 Almost universally, research findings show a poor vitamin B12 status among vegetarians because they're not taking vitamin B12 supplements like they should. And this results in an elevation of homocysteine levels that may explain why vegetarians were recently found to have higher rates of stroke. Of course, plant-based eating is just one of many ways to get B12 deficient. I mean, even laughing gas can do it. Even as short as two days, thanks to the recreational use of whipped cream canister gas. That's something new I learned today. Anyways, if you do eat plant-based, giving vegetarians and vegans even as little as 50 micrograms once a day of cyanocobalamin, the recommended most stable form of vitamin B12 supplement. And their homocysteine levels start up in the elevated zone and within one to two months their homocysteines normalize right down into the safe zone under 10, or just 2,000 micrograms of cyanocobalamin once a week and you get the same beautiful result. But not always. In this study, even 500 micrograms a day, either as a sublingual chewable or swallowing regular B12 supplement, didn't normalize homocysteine within a month. Now presumably if they had kept it up, their levels would have continued to fall like in the other study. But if your plant-based have been taking your B12 and your homocysteine levels are still too high, meaning above 10, is there anything else you can do? Now inadequate folate intake can also increase homocysteine, but folate comes from the same root as foliage. It's found in leaves, concentrated in greens, as well as beans. But if you're eating beans and greens, taking your B12 and your homocysteine levels is still too high. And I'd suggest trying as an experiment, taking one gram of creatine a day and getting your homocysteine levels retested in a month to see if it helped. Creatine is a compound formed naturally in the human body that is primarily involved in energy production in our muscles and brain. It's also naturally formed in the bodies of many animals we eat. And so when we eat their muscles, we also can take in some creatine through our diet. We need about 2 grams a day, so those who eat meat may get like one gram from their diet, and their body makes the rest from scratch. There are rare birth defects where you're born without the ability to make it, in which case you have to get it from your diet. But otherwise, our bodies make as much as we need to maintain normal concentrations in our muscles. When you cut out meat, the amount of creatine floating around your bloodstream goes down, but the amount in your brain remains the same, knowing dietary creatine doesn't influence the levels of brain creatine, because your brain just makes all the creatine you need. The level in vegetarian muscles is lower, but that doesn't seem to affect performance. As both vegetarians and meatians respond to creatine supplementation with similar increases in muscle power output, and if vegetarian muscle creatine was insufficient, then presumably they would have seen an even bigger boost. So basically, all that happens when you eat meat is that your body just doesn't have to make as much. What does this all have to do with homocysteine? Okay, in the process of making creatine, your body produces homocysteine as a waste product. Now, normally this isn't a problem, because your body has two ways to detoxify, using vitamin B6, or using a combination of vitamins B12 and folate. Now, B6 is found in both plant and animal foods, it's rare to be deficient, but B12 is mainly in animal foods, and so it can be too low in those eating plant-based who don't supplement or eat B12-fortified foods, and folate is concentrated in plant foods, so it can be low in those who don't regularly eat greens or beans or folic acid-fortified grains. And without that, scape valve, homocysteine levels can get too high. If however, you're eating a healthy plant-based diet and taking your B12 supplement, your homocysteine levels should be fine, but what if they're not? One might predict that if you started taking creatine supplements, the level of homocysteine might go down, since you're not going to have to be making so much of it from scratch, producing homocysteine as a byproduct. But you don't know until you put it to the test, which we'll cover next.