Should You Take Creatine?

Supplements are all the rage for midlife women. Find out if creatine is the real deal.

What is Creatine?

Creatine is a compound comprised of three amino acids called arginine, glycine, and methionine.  The liver and kidneys produce about one gram of creatine daily, nearly 95% of which is stored in cardiac and skeletal muscle (think: arms and legs) in a form called phosphocreatine. Phosphocreatine helps satisfy the energy needs of muscle and heart tissue. The brain also makes and uses creatine to support its high energy requirements.

Animal flesh such as seafood, meat, and poultry, contains creatine. Plant foods, including soy, nuts, and seeds don’t have creatine, but they do supply the amino acids the body needs to make it.  Creatine supplements provide a more concentrated creatine source than food, including animal products.

Creatine May Benefit Your Midlife Brain

The human brain accounts for just 2% of the body’s weight, but uses about 20% of the body’s oxygen and 25% of its glucose.  Normal brain functions and the creation of energy from glucose to fuel the brain require oxygen, which causes the formation of reactive oxygen species (ROS). Though a certain amount of ROS is necessary for normal metabolism, consistently elevated levels can damage brain cells and contribute to a decline in cognitive abilities, which tends to be related to aging. According to a 2021 article in Antioxidants (Basel), midlife is when these “prooxidative” processes start to happen more often.

Creatine may improve cognitive performance by increasing energy reserves in brain cells and reducing the oxidative stress and inflammation created by ROS. The communication between brain cells is heavily dependent on adenosine triphosphate (ATP), which is the compound cells use to store and transfer energy and is produced from glucose. Pound for pound, the brain consumes the most ATP of any organ. Creatine helps maintain levels of ATP in the brain.

Several studies suggest that creatine provides energy without having to use oxygen, particularly during times of increased energy demand, such as stress or intense concentration.  A review published in Experimental Neurobiology in 2018 pooled the results of 6 randomized controlled trials (RCT) and found evidence that creatine supplementation may improve performance on memory and intelligence tasks. For other aspects of cognition, such as attention, executive function, and mental fatigue, the results were inconclusive. The study also found that while supplementation doesn’t affect brain function in younger adults, creatine intake may have a particularly positive effect in older people and in those under stress.

A 2024 Frontiers in Nutrition study analyzed the combined results of 16 RCT in people ages about 21 to about 76 years old.  All of the study participants took creatine in the form of creatine monohydrate. The researchers concluded that creatine supplementation may provide beneficial effects on memory and the speed of processing new information.

Photo by JESHOOTS.COM on Unsplash

Creatine Helps Support Muscle Mass

The phosphocreatine stored in muscles is used to harness energy and allows them to contract more powerfully and for longer. Creatine supplementation is most effective for high-intensity, short duration activities including resistance training. Creatine consumed in supplement form may improve your work outs and result in greater gains in muscle mass and strength.  Though there’s a large body of scientific evidence that points to creatine supplementation for enhancing muscle, you must combine it with strength training to get results.

A 2013 RCT published in the European Journal of Applied Physiology found that women who took 5 grams of a creatine supplement daily combined with 12 weeks of resistance training gained muscle mass and strength in their upper and lower body as compared to women who took a placebo.

In a 2015 Applied Physiology, Nutrition, and Metabolism study, adults ages 50 to 71 years old combined 32 weeks of strength training with either creatine (0.1 g/kg of body weight/day – about 7 grams daily for a 160-pound person) or a placebo. Researchers found that compared with resistance training alone, creatine supplementation improved muscle strength. Study participants experienced greater gains in tissue mass by taking creatine after exercising.

A 2021 Nutrients meta-analysis found older adults may need a creatine loading phase, such as up to 20 grams of creatine daily for as many as 7 days to improve their muscle strength. In addition to the loading phase, a daily dosage of 5 grams or less was enough to improve upper body strength, but study participants needed more than 5 grams daily to increase lower-body strength.

A 2023 study Medicine and Science in Sports and Exercise found that postmenopausal women who took 0.14 grams per kilogram of body weight daily of supplemental creatine saw no effect of creatine supplementation alone on muscle strength after two years.  However, the study participants, who strength trained 3 times weekly and walked 6 days a week, had a faster walking pace by the end of the study. The authors concluded that the lack of change in strength measures with creatine supplementation may be due to the large beneficial effect of strength training alone on muscular strength, which could have masked small improvements caused by the supplement.

Creatine and Heart Health

There isn’t a lot of information about creatine and heart health, but the limited amount points in a positive direction.  

A 2024 Clinical Nutrition ESPEN study found that men ages 55 to 80 who took 20 grams of creatine for 7 days had reduced stiffness in their arteries. Flexible arteries are important as arterial stiffness can increase blood pressure and increase the risk for tearing. A 2021 Nutrients review concluded that creatine supplementation may support heart metabolism and health, particularly when the heart has trouble with adequate blood flow.

Creatine and Bone Health

When combined with resistance training, creatine may benefit post-menopausal bones, although the findings are inconclusive. A 2015 study published in Medicine and Science in Sports and Exercise found that postmenopausal women who took 0.1 grams per kilogram of body weight of creatine daily for 52 weeks and did supervised strength training lost less bone mass in their hips compared to women who took a placebo.However, a 2-year RCT in Translational Exercise Biomedicine, considered the largest and longest study to date, used a much higher dose of creatine (0.14 grams per kilogram body weight per day) found that it didn’t improve bone density. 

How Much Creatine is Safe to Take?  

According to the Office of Dietary Supplements (ODS), creatine is one of the most thoroughly studied and widely used dietary supplements. Creatine monohydrate powder has been the most commonly used form of creatine in dietary supplements since the early 1990s and the most-studied type. There’s no proof that other forms of creatine are more effective than creatine monohydrate.

When used orally and in modest doses, creatine monohydrate is considered safe for most people. You must take creatine daily to see results.

The ODS says that a typical regimen for creatine supplementation starts with a loading phase of 20 grams of creatine monohydrate for 5 to 7 days followed by a maintenance phase of 3 to 5 grams daily.  Potential side effects, especially with higher doses, include nausea, diarrhea, cramping, muscle pain, and fluid retention. You can take less if higher amounts bother you. Ask your doctor before taking creatine. 

What do you think? Will you try creatine? I just ordered some!