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Creatine For Martial Arts

Unmasking Creatine – Fuel for the Ageing Martial Artist

By now, I’m sure you’ve heard of creatine, but what is it, and as a martial artist, why should you care?

In the unforgiving world of martial arts, two primal forces clash; our relentless pursuit of mastery and the stark reality of our bodies’ advancing years. As we age, that high-octane kick doesn’t land as easily, the reflexes aren’t as lightning-fast, and recovery time feels like an eternity. For those of us grappling with the limits of age and ambition, we yearn for that something – a potential game-changer – to tip the scales back in our favor. 

Enter creatine. This much-talked-about supplement is rumored to be the secret weapon in the fight against time and fatigue. Yet, in the chatter of locker rooms and online forums, it is shrouded in half-truths and bro science. Does it boost performance, or is it just another overhyped supplement? Does it risk our health or help us maintain our fighting edge? 

In this “Fit To Fight installment,” we pull no punches. We’re stepping onto the mats with science to knock out the myths and highlight the facts surrounding creatine. We’ll explore what it is, what it does, and whether it’s the ally the mature martial artist needs in this fight against time. From daily dosages to potential side effects, we’ve got you covered. Get ready to discover if creatine can make you a better fighter, regardless of what the calendar says. 

Fit To Fight


Welcome to another installment of Fit-To-Fight, the series where we explore the intersection between ancient practices and modern science as part of a more natural way of living.

This series aims to help you experience your best physical and mental health by incorporating these practices into your life. We explore exciting topics that will get you thinking about your fitness and martial arts routine in a whole new way.


What Is Creatine?

Creatine is a naturally occurring substance in the human body, particularly in our muscle cells. Creatine monohydrate is an organic compound with the chemical formula CNCH₂CO₂H. The human body produces around 1 to 2 grams of creatine per day, and the rest is taken in through diet, particularly from foods like meat and fish.

Chemically, it’s known as a quaternary ammonium compound, chiefly involved in facilitating energy production in our cells. Creatine acts as a reserve of quick energy, especially during high-intensity, short-duration exercises like weightlifting or martial arts moves where we need sudden bursts of power.

Creatine also comes in a synthesized form, which is sold as a dietary supplement. This form is chemically identical to the creatine naturally produced by our bodies. This supplement is popular among athletes and fitness enthusiasts due to its potential benefits in enhancing athletic performance, strength, muscle gain, and even cognitive (brain) function. 

What Does Creatine Do?

Power Play: How Creatine Monohydrate Supercharges Your Muscles

Imagine your muscles are like high-performance cars. To accelerate rapidly or maintain top speed, they need high-octane fuel. This “fuel” in our bodies is a molecule called ATP (adenosine triphosphate). It’s what keeps our biological engines revving, powering everything from a lightning-fast jab to a knee-crushing kick.

But here’s the rub: the body’s ATP reserves are limited and depleted quickly during intense activity. It’s akin to draining your sports car’s gas tank after a high-speed run. That’s where creatine steps into the spotlight.

Picture creatine as your muscle’s pit crew. During those high-intensity bursts, when ATP is rapidly used up, creatine helps quickly regenerate ATP. It does this by donating a phosphate group to produce new ATP, effectively refueling your muscle car mid-race. The result? You can maintain that high-speed, high-power output for a little longer, making each workout or training session more effective.

So, creatine doesn’t give you energy per se. Instead, it’s more of a recovery tool, a “recharger” that helps replenish your body’s quickly-depleted energy stores. By aiding in ATP restoration, creatine allows you to train harder and more effectively, potentially leading to better performance and strength gains.

Whether launching a flurry of punches or executing a masterful sweep, creatine is the pit crew your muscles need to go that extra round. But, like any supplement, it’s not a magic bullet. It must be considered within the broader scope of diet, exercise, and lifestyle. Stay tuned as we tackle more questions about creatine, so you can decide if it’s right for your fitness journey.

Is Creatine Bad For You?

Performance Booster or Health Hazard?

By nature’s design, creatine is not the bogeyman it’s sometimes made out to be. After all, our bodies craft it daily from amino acids in the liver. It’s like the body’s in-house blacksmith, fashioning an essential tool for high-performance activity. That tells us something about its value.

There’s a pervasive myth linking creatine to kidney damage. It hinges on the fact that creatine supplementation increases creatinine levels in the body. For the uninitiated, creatinine is a waste product often used as a marker of kidney health. Higher levels can indicate kidney problems, leading some to draw a dangerous line connecting creatine to kidney harm.

But here’s the catch: research has shown that increased creatinine levels due to creatine supplementation are not a sign of kidney damage in otherwise healthy individuals. It’s more like a harmless false alarm triggered by the body processing the extra creatine, akin to the effects of increased dietary protein.
Bruce Lee, a paragon of martial arts and fitness, was a creatine user. His legendary status, formidable power, and enduring legacy speak volumes about this supplement’s long-standing efficacy and safety. The science concurs: for healthy individuals, judicious use of creatine is safe, supported by numerous studies endorsing its long-term use.

To recap: creatine isn’t your adversary—it’s a trusted companion in every fighter’s corner, ready to back you up in your martial arts journey.

Is Creatine Good For Martial Arts?

Powering the Punch: Turbocharge Your Martial Arts Game

Martial arts aren’t just about strength; it balances power, endurance, and speed. Can creatine help you strike harder and grapple longer? Emerging science suggests it is your secret weapon.

Creatine is like a trusted cornerman, boosting your muscular strength and enhancing anaerobic power. Think of it as an extra gear, allowing you to go harder, faster, and more effectively during those high-stakes sparring sessions and grueling workouts.

But that’s not all. Creatine takes your muscle cells to the hydration station, leading to what’s known as ‘hyper-hydration.’ This is akin to supercharging your muscles’ water retention capacity, helping to increase glycogen storage – that’s your muscles’ ready-to-use energy reserve. More glycogen equals more fuel for your martial arts training, letting you push harder and go longer.

Another unseen advantage is reduced muscle damage. After those heavy-duty workouts, your muscles are like warriors returning from battle – bruised, battered, and needing repair. Here, creatine steps in as the medic, decreasing markers of muscle damage and accelerating recovery.

The upshot? More work capacity, improved recovery, and over time, potentially more muscle hypertrophy and strength. This doesn’t just translate to a better physique but also a more potent martial arts performance.

Yet, remember, creatine is an ally, not a miracle worker. It works best with a balanced diet, a consistent training regimen, and plenty of rest and recovery. So, if you’re eyeing that extra edge in your martial arts journey, creatine might be worth considering.

Is Creatine Illegal In Combat Sports?

The arena of combat sports has stringent rules, especially around performance-enhancing substances. So, is creatine classified as a legal supplement?

According to the United States Anti-Doping Agency (USADA), the referee of fairness in sports, creatine gets the green light. It’s not on their list of banned substances, meaning athletes, including martial artists, can use it without breaking the rules.

However, when shopping for creatine, it’s a buyer-beware market, and you should vet your creatine source. Buying from reputable manufacturers based in the US, Canada, or Germany that adhere to good manufacturing practices is a smart move.

Why the caution? Some supplements, particularly those from China, may contain heavy metals or be produced in facilities that also handle banned substances. It’s a classic case of cross-contamination that could result in an accidental failed drug test. 

The Mindful Warrior: Can Creatine Boost Your Brainpower?

Martial arts is as much about mental acuity as physical prowess. Creatine, often celebrated for its muscle-boosting benefits, might also have a starring role in the theater of the mind.

Creatine’s cognitive-enhancing potential shines especially bright in certain groups. Vegans and the elderly, who are more likely to be creatine deficient, may find it particularly beneficial. Creatine can step in to refill the body’s lower reserves, potentially sharpening mental focus and cognition.

Beyond this, creatine shows promise in more challenging scenarios, where the brain’s energy demands – and consequently ATP turnover – are high. Think of it as bringing a supercharged battery pack to an energy-intensive party.

Those late-night training sessions when sleep deprivation gnaws at your focus? Creatine might help keep your mind sharp. When you’re grappling with complex strategies or decoding an opponent’s moves? It could offer that mental edge. 

While empowering and thrilling, martial arts carries the inherent risk of concussions and traumatic brain injuries (TBIs). Blows to the head can be part of the game. Interestingly, creatine may play a defensive role here. Some studies suggest it can aid brain recovery post-injury, offering a potential protective effect against such risks. So, beyond muscle power, creatine might also be your brain’s ally on the mats.

By bolstering brain ATP, creatine ensures your mental engine has the juice to run optimally, even under demanding conditions. Remember that while the scientific picture is promising, it’s still developing. Further research is needed to comprehend creatine’s cognitive potential fully.

Bottom line? Creatine might amplify your physical game and potentially sharpen your mental edge, making you a more formidable martial artist both in body and mind. But how much creatine is ideal, and when should you take it? We’re ready to tackle that in the next section!

Get Fit To Fight

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The dojo is the easy part. What we do off the mats matters just as much as what we do on the mats. 1:1 health coaching for martial arts to get you fit to fight.

What Is The Proper Way To Take Creatine?

Tuning Your Strategy: From Loading to Maintenance

The road to creatine optimization can be viewed in two stages – Loading and Maintenance. Let’s break these down.

Loading Phase

During the Loading phase, a guideline of 0.3 g/kg/day, split into four intervals, is suggested, given that creatine needs can vary with body weight. An alternative path is a slower pace, where taking 3 grams a day for 28 days could increase muscle creatine storage to similar levels as a speedy load-up of 20 g/day over just six days. Remember that creatine’s benefits will be fully felt once your muscles are fully loaded, like a well-tuned engine ready to roar.

Loading Phase:

  • Lasts 5-7 days.
  • Daily: 0.3 g/kg body weight.
  • Divide into 4 doses.
  • Or, slower load: 3g/day for 28 days.

Maintenance Phase:

  • Shift to 3-5 g/day post-loading.
  • Maintain this daily.

Taking creatine with carbohydrates or carbs plus protein can enhance creatine retention, much like a well-timed punch can deliver a more potent impact. This increase in muscle creatine storage is linked with the performance-boosting benefits we’ve discussed.

Maintenance Phase

Once you’ve hit the 5-7 day mark in the Loading phase, you’re onto Maintenance. At this point, your muscle creatine stores are fully saturated, like a water balloon ready to burst. Your supplementation now only needs to cover the amount of creatine broken down daily. This was initially reported to be around 2-3 g/day, but recent research suggests a 3-5 g/day dose could better maintain those fully loaded creatine levels.

With your creatine strategy finely tuned, you’re ready to step back onto the mats, powered by science. 

So, you’re considering making creatine your training ally. But like learning the right stance or mastering a precise move, there’s a proper way to take creatine too. 

When it comes to form, creatine monohydrate wears the championship belt. A daily dose of 5 grams post-workout is typically recommended. Timing it right is key – just as you wouldn’t execute a roundhouse kick at the wrong moment. 

Why after your workout? When your muscles have been tested in the mats or the gym, they’re ready to absorb nutrients, a state we can liken to a sponge freshly wrung out and ready to soak up water. Adding carbohydrates and protein to the mix further enhances creatine absorption, creating a potent recovery cocktail. It’s like the perfect one-two punch, knocking out muscle recovery and performance optimization in one swing.

Conclusion

Creatine, a naturally occurring compound in our bodies, steps into the mats as a potential ally in the ceaseless fight against age and time. It is not an elixir of youth nor an overblown myth; it is a supplement with proven benefits in replenishing energy stores and enhancing high-intensity performance – the very attributes a martial artist needs to endure the grueling gauntlet of training and competition.

Does creatine turn the clock back? No. Does it promise unending strength and stamina? Certainly not. It offers a potentially improved training outcome, faster recovery, and an edge against opponents. It’s not a miracle worker, but it can be a potent tool in a martial artist’s demanding regime.

From the aging martial artist grappling with the challenges of time to the passionate novice striving for an edge and to every warrior in between – this edition of “Fit To Fight” is dedicated to you. As we walk this path together, we know that the quest for mastery never ends; it merely evolves. In the arena of martial arts, victory lies not in conquering opponents but in the constant pursuit of becoming better, stronger, and wiser. Here’s to that quest, and here’s to the martial artist in each of us. Let the journey continue.

About the Author

Ashe Higgs, I Liq Chuan Master Instructor & L2 Nutrition Coach

Ashe is a highly skilled martial arts instructor and certified nutrition coach with over two decades of experience in the field. He holds a Master Instructor certification in I Liq Chuan under Sam FS Chin, making him one of only several individuals worldwide to hold the title. He has taught classes and workshops worldwide and is passionate about helping others achieve their fitness and wellness goals.

With a background in full-contact fighting and a Level 2 certification from Precision Nutrition in nutrition coaching, Ashe is a well-rounded expert in the fields of martial arts. In addition to his expertise, he has a wealth of experience in teaching and mentoring others. He has a natural ability to connect with his students and inspire them to reach their full potential.

Read more about Ashe here…

Disclaimers & Conflicts of Interest

I am not a doctor or a lawyer, and the information provided should not be considered medical or legal advice.

The information provided is for educational and informational purposes only and should not be used as a substitute for professional legal or medical advice, diagnosis, or treatment. Consult your doctor or a qualified healthcare professional before making any changes to your diet, exercise routine, or lifestyle.

Please note that some of the links provided in this content may be affiliate links, meaning that I may receive a small commission if you purchase through them. However, please rest assured that any products or services recommended are based on my personal experience and belief in their value. I only recommend products or services that I have personally used and believe in.

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Magnesium & Vitamin D Role In Chronic Pain

While martial arts like Tai Chi can be a great way to manage chronic pain and improve overall health, two key lifestyle factors – vitamin D and magnesium – can also play a significant role. Vitamin D, often known as the “sunshine vitamin,” is crucial for bone health and immune function, while magnesium is a key player in muscle function and energy production. Both of these nutrients can not only help manage pain, but they can also maximize performance for martial artists who are already healthy. So, in this week’s “Fit To Fight,” we’ll dive deeper into the roles of vitamin D and magnesium and how they can help you on your martial arts journey.


Welcome to another installment of Fit-To-Fight, the series where we explore the intersection between ancient practices and modern science as part of a more natural way of living.

This series aims to help you experience your best physical and mental health by incorporating these practices into your life. We explore exciting topics that will get you thinking about your fitness and martial arts routine in a whole new way.


Vitamin D Deficiency & Magnesium Deficiency For Chronic Pain

Chronic pain is a prevalent condition that affects millions of people worldwide. It can be caused by various factors, including autoimmune diseases, injuries, and nerve damage. In recent years, there has been a growing interest in the potential benefits of vitamins and minerals in the management of chronic pain. Two such nutrients that have garnered attention are Vitamin D and Magnesium.

What Is Vitamin D?

Vitamins are like the helpful friends our bodies need to work properly. They act as co-factors or co-enzymes, which means they help proteins in our body complete chemical reactions, like breaking down our food or building our cells. Some vitamins are water-soluble, which means they dissolve in water and leave the body quickly. Others are fat-soluble, which means they can be stored in our body’s fat and used over time. So, whether it’s helping us get energy from our food or keeping our skin healthy, vitamins are key players in keeping us feeling and performing our best.

Vitamin D3, also known as cholecalciferol, is a type of steroid hormone. Steroid hormones are powerful chemicals that can travel through the body and cause various changes. They’re like messengers, delivering important instructions to our cells.

What Is Magnesium?

Magnesium is the fourth most common mineral in our body and the second most common positively charged particle found inside your body’s cells, playing a crucial role in many of the body’s functions, including as an electrolyte. It is needed for about 300 enzymes in the body and may help with various conditions such as sugar absorption, high blood pressure, pain, mood, and sleep.[1]

Magnesium Deficiency & Benefits

Magnesium deficiency is a common problem, especially among people who consume a low-magnesium diet (which is pretty much everybody in the 21st century). 

Symptoms of magnesium deficiency include muscle cramps, heart palpitations, anxiety, and fatigue. Magnesium supplementation may help with:

  • Pain relief
  • Sleep
  • Mood improvement
  • Conditions such as neuropathy, migraines, and chronic regional pain syndrome.

Autoimmune Diseases & Chronic Pain

Autoimmune diseases, such as lupus, rheumatoid arthritis, and multiple sclerosis, can cause chronic pain. These conditions occur when the immune system mistakenly attacks healthy cells in the body, resulting in inflammation and pain. 

Vitamin D Benefits

Vitamin D is like a multitasking superhero for our bodies. We all know it’s important to keep our bones and teeth strong, but it does much more. 

Imagine vitamin D as a master controller that can turn on and off certain functions in our body. It does this by interacting with special areas in our cells called vitamin D response elements. It’s like flipping a switch to activate over 900 different genes in our body.[2]

One of the key roles of vitamin D is to help our body absorb and use calcium, which is crucial for strong bones and teeth. But it doesn’t stop there. Vitamin D also helps our cells grow properly and can even slow down the growth of some cancer cells.

This study found that men with sufficient vitamin D levels had significantly higher levels of testosterone than those with insufficient or deficient vitamin D levels, revealing a concordant seasonal variation between vitamin D and androgen levels.[7]

Vitamin D also plays a role in our immune system. It can help control how our immune cells respond to threats, ensuring they react just the right way.

Vitamin D has been shown to improve: 

  • Autoimmune disorders[5]
  • Testosterone levels
  • Diabetes
  • Muscle function, mood, and sleep 
  • Immune system and recurrent infections
  • Heart health

In a nutshell, vitamin D is a vital part of many different processes in our bodies. From our bones to our immune system, it helps keep us healthy in more ways than we might realize. 

Vitamin D Levels

Vitamin D levels in our body can be a bit tricky to measure. The best way we currently have is to look at the levels of a form of vitamin D called 25(OH)D3 in our blood. This gives us a good idea of how much vitamin D we’re getting from sunlight, food, and supplements. But it doesn’t tell us how much vitamin D is stored in our body’s tissues.

We also look at parathyroid concentrations, which can give us a better idea of how our body uses vitamin D. 

When we talk about vitamin D levels, we usually use units like nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL).

  • Vitamin D insufficiency is defined when the levels of 25-hydroxyvitamin D (25OHD) are between 20–29 ng/mL
  • Deficiency is considered when the levels are ≤20 ng/mL.
  • Adequate levels of vitamin D are generally defined as a serum concentration of 25-hydroxyvitamin D (25OHD) of 30 ng/mL or above.

How Is Vitamin D Made

Here’s how our bodies create this superhero, vitamin D3: When our skin gets some sunshine, a substance in the skin called 7-dehydrocholesterol gets excited and transforms into pre-vitamin D. This pre-vitamin D then changes itself into vitamin D3.

Once D3 is formed, it hops into our bloodstream and travels to the liver. It changes into a new form called 25-hydroxyvitamin D, or 25(OH)D. This is the main type of vitamin D that circulates in our bodies.

But the journey doesn’t end there. The 25(OH)D then heads to the kidneys, where it transforms into its most active form, 1α,25-dihydroxyvitamin D, or 1,25(OH)2D. This superhero version of vitamin D does all the amazing things we’ve discussed, like helping our bones and immune system. This whole process is carefully controlled by our bodies, ensuring everything happens just right.

However, the amount of Vitamin D produced from sunlight exposure can vary depending on several factors, such as time of day, season, skin color, and geographical location. 

In Arizona, we’re lucky to be close enough to the equator that we can get some vitamin D all year round, depending on the time of day. However, anywhere north of Atlanta, you can only get vitamin D from sun exposure between April and October.

Magnesium And Vitamin D Research Studies

Several research studies have shown a correlation between Vitamin D and Magnesium levels and chronic pain. One study found that taking Vitamin D and Magnesium supplements together can help reduce pain and improve the overall quality of life in patients with fibromyalgia. Another study found that Magnesium supplementation can help reduce pain in patients with chronic lower back pain.

Magnesium & Chronic Pain

Magnesium is important for nerve function and may help alleviate chronic pain. It works by blocking N-methyl-D-aspartate (NMDA) receptors, which are involved in the transmission of pain signals to the brain.[3] Magnesium supplementation may also help improve sleep quality, which can be beneficial for individuals with chronic pain.[4]

Magnesium Benefits

Magnesium has many benefits for the body. It helps regulate blood pressure, supports the immune system, and aids in the absorption of calcium. Magnesium may also play a role in mood regulation and can help alleviate symptoms of anxiety and depression. We’ll go into depth on all the benefits of magnesium in another article; for now, we’ll focus on the interaction between magnesium and vitamin D.

Magnesium & Vitamin D

Magnesium works with Vitamin D by helping it bind to transport in the blood vessels and converting basic forms of Vitamin D to more functional forms. This process is essential for the body to utilize Vitamin D effectively.[6]

  • Magnesium plays a crucial role in the conversion of pro-vitamin D into active Vitamin D3 in the body.
  • Vitamin D starts as cholesterol in the body and goes through a conversion process to become 25 hydroxy Vitamin D through the catalyzation of UV light.
  • This 25 hydroxy Vitamin D further converts to 1,25 hydroxy Vitamin D, also known as calcitriol, which is the active form of Vitamin D in the body.
  • Magnesium is needed to help convert the basic forms of Vitamin D to the more advanced forms that are functional in the body.
  • Additionally, Magnesium assists in the binding of Vitamin D to transport in the blood vessels, further supporting its role in Vitamin D metabolism.

Magnesium Foods

Dark, leafy green foods are your best source of magnesium from foods.  Almonds and dark chocolate are other options. However, some people are sensitive to oxalates in dark, leafy greens or allergic to foods like almonds and chocolate.

Large-scale, mono-crop agriculture has depleted our soils over time, which means that the micronutrient density of fruits and vegetables today is not as high as it was in the past, so even if you eat plenty of fruit and veg, you may not be getting enough magnesium to meet your needs, especially if you’re a hard-charging athlete or martial artist, so you may still benefit from supplementing with additional magnesium.

Best Way To Take Magnesium Dosage

The current Recommended Dietary Allowance (RDA) for magnesium for adult men is 400-420 mg per day and 310-320 mg per day for adult women.

It’s important to consult with a doctor before starting magnesium supplementation, especially for individuals with kidney problems. Avoid taking magnesium supplements with dairy.

Best Magnesium Supplements

Getting sufficient magnesium through food alone can be challenging, and absorption through the gut may be limited, so supplements and topical sprays are alternative options.

The research around magnesium sprays and creams has mostly been sponsored by manufacturers of those products.  Independent research has shown that topical magnesium is not well absorbed, so for that reason, I prefer to supplement with caps.  My favorite brand is BioEmblem Triple Magnesium Complex.

Vitamin D Deficiency

Vitamin D is a crucial nutrient that our bodies need for many functions. Despite this, over a billion people around the world don’t get enough of it.[8] This isn’t just about strong bones – lack of vitamin D can lead to a host of health problems, from heart disease and diabetes to certain types of cancer. 

The study “Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012)” looked at how common vitamin D deficiency is among different groups of people in the United States, using health data from over 4,900 adults.[9]

Here are some key points to consider:

  1. Race and Vitamin D Deficiency: The study found that race was a significant risk factor for vitamin D deficiency. African-American adults had the highest vitamin D deficiency prevalence rate, followed by Hispanic adults. This is due to the increased melanin levels found in the skin of these races, which absorbs and scatters ultraviolet rays from sunlight, resulting in less efficient conversion of 7-dehydrocholesterol to pre-vitamin D3, a precursor of vitamin D.
  2. Age and Vitamin D Deficiency: Contrary to common belief, the study found an increased incidence of vitamin D deficiency among participants aged under 65 years of age, thus refuting the commonly accepted notion that increasing age is directly proportional to the risk of being vitamin D deficient.
  3. Education, Health Status, and Vitamin D Deficiency: The study found that individuals with college education had statistically significantly lower rates of vitamin D deficiency. Similarly, individuals with poor/fair health status were more likely to be vitamin D deficient. 
  4. Smoking and Vitamin D Deficiency: The study found that current smokers were more likely to be vitamin D deficient. This may be related to the ability of sinus mucosa to activate circulating vitamin D levels, which is impaired in smokers.
  5. Obesity and Vitamin D Deficiency: The study showed statistically significant differences in vitamin D deficiency rates with respect to weight, with a higher percentage of vitamin D deficient participants falling under the category of obese (BMI ≥30).
  6. Daily Milk Product Consumption and Vitamin D Deficiency: The study found that daily consumption of milk products serves as an effective prophylaxis against vitamin D deficiency in conjunction with daily sun exposure.
  7. Cancer and Vitamin D Deficiency: Contrary to established associations, the study found a statistically significant higher rate of cancer among the vitamin D sufficient population compared to the vitamin D deficient population.
  8.  Diabetes and Vitamin D Deficiency: The study found a statistically significant relationship between vitamin D deficiency and diabetes, supporting growing evidence suggesting vitamin D deficiency is a contributing factor to the development of both type 1 and type 2 diabetes.

Our bodies usually make vitamin D when our skin is exposed to sunlight. But most people spend over 90% of their time indoors. Combined with an indoctrinated sense of fear of the sun, most people cover their bodies with sunscreen and clothing when outside, meaning most of us don’t get nearly enough sun exposure to match ancestral levels of vitamin D.

To tackle this, we need to educate people about the importance of vitamin D, check people’s vitamin D levels regularly, and make sure our food contains enough of this vital nutrient. It’s a big task, but one that could make a huge difference to our global health.

Best Way To Get Vitamin D

Sunlight exposure is the best way to get Vitamin D. 10 to 15 minutes of sun exposure per day is recommended as it has additional benefits beyond Vitamin D production. The darker skinned, or the further north you live, the longer it takes to generate enough vitamin D. If sunlight exposure is limited, Vitamin D supplements, particularly Vitamin D3, can be taken. However, caution should be exercised to avoid toxicity.

Best Vitamin D Supplements

Vitamin D supplements come in various forms, such as Vitamin D2 and Vitamin D3. Vitamin D3 is the more active form of Vitamin D and is preferred by most health professionals. 

Dr. Weston A Price was a pioneer in research on nutrition and degenerative disease.  He knew that vitamin D worked in concert with another compound that was unidentified at the time, which he referred to as “activator x.”  In the modern era, many researchers now believe that “activator x” is vitamin k2. While vitamin D helps the body absorb calcium, vitamin K2 helps shuttle it to the correct places in the body and away from areas we don’t want it deposited (like the arteries). For this reason, it’s important to supplement with both of them in the correct ratios.[10] That’s why I prefer Thorne Labs Vitamin D3/K2 combo.

Thorne Labs is a trusted health supplement company known for its high-quality products and adherence to good manufacturing practices. When supplementing with something as important as Vitamin D3, it’s crucial to choose a reputable manufacturer like Thorne Labs to ensure you’re getting a safe and effective product.

Vitamin D Dosage

The recommended daily dose of Vitamin D varies depending on age, sex, and health status. It’s important to consult with a doctor before starting Vitamin D supplementation to determine the appropriate dosage.

The current Recommended Dietary Allowance (RDA) for Vitamin D for adults aged 18-70 is 600 International Units (IU) per day, and for adults over 70, it’s 800 IU per day.

While the recommended doses of Vitamin D are typically around 600 to 800 International Units (IU) per day, this might be less than what our bodies naturally produce – about 25,000 units per day – when we spend time in the sun. In fact, a seven-year study found that giving hospitalized patients daily oral doses of Vitamin D3, ranging from 5,000 to 50,000 IU, was safe and well-tolerated.[11] This long-term supplementation of Vitamin D3 not only appeared to be safe, but it also led to improved health outcomes without any adverse reactions. Interestingly, the study found that it took around 12 months for blood levels of Vitamin D to plateau with daily doses of 5,000 to 10,000 units, suggesting that our bodies slowly absorb and utilize this vital vitamin.

Light Therapy For Vitamin D

Light therapy and phototherapy have proven benefits beyond Vitamin D production, including improved sleep, mood, and overall well-being. Light therapy involves exposure to light that mimics natural sunlight and can be beneficial for individuals with limited sun exposure.[12]

In the 1930s, vitamin D lamps were a popular way to combat vitamin D deficiency, especially in areas with limited sunlight. These lamps emitted ultraviolet B (UVB) light, which our skin uses to produce vitamin D naturally. People would sit in front of these lamps, much like a sunbathing session, to boost their vitamin D levels. This was particularly useful during winter months or in places with long periods of darkness.  Bonus: you will tan (or possibly burn) when using a Sperti!

The Sperti Lamp is a specialized UV lamp designed to help the body naturally produce vitamin D. It was developed by Dr. George Sperti, known for his research in the field of photobiology. The lamp emits UVB light, the same type of light that triggers vitamin D production in our skin when we’re exposed to sunlight. This makes the Sperti Lamp a useful tool for people who may not get enough sun exposure, especially during winter months or in regions with less sunlight. The main benefit of using phototherapy for vitamin D is there is no risk of vitamin D toxicity, as is a potential with nutritional supplements.

Light Therapy For SAD

A full-spectrum light therapy panel can be a great option for those dealing with Seasonal Affective Disorder (SAD). These panels emit light that covers the entire spectrum of natural sunlight. This type of light can help regulate sleep patterns and mood, which are often disrupted in people with SAD. It’s important to remember that light therapy should be used under the guidance of a healthcare professional, as they can provide advice on how to use the panel safely and effectively.

Get Fit To Fight

image of healthy foods
The dojo is the easy part. What we do off the mats matters just as much as what we do on the mats. 1:1 health coaching for martial arts to get you fit to fight.

About the Author

Ashe Higgs, I Liq Chuan Master Instructor & L2 Nutrition Coach

Ashe is a highly skilled martial arts instructor and certified nutrition coach with over two decades of experience in the field. He holds a Master Instructor certification in I Liq Chuan under Sam FS Chin, making him one of only several individuals worldwide to hold the title. He has taught classes and workshops worldwide and is passionate about helping others achieve their fitness and wellness goals.

With a background in full-contact fighting and a Level 2 certification from Precision Nutrition in nutrition coaching, Ashe is a well-rounded expert in the fields of martial arts. In addition to his expertise, he has a wealth of experience in teaching and mentoring others. He has a natural ability to connect with his students and inspire them to reach their full potential.

Read more about Ashe here…

Disclaimers & Conflicts of Interest

I am not a doctor or a lawyer, and the information provided should not be considered medical or legal advice.

The information provided is for educational and informational purposes only and should not be used as a substitute for professional legal or medical advice, diagnosis, or treatment. Consult your doctor or a qualified healthcare professional before making any changes to your diet, exercise routine, or lifestyle.

Please note that some of the links provided in this content may be affiliate links, meaning that I may receive a small commission if you purchase through them. However, please rest assured that any products or services recommended are based on my personal experience and belief in their value. I only recommend products or services that I have personally used and believe in.

References

  1. Volpe, Stella Lucia. “Magnesium in disease prevention and overall health.” Advances in nutrition 4.3 (2013): 378S-383S. (https://doi.org/10.3945/an.112.003483)
  2. Reference: Wang, Tian-Tian, et al. “Large-Scale in Silico and Microarray-Based Identification of Direct 1,25-Dihydroxyvitamin D3 Target Genes.” Molecular Endocrinology, vol. 19, no. 11, 2005, pp. 2685–2695, [DOI: 10.1210/me.2005-0106](https://dx.doi.org/10.1210/me.2005-0106).
  3. Shin, Hyun-Jung, Hyo-Seok Na, and Sang-Hwan Do. “Magnesium and pain.” Nutrients 12.8 (2020): 2184. (https://doi.org/10.3390/nu12082184)
  4. Cao, Yingting, et al. “Magnesium intake and sleep disorder symptoms: findings from the Jiangsu Nutrition Study of Chinese adults at five-year follow-up.” Nutrients 10.10 (2018): 1354. (https://doi.org/10.3390/nu10101354)
  5. Hahn, Jill, et al. “Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial.” Bmj 376 (2022). (https://doi.org/10.1136/bmj-2021-066452)
  6. Uwitonze, Anne Marie, and Mohammed S. Razzaque. “Role of magnesium in vitamin D activation and function.” Journal of Osteopathic Medicine 118.3 (2018): 181-189. (https://doi.org/10.7556/jaoa.2018.037)
  7. Wehr, E., et al. “Association of vitamin D status with serum androgen levels in men.” *Clinical Endocrinology*, vol. 73, no. 2, 2010, pp. 243-248,. DOI: 10.1111/j.1365-2265.2009.03777.x. (https://doi.org/10.1111/j.1365-2265.2009.03777.x)
  8. Naeem, Zahid. “Vitamin D Deficiency- An Ignored Epidemic.” *International Journal of Health Sciences*, vol. 4, no. 1, 2010,. (https://pubmed.ncbi.nlm.nih.gov/21475519)
  9. Parva, Naveen R., et al. “Prevalence of vitamin D deficiency and associated risk factors in the US population (2011-2012).” Cureus 10.6 (2018). (https://doi.org/10.7759/cureus.2741)
  10. Mandatori, Domitilla, et al. “The dual role of vitamin K2 in “bone-vascular crosstalk”: opposite effects on bone loss and vascular calcification.” Nutrients 13.4 (2021): 1222. (https://doi.org/10.3390/nu13041222)
  11. McCullough, Patrick J., Douglas S. Lehrer, and Jeffrey Amend. “Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience.” The Journal of steroid biochemistry and molecular biology 189 (2019): 228-239. (https://doi.org/10.1016/j.jsbmb.2018.12.010)
  12. Rosenthal, Norman E., et al. “Seasonal affective disorder: a description of the syndrome and preliminary findings with light therapy.” Archives of general psychiatry 41.1 (1984): 72-80. (https://doi.org/10.1001/archpsyc.1984.01790120076010)
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Unleash the Power of Methylene Blue

Introduction

As martial artists, we train hard to perfect our kicks, punches, and grappling techniques which takes a lot of energy and puts a lot of stress on our bodies. So, if you’re like me, you’re always looking for ways to boost your mental and physical performance.

There’s a powerful and fascinating supplement that might give you that extra edge you’ve been looking for. Enter the world of methylene blue! The best part is it’s cheap, available over the counter, and has tons of research stretching back over 100 years.

Like most long-time martial arts practitioners, I am not normally a proponent of synthetic chemicals, preferring instead to rely on substances from the earth. However, methylene blue has earned a spot on my short list of exceptions. 

This synthetic compound offers martial artists and athletes a unique blend of benefits. With its proven track record of safety and effectiveness, backed by over a century of research, methylene blue stands out from the crowd. 

Its ability to improve mental clarity, enhance recovery, and provide antimicrobial and antioxidative properties makes it an invaluable addition to any training regimen. While it may not be a natural substance, methylene blue has demonstrated its potential to support the overall well-being.

The world of nutritional supplements is full of over-hyped claims and disappointments. However, methylene blue stands out from the crowd due to its well-documented benefits backed by scientific research and its unique mechanism of action.

What sets methylene blue apart is its ability to assist the mitochondria – the energy-producing centers of our cells. It improves mental clarity, motivation, and overall well-being. Its antioxidant properties also help protect our cells from damage caused by oxidative stress, which can result from intense training. Plus, methylene blue has antimicrobial properties.

What Is Methylene Blue?

In simple terms, it’s a synthetic compound originally developed as a dye in the 19th century. But don’t let its humble beginnings fool you! Over the years, scientists have discovered that methylene blue has some seriously impressive benefits for both the body and the brain, making it a potential game-changer for martial artists like you.

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Where Does Methylene Blue Come From?

The discovery of methylene blue dates back to the 19th century. It was first synthesized in 1876 by German chemist Heinrich Caro, who worked for the chemical company BASF (Badische Anilin & Soda-Fabrik). Caro synthesized methylene blue by combining dimethylaniline with hydrogen chloride, creating a dark blue dye that would significantly impact various fields.

Initially, methylene blue was used primarily in the textile industry as a dye for fabrics. However, it didn’t take long for its staining properties to catch the attention of researchers in biology, who began using it as a staining agent for the microscopic examination of cells and tissues. Its ability to selectively stain certain cellular structures made it a valuable tool for studying cell morphology and function.

In the late 19th century, Paul Ehrlich, a renowned German physician, and scientist, discovered methylene blue’s medical applications. Ehrlich observed that methylene blue stained the malaria parasite, making it easier to identify under the microscope. This led to the first use of methylene blue as an antimalarial treatment in 1891, marking its entrance into medicine.

Since then, the applications of methylene blue have expanded to include various medical and therapeutic uses. Researchers have continued to study its properties, leading to discoveries related to its antioxidant effects, ability to increase cellular energy production, and potential in treating neurodegenerative disorders, among other applications. Today, methylene blue is recognized as a versatile compound with fascinating potential in medicine and everyday life.

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What Is Methylene Blue Used For?

Methylene blue has a rich history of diverse applications beyond health and medicine. Here are some of its past and current most common uses not related to health:

  1. Textile dye: Methylene blue was first synthesized as a dye in 1876 and has been used extensively in the textile industry ever since. Its vibrant blue color makes it an ideal fabric dye, and its chemical stability ensures long-lasting colorfastness.
  2.  Biological staining: Methylene blue’s staining properties have made it a popular choice in biology. It is widely used as a staining agent for microscopy, allowing researchers to visualize cellular structures better and study their morphology and function. 
  3.  Aquaculture: Methylene blue is commonly used to treat fungal infections and external parasites in the fish and aquarium industry. It can also serve as a preventive treatment for fish eggs, helping to ward off fungal growth during their development.

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How Methylene Blue Works

The potential health benefits of methylene blue arise from its involvement with the production of energy in our cells via the electron transport chain.

1. The electron transport chain can be considered a tiny power plant inside our cells, specifically within the mitochondria. The main job of this power plant is to generate energy in the form of a molecule called ATP. To do this, our cells use nutrients from our food and convert them into fuel through a series of chemical reactions.

Picture the electron transport chain as a series of steps, each representing a specific protein or molecule. Electrons are passed from one step to another during these chemical reactions, like a relay race. As the electrons move along these steps, they help pump positively charged particles called protons across a membrane within the mitochondria. This creates a kind of “proton battery,” which is used to generate ATP, the energy currency our cells need to perform their functions.

2. Methylene blue comes into play by acting as a “helper” in this electron relay race. Sometimes, the electron transport chain may not work as efficiently as it should due to factors like aging or stress. This can lead to less energy and a buildup of harmful molecules called reactive oxygen species, or ROS, which can damage our cells.

Methylene blue helps by stepping in as an artificial electron carrier, making it easier for electrons to move along the steps of the electron transport chain. This improves the efficiency of the whole process, leading to better energy production and fewer harmful byproducts. As a result, methylene blue may contribute to increased energy levels, improved cognitive function, and overall well-being, making it a fascinating supplement with potential benefits for our minds and bodies.

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Methylene Blue Benefits

Improving mitochondrial efficiency and energy production supports cognitive functions such as focus, memory, and mental clarity, helping maintain a sharp mind. Simultaneously, methylene blue’s antioxidant properties protect the body from oxidative stress, bolstering overall physical health. Consequently, this dynamic supplement offers a unique combination of benefits that can enhance one’s mental and physical well-being, making it a promising option for those seeking a comprehensive boost to their daily performance.

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Brain Benefits

Exciting new research shows that methylene blue may protect the brain, especially against conditions like stroke and Parkinson’s disease.[1]

One of the many ways methylene blue helps out is by decreasing the production of harmful oxygen molecules, protecting our brain cells from damage. This is super important in conditions like Alzheimer’s disease, Parkinson’s disease, and stroke.

Lower doses of methylene blue (1-10mg) have been found to enhance mental clarity, motivation, and overall well-being. This is primarily due to how methylene blue interacts with our body’s mitochondria – the energy-producing powerhouses of our cells.

By improving mitochondrial function and boosting cellular energy production, methylene blue helps our brain cells work more efficiently. This translates into better cognitive performance, including improved focus, memory, and mental alertness. Additionally, it can lead to increased motivation and well-being, making it easier to tackle everyday tasks and challenges.

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More Energy

As we age, it’s normal to experience changes in our bodies that can impact our energy levels and make it more challenging to engage in activities like martial arts the way we used to. One reason is that our mitochondria, often called the “powerhouses” of our cells, may not function as efficiently as they once did.

Mitochondria produce energy that fuels our body’s daily activities, including exercise and training. When our mitochondria don’t work as well, we might feel more tired, have a harder time recovering from workouts, or just find it more difficult to keep up with our martial arts routines.

This decline in mitochondrial function can be due to various factors, such as the natural aging process, exposure to environmental toxins, or chronic stress. As a result, our cells may struggle to produce enough energy to meet our body’s needs, leaving us feeling sluggish and less motivated to train.

This is where supplements like methylene blue can potentially help. By supporting mitochondrial function and enhancing cellular energy production, methylene blue may significantly boost our overall energy levels, making it easier to keep up with our martial arts practice, even as we age.

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Antioxidant Activity

It’s important to understand that our bodies naturally produce molecules called Reactive Oxygen Species (ROS) during various processes, including energy production. While ROS have essential roles, such as helping to fight off infections, they can also cause damage when their levels become too high. You can think of ROS as being similar to exhaust from a car – it’s a normal byproduct, but too much can be harmful.

Our bodies require more energy when we engage in intense physical activities like martial arts training. This increased energy production can lead to a higher production of ROS, which can cause oxidative stress. Oxidative stress occurs when there’s an imbalance between the amount of ROS and our body’s natural ability to neutralize them using antioxidants. Over time, this oxidative stress can contribute to muscle fatigue, inflammation, and slower recovery from workouts.

This is where methylene blue comes into play. Acting as an antioxidant, it can help combat oxidative stress by neutralizing and removing these potentially harmful ROS from our bodies. Methylene blue may protect our cells from damage by reducing ROS levels, supporting faster recovery, and promoting overall well-being.[3] This makes it a valuable addition to the routines of martial artists and other athletes, helping them maintain their performance and recover more efficiently from intense training sessions. 

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Stress & Recovery

Training hard in martial arts or other physically demanding activities puts significant stress on our bodies. This stress causes the release of hormones like cortisol, which play essential roles in our body’s stress response. While these hormones are necessary for our bodies to adapt and respond to challenges, chronically elevated levels can harm overall health and recovery.

High cortisol levels can impair the recovery process by promoting inflammation, disrupting sleep, and reducing the rate of tissue repair. These factors can lead to longer recovery times, increased susceptibility to injury, and hindered performance. Thus, managing stress hormones is crucial for optimal recovery and performance.

Methylene blue has been shown to help reduce stress hormones like cortisol.[3] By lowering these hormone levels, methylene blue can promote a better recovery environment within the body, allowing martial artists and other athletes to bounce back more quickly from intense training sessions. Improved recovery can lead to more consistent progress and reduced risk of injury, ultimately enhancing athletic performance.

Obviously, methylene blue should not be considered a standalone solution for stress management or recovery. It should be used in conjunction with proper nutrition, sleep, and stress-reducing practices like mindfulness and the kinds of breathing techniques passed down by the Old Masters. 

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Anti-Fungal & Anti-Microbial

Martial arts practitioners, especially those involved in disciplines like Brazilian Jiu-Jitsu (BJJ), are often susceptible to skin abrasions, commonly known as “mat burn.” Brazilian Jiu-Jitsu (BJJ) is a contact sport that primarily involves ground-based grappling techniques. Due to the nature of the sport, participants often find themselves in close contact with one another, sharing sweat and bodily fluids. This environment and multiple training partners make BJJ gyms a potential breeding ground for skin infections. Among these, staph and ringworm infections are among the most common skin conditions practitioners can contract on the mats. Maintaining good hygiene and keeping training facilities clean is essential, but methylene blue may offer additional protection.

Methylene blue has antimicrobial properties, which can inhibit the growth of bacteria and fungi, including toenail fungus.[4] Its antibacterial benefits are particularly relevant for martial artists, as it may help prevent or reduce the severity of skin infections caused by bacteria, such as staph. While methylene blue is not a replacement for proper wound care and hygiene practices, it may provide an extra layer of defense against these common infections.

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Is Methylene Blue Toxic?

Methylene blue is generally safe when taken in recommended doses (<2mg/kg), but too much can cause unwanted side effects. These can include heart-related issues, decreased kidney function, and breathing problems. In rare cases, it may cause skin damage. Methylene blue can also lead to a specific type of anemia, particularly in people with certain pre-existing conditions. Babies are more sensitive to the side effects of methylene blue, which can affect their breathing and cause other issues. People taking SSRI inhibitors should also avoid using methylene blue.

You should also be aware that methylene blue will stain anything it touches and turns your pee green.

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My Experience With Methylene Blue

My experience with methylene blue has been quite remarkable. I noticed a significant boost in my energy levels, taking me back to the vitality I had in my 20s. Instead of walking, I found myself frequently sprinting between locations “just because.”

However, it seemed to raise my blood pressure, so I adjusted my intake. I take methylene blue only three days a week, specifically on my weight training days. This way, I can still enjoy the energy boost without the constant impact on my blood pressure, striking a balance that works best for me.

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Where To Buy Methylene Blue?

Methylene blue is available over the counter, making it easy for consumers to access this fascinating supplement. Amazon offers a wide range of methylene blue products from various brands. This provides a convenient way to compare and choose a high-quality product that suits your needs.

When shopping for methylene blue on Amazon, consider the following tips to ensure you’re getting a reliable and effective product:

Shopping Tips

  1. Look for pharmaceutical-grade (USP grade) methylene blue, as this ensures it meets the highest quality and purity standards.
  2. Check the product description and label for detailed information on dosage, ingredients, and any additional benefits or precautions.
  3. Read customer reviews and ratings to understand other users’ experiences with the product. This can provide valuable insights into its effectiveness and potential side effects.
  4. Pay attention to the brand reputation and manufacturing location. Look for companies that manufacture their products in countries with stringent quality control standards, such as the United States, Canada, or Germany. It’s generally a good idea to avoid brands manufactured in countries with less rigorous regulations, like China. This helps ensure you choose a product that adheres to high-quality manufacturing practices and safety standards.
  5. As always, consult with a healthcare professional before incorporating methylene blue into your routine, especially if you have any pre-existing conditions or are taking other medications.

Many supplements manufactured in China have faced issues with contamination, which can pose significant health risks and cause complications for competitive athletes, including martial artists. Contaminants like melamine, heavy metals, or substances banned by athletic associations can jeopardize an athlete’s health and eligibility to compete.

To minimize these risks, athletes must choose supplements manufactured in countries with stringent quality control standards, such as the United States, Canada, or Germany. These countries enforce strict regulations ensuring that products are safe, pure, and free of harmful contaminants or banned substances.

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Chris Masterjohn’s Guide To Methylene Blue

Chris Masterjohn, Ph.D., a well-respected researcher and educator in the field of nutrition sciences, has penned an extensive, comprehensive guide on methylene blue, available for free access here. Chris Masterjohn holds a PhD in Nutritional Sciences and has a profound understanding of biochemical mechanisms, making his insights particularly valuable for those seeking to understand the nuances of substances like methylene blue. His guide delves deep into the properties, uses, and implications of methylene blue, providing a rich resource for readers interested in this compound.

Conclusion

Before you rush to buy a bottle of methylene blue, it’s essential to remember that supplements can affect everyone differently, and it’s always a good idea to consult with a healthcare professional before trying something new. Also, remember that the key to success in martial arts (and life!) is maintaining a balanced approach, which includes proper training, nutrition, rest, and dedication to your craft.

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If you’re ready to embark on your own journey of personal growth through martial arts, here are three ways I can help:

  1. Consider our small group or online martial arts classes to start your practice.
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About the Author

Ashe Higgs, I Liq Chuan Master Instructor & L2 Nutrition Coach

Ashe is a highly skilled martial arts instructor and certified nutrition coach with over two decades of experience in the field. He holds a Master Instructor certification in I Liq Chuan under Sam FS Chin, making him one of only several individuals worldwide to hold the title. He has taught classes and workshops worldwide and is passionate about helping others achieve their fitness and wellness goals.

With a background in full-contact fighting and a Level 2 certification from Precision Nutrition in nutrition coaching, Ashe is a well-rounded expert in the fields of martial arts. In addition to his expertise, he has a wealth of experience in teaching and mentoring others. He has a natural ability to connect with his students and inspire them to reach their full potential.

Read more about Ashe here…

Disclaimers & Conflicts of Interest

I am not a doctor or a lawyer, and the information provided should not be considered medical or legal advice.

The information provided is for educational and informational purposes only and should not be used as a substitute for professional legal or medical advice, diagnosis, or treatment. Consult your doctor or a qualified healthcare professional before making any changes to your diet, exercise routine, or lifestyle.

Please note that some of the links provided in this content may be affiliate links, meaning that I may receive a small commission if you purchase through them. However, please rest assured that any products or services recommended are based on my personal experience and belief in their value. I only recommend products or services that I have personally used and believe in.

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References

  1. Poteet, Ethan, et al. “Neuroprotective actions of methylene blue and its derivatives.” PloS one 7.10 (2012): e48279.
  2. Xiong, Zheng-Mei, et al. “Anti-aging potentials of methylene blue for human skin longevity.” Scientific Reports 7.1 (2017): 2475.
  3. Meynaghizadeh-Zargar, Reza, et al. “Effects of transcranial photobiomodulation and methylene blue on biochemical and behavioral profiles in mice stress model.” Lasers in medical science 35 (2020): 573-584.
  4. Figueiredo Souza, L. W., S. V. T. Souza, and A. C. C. Botelho. “Randomized controlled trial comparing photodynamic therapy based on methylene blue dye and fluconazole for toenail onychomycosis.” Dermatologic therapy 27.1 (2014): 43-47.

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