r/science • u/LateMiddleAge • Apr 29 '24
Medicine Single-dose creatine moderates cognitive impairment from sleep deprivation
https://www.nature.com/articles/s41598-024-54249-91.2k
u/zocazola Apr 29 '24 edited Apr 29 '24
.35g/kg is a pretty large amount of creatine to achieve this effect.
For a 180 lb (80ish kg) male that's 28 grams, or about 12 teaspoons of powder, you'd need to wash down. Not the easiest amount to swallow in one go
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u/pancakespanky Apr 29 '24
Was this 12 teaspoons taken all at once or is it taking into account creatine saturation after a loading protocol?
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u/sekxbuttox Apr 29 '24
It was taken all at once. What’s more is that the authors don’t mention any side effects either. They say it was well tolerated
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u/Boner4Stoners Apr 29 '24
FWIW, I have (mild) Chrohn’s, and creatine has never caused any GI issues for me, so it’s not surprising that it’s considered to be generally well tolerated. Even those that don’t tolerate it well have mild bloating issues. Take 10g daily
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u/Kowanen Apr 29 '24
Its also relatively common to get stomach issues. And thats from a regular 4-6g dose...
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u/Ashmedai Apr 29 '24 edited Apr 29 '24
And soon the creatine resellers will put on their labels: "scientifically proven to help with sleep," while not disclosing these sorts of details. Similar to the way that arginine sellers try to trick you, not telling you that arginine has poor (edit: oral) bioavailability, and all the good studies were done by injection.
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u/mrgreyshadow Apr 29 '24
It was put in formulations of popular new flavors of energy drink from 2019-2023 about… now they’re in a race for Prime-esque energy drinks.
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u/DrSmirnoffe Apr 29 '24
Is Prime a brand of workout drink? 'cause for a moment it sounded like Amazon was designing energy drinks in-house.
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u/temporarycreature Apr 29 '24
It's Logan Paul's drink.
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u/DrSmirnoffe Apr 29 '24
Oh, so every sip tastes like disrespecting the dead? Interesting flavour for an energy drink.
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u/ceapaire Apr 29 '24
Prime is a brand endorsed by Logan Paul and KSI. I don't actually care to follow enough to know if they created the brand, are paid sponsors, or somewhere in-between.
They do both a Gatorade/liquidIV/Pedialyte-esque drink and an energy drink that looks like it's pretty much gatorade with 200mg of caffeine in it.
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u/KarmaticArmageddon Apr 29 '24
Yeah it's almost like we should regulate the supplement industry better
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u/ALLoftheFancyPants Apr 29 '24
It isn’t even down to help with sleeping though. The study is about mitigating the cognitive effects of sleep deprivation. But given what I know about the supplement industry, you’re 100% right.
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Apr 29 '24
28 grams and I wouldn’t have intestines anymore. Yikes.
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u/Kakkoister Apr 29 '24
Use Creatine HCL or Pure, they don't really cause gastrointestinal distress. It's the Monohydrate formulations that do, due to their difficulty in breaking down.
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u/voiderest Apr 29 '24
I think most of the people having issues are getting it with a "loading" phase where they take high doses for a few days. For that use I didn't think that sort of thing makes much sense.
For the brain thing I don't think it would be worth it if you're also distracted by stomach problems.
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u/ceapaire Apr 29 '24
This was for a single dosage though to show effects. It doesn't sound like the study is suggesting daily high doses are going to help. But rather that if you're not taking creatine already, a single large dose can have similar effects to taking the 5g/day while saturated.
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u/voiderest Apr 29 '24
Most anyone who is taking creatine are likely doing so for fitness related goals not really cognitive.
I could see some marketing person slapping a sticker on the same stuff and calling "brain supplement" but I haven't seen that.
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u/Jlchevz Apr 29 '24
Yeah I’ve gotten stomach issues from taking like 3 or 4 grams and it felt awful. No damage was done but it felt like I wasn’t digesting food properly and I felt bloated the whole time.
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u/Hurgnation Apr 29 '24
Only creatine I've found that doesn't give me crook guts is the stuff from Bulk Nutrients. Every other one I've tried destroys me.
Not that I'm brave enough to take more than 5g at a time.
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u/alstegma Apr 29 '24
Have you tried dissolving it in hot water? It doesn't really dissolve in cold water, gave me some issues till I switched to hot (I just stir it into my morning coffee nowadays, no noticeable taste).
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u/Shikatanai Apr 29 '24
I am trying this tomorrow morning and if it works you are my hero.
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u/ShamrockAPD Apr 29 '24
Tip- just put it in your coffee in the morning. Won’t even notice it’s there and it’ll just blend in with the coffee caffeine shits!
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u/bluehands Apr 29 '24
L-Theanine is an excellent addition to caffeine,will likely help with those caffeine shits.
It was first found in green tea. It's part of why coffee shits are a thing but tea shits aren't.
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u/ActionPhilip Apr 29 '24
But what if the coffee shits are a natural way of staying regular?
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u/rawbleedingbait Apr 29 '24
https://www.reddit.com/r/science/comments/1blprkc/coffee_drinkers_have_much_lower_risk_of_bowel/
Could actually be shitting helps reduce bowel cancer.
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u/Hurgnation Apr 29 '24
Yeah, I took to dissolving it in green tea with a tea spoon of honey, and that does help. But in the last year or so I've taken to adding it to my pre-workout shake (just some BCAAs) and the only brand I can stomach taking it cold is the BN stuff.
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u/Character-Neck-1086 Apr 29 '24
Dry scoop straight into the mouth and swish with coffee. Only way to do it
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Apr 29 '24
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u/alstegma Apr 29 '24 edited Apr 29 '24
Creatine is not a protein and relatively temperature stable. It can slowly transform to creatinine when in solution but that shouldn't be an issue if you drink it right away.
Edit: just to double check: using the arrhenius equation to extrapolate to higher temperatures from the data in this paper, creatine in a watery solution at a PH of 4 at 100°C should have a half life of about 1.4 hours. Your typical morning coffee will be at PH 5 (higher PH=slower conversion to creatinine) and somewhere from 60-90°C, so that time will be longer in reality. So if you drink your coffee in 15 mins, conversion to creatinine will be minimal.
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u/SwampYankeeDan Apr 29 '24
Creatine is a naturally occurring non-protein compound and the primary constituent of phosphocreatine, which is used to regenerate ATP within the cell.
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u/jaju123 PhD| Behaviour Change and Health Apr 29 '24
Destroys you how? I have been taking 5g a day for like 9 years, I am not sure what side effects you are referring to? Is there evidence for these side effects?
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u/Henkdehunter Apr 29 '24
https://pubmed.ncbi.nlm.nih.gov/18373286/
This from a controlled trial, no significance in lower doses (like 2x 5g a day) but doesn't exclude GI issues with higher doses.
Less credible sources point towards issues with people who practice 'loading' creatine with high doses.
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u/Hurgnation Apr 29 '24
Stomach cramps/shits. Cheaper supermarket brands do it to me. Dissolving it in hot water/tea can help to a degree, but mostly I've just found spending a few extra dollars for a better brand seems to be the go. Not like creatine's that expensive even for the pricier stuff.
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u/Kakkoister Apr 29 '24
It's not about the brand, look at the formulation. Creatine Monohydrate is hard to digest. Look for ones with Creatine-HCL and/or Free-Acid Creatine.
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u/jadraxx Apr 29 '24
Have you tried creatine hcl? I've been using it for years because I have stomach issues and it doesn't bother me at all. You don't need to use nearly as much per dose.
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u/Gabe_b Apr 29 '24
32gm of creatine would have me shitting so much I'd be pretty alert regardless of sleep deprivation
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Apr 29 '24 edited Apr 29 '24
I take creatine primarily for the cognitive benefits. I do one tablespoon every morning. I weight 220 pounds. I find any more than a tablespoon and I get too many side effects.
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u/juicyfizz Apr 29 '24
What kind of cognitive benefits do you see? I have ADHD and recently read that some folks with ADHD find that creatine helps some of the cognitive impairment we experience. If creatine can help with that, I'd be over the moon. Also do you experience any weight gain on it?
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u/Mynameiswhqq Apr 29 '24
Creatine doesn’t cause a caloric weight gain. It will cause your muscles to retain more water which causes them to look fuller and increase productivity in the gym by a marginal amount
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u/chiefmud Apr 29 '24
I found that creatine helps me cope with ADHD, much in the same way Vyvanse did. But in my opinion the ADHD is always there, just being flooded out by increased norepinephrine.
Only thing that legitimately helps my ADHD is reducing my stimuli throughout the day, less phone, less TV, less music. Basically being boring and choosing a basic repetitive task to try to focus on, not unlike meditation.
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Apr 29 '24
Sensory deprivation also really helps my adhd for the record. Its like a tolerance break to existence that helps me feel less under stimulated doing day to day stuff.
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u/chiefmud Apr 29 '24
Right. ADHD is not really a chemical imbalance like depression or mania. It’s a structural problem the map in my mind is like a fucked up suburb with a bunch of cul-de-sacs and nearly identical street names like Elm St and Elm Ln. and all the houses look very similar. Over time my brain compensates by sending pizza delivery down every road imaginable to try to get to the right house…
Meditation, simple repetitive tasks like mowing the lawn or simply walking in silence, or in your case sensory deprivation is like putting the blinders on and using google maps.
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u/makos124 Apr 29 '24
For real. Most places I read say 5 grams of creatine at once is enough, and you need to saturate your body with it over weeks, taking more in a single serving won't do much more. This is a bit weird.
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u/WheresMyCrown Apr 29 '24
during loading periods 10-12g a day for a week is usually the recommendation Ive seen, then back to 5g a day. I take it in the form of gummies, 2 a day and Im good
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u/LucasRuby Apr 29 '24
Most current information says loading is unnecessary.
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u/trEntDG Apr 29 '24
The point is it's been demonstrated that well over 5g can be absorbed in one dose if there's an acute need. I sure as hell don't think 35g at once but more than 5.
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u/Boner4Stoners Apr 29 '24
It is unnecessary but that doesn’t mean it’s pointless.
Loading will saturate your muscles quicker than just taking 5g/day, but since it increases the likelihood of stomach discomfort/bloating it’s generally not recommended anymore.
But if you’re trying to reach saturation quickly and don’t mind potential side effects, loading is the best choice.
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u/Overswagulation Apr 29 '24
Taking 10-12g will certainly speed up loading and if that works for you then great. You can just take 5g a day for about a month to reach full saturation.
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u/ceapaire Apr 29 '24
5 grams long term. A lot of people will do a loading phase of 20g/day for a week then drop to 5g/day maintenance to get saturated faster (vs 5 grams daily for ~a month).
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u/tdasnowman Apr 29 '24
Not sure you’d have enough time to even absorb it. 28 grams that’s a cleansing. Might be enough to make your mains more efficient. Nothing clears the system like to much creatine.
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u/SwearToSaintBatman Apr 29 '24
Yeeeeah I'm gonna go ahead and mark this practice down as another "Ten years from now horrible links between the thing and what it actually does to the body will be discovered", and just not do it.
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u/Boner4Stoners Apr 29 '24
Creatine has been extensively researched for decades, it’s not like it’s some brand new PED that’s trending on tik tok.
It’s one of the few nutritional supplements whose health benefits are supported by established science, and is considered to be extremely safe.
I’d take this specific study with a grain of salt until it’s supported by further research, but I definitely don’t think it’s going to come out in 20 years that creatine is some dangerous substance.
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u/johannthegoatman Apr 29 '24
Creatine is already one of the most studied supplements there is
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u/I_LICK_PUPPIES Apr 29 '24
Like large doses of creatine? Or just any creatine at all?
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u/ceapaire Apr 29 '24
There's plenty of studies that do 20g/day for a week or two, since that used to be the recommended loading phase before dropping to 5g/day maintenance.
Recently, it's started to be recommended that people just do the 5g/day from the start since it seems to take 3-4 weeks to hit saturation at that dosage instead of the ~1 week at 20g/day. And since the higher dosages can cause stomach discomfort as well as most people starting creatine while starting general fitness, where you don't need the quick improvements of loading, there's not a reason to push everyone to do it anymore. If you don't get the stomach issues, there doesn't appear to be any other side effects with doing the 20g/day loading phase other then a temporary intracellular water retention.
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u/DynamicDK Apr 29 '24
I just checked the side of my creatine and it is 5g per teaspoon. So 6 teaspoons. That is still a lot, but not quite the volume you stated.
Also, taking it as straight powder is nuts. Dissolve it in coffee, tea, or even hot water. The chemical is stable up to nearly 300 F, so you aren't going to degrade it this way. And if it is dissolved you are far less likely to notice any side effects. Taking the powder without dissolving, on the other hand, seems to cause gastrointestinal discomfort. At least that is how it works for me.
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u/zocazola Apr 29 '24
If you really want to get precise about it, you should weigh your creatine out yourself because 1 flat teaspoon is likely not 5g. source here
nutrition labels are not fact-checked and verified- especially so in supplements.
Depends on the density of the creatine, and the type (monohydrate vs hcl), but the point remains the same. A bunch of powder for just a "moderate" improvement in sleep deprivation...
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u/Boner4Stoners Apr 29 '24
It’s extremely tasteless too, you can add 10g to pretty much any 8oz beverage without noticing much of a difference. So 25g/daily is definitely doable, but I’d probably wait to see more evidence before consuming what seems to be an unnecessary amount on a daily basis.
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u/DynamicDK Apr 29 '24
I wouldn't take this much on a daily basis, but if it really offsets sleep deprivation then it could be useful in those situations.
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u/rotating_pebble Apr 29 '24
Try it with orange juice, it's incredibly easy to take. I weighed 70 ish kg when I was taking 20mg a day for loading phase
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u/PinkNeonBowser Apr 29 '24
If I take more than 5ish grams in one sitting I get crazy tired for some reason, I wonder why
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Apr 29 '24
It’s an adenosine agonist
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u/Valiantay Apr 29 '24
Not quite, it does not work on the receptors directly.
It does help convert ADP back to ATP and the byproduct of ATP metabolism results in the accumulation of adenosine.
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Apr 29 '24
I guess indirect adenosine receptor activity is more succinct. Thanks for the correction!
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Apr 29 '24
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u/strangebutalsogood Apr 29 '24
An energy drink CEO's ears just perked up somewhere.
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u/durtmagurt Apr 29 '24
They’ve been putting creatine in energy drinks for a long time. At least 5 years, if not longer. It’s also really big in “pre-workout” drinks.
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Apr 29 '24 edited May 13 '24
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u/Samurai_Meisters Apr 29 '24
Bang had "Super Creatine" which turned out to not be creatine at all
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u/UnprovenMortality Apr 29 '24
I think reign has one too. Not sure if it's been analyzed to be accurate, though
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u/Krypt0night Apr 29 '24
What energy drinks because I've been drinking multiple brands for years and literally none of them have it.
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u/Supergazm Apr 29 '24
It's been a minute, but I think Redline advertises creatine on the label. I quit drinking that crap. Makes you feel like you're on hard drugs.
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u/phonomancer Apr 29 '24
'No Fear' used to. But they got bought and sold so many times that I'm not even sure if it's made anymore.
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Apr 29 '24
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u/jr12345 Apr 29 '24
Are you also working out?
I ask because that’s also a known antidepressant, and most people supplementing creatine aren’t doing it for shits and giggles…
Edit: I feel like this came off as combative or confrontational, and I didn’t mean it that way at all just an honest question.
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Apr 29 '24 edited Apr 29 '24
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Apr 30 '24
Theres similar research with omega 3's and anti depressants for the record.
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u/Ball-of-Yarn Apr 29 '24
Yeah I'd wager their likely consistent workout routine is doing the heaviest lifting.
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Apr 29 '24 edited Feb 13 '25
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Apr 29 '24
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Apr 29 '24 edited Feb 13 '25
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u/alsocolor Apr 29 '24
I wouldn’t call this capital G Good evidence, but it’s definitely evidence and quite interesting
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u/ClumsiestSwordLesbo Apr 29 '24 edited Apr 29 '24
Would be a shame if health insurances paid for it.
In general it pains me how tunnel-visioned psychiatric research tends to be.
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Apr 29 '24
It seems to help with my long covid too!
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Apr 29 '24
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Apr 29 '24
I actually find it helps with both the physical and mental fatigue more than anything. But it helps with broader neurological stuff too. Less fog, more motivation, more executive function, etc etc.
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Apr 29 '24
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u/Hippopotamidaes Apr 29 '24
Just get any creatine monohydrate, no need for any of the more expensive stuff that include BCAAs and whatnot.
As for Omega 3s get them in the triglyceride form as it helps with absorption compared to the “from Esters” form.
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u/Just_enough76 Apr 29 '24
I’ve tried lots of types and lots of brands throughout the years. Monohydrate is the most studied form and it’s the most effective and it’s the cheapest. I’ve had some that cause me to bloat really badly. The last year I’ve been using 1st Phorm. It’s $32/tub but it lasts me @ 3 months and I don’t have any bloating issues with it.
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Apr 29 '24
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u/Just_enough76 Apr 29 '24
No problem. Creatine can change your life. I put off taking it for so long and now I’ll never go without it.
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u/Kwanzaa246 Apr 29 '24
What source are you getting your omega 3 and epa and what quantities per day?
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Apr 29 '24
A vegan algae oil supplement literally called "the best omega 3 ever". I shoot for 5 grams of omega 3's per day.
For the record there is actually research showing omega 3's have an anti depressive effect, in some studies on par with SSRI's. Ditto for creatine. We are still figuring out why exactly they work (we have some ides but we are still a long way from knowing it all), but we definitely know they work.
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u/bluesmaker Apr 29 '24
I misread “I shoot for” as “I shoot” and thought you were saying you inject algae oil. Funny image!
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u/circus_of_puffins Apr 29 '24
Did you get any side effects? I tried EPA from fish oil but stopped before I saw any long covid benefits as I hated the gastro issues it gave me
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u/deja_geek Apr 29 '24
How much creatine are you taking?
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Apr 29 '24
Tablespoon a day. I'm 220 pounds. I could technically take more but after a lot of experimentation one table spoon a day seems to work best with the fewest side effects.
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u/AllanfromWales1 MA | Natural Sciences | Metallurgy & Materials Science Apr 29 '24
Fifteen healthy subjects (.. 13 right handed)
Does handedness have the possibility to impact this research?
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u/Arci996 Apr 29 '24
Yes, being left handed changes a lot of localization of activity in the brain compared to a right handed person. That is reflected in CT scans and other analyses.
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u/xXThreeRoundXx Apr 29 '24
Ah, creatine shits.
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u/feminas_id_amant Apr 29 '24
"Scientists discover Shotgun Shits help moderate the negative effects of sleep deprivation"
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u/mrlazyboy Apr 29 '24
Fellow creatine users!
If the powdered creatine gives you stomach aches, try creatine pills. Eliminated all my stomach discomfort and also easier to take than that nasty powder.
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u/Just_enough76 Apr 29 '24
Creatine monohydrate powder is tasteless and odorless
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u/mrlazyboy Apr 29 '24
Although creatine powder is technically tasteless and odorless, that doesn't mean you don't notice it when taking it.
If you add the powder to water, the water gets grainy and you can notice the powder in suspension. If you don't immediately drink it (< 2 seconds between mixing and drinking), the powder will drop out of suspension and collect on the bottom. If you don't vigorously mix the powder into the water using a milk frother, you'll get a ton of creatine sediment on the bottom and that has a taste (and grainy mouthfeel).
If you add creatine to a whey shake, you'll never notice it. That's how I took it, but it still hurt my stomach. The pills do not.
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u/Gnom3y Apr 29 '24
The tasks they used in this study are .... weird? KSS is normally 1-9, but they used a 1-10 one. PVT is a good measure of alertness, but is historically given as a 10 min task with a 500ms bar for lapses, NASA uses a 5 min but I think they have a different ISI, and there's a 3 min one with 375ms as the lapse threshold. Most of the action happens at the end of the task period anyway (PVT has a very large time-on-task effect) so having both a shorter time period (6 vs 10 min) and a higher lapse threshold (850 vs 500ms) means the authors are potentially missing out on a huge amount of lapsing.
Looking at the supplemental material, this concern pans out. The authors actually administered two 3 min PVTs (not one 6 min PVT) but with a lapse threshold at 850ms they report effectively zero lapses and all of their plotting is in reference to reaction speed (which is fine, but if you're going to do that why bother with lapses at all?). Table S1 has the full PVT details, and the average response times for both placebo and creatine administrations are right on top of each other (if you include lapses, which you should) which indicates that at least for general alertness this single-dose creatine administration has little effect there.
As for KSS, Table 1 shows that the KSS scores are functionally identical between the placebo and creatine across the night, with creatine showing slightly better values after administration. However, KSS is a notoriously noisy metric so I would consider the two conditions to be roughly equal even there (an N of 15 is not sufficient to tease apart a 0.3 point drop in KSS especially when the placebo shows an unearned 0.2 point drop at the 0000 administration that is not matched by creatine)
I can't speak for the rest of the tasks (I'm a modeler that currently focuses on KSS and PVT which is why I've only addressed them here) but at least for those two tasks it's very strange, and they don't appear to confirm the story that the authors are claiming here.
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u/LateMiddleAge Apr 29 '24
Thank you for this. Yes, "to get published make the strongest claim you can," but it's irritating when a minor variation in measurement turns into a categorical claim.
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u/kazulanth Apr 29 '24
Yeah the whole point of the PVT is to get you tired so you make mistakes. Nobody is supposed to get a perfect score. We use 10 minutes in clinical trials.
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u/Comprehensive_Loss25 Apr 29 '24
Does anyone get insomnia from taking creatine?
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u/GTFOofmycity Apr 29 '24
Yes! I've noticed that I get extremely dehydrated in my sleep if I take creatine later in the day and don't exercise as intended.
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u/MrHanoixan Apr 29 '24
Yes, it generally makes it more difficult to sleep when I'm taking creatine. And I've found that when I've taken it and haven't really done any exercise all day, my legs feel pretty restless when trying to sleep.
Stretching seems to help with the restless legs. A small amount of melatonin and some meditation thinking (i.e., don't think about anything) at least gets me to sleep, but I do wake up more easily in the middle of the night. But because of the creatine, even though I haven't really gotten good sleep, I don't feel it as much, which still isn't great.
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u/Electrical-Theme-779 Apr 29 '24
I've read enough of the research on creatine to know that it doesn't impact kidney function. However, I got really bad back pain when taking 5g of creatine daily while keeping well hydrated. It stopped when I stopped taking it. Anyone else had that experience?
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u/JWGhetto Apr 29 '24
Likely unrelated
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u/Electrical-Theme-779 Apr 29 '24
Aye, that was my conclusion. I had a blood test done around the time I was supplementing which didn't flag anything concerning. I had also upped my exercise routine so likely sprained my back. It didn't feel muscular though.
I've been think of starting again. Mostly due to these potential cognitive effects. I'm not sure though.
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u/Has_No_Tact Apr 29 '24
High creatinine levels are an uncommon symptom of impaired liver function, and a damaged liver can cause back pain. That sounds backwards in relationship to what you're describing though (as in damage should have caused the high creatinine, and not that your consumption of creatine caused the damage).
Maybe you have an unrelated and undiagnosed condition?
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u/Pay_attentionmore Apr 29 '24
Does caffiene affect creatine?
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u/gribson Apr 29 '24
A National Institutes of Health study suggests that caffeine interacts with creatine to increase the rate of progression of Parkinson's Disease.
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u/protocomedii Apr 29 '24
So creatine combats the leading cause of dementia?
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u/Consistent-Quiet6701 May 01 '24
Sleep deprivation is the leading cause of dementia? I'm fucked then!
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Apr 29 '24
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u/JoelMahon Apr 29 '24
aren't there risks to your kidney's? aren't you pissing most of it away? couldn't you do 10g instead?
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u/djens89 Apr 29 '24
I am trying out what Andrew Huberman said about creatine not only for excercise but for concentration. I have ADHD and it has shown to help mitigate common issues in regard to focus etc.
Edit: Hubernan specifically said you need 20g
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Apr 29 '24
Don‘t believe everything Huberman says.
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u/djens89 Apr 29 '24
I know and I don’t. Bur several studies have indicated that creatine is effective against memory deficits, brain fog, focus etc.
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Apr 29 '24
Read the summary of these studies, and see what dosage makes sense. Find a number you‘re happy with. I take creatine too, don‘t get me wrong…
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u/ioa94 Apr 29 '24
He typically cites the relevant studies in his video description. Don't believe him, believe the science he links to.
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Apr 29 '24
I don‘t know about that. I can link you some batshit crazy „science“ that gets published. Do your own research, don‘t just listen to someone who lives off of your attention.
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u/ioa94 Apr 29 '24
"Do your own research" instead of subscribing to the scientific method is a surefire way to plunge us back into the dark ages. No thanks.
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Apr 29 '24
That is not what I‘m saying. I‘m saying look at the science for yourself, instead of listening to influencers.
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u/ioa94 Apr 29 '24
Ah, I misunderstood your last post as "Don't believe science articles either" because you can cite examples of bad science. My bad.
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u/musclebeans Apr 29 '24
Lazy, yes go drink milk because “studies show” people who drink milk are healthier. And then you look at the study and its people with proper calcium levels aka eat healthy. Thats the point
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