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October 26, 2021

Sports Supplements: What Works for Women

Reposted with permission from Dr. Stacy Sims
Surprise, surprise, some ergogenic aids work differently for us than they do for the guys.
Research on female college athletes shows that more than 65 percent of them use some type of supplement at least once a month. I don’t know what the percentage is among performance-minded women outside of the collegiate ranks but based on my experience I’ll say it’s as high if not higher.
I am obviously not anti-supplement, since I use a few ergogenic aids like branched-chain amino acids, caffeine, and adaptogens myself. But I think it’s important for women to recognize that just as women have been traditionally understudied in sports science in general, we have been very understudied in the realm of ergogenic aids. Based on what we know about how women respond differently to strategies like intermittent fasting (previous Blog) and ketogenic diets, we should also take a closer look at how we might respond (or not) to sports supplements. 
A study published in 2016 in the Strength and Conditioning Journal did just that and provides a good springboard into some of the most recent research to paint a picture of what you can expect from some of the most popular sports supplements.
Caffeine
Hands down the most popular ergogenic aid in the world. It’s found in coffee, teas, sodas, pills, gums, and shots (e.g., 5h energy). Each of these products deliver varied doses of caffeine.
Caffeine is a strong nervous system stimulant and was actually listed on WADA’s banned substance list in 1984 but removed in 2004 when they realized that using enough to get popped in a test was extremely difficult (and not exactly performance-enhancing in those huge amounts). 
Aside from the stimulating effects on the brain, caffeine also raises blood pressure, heart rate, and stomach acid production and it helps break down fat stores and releases them into the bloodstream for easy access during exercise. Some of these effects, particularly those on blood pressure and heart rate are less pronounced in regular caffeine users.
The 2016 analysis found minor gender differences. Women had greater blood pressure increases, but less heart rate changes compared to men. High levels of circulating estrogen made women feel the effects of caffeine—such as the jitteriness—more but that didn’t change their performance improvements. Research on women hasn’t shown the benefits of caffeine for short high-intensity sprints, but is most effective for longer, sustained exercise.
The recommended dose of caffeine to supplement for performance is 2 to 3 mg of caffeine per kilogram body weight, based on the most current evidence. Higher doses of caffeine do not appear to produce any additional performance benefit. That said, tolerance depends on the individual. A reasonable starting point is 2 mg caffeine/kg body weight, which is about 125 mg caffeine for a 60-kg individual.
You hit peak blood levels 45 to 60 minutes after ingesting caffeine. The maximum caffeine effect on fat stores can take up to 3 to 4 hours, however. During exercise, your body clears it much faster than it does when you’re sedentary, so when you start using caffeine in an event, you need to keep using it till the end. Athletes should make sure they use caffeine during training prior to using it as an ergogenic aid on competition day
Creatine Monohydrate
Creatine is a naturally occurring substance found in your muscle cells that helps them produce energy during high-intensity exercise and heavy lifting. Ninety-five percent of all creatine is stored in your skeletal muscles, and you can bump up those creatine reserves by about 20 percent with supplementation.
Women naturally have 70 to 80 percent lower creatine stores than men and we typically consume significantly lower amounts of dietary creatine, which comes primarily from animal foods like beef, compared to men. So, it’s little surprise that research finds that women may benefit more from supplementing this ergogenic aid.
The 2016 study found that females had greater relative performance improvements over males, with males experiencing about a 6 percent increase in performance and females enjoying a 15 percent increase in performance—more than double the benefit. 
Most recently a 2021 review of the literature published in Nutrients reported that “creatine supplementation may be of particular importance during menses, pregnancy, post-partum, during and post-menopause” and that “females with varying levels of training and fitness may experience improvements in both anaerobic and aerobic exercise performance from both short-term and long-term creatine supplementation.” 
Creatine is traditionally viewed as an ergogenic compound known to promote cell survival and influence the production and usage of energy for fast and high-demanding energetics of the body, in particular the brain. It may also help with mood disorders.
The review included interesting research on brain health in women; identifying research that women with a major depressive disorder who augmented their daily antidepressant with 5g of creatine responded twice as fast and experienced remission of depression at twice the rate of women who just took the antidepressant.  
The researchers recommend a traditional loading dose (0.3 g∙day−1 5–7 days) or a routine daily dose (3 to 5 g) for 4 weeks as effective for women, regardless of age. The traditional side effect of weight gain (due to water retention) does not occur with this low dose, yet the health and performance outcomes increase significantly.

Beta-Alanine
Beta-alanine is an amino acid found in poultry, meat, and fish. Your body uses it to produce carnosine, which serves as an acid buffer and helps improve exercise performance. Beta-alanine also improves muscle fiber firing rates and recovery.
Carnosine levels are naturally lower in females than males, according to the 2016 study, but females experience greater relative increases in carnosine after beta-alanine supplementation. Studies on female masters athletes show performance gains with beta-alanine supplementation, including improving lower body exercise performance and improving cycling time trial performance. A study on premenopausal soccer players found that beta-alanine supplementation during plyometric training appeared to add further adaptive changes in endurance and repeated sprinting and jumping ability.
If you are in the menopausal transition and suffer hot flashes during exercises, a dose of beta-alanine, which helps open your blood vessels, before you head out can help ward them off.
Research has shown exercise improvements with consumption of 3.2 to 6.4 grams a day. Some people get pins and needle sensations at the higher end of that recommended dosage. You can avoid that by taking it in two separate doses over the course of the day.

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