Is Creatine Right For You?
What is the supplement that is a long time favorite of bodybuilders and now a favorite of those wanting to age with vitality? Creatine of course. Creatine is probably one of the most studied supplements. It has been utilized for a long time in support of building muscle and muscle recovery from workouts. What is new is that Creatine is now being studied to help prevent sarcopenia, loss of muscle with aging and even in support of brain health and aging.
Creatine in the Body
Your body naturally makes creatine in the liver, kidneys and pancreas from the amino acids glycine, arginine and methionine. You can eat foods that have creatine and the foods that have the highest amount are beef, poultry and fish. In 4 ounces of meat there is somewhere in the realm of 500 mg -1 gram of creatine.
Creatine is shuttled into the muscle cell and is used by the cell to make Phosphocreatine. Phosphocreatine then donates the phosphate group to become the “P” in ATP which stands for Adenosine Tri-Phosphate. ATP is the energy that the body basically runs on. Creatine plays a role in reducing oxidative stress and inflammation specifically in the mitochondria and drives formation of new mitochondria. This is a good thing, as more mitochondria means increased strength and the ability to generate more energy to do the work of the muscle.
“Strength” of the evidence for Creatine
In clinical trials where subjects were given creatine supplementation (3-5 grams is typical dose) there was an increase in muscle strength. Specifically post menopausal women performed better in leg press and bench press compared to the control group that did strength training alone after 24 weeks. The effect was statistically significant.
When creatine is used alone without strength training results in studies are less consistent. For efficacy, with regards to increasing muscle strength creatine should be used in conjunction with strength training.
In another study older adults were given a mobility test called the “Sit to Stand Test”. In this test patients are asked to rise from an armless chair with full leg extension typically five times. If that takes more than 10-12 seconds the individual is considered to be a higher fall risk. This is important as falls are a big factor in morbidity and mortality in aging populations. When adults aged 57-69 were given creatine supplementation in combination with strength training they performed better on sit to stand compared to just strength training.
The Muscle-Brain Axis
There is a growing body of evidence that beyond the benefits to muscle, creatine may also be beneficial for brain health. The muscle – brain axis refers to the link between muscle health and cognition. A recent review article in Nutrition Reviews examined the relationship between cognition and creatine supplementation in older adults. It does appear that supplemental creatine does increase brain creatine. In this article 6 studies were examined – two of which were randomized controlled trials while the others were cross sectional and relied more on dietary recall. Overall the studies included did show some positive effects of creatine on cognitive health in older individuals but because of the differences in the studies, it is hard to quantify how significant the impact.
The mechanism of the improvement is hypothesized to be connected to improvements of ATP production in the brain with the use of creatine. If this is the case then the benefits from creatine supplementation would be greater in the setting of mental fatigue and when prolonged attention is required. In other words, when the brain is depleted of creatine, a bigger impact would be observed with supplementation.
In a study looking at vegetarians vs omnivore’s, a greater impact was observed in vegetarian patients consuming less dietary creatine from animal sources. If one is sleep deprived, there does seem to be a greater impact on memory and concentration with creatine supplementation.
Regarding mental health, there is a link between low levels of creatine and depression. If for example dietary creatine intake is lacking, using creatine may benefit mood and energy metabolism in the brain.
Another area of research is the use of creatine post concussion. This would particularly be useful after the immediate acute period of concussion. The early stages have characteristically hypermetabolism then the later stages by hypometabolism in the brain. It is those later stages that the creatine is specifically hypothesized to have some benefit in recovery.
In summary the studies on creatine are more robust when it comes to building and repairing muscle and more studies are needed for definitive information on cognitive health. Without a doubt as the body ages there is loss of muscle and metabolic efficiency of ATP / energy production in the muscles and the brain. The use of creatine to augment lifestyle changes appears to be a safe intervention and likely does benefit muscle health, and risk of frailty with aging and possibly brain health as well.
References:
Dos Santos EEP. Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis. Nutrients. 2021 Oct 24;13(11):3757.
Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J Clin Med. 2019 Apr 11;8(4):488.
Marshall S, Kitzan A, Wright J, Bocicariu L, Nagamatsu LS. Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults. Nutr Rev. 2026 Feb 1;84(2):333-344.
Watanabe A., Kato N., Kato T. Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation. Neurosci. Res. 2002;42:279–285.
Forbes SC, Cordingley DM, Cornish SM, Gualano B, Roschel H, Ostojic SM, Rawson ES, Roy BD, Prokopidis K, Giannos P, Candow DG. Effects of Creatine Supplementation on Brain Function and Health. Nutrients. 2022 Feb 22;14(5):921.
