Creatine has long been popular with male athletes and bodybuilders for building strong muscles. More recently, the supplement has caught the attention of a broader audience.
Growing evidence shows that taking creatine also benefits muscle strength in females and older adults. And it might help improve memory, among other possible health benefits.
Here’s what the science says.
What is creatine?
Creatine is a natural substance produced by our kidneys, liver and pancreas. Most of it (95 per cent) is stored in skeletal muscle; about 5 per cent is in the brain. Diet also contributes to our body’s creatine stores. It is found in animal foods, especially red meat, chicken and certain fish such as tuna, salmon, cod and herring.
Creatine is used to generate adenosine triphosphate (ATP), a compound that provides on-demand energy for cellular processes, including muscle contraction. During intense exercise, muscles use up ATP very quickly, in just a few seconds. The rate at which the body regenerates ATP, however, isn’t fast enough to allow a person to continually perform high-intensity exercise.
Taking supplements to increase muscle creatine stores can, therefore, help you give near-maximum effort for a little longer before fatigue sets in.
Performance and muscle gains
Since the early 1990s, a wealth of evidence has established that creatine supplementation, combined with exercise, improves athletic performance.
It is effective for activities that involve fast, powerful movements (i.e., bursts of intensity) such as weightlifting, sprinting, jumping, rowing, mountain biking, swimming, soccer, football and basketball. It offers little or no benefit for lower intensity exercise.
Since creatine supplementation can allow you to lift heavier weights and do more repetitions, it can help increase muscle mass and muscle strength. Taking it may also improve recovery from intense exercise.
Creatine doesn’t work for everyone, though. People with naturally high muscle creatine levels, for example, may not respond to extra creatine the same way those with lower levels do.
Most research on creatine and exercise performance has involved young healthy male adults. There is mounting evidence, however, that females can also benefit. Studies show that, together with resistance training, creatine is effective for increasing muscle mass, muscle strength and athletic performance in pre- and post-menopausal females.
Creatine supplementation may also counteract sarcopenia – age-related muscle loss – and by doing so improve balance in seniors. Studies conducted in adults aged 65 and older who participate in resistance training have demonstrated that those who take creatine experience greater gains in muscle mass and strength compared with those who do not.
Creatine may have cognitive benefits
Our brain is the most ATP-demanding organ. Creatine can help brain cells generate energy, and it may protect the brain by reducing inflammation and oxidative stress.
Findings from a review of 16 randomized controlled trials, published in 2023, suggest that the supplement has positive effects on both memory and attention time. It appeared to be more beneficial for females and those aged 18 to 60 years.
Creatine is also being studied for its potential beneficial effects on bone density, mood disorders and managing blood glucose in type 2 diabetes, but it’s too soon to draw conclusions.
How to take creatine
Creatine supplements are typically sold as powders. Look for creatine monohydrate, one the most well-studied supplements overall. (Scientific support for other variations is lacking.)
It can be taken by starting with a “loading” dose of 20 grams for five to seven days to quickly saturate muscle stores. A daily dose of three to five grams is then taken to maintain levels.
Alternatively, you can simply take three to five grams of creatine a day without loading. This method is equally effective at increasing stores but takes a little longer to do so.
A five-gram dose of creatine monohydrate typically costs between 35 and 70 cents, depending on the brand. That’s similar to many multivitamins.
Safety, side effects
Creatine monohydrate is considered generally safe and well tolerated. Studies conducted in adults have lasted up to five years. (There’s limited evidence about the safety of creatine supplements in children and adolescents.)
Side effects such as bloating, digestive upset and diarrhea may occur initially during the loading phase.
People with kidney disease, high blood pressure or liver disease should not take creatine. (It does not harm kidney function in healthy individuals when used at recommended doses.)
If you have an underlying illness, consult with your doctor before taking creatine.
Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD
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