How Creatine Helps More Than Muscle Health

It’s often the subject of conversation at the gym for its ability to support muscle function, improve strength and performance, and increase lean muscle mass. There are even 1000+ peer-reviewed papers published on creatine and its benefits for muscle health. But, emerging research suggests that creatine supplementation may benefit women specifically, by supporting hormone fluctuations, improving bone strength, and acting as a nootropic in our brains.

What is creatine?

Creatine is an amino acid derivative made from arginine, glycine, and methionine.[1] In highly active tissues, creatine is stored as phosphocreatine, and serves as an energy reserve, donating phosphate to sustain levels of adenosine triphosphate (ATP). ATP is our cellular energy currency, and it’s what enables everything we do, from moving to thinking. It is especially important in our most active tissues, like our muscles, heart, and brain.

Creatine is making waves in the brain

With its unique ability to harness the energy in our cells- including brain cells- creatine supplementation may be the next big thing to improve cognitive function, especially as we age. So just how does creatine help more than just your muscles? Creatine plays an important role in supporting energetically demanding brain tasks like learning and memory. By increasing creatine stores inside the brain, ATP levels remain more stable during these energy-demanding cerebral activities, which account for an astounding 20% of the body’s energy consumption![2]

One recent study showed that in healthy elderly participants aged 68–85 years, improvements in tasks like recall and long-term memory were found following supplementation of 20 grams of creatine for only 7 days.[3] Creatine supplementation also shows promise for alleviating some symptoms of traumatic brain injury, including concussion, and has the potential to reduce symptoms of depression and anxiety.2,[4] In practice, I have had a handful of patients report improvements in brain fog and focus, with the use of 10 grams of creatine daily.

The greatest improvements in brain function and memory seem to occur in older adults taking creatine supplements, or when there is a higher level of metabolic stress. But even in healthy individuals, taking a creatine supplement has been shown to improve short-term memory, intelligence, and reasoning.[5]

From our brain to our bones

At least 1 in 3 women will suffer a bone fracture due to osteoporotic (weak) bones during their lifetime. And to some experts, hip fractures can be a death sentence. Almost one-quarter of women who suffer a hip fracture will die within one year.[6] To counter this, creatine supplementation has been investigated and the results are something to celebrate. During resistance training, postmenopausal women supplementing with creatine improved their bone geometry, which is protective against hip fracture.[7]

Creatine for our hormones

Consuming a diet rich in creatine has been associated with a lower risk of reproductive disorders in women aged 12 and above. Women who consumed the recommended intake of 13 mg of food-derived creatine per kg body mass per day exhibited a significant reduction in irregular menstrual periods, painful periods, and even the risk of having a hysterectomy.[8]

This study has opened the conversation of creating strategies to ensure an adequate supply of creatine in food systems, incorporating low-dose supplementation, and food fortification.

Why supplement?

We make about half of our daily requirement of creatine, so to meet the other half, we depend on dietary sources. But it’s only found in animal products, like red meat, poultry, fish, and shellfish. A recent study found that 7 out of 10 women consume creatine below recommended amounts, with intakes declining with age, meaning supplementation could be very beneficial for many.8

Creatine monohydrate is the most effective and bioavailable form of creatine and is sold by many reputable supplement brands. This form has been clinically proven to raise plasma creatine levels, support brain and muscle creatine content, and improve performance outcome measures.[9] 

How to take creatine?

To support muscle energy, stamina, and power, it’s better to take creatine shortly before or after you exercise, rather than long before or after. For brain, hormone, and bone health, any time is a great time. In terms of who can benefit, it’s everyone, but it becomes more important as we age.

Unlike its crucial role in muscle function and athletic performance, creatine’s role in other areas of the body is complex. Nonetheless, as researchers continue to pivot towards mitochondrial optimization to enhance cognitive function and healthy aging, creatine could be the next nutrient to keep an eye on.

References:

1. Wyss M, Kaddurah-Daouk R. Creatine and creatinine metabolism. Physiol Rev. 2000;80:1107–213.

2. Candow DG, Forbes SC, Ostojic SM, et al. "Heads Up" for Creatine Supplementation and its Potential Applications for Brain Health and Function. Sports Med. 2023;53(Suppl 1):49-65.

3. McMorris T, Mielcarz G, Harris RC, Swain JP, Howard A. Creatine supplementation and cognitive performance in elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2007;14:517–52

4. Forbes SC, Cordingley DM, Cornish SM, Gualano B, Roschel, H, Ostojic SM, et al. Effects of creatine supplementation on brain function and health. Nutrients. 2022;14:921.

5. Avgerinos KI, Spyrou N, Bougioukas KI, Kapogiannis D. Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Exp Gerontol. 2018;108:166-173.

6. Morin S, Lix LM, Azimaee M, Metge C, Caetano P, Leslie WD. Mortality rates after incident non-traumatic fractures in older men and women. Osteoporos Int. 2011;22(9):2439-2448.

7. Chilibeck PD, Candow DG, Gordon JJ, et al. A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health. Med Sci Sports Exerc. 2023;55(10):1750-1760.

8. Ostojic SM, Stea TH, Ellery SJ, Smith-Ryan AE. Association between dietary intake of creatine and female reproductive health: Evidence from NHANES 2017-2020. Food Sci Nutr. 2024;12(7):4893-4898.

9. Kreider RB, Jäger R, Purpura M. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022;14:1035.