YOUUntil relatively recently, mixing a scoop of creatine powder into a glass of water every day probably meant you were a bodybuilder or training for an athletic event. Although creatine is a compound that occurs naturally in the body, its role in producing quick bursts of energy meant that if you took extra, it was accepted to improve your performance (legally) – to help you to squat a fractionally heavier weight or run a little faster.
But evidence is mounting that creatine may play an important role in cognitive function and improving brain health—and may be more beneficial for women than it is for gym bros. So, should we all be taking it—or at least trying to get more of it from food?
Let’s start with creatine’s best understood benefit – boosting physical strength and energy. In the simplest terms, the body generates energy by breaking down a molecule made from glucose called adenosine triphosphate (ATP). The problem is that ATP is not easy for the body to store, so it is constantly being produced and used up quite quickly. This means that the small amount of ATP normally available provides enough energy for your body to run at full capacity for just a few seconds – which is why sprinters and weightlifters can only do near-maximal effort in short bursts.
Creatine helps this process by acting as a buffer: it allows ATP to be produced faster, so you can exert yourself longer.
The effect can be dramatic. In some studies, it helped volunteers increase the amount of weight they could lift more than 30% and, in other research, to add significantly more muscle. More recently, studies suggest that supplementing with creatine while following an exercise program can help people aged 50 or older lose moderate amounts of body fat and can help with recovery of tough workouts.
But the benefits go beyond getting stronger, faster or leaner. Creatine can help older people in several other ways. “We’ve known for a long time that creatine helps muscle protein synthesis – the research on that is very clear,” says Dr Henry Chung, a lecturer in sports, rehabilitation and exercise science at the University of Essex. “But there is now a lot of research that says creatine can have beneficial effects on age-related issues, such as muscle loss or cognitive decline. It is not conclusive – and it may be more beneficial for some people than others.”
A meta-review of over 1,000 studies, published in 2021suggests that creatine can have a host of beneficial effects in the body, from helping to control blood sugar levels to lowering cholesterol and the risk of stroke. But where does cognitive function fit in?
“The brain consumes a lot of energy to function properly,” says Dr Jenna Macciochi, an immunologist at the University of Sussex who specializes in the intersection of nutrition, exercise and lifestyle with health; she is also part of a team developing a creatine supplement for post-menopausal women. “By supporting our energy systems, creatine supports the neurons of the brain as they do their work. There’s a decent amount of evidence to support the idea that it helps with things like mental clarity, focus and cognitive endurance over long periods of time.”
A study released in Februaryfor example, suggests that creatine may reduce some of the negative effects of sleep deprivation. Other studies has been investigated to see if it works as an antidepressant (more research is needed).
Another long-term benefit is still being investigated, says Macciochi: “It may have neuroprotective properties, which means it may help protect the brain from damage caused by things like oxidative stress—which is basically what happens when the free radicals are produced by things like alcohol, cigarette smoke or pollution outweigh the antioxidants your body produces.”
Oxidative stress is a central driver of aging, she says: “Like a car that rusts over time … even if you take really good care of it, there’s a certain amount of wear and tear that builds up.”
Although there is not enough evidence to show that creatine can protect against neurodegenerative diseases such as Alzheimer’s, the effects it has shown on cognitive decline make it a promising area of investigation. And it may be more beneficial for women than men.
“I’ve seen how creatine is very beneficial for women going through menopause,” says dietitian Brittany Werner, who is the director of Working Against Gravity, a nutrition coaching company. “Women usually have in between 70% and 80% less creatine stored than men and also tend to consume less through the diet. This means that it can be very important for women to make sure they are getting enough – especially during periods of hormonal fluctuations, including periods, pregnancy, postpartum, perimenopause and post-menopause.”
So how do you make sure you’re getting enough? If you’re an enthusiastic omnivore, you might have a lot in the tank – creatine is a carninutrient, meaning most of us can only get it through animal products (babies get it from breast milk).
Wild game is one of the best sources, but red meat and fish – especially herring, salmon and tuna – are excellent, as are most types of milk and cheese. If you’re a vegan, you’ll have to rely on the stores your body can produce through amino acids – you can supplement them with seeds, grains, nuts and legumes, but you may be working with sub-optimal levels. Extremely low levels can lead to weight loss or fatigue, but even a bit of a deficiency can make you tired or struggle at the gym.
So how much should you take – and how? Traditionally, the way to supplement creatine was as a scoop of (slightly gray) powder in water, but brands have branched out into tablets, gummies and more. It is mostly sold in monohydrate form – so called because each creatine molecule is bound to a water molecule. Other types, such as creatine hydrochloride and creatine ethyl ester, are sometimes claimed to be more easily absorbed by the body, but the research is unconvincing.
“The dosing is a bit challenging,” says Macciochi. “We know very well that, in terms of exercise performance, 3g to 5g a day is a very solid dose – if you take it consistently, it’s going to give you evidence-based performance improvements. But in terms of other benefits, some studies use 10 g per day and some even 20 g, depending on the conditions they are studying, so that is still under discussion.”
Bodybuilders used to suggest a “loading” phase – extra help to quickly build up your body’s stores – but this is probably unnecessary, explains Macciochi. “If you’re already 70% full, you want to get to 100% – you can do this faster by taking a higher dose and then going on a maintenance dose,” she says. “But if you start with a maintenance dose, like 5g a day, and then continue with it, it’s just going to take a few days longer. I think the loading idea comes from the need to get those performance benefits in the gym as soon as possible, but it’s not strictly necessary.”
It used to be thought that supplementing with creatine increased the risk of dehydration from heavy exercise, but a 2021 meta-review rule out this effect – high doses can increase muscle water retention, but this seems to decrease once the body has adapted.
Creatine has also been thought to affect kidney function; a recent meta-analysis seems to suggest otherwise, although it’s important to note that if you already have kidney damage, excess creatine can make it worse. Consult a doctor before starting any supplement program.
Finally, some scare stories have linked creatine to baldness, with one 2009 study to find elevated levels of DHT, a byproduct of testosterone that can lead to hair loss. However, the study only looked at 20 men, the dose was very large (20g per day, which almost no one would recommend for everyday use) and no direct link was found. In any case, the 2021 meta-review appears to have ruled out the problem.
Some studies have found that bowel problems, including diarrhea and belching, can occur with high doses, but they appear to be avoidable. “In general, it doesn’t bother most people, but gut health is unique to us,” says Macciochi. “That said, if you take it with food or drop the dose and build up slowly, it gives your body a chance to adjust better. It’s like any sudden dietary change – you get digestive feedback.”
To summarize, creatine has benefits for strength and sports performance, appears to have benefits for cognition, and may support women’s health during menopause. But it is not a magic formula. “Creatine works because you can push yourself at an intensity that creates an adaptive response,” says Chung. “If you’re taking creatine and not doing those activities, either physically or cognitively, the benefits are probably pretty minimal.”
In other words, you still have to do the work. But you probably knew that anyway.
Eat for your age
Creatine isn’t the only nutrient that can be helpful to supplement as you age. Here’s what else you might be missing.
Vitamin D
Essential for maintaining bone, muscle and tooth health (it helps the body absorb calcium), especially for older women who are at increased risk for osteoporosis after menopause. It’s impossible to get enough of the sun during the UK’s winter months. You can get some through oily fish, eggs, liver and red meat, but the government recommends that everyone take a 10 microgram (400iu) supplement from the end of September to the end of March. It is recommended not to exceed this dose.
Potassium
It helps the body send nerve signals and regulate muscle contraction, but it has also been shown to help reduce high blood pressure and the risk of kidney stones. Replenish by eating avocados, sweet potatoes and spinach.
Vitamin B12
B12 is important for creating red blood cells – fatigue is often an early sign that you are not getting enough. Getting enough B12 can be a challenge for older people due to changes in digestion as we age – fish, meat, poultry and eggs are all good sources, but if you’re concerned it’s worth checking with ‘ a doctor to talk about supplementation.
