Why is everyone talking about creatine?

Creatine has become one of the most talked-about supplements in nutrition and sports science, and for good reason. Once known for its role in bodybuilding, creatine is now being studied for benefits that extend far beyond muscle, including brain health, cognition, and mental health.

What is creatine?

Creatine is involved in energy production and can be obtained from the diet (red meat, seafood), and it can also be made in the liver, kidneys, and brain.

The International Society of Sport Nutrition concluded that creatine is likely to be more beneficial than harmful to many people[i].

Physical performance

The strongest evidence for creatine monohydrate is the enhancement of short-term high-intensity exercise (jumping, sprinting, resistance training). In trained populations, it does not consistently improve endurance performance[ii], however some studies have shown improved performance in long-distance races, biking, etc., compared to placebo[iii].

Creatine supplementation has been associated with a small negative effect on VO2max in some studies[iv].

Creatine and caffeine

Combining caffeine and creatine may provide additional benefits to exercise performance, but timing matters. It is most effective when caffeine is drunk 1 hour before exercise, after creatine loading in the prior 5-6 days[v].

Memory & cognition

Creatine supplementation improved memory (number recall, long-term memory) compared to placebo, particularly in 66-76 years at dose 20g per day[vi]. At 5g per day, studies showed improvement in working memory in vegetarians who tend to have lower creatine baseline stores in muscle.

Creatine has also been shown to improve brain performance and reduce brain fatigue during stressful mental tasks, and enhance mental capacity when sleep deprived. Notably, the cognitive benefits appear to be more pronounced in elderly participants (age 68-85) compared to young adults (age 19-23)[vii].

Mental health

Women experience depression at roughly twice the rate of men, possibly linked with hormonal changes (puberty, luteal phase, after pregnancy, perimenopause), perhaps due to brain sensitivity to hormones.

There is emerging research on the link between brain creatine metabolism and depression. Creatine may help restore brain energy levels and enhance the effects of antidepressant medication when taken in combination[viii]. Small studies have shown improvement in depressive symptoms when creatine was combined with antidepressants using 5g for 8 weeks, or 20g for four weeks[ix]. But, if you are taking medication and considering taking creatine supplements, please check with your Doctor first.

Women’s health

Most creatine research has been conducted in young healthy men, but interest in female-specific effects is growing. Women typically have 70-80% lower creatine stores and consume less creatine compared to men.

Research suggests pre-menopause women experience strength gain with creatine, without significant changes in weight gain. Post-menopause women benefit from increases in muscle size, and when combined with resistance training, creatine may also support bone health[x].

Importantly, studies in women have not identified serious adverse effects from creatine supplementation[xi].

Dosage

Typical effective doses range from 3-5g per day[xii] and consuming alongside carbohydrate and protein may increase muscle concentrations. Some protocols include a short loading phase of 20g day.

Creatine safety

In women, no serious adverse events (including kidney and liver function) were identified[xiii]. Mild side-effects included feeling bloated, headache, gut disturbance, and muscle cramps.

In men, case reports identified serious adverse outcomes: kidney dysfunction, stroke, liver injury, atrial fibrillation, but these were not replicated in placebo-controlled trials, and no evidence was found for a causal link between these symptoms and creatine supplements. Weight gain was the most reported side effect in men, likely due to increased water retention in muscle. This effect was not consistently observed in women.

And finally, if you’d like more information about creatine, contact us about Weight Management and Endurance webinars for your workplace.

[i] https://pmc.ncbi.nlm.nih.gov/articles/PMC7353222/

[ii] https://pubmed.ncbi.nlm.nih.gov/36877404/

[iii] https://pubmed.ncbi.nlm.nih.gov/37720119/

[iv] https://pubmed.ncbi.nlm.nih.gov/34859731/

[v] https://pubmed.ncbi.nlm.nih.gov/34845944/

[vi] https://pmc.ncbi.nlm.nih.gov/articles/PMC9999677/

[vii] https://pmc.ncbi.nlm.nih.gov/articles/PMC10721691/

[viii] https://pmc.ncbi.nlm.nih.gov/articles/PMC7998865/

[ix] https://pmc.ncbi.nlm.nih.gov/articles/PMC10721691/

[x] https://pmc.ncbi.nlm.nih.gov/articles/PMC7998865/

[xi] https://pmc.ncbi.nlm.nih.gov/articles/PMC7353222/