April 3, 2025
115: Creatine, Blood Tests & Supplement Hype with Sarah Gray
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Supplement confusion is at an all-time high, with social media feeds flooded with miracle promises targeting menopausal women. But how do you know what you actually need, what works, and what's just expensive snake oil?
Pharmacist and nutritionist Sarah Gray brings her dual expertise to this conversation, offering practical guidance for navigating the overwhelming world of supplementation.
Unlike most health professionals who specialise in either conventional medicine or natural approaches, Sarah bridges both worlds, providing uniquely balanced insights into what supplements might actually benefit women in midlife.
This episode delivers specific, actionable advice you can use immediately. Learn the simple trick for identifying quality supplements (look for the AUST-L or AUST-R code), understand which baseline blood tests you should request from your doctor, and discover why blindly following supplement trends can waste your money and potentially harm your health.
Sarah warns against the common practice of continuously adding supplements without removing any, explaining how this can lead to accidental overuse of certain nutrients.
We take a deep dive into the essential blood work every midlife woman should request annually. Sarah explains how certain symptoms commonly attributed to perimenopause could signal nutritional deficiencies that won't necessarily improve with hormone therapy.
And you don't want to miss our discussion about Creatine - arguably the most evidence-backed supplement for women in midlife - which offers benefits for muscle strength, mood regulation, and the immune system.
Take control of your health by understanding exactly what your body needs rather than what clever marketing suggests you buy. Your journey through perimenopause and beyond deserves an evidence-based approach to supplementation that works.
Links
Sarah Gray - Nutrition Pharmacist website
Sarah on Instagram
Sarah on Facebook
The Benefits of Creatine by Dr Mary Claire Haver
Why Creatine Matters for Women 40+ by Harvard Lifestyle Medicine
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WEBVTT
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Welcome to the Dear Menopause podcast.
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I'm Sonya Lovell, your host Now.
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I've been bringing you conversations with amazing menopause experts for over two years now.
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If you have missed any of those conversations, now's the time to go back and listen, and you can always share them with anyone you think needs to hear them.
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This way, more people can find these amazing conversations, needs to hear them.
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This way, more people can find these amazing conversations.
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Welcome to Dear Menopause this week.
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I am delighted to be joined today by Sarah Gray.
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Welcome, Sarah.
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Thank you so much, Sonya.
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Thanks for having me Really excited to be here on this wonderful podcast.
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So let's jump in.
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Why don't you do a much better job than I did and explain to everybody who you are and what you do?
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Yeah, absolutely, I'm a nutritionist and a pharmacist.
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I started by studying pharmacy in my first degree out of high school and I learned a few years into working in community pharmacy that there was just a bit more I wanted to be able to help people with.
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I felt like I would give them things to fix their problems, but not necessarily try and prevent things so much so I had a really interested in nutrition.
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So, being the curious person I am, I went and did a master's of human nutrition at Deakin University and so now I hold both those degrees and it's really interesting.
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Actually, I thought I'd actually hang my pharmacist hat up and put my nutritionist hat on, but as time went on, hang my pharmacist hat up and put my nutritionist hat on, but as time went on I realised the two actually went really well together and there's more and more I explore about this every day.
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Yeah, they work well together in terms of being able to look at someone holistically and think about medicines, supplements, lifestyle, having that pharmacy background of medical conditions.
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It's actually turned out to be perfect.
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Sarah, that's amazing and I can absolutely see how, working in a pharmacy, you would especially if you're someone that was quite kind of holistic in your approach to health really feel that there was areas where you could be able to expand on that advice.
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And I've actually come across a pharmacist and a nutritionist before.
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My local pharmacist was a nutritionist as well, so it totally makes sense and I think that's a beautiful use of all of your skills and probably all your interpersonal skills as well.
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So how do you support women today as a nutritionist and a pharmacist?
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I don't still work in a pharmacy.
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I do the odd shift to help friends if they need some help.
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I do love working there, but I'm probably much too talkative and want to have a full consultation with people, so I'm not probably the fastest as they would like.
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But what I do now is I have an online clinic where I help all people, but I tended to get lots of women booking in and I was getting lots of women coming with low energy.
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It was a common theme.
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That was just time after time after time and then when you do further exploration, you'd find there's the brain fog, the stubborn belly fat and hormonal symptoms and not saying it was every time, but tended to be around these kind of hormonal changes.
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So I now say that my mission is to help women better navigate the really confusing health and wellness space, because this then means you're sort of empowered to make those great choices and you can spend your cash on things that will work, based on science.
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You can get cut through the overwhelm, because the biggest thing that happens is they come to see me and they say I've eaten eight different types of supplements, I've tried intermittent fasting, I've tried all types of different things, I've cut out carbs.
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But when I asked them, well, have any of those things made you feel better?
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The answer is generally no.
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So my mission is to try and help people use things or try things that work, and if they don't work, know that it's okay to sort of trial things, but doing it with a systematic approach is better for you and you'll feel better because of it.
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Yeah, that's so awesome, so important and so needed.
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So one of the things that we agreed when we sat down and chatted about recording an episode was what aspect of all the amazing work that you do can we really narrow our focus on and speak specifically to, a topic that I know is really top of mind for a lot of people when they are trying to feel better and they're on that elusive search for whether it's supplements or nutrition advice.
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But today we decided we were going to really focus in on supplements.
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We're going to deep dive into some of the things you touched on then, which were really beautiful around.
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How do you not waste your money on supplements, which is super easy to do.
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We've all done it.
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How do we know what is a good supplement to take, versus the marketing hype that exists and is just being further amplified now that menopause in particular, and perimenopause is this hot topic, and how do we know when we actually need supplements?
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So they're the kind of conversations that you and I are going to dive into today.
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So, sarah, why don't we start off with?
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How do we know what is a good supplement Like?
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How do we know we're not just flushing our money down the toilet at the end of the day.
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Yeah, such a great question and I do have some tips I give people.
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I'll go through them in a really sort of simplified way because we don't want to have a science lesson today, but I'll give you some tips that are kind of practical that you can use next time.
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You're kind of staring at that mega aisle of supplements or online choosing or being recommended.
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So the one thing I do want to start with is it is best to get personalized advice, because I often hear, oh, my friend used this, or my neighbor used this, or my Pilates teacher used it and I overhear it, probably very tuned into these conversations.
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But just because it works for you and it was safe for you doesn't mean it will work for someone else or be safe for someone else.
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So it's very personal.
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I tend to find women are taking a whole bunch of things just because people have told them and they just add and add and add.
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So my first recommendation is if you want to treat or alleviate a symptom or prevent a disease, you'll need a therapeutic product.
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So you can get foods that are kind of I call them kind of dressed up in fancy marketing packaging to make them look like supplements, and some of them.
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A few of them are actually compliant with the claims they can make, but some of them often go a bit off kilter on being a bit exaggerating on things they can do.
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It's hard to be able to tell that.
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So the first thing to do is say, well, I'm treating something therapeutic, I should get a therapeutic good.
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And the way you can find that is by looking on the label for a little OST-L or OST-R on the bottom right-hand corner of the label.
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So that's your first tick to say this is actually a supplement.
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So sorry, Sarah, is that OST-L?
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And why so sorry Sarah is that OST, a-u-s-t-l yes, okay, and then R?
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Now, the reason that that's a good idea is because foods don't usually have the right dose of an active ingredient at the right amounts and formats to give a therapeutic outcome.
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Because they're foods that are functional, they boost and support the diet.
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So they still have a place.
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But if you want to improve your sleep, you may need a dose of magnesium of a certain format that's proven to help you with sleep in certain conditions.
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That's why you can do that.
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It doesn't mean it's perfect, it just means it's the first thing that you can look at and in a space where it's so hot this topic right now, it can be overwhelming with what you get served up.
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So that can be your first thing.
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Then the second, which I wish was much more wide, but it's particularly only for sports supplements is there a third-party certification that tells you tick, this product is and you probably know about this well, sonia in your space like is this a high-quality, high-potent product?
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Is it something I can rely on?
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So a third-party comes in that has nothing to do with the supply or manufacture or selling of the drug or the supplement, I should say, and they put a stamp on it.
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Independent, more for sports supplements, but super relevant because things like magnesium and creatine, which are becoming popular in this space because of their efficacy, will often have those.
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So it's another thing you can look for.
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The third is the claims.
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Can you trust the claims?
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Now, this is what I say is the ultimate can of worms, and I wish I had a really easy way of telling you what you could and couldn't trust.
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I will say the TGA products can only contain ingredients that are approved by the TGA and only list claims that are from a set of claims the TGA allows you to select from, so that's a good thing.
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However, not every single product is detailed reviewed by the TGA allows you to select from, so that's a good thing.
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However, not every single product is detailed reviewed by the TGA before it goes to market.
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You sort of apply for it, you get a number and then they may check you afterwards.
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So there may be some claims that are exaggerated, but it's less likely for the therapeutic good.
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So this is my kind of pragmatic way of how you should check this, based on what I've seen Look at the label, which is usually really compliant because it's highly regulated and if the label is completely different to what's on the Instagram page and the website, that's a red flag.
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So the label says it may support energy levels.
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If the Instagram page says you're going to go from one to 10 out of 10 energy levels in two days, well, that sounds a little bit exaggerated.
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So that to me, is a red flag that you may want to choose a different brand in that case, just because you can't be confident that's truthful information, because it's exaggerated.
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I think that's a really good point to dwell on for a moment and that is that exaggeration of claims in marketing.
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And I've actually seen a few examples of these recently crop up in my social media feeds of particular products.
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And there was one recently that caught my eye.
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I'm not going to name what the product was, although I don't know.
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Sometimes I am tempted to name and shame, but I'm not going to today and it had a image of a probably middle-aged woman and she was standing side on so that you could see her shoulder and she had like a tank top on.
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I think she looked like she was at the gym, maybe exercising, and she had her hand up and written on her hand with a marker looked like she'd written it on there said frozen shoulder disappeared in and this isn't going to be correct, but it was something like five days or two weeks it was an actual time and it was quite from my perspective, very short period of time and it was an advertisement for a particularly well-known menopause related.
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It really caught my eye because I thought that is hugely exaggerated, because I know that you are not going to fix a frozen shoulder taking this particular product in that period of time, and I think that's really good to point out to people because it is a really easy way to identify.
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Does this claim that the product is making seem exaggerated?
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Does it seem a little like they're expecting great things in very short periods of time?
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yeah I'm glad you brought that up, because I think that's something we need.
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We can easily look for, but we can also really easily fall prey to yeah, and my common saying is and this is in everything in life, not just this space if it sounds too good to be true, it probably is.
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And um, but the reason why I anchor you back to looking at the label is they are often very compliant on the label.
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So if you see an ad like that, think, oh, I'm not sure if the label doesn't say it's going to remove your, alleviate your frozen shoulder in three days, it's probably not something that they were probably allowed to say within their claim.
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So use the label as your guide.
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That's a really kind of you know less markety type piece that tells you what it might do, so that hopefully they're helpful.
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The next one is around safety.
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So, although this is not how you can choose one, just being more conscious when choosing, just because a supplement's natural or herbal, it doesn't mean it's 100% safe.
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Often can interact with other supplements, medication, foods, certain diagnosed medical conditions.
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You shouldn't take them.
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So be very careful to read the warnings or speak to a health professional and be conscious of that.
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Don't just think if I can bite so easily, it must be safe.
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It's not the case, and we see things like ashwagandha, a very commonly used adaptogen herb, which does have its place for some people, being used really a lot at the moment, and then studies showing that higher level doses over extended periods may actually impact our liver.
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So remember that they are still active substances most of the time, so just bearing that in mind is really important.
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I think that reminder as well of interactions with either other conditions or other medications or even sometimes other supplements that you're taking, can be really problematic, which is why I think your very, very first advice, of seeking advice from an expert first, is actually so beneficial and highly suggested 100%.
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And I end with that one again just to kind of double up on the importance.
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But the reason why I end on seek advice at the end is just check who you're getting the advice from too.
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So is the person.
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Not all health professionals do the same thing.
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We all do different things.
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So I sort of put the analogy like I wouldn't tell somebody how to manage a chronic dental issue, I would refer them to a dentist.
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Or how to manage their frozen shoulder'd probably send them to a physio and a doctor.
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So just be conscious that just because you have one qualification doesn't mean you know so good things to look for.
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Are they sort of pharmacists that generally have the knowledge?
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Have they got added like lovely to hear that you're older.
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Where you used to live the pharmacist there was also nutritionist degree qualified naturopaths.
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So just checking, they've got a degree.
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Lots of the ministry have wonderful health science degrees now clinical nutritionists and integrative doctors.
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So have they got that expertise?
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Because they're more able to support you in a more rounded way as well.
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So yeah, and do you happen to know where GPs would fall into that?
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Obviously, we see our GPs to prescribe medications, but many women and I think I've probably done this myself at some point in time has been having that conversation with the GP and what supplements should I take as well?
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My girlfriend's taking creatine should I?
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So are GPs likely to be as educated in supplements?
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Good question.
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It again depends on the GP.
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They'd have a very good knowledge of the things we're talking about.
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Whether or not they're experts in specific types of supplements would be another question.
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So it really is dependent.
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There is also GPs you can find that have done a lifestyle medicine degree and you can find that on the lifestyle medicine website and also integrative doctors, through the Australian Institute of Integrative Medicine, I believe.
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So you can actually check for doctors who have done additional study.
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That's more about lifestyle and supplements.
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So that's the case.
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But you may also find there's a GP in your area who really has specialised in this and looked into it.
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So just look into it, because they'll often say, on the hot doc or wherever you book, they'll say what their specialty is.
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Yeah, fantastic.
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Then you're more likely to get a sort of more well-rounded response, I guess.
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Yeah, great advice.
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And while we're talking about healthcare practitioners, let's dive into.
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One of the most common questions that I imagine comes up is how do I actually know what I need to take?
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You touched on earlier like everyone at the moment is talking about creatine, and personally I think that's for good reason.
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I think creatine is amazing.
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I've been taking creatine daily for about five years, but I just continue to see more and more studies come out.
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Isn't it the most researched supplement that's on the market?
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So you might be someone that's heard a lot of buzz about creatine and so you're thinking, oh, do I need to take creatine or do I need to take magnesium?
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Do I need to take vitamin D?
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Like there are so many questions around, just because someone else is taking it or because it's getting a lot of media attention, how do I know if I need it?
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So what's your recommendation in getting to the bottom of that?
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Yeah, I do agree with you on creatine.
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I think it's as wonderful, as you say as well.
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I guess.
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A couple of things.
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Firstly, we mentioned blood tests earlier when you and I were talking before this session was recording.
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So blood tests are really great.
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Once a year Check for any, or if there's any specific symptoms.
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First we want to say, well, do we have any deficiencies or sort of at-risk areas that might need a bit more of supplementation?
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That's the first place, because you want to correct anything that needs correcting.
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The other thing then is symptoms.
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So are there specific symptoms that you can't manage with diet and lifestyle?
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So I have this analogy.
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It's about a cake.
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I know not all cakes are healthy, but I love cakes, so I use the analogy of cake.
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So when you've got a cake, you've got the flour, the eggs, the butter, the base of the cake.
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For me, that is if you've got any symptoms.
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You've corrected nutritional deficiencies through blood work.
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You've got symptoms.
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Is your diet optimized?
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Is your lifestyle optimized?
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Are you doing all those good things movement, mindfulness.
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Then supplements are kind of like the carrot and walnuts or the chalk chips or whatever the flavor is.
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It makes the cake taste better.
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You don't really need it, but in some cases it makes the cake better and it actually boosts it.
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And then, for me, then, the icing on top, which I know we'll talk about later, is that hrt or mht, which you know not all cakes need.
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It is that HRT or MHT, which not all cakes need it but often taste better with it and make them easier to eat.
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So it's kind of a weird analogy that I've built up over time to explain that.
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But supplements you need are things to help you treat symptoms.
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So if you're let's use an example so when you sit down and think about what symptoms you're having, you've corrected your nutritional deficiencies, let's just say, with blood tests, so your iron's back to normal if it wasn't, et cetera, but you still cannot sleep.
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That's where we think, okay, what can we do before we go to?
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Maybe sleeping tablets?
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Or if you are on HRT, we can talk about that.
00:16:57.610 --> 00:17:00.205
But what can we do to try and support your body to sleep?
00:17:00.205 --> 00:17:06.542
So we look for something like a magnesium glycinate or bisglycinate, which is a relaxing form of magnesium.
00:17:06.542 --> 00:17:09.911
We try that, but we don't just keep taking that forever.
00:17:09.911 --> 00:17:11.621
We try that for three, four months.
00:17:11.621 --> 00:17:13.105
Is it making a difference?
00:17:13.105 --> 00:17:16.444
No, it's not making a difference, then we might try something different.
00:17:16.444 --> 00:17:24.164
So it's about treating the symptoms and if they don't work I often ask this question if it's not making a difference, you shouldn't continue taking it.
00:17:24.246 --> 00:17:35.251
Some things you can't feel, for example, caveat with if you're using certain types of omega-3s to manage your cholesterol levels and your HDL and LDL, your good and bad cholesterol.
00:17:35.251 --> 00:17:45.127
You won't feel that, but you will know if that's having an impact when you have that next blood test, which may be more frequently than 12 months if you're treating a cholesterol imbalance.
00:17:45.127 --> 00:17:47.231
So that's sort of the way I look at it.
00:17:47.231 --> 00:17:49.535
You know, is it a deficiency or do you have symptoms?
00:17:49.535 --> 00:17:54.163
And the other one would be.
00:17:54.163 --> 00:17:56.536
Then I have kind of a set of general supportive supplements that are really great for women in this phase of life.
00:17:56.536 --> 00:17:57.160
Creatine is one of them.
00:17:57.160 --> 00:17:59.220
Probiotics are another really good one.
00:17:59.220 --> 00:18:04.011
But again, firstly, have we looked at how you might get some of those pre and probiotics through diet?
00:18:04.011 --> 00:18:06.919
Firstly, have we looked at how you might get some of those pre and probiotics through diet?
00:18:06.919 --> 00:18:11.153
Not possible for everybody, so there's some that I sort of have as kind of general supportive supplements that I'll recommend.
00:18:11.153 --> 00:18:13.362
But generally you want to look at symptoms and see how you can support somebody.
00:18:13.561 --> 00:18:22.647
Okay, cool, doing some blood panels with your healthcare practitioner to get an idea of those, the big identifiable markers.
00:18:22.647 --> 00:18:34.625
Like you mentioned, iron, I know vitamin D is one of those ones that you can test on a regular basis, looking at where those are sitting with your health practitioner, but then also going through that symptomology.
00:18:34.625 --> 00:18:48.026
And I loved your suggestion of just because you start taking something doesn't mean you keep taking it forever, checking in every 12 weeks, six months, whatever it is, and saying, okay, but am I actually noticing a difference?
00:18:48.026 --> 00:18:50.613
Because of this, I think that's really good advice.
00:18:51.380 --> 00:18:58.085
And also what happens is sometimes people layer things on, layer things, and I'll just give an example where that actually might be not great.
00:18:58.204 --> 00:19:02.801
So vitamin B6 recently has been in the media with the TGA.
00:19:02.801 --> 00:19:12.393
So if you have too much vitamin B6, it actually can cause things like tingling or numbness in your extremities and a range of symptoms because it can cause kind of nerve sort of type damage.
00:19:12.393 --> 00:19:21.170
But vitamin b6 is actually sort of thrown into a lot of supplements, like if you're taking a women's health blend or a greens or this or that, it can often be added in.
00:19:21.170 --> 00:19:33.219
And what the tga were finding is people were taking lots of different things, just kept adding and adding and adding oh, I'm not sleeping, I'll add the greens, I'm not doing this or that, and that cumulative increase in the b6 was actually causing almost a toxicity.
00:19:33.219 --> 00:19:35.162
So it's not about one's not working.
00:19:35.162 --> 00:19:44.702
Add another, put, put a Band-Aid on that, it's about well, I don't like recommending more than one or two supplements at a time for someone, because if you add five and it's working, what do you do?
00:19:44.702 --> 00:19:45.726
You stay on the five.
00:19:46.515 --> 00:19:47.919
Well, yeah, it's a great point, isn't it?
00:19:47.919 --> 00:19:52.317
Like how do you then join the dots of which one is actually having the most impact?
00:19:52.317 --> 00:19:53.778
So I think that's good advice too.
00:19:53.798 --> 00:19:54.979
Yeah yeah, that's good advice too.
00:19:54.999 --> 00:19:57.162
Yeah, yeah, that's how I see it.
00:19:57.162 --> 00:19:57.461
Awesome.
00:19:57.461 --> 00:20:05.329
Now, I did ask my Instagram community for any questions and, while we're talking on this topic, I think there's one that is relevant to this.
00:20:05.329 --> 00:20:06.590
I'm going to throw it in right now.
00:20:06.590 --> 00:20:23.269
So, whilst we're talking about diet as well as supplementing on top of that, if we looked at the population in general, how many of us are actually getting what we need from our diets on a day-to-day basis without then the need for additional supplements?
00:20:24.152 --> 00:20:41.588
Yeah, and I haven't looked at sort of any evidence to respond to this one, but in terms of like statistical views, because really our national nutrition survey is pretty dated so we probably don't really know how well people are eating, I would just say, anecdotally, you'd be surprised like most people are actually getting a lot of what they need.
00:20:41.588 --> 00:21:01.348
So if you're eating, you know you may not be eating that great in terms of snacking and things in between, but if you're getting sort of three decent meals and you're generally getting most of what you need, I do find that people who don't get what they need, they can't even a buckets, so they might have a chronic disease where there's impact on the way that they can eat.
00:21:01.348 --> 00:21:14.180
If you've got an ulcer or something, it may impact the amount of food you have, or maybe it's somebody who is eating more plant-based, so therefore they're really going to have trouble with our iron, our B12 and some other things and creating deficiencies there.
00:21:14.180 --> 00:21:23.017
So, without having a statistic, I'd probably say like seven or eight out of 10 people that I see I generally feel pretty comfortable that they're getting the right type of food.
00:21:23.017 --> 00:21:26.866
It's just are they getting it in the right quantities to optimize their health.
00:21:27.055 --> 00:21:32.877
So and we'll talk about blood work later but you know you get that range of okay if you get your iron tested.
00:21:32.877 --> 00:21:40.981
It can be from the low range to the high range and a lot of people, yes, are in the middle of that average, but many people sit right at that bottom edge.
00:21:40.981 --> 00:21:49.597
So they might be getting enough, but are they getting enough to actually optimize their energy levels and ensure that they're in a really optimal range?
00:21:49.597 --> 00:21:54.375
So it's that view of you know the doctor's view more is it outside of the range?
00:21:54.375 --> 00:22:02.436
It's a traditional view, whereas a more integrative practitioner might say well, actually towards the bottom end, so let's actually give you some now to improve your outcomes later.
00:22:02.436 --> 00:22:05.946
So without a percentage, that's my kind of best guess at that one.
00:22:06.755 --> 00:22:21.211
Yeah, that's great, and I think it's also really encouraging to hear that, from your perspective and the anecdotal evidence that you're kind of got available to you at your fingertips, that there is a higher percentage of people that are actually getting a lot of what they need from their diet.
00:22:21.211 --> 00:22:34.544
And yeah, which, again, if we go back to that marketing kind of hype, it can be a trope that gets rolled out there, isn't it that you know, like you're not getting this in your diet, so therefore, you should, you know, be topping it up with our wonderful supplement.
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