sources of alliin/allicin, known to inhibit platelet function and induce bleeding.39 Whether these differences drive the discrepant findings warrants further investigation.

    Vegetarian diet and incidence of total, ischemic, and hemorrhagic stroke in 2 cohorts in Taiwan
    https://n.neurology.org/content/94/11/e1112

    It makes me wonder if I should ditch my B12, my nightly glass of wine, and my TMG supplements.

  12. Here are direct quotations from the current presentation’s transcript:

    “Maybe that’s one of the reasons why . . . ”

    ” . . . that may help explain . . . ”

    “. . . maybe for people with stubbornly high homocysteine levels . . . ”

    “. . . perhaps creatine supplementation may represent . . . ”

    “It seemed to work . . . ”

    . . . but that’s presumably because . . . ”

    ” . . . suggests—to me at least . . . ”

    “. . . it might be worth experimenting with supplementing . . .”

    “. . . Most likely . . .”

    “. . . I don’t think . . .”

    “. . . I don’t think . . .”

    ” . . . they have the potential to achieve . . . ”

    ——————————————————————–

    Let’s see. Given a choice, which one of these would I prefer to do?

    (1) Go the the front of the line to take any one of the more than 100 untested experimental Novel Coronavirus vaccines – after first signing a legal waiver releasing the vaccine maker from any possible liability whatsoever?

    (2) Take creatine as a supplement?

    (3) Adopt a pit bull from the animal shelter which they state right up front has been abandoned by his owner for habitually exhibiting highly destructive and uncontrollable violence?

    (4) Go on a world cruise? Cruises are an incredible bargain these days! Great way to meet new people – to mingle, to travel to cites all over the world. Just one continual party – dancing and dining – the whole time you’re on board.

    (5) Travel to California – on commercial air – right now – to enjoy the lush weather and general laid-back ambiance and meet new people up close and personal?

    (6) Get extra work as an elementary school bus driver to help the kids get back to school?

    (7) Live in a house of cards?

    It’s a hard choice.

    Which to choose, which to choose, which to choose . . .

    Ya know – it’s been a long time since I owned a dog . . .

    ——-

    If you are considering taking this chemical supplementation as described – you may wish to first check it out with your locally licensed M.D.

    All the best –

    Vivamus

    1. Vivamus,

      I had been looking at the California fire maps and was reading about the power outage issues in California.

      I Googled TrueNorth and McDougall and other WFPB groups in California and I looked up my friends who are out there and places I used to visit.

      Then, I came here and read your comment and then my fire alarm wired into my house pitched and said Fire and I ran out into the kitchen but nothing. I went to every appliance and removed every plug-in light and went into the basement and into each room and opened the door and looked outside. It didn’t keep going and I looked everywhere and I think one of the batteries just died. (There are detectors in every room and the basement but the man who put them in put in two that are AA batteries and the rest are 9-Volt and the AA die sooner. I

      1. I like that my smoke detectors say ”Fire” but that was just a little unnerving.

        Year’s ago when my brain was very bad, I had a tiny stove top fire but it was a burner that looked off but wasn’t quite off.

        I didn’t use the drove for several years after that.

        I was so happy that I didn’t do that again.

      2. Deb,

        Fiery words!

        When I had battery-based smoke detectors, I would change the batteries every New Years. It was a little New Year’s ritual for me.

        Resolve t o lose weight (aspirational) and change the batteries (action!). Made a good mixture – one reinforced the other.

        Now the smoke detectors are wired into the building wiring. Great for those who are too irresponsible to change out their smoke detector batteries. But think – if the fire starts elsewhere in the house and the intervening wiring is damaged, the smoke alarms may not go off when needed.

        I much prefer the battery concept.

        Oh – my next-door neighbors’ lives were saved by their smoke detector. I awoke at ~three o’clock in the morning – thinkin’ the the police had finally learned about me . . .

        Flashing red lights spinning through my windows.

        But it was all the fire engines next door.

        Whew!

        Window air conditioner in their guest bedroom left plugged though turned off in over the winter – decided to try to burn the house down and kill everyone in it.

        Would have succeeded, too – if not for a hallway smoke alarm.

        Even the dog got out.

        Who knew that air conditioners bear such hatred for their human masters?

        I’ve seen their manifesto.

        One day they will all rise up . . .

        Deb.

        You be careful around machinery –

        Vivamus

        1. Actually, some states, it is the law for them to be wired into the building.

          I do have batteries. They are all wired together though, so the system informs me by saying, “Fire” when any of them go dead.

          The fact that I have such a small house and so many smoke detectors, I don’t worry as much, but the timing of it saying, “Fire” was scary this morning.

          I usually change them in October, so 1 being dead in September tells me that I used my rechargeable batteries for the AA. I generally have the highest quality, longest lasting 9-volts. They have some that will last 10 years.

          Vivamus,

          I do try to be careful and I have built-in double-checks into my daily system.

          Mostly, I try to limit which days of the week and time of day that I use the stove.

          When I use the stove, I turn on the stove timer and a cell phone timer and pair that with using my infrared which shuts off in exactly 20 minutes.

          With my relatives who have had brain problems, they all had a stove-top small fire, but it was always that they went in the other room and sat and watched tv and didn’t hear the timer.

          Putting nothing else on the stove helps and, cooking things in extra water helps. Pasta-style cooking of rice helps. It would take so long for the water to boil down that it is a safety back-up.

          It was years ago when I made the mistake and my brain is stronger.

          I was just listening to How Not To Diet last night and I got to the part where even eating one fatty meal per day for a few days messed up the brain functioning. I know my brain got worse when I ate processed food again. I loved tasting the Gardein and Amy’s products, but not eating them may not only be smarter, it may literally make me smarter.

          I know that when I lose brain function, I get needier, even though I don’t really turn to people anymore. But I know that I have posted so many comments when I haven’t been sleeping again and processed food or covid made my sleep worse again. Plus, injured my brain. Plus, having the injured brain, I get more emotional and end up just sharing too much and then that makes me emotional.

          Gotta not eat processed food.

    2. “Adopt a pit bull from the animal shelter which they state right up front has been abandoned by his owner for habitually exhibiting highly destructive and uncontrollable violence?”

      Sounds like the belief that pit bulls are inherently violent dogs when the opposite is actually true. Pit bulls are actually extremely loving and loyal dogs to the point where they used to be used as “nanny dogs,” known for how great they were with kids. They are physically powerful dogs, though, which is why they were targeted for abuse to use in “dog fighting.” Very rarely does a dog have a brain problem that makes them lash out (but this can happen in dogs due to issue stemming from breeding and just like humans, animals can have something go wrong with their brains), dogs, including pit bulls, have to be made “mean.” Really, they’re just terrified.

      1. S.

        Various insurance companies have lists of dogs that they require higher amounts of homeowner/liability insurance to cover.

        As these policies change, people sometimes actually feel compelled to get rid of their dogs – with all the heartbreak that may ensue – or change insurance companies at significantly higher rates

        My insurance company had no such requirement last I checked – but it is a changing fashion with insurance companies, so I made inquiries.

        I got a few of these lists once prior to lookin’ for a dog, just to make sure a problem would not crop up sometime in the future.

        Pit bulls – Boston terriers – whatever you want to call them – were on all these lists.

        I inquired – the insurance company that I spoke with claimed that the list was based on actual actuarial data – their own insurance company-customer experience over time – not just on fraidy cat societal myths.

        Just a dollar decision – you take higher risks, you pay more.

        You may think it a myth – but the insurance companies have data. An they don’t think so.

        And I don’t, either.

        If you own a pit bull -you might want to give a call to your homeowner insurance company to make sure you are (still) covered.

        Because if you do not stay on top of this issue – somewhere in the fine print – you may not be.

        S.

        All the best –

        Vivamus

        —————

        “It’s not a matter of “breed-hating” – insurance companies must take statistics into account in order to mitigate costs. Much like the increased price of insuring a young male driver over insuring a young female driver, it’s not personal, it’s just statistical: the motor vehicle death rate for male drivers ages 16 to 19 is twice that of their female counterparts (www.cdc.gov).

        The same goes for dogs. A majority of serious injuries reported through insurance claims are caused by a rather short list of dog breeds – not because all dogs of a certain breed are bad, but because when these breeds do cause harm, they tend to cause more harm than other breeds because of their size and/or strength. This includes not only bites, but also other injuries, like a child or elderly person being knocked down.

        Standard breeds of concern to insurance companies typically include, but are not limited to Akita, Chow Chow, Pit Bull-type breeds, Doberman Pinscher, Presa Canario, Rottweiler, German Shepherd, and any kind of wolf hybrid.”
        http://getsafeharbor.com/insuring-dangerous-dog-breeds/

        “Dog bite-related claims accounted for more than one-third of all homeowners’ insurance liability claims paid out in 2013. That amounted to about $490 million, with the average claim costing close to $30,000. But the actual costs can be much higher. In 2011, a Washington State Superior Court jury awarded a $2.2 million verdict to a woman who was attacked by two neighborhood pit bulls near her home in Tacoma, Washington. The woman sued the dogs’ owners whose homeowners’ policies were unfortunately limited to $100,000 each.”

        “The 14 most often blacklisted dog breeds were:

        Pit Bull Terriers
        Staffordshire Terriers
        Rottweilers
        German Shepherds
        Presa Canarios
        Chows Chows
        Doberman Pinschers
        Akitas
        Wolf-hybrids
        Mastiffs
        Cane Corsos
        Great Danes
        Alaskan Malamutes
        Siberian Huskies”

        https://www.psychologytoday.com/us/blog/canine-corner/201405/14-dog-breeds-blacklisted-insurance-companies

        https://www.valuepenguin.com/homeowners-insurance-restricted-dog-breeds

        https://www.everquote.com/blog/home-insurance/homeowners-insurance-dog-breed-restrictions/

        https://www.cheatsheet.com/money-career/dog-breeds-no-insurance-company-wants-cover.html/

        1. Vivamus,

          Yes, pit bulls require owners who know what they are doing.

          If you watch Dog Whisperer, he can transform dangerous dogs into dogs that are safer and he ends up with a whole lot of pit bulls.

          But owning a pitbull is still different than owning a lab.

          If you have a passive or timid owner or one who is nervous or who doesn’t take authority properly or someone who doesn’t understand that different breeds of dogs have different needs, it is way easier to have the situation become a bad situation.

          Around here, it has tended to be Pitbulls who did things like burst through the screen door to chase after someone.

          I have been in families that have had labs and retrievers and other gentle, friendly dogs, but I did take care of one pit bull and it is the one that was too much for me to deal with because it snapped at my face a few times and growled at the males.

          Not putting the dog down. I am not a highly authoritative person and neither was anybody else and a dog that needed that wasn’t a good match for the family.

          1. Deb,

            Abstract
            Journal of the American Veterinary Medical Association
            September 15, 2000, Vol. 217, No. 6, Pages 836-840
            https://doi.org/10.2460/javma.2000.217.836
            Jeffrey J. Sacks, MD, MPH Leslie Sinclair, DVMJulie Gilchrist, MDGail C. Golab, PhD, DVMRandall Lockwood, PhD

            DBRF = Dog Bite Related Fatality:

            “Results—During 1997 and 1998, at least 27 people died of dog bite attacks (18 in 1997 and 9 in 1998). At least 25 breeds of dogs have been involved in 238 human DBRF during the past 20 years. Pit bull-type dogs and Rottweilers were involved in more than half of these deaths. Of 227 reports with relevant data, 55 (24%) human deaths involved unrestrained dogs off their owners’ property, 133 (58%) involved unrestrained dogs on their owners’ property, 38 (17%) involved restrained dogs on their owners’ property, and 1 (< 1%) involved a restrained dog off its owner's property."

            Be safe –

            Vivamus

        2. Vivamus,

          Insurance companies have data because they told you they have data…? As Dr. Greger teaches us to say, “show me the evidence!” Presumed evidence, is not evidence. Let’s not forget the dairy, egg, meat, supplement, pharmaceutical, etc. industries all have “data” as well.

          My guess is it’s simply a cheap gathering of statistics, if at that. Like I said, many physically powerful dogs, especially pit bulls, are targeted for extreme abuse to be made “mean” for game and profit. A lot of adopted out dogs are rescues from these situations. Dogs who have been exposed to such abuse need special attention and care. Humans are not always that responsible.

          Btw, when asking an insurance company of all places, why they have a policy, if they don’t say it’s due to actual data (whether or not it is or whether how good it is or not), they won’t be in business long with that strategy. What else would they say?

    1. Tommy,

      Please see Table 1: Recommended Dietary Allowances (RDAs) for Vitamin B12

      https://ods.od.nih.gov/factsheets/vitamin%20B12-HealthProfessional/

      Best regards,

      Vivamus

      ——————

      Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.

      Please note that neither the CDC nor the NIH nor the Academy of Nutrition and Dietetics recommend doses higher than the RDA for healthy individuals.

      1. That link says nothing about +65 needing more. And how is RDA related to frequency? Do i take 2.4 mcg per day? How did Dr G arrive 1000 mcg per day for 65+ eating vegan WFPB?

        Table 1 lists the current RDAs for vitamin B12 in micrograms (mcg) [5]. For infants aged 0 to 12 months, the FNB established an AI for vitamin B12 that is equivalent to the mean intake of vitamin B12 in healthy, breastfed infants.

        Table 1: Recommended Dietary Allowances (RDAs) for Vitamin B12 [5]
        Age Male Female Pregnancy Lactation
        0–6 months* 0.4 mcg 0.4 mcg
        7–12 months* 0.5 mcg 0.5 mcg
        1–3 years 0.9 mcg 0.9 mcg
        4–8 years 1.2 mcg 1.2 mcg
        9–13 years 1.8 mcg 1.8 mcg
        14+ years 2.4 mcg 2.4 mcg 2.6 mcg 2.8 mcg
        * Adequate Intake

        1. Tommy,

          You wrote: “That link says nothing about +65 needing more.”

          Yup.

          Sure doesn’t.

          That is because they don’t need more.

          “How did Dr G arrive 1000 mcg per day for 65+ eating vegan WFPB?”

          Space Aliens?

          Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.

          Please note that neither the CDC nor the NIH nor the Academy of Nutrition and Dietetics recommend doses higher than the RDA for healthy individuals.

          Recommendations above that go against the collective knowledge of a significant number of learned people who do this for a living and who actually know what they are doing.

          No one man can be a Universal Expert on everything. Even clever people can be fallible.

          Absorb information from multiple sources – weigh conflicting information carefully – and make your own decisions on what is best for you.

          That’s all you can do.

          Tommy.

          All the best –

          Vivamus

        2. Hi Tommy,

          He based his recommendation on this study (https://pubmed.ncbi.nlm.nih.gov/15911731/) which concludes, “Daily doses of 647 to 1032 mug of cyanocobalamin were associated with 80% to 90% of the estimated maximum reduction in the plasma methylmalonic acid concentration” and this study (https://pubmed.ncbi.nlm.nih.gov/12410896/) that found that most didn’t normalize their MMA (MMA suppression is a measure of B12 sufficiency) until after the 1,000-μg dose.

    1. Brad,

      Please note the the recommendations in regards to Vegans/creatine were largely based on a three week-long study.

      Plus a patchwork of assumptions.

      These are not widely accepted concepts.

      All the best –

      Vivamus

  13. A great bottom line.

    Just an FYI to those who are truly vegan and not just plant based, there are vegan creatine supplements.

    In the world of animal activism, you would be surprised at how many vegans roll their eyes at the thought of taking a B12 supplement. They feel fine so they assume they don’t need it. But a reminder to all non-vegans or plant based eaters reading, even people eating animal products need a B12 supplement, but they’re getting it through the animal who was first supplemented which doesn’t make much sense. Just something I like to point out to those who think they’re supposed to eat animals because of B12… if anything it would constitute as more of an argument for being “supposed to” eat dirt/dirty vegetation and drink untreated water. Either way, just supplement. Though I’m hoping for more research into water lentils! And a conclusion on purple laver/nori.

  14. According to this Harvard health letter, https://www.health.harvard.edu/alzheimers-and-dementia/regular-tea-drinking-linked-with-dementia-prevention tea drinkers had 50 percent less risk of cancer. Tea is rich in Nickel, and nickel was known to fight alzheimer’s in a separate study on pubmed. The superior nutrients in tea, the whole plant, treated dementia better. I think green tea found dementia even better. Nuts fought alzheimer’s according to Persian doctors on pubmed. Beans have similar nutrients. Do you think Molybdenum and Nickel and the other compounds in nuts green tea and beans would fight alzheimer’s https://pubmed.ncbi.nlm.nih.gov/31770557/ ? Do you think pharma and come up with superior drugs? How about an interventional study of green tea, nuts, and beans with alzemier’s.

    1. Matthew Smith,

      Please note that the traditional Okinawans – amongst the longest lived people on the planet – favor Jasmine Tea.

      That is traditional Green Tea processed with Jasmine Blossoms.

      (Black Tea is oxidized Green Tea – it works ~6X less well as an anti-oxidant than Green Tea).

      Perhaps the Traditional Okinawans know something we don’t know.

      I don’t think that the Traditional Okinawans made their decisions on the basis of experimental controlled double blind scientific studies.

      But I am often wrong.

      Corrections are always welcome.

      All the best –

      Vivamus

    2. Matthew,

      I like the way you think.

      If I had a nickel for every study done on nickel, I would probably need very strong arms to take it to the bank.

      1. A nickel biter joke probably would have been funnier.

        I just got off of a chat with Tesla for my solar and I love the way they are doing business now.

        Sunrun is still is slick charming mode.

        I have been waiting to see if they will actually give me a quote without a spiel but they don’t want to.

        I think of them and stress comes over me. I don’t want even to interact with them versus Tesla all their numbers, including the absolute worst case scenario is already in writing on their site and they are willing to be flexible even within their packages.

        I can dump 1 or 2 powerwalls and they are not trying to manipulatE and I feel like ten thousand burdens are being removed just by having them let me have the information versus sunrun trying to get more information from me.

  15. I am concerned about the cyanide content of cyanocobalamin. I am taking 1000 mcg daily to supplement my plant-based diet. Can you please address this???
    Thank you.

  16. Hi Brad, thanks for your question, creatine is naturally produced by your body in your kidneys, liver, and pancreas. It’s made from three amino acids — glycine, arginine, and methionine .

    On average, you make 1–2 grams of creatine per day, which is stored primarily in your skeletal muscles. Dr Greger indicates that Because of the potential risks I don’t think people should be taking creatine supplements willy-nilly, but the potential benefits may exceed the potential risks if, again, you’re on a healthy plant-based diet, taking B12 and your homocysteine levels are still not under 10 I would suggest giving a gram a day of creatine a try to see if it brings it down.

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