Can Older Adults and Seniors Still Take Creatine Supplements?

Can Older Adults and Seniors Still Take Creatine Supplements?

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Creatine is a popular workout supplement due to its impact on muscle performance and growth. But, it's also a chemical used by the brain and throughout the body, with impacts on many different systems. Sure, 95% of your body's creatine is used by your muscles, but the remaining 5% can be found in the kidneys, liver, and even the brain.

That means creatine can be an important option for purposes beyond just muscle performance. Let me tell you why even my grandma has started taking creatine supplements and why you might consider doing the same.

What is Creatine?

Other than a workout supplement, creatine is an amino acid compound made from three different aminos. It's commonly found in your diet and comes primarily from seafood and red meat. Your body also produces creatine naturally and stores it as phosphocreatine for use as readily available energy in your muscles.

Reading the intro, you may have noticed something intriguing. Most of the body's creatine is found in the muscles, yes. Some of the remainder is found in the kidneys and liver, but that's not unusual. Basically, everything is found in the kidneys and liver sooner or later. But the brain, the brain stands out.

What is Creatine

Humans have a barrier between the brain and the rest of the body. Nerve signals and blood can pass through it to deliver nutrients and allow the brain to control the rest of the body, but it's very selective about what can pass through. Given how critical the brain is, any contamination can be very rapidly damaging or even fatal, so when we discover a substance that makes it through or that the body uses in a particular way for brain health, it's an exciting proposition.

Henry Ford once said the mind is the strongest muscle, but I doubt he had any idea that a workout supplement might be able to affect it. So, that's our question. Can creatine impact the brain positively or otherwise? Are there risks to taking it? Should you consider it as well? Let's talk about it.

New Research on Creatine

The brain is a very hungry organ. It requires a ton of energy to operate, which is part of why you feel sluggish and have worse reactions and thought patterns when you haven't eaten. Creatine, as it turns out, is a very effective source of energy for the body, and that includes the brain.

New Research

You get some creatine from your diet, and your body naturally produces about a gram of it per day, but that's not necessarily very much. Some research has shown that the optimal intake for muscle growth is as much as 20 grams per day. Now, again, that's for muscle growth, and that's not what my grandma – or most people, honestly – are looking for here. I just bring it up to give you an idea of the scale we're working with.

Recent research published in March 2022 shows that creatine supplementation seems to increase creatine in the brain, not just in the muscles. That's the first step, right? If taking creatine doesn't impact creatin in the brain, we can disregard it.

Abstract Study

However, the effects seem positive, with the researchers concluding that "accumulating research shows that creatine supplementation and GAA can increase brain creatine content."

Research like this is always tricky to analyze. It's one thing to observe that creatine is used by the brain; it's another thing entirely to figure out what it's doing and if it's beneficial.

How Creatine May Affect the Brain

Let's start with the positive.

Some studies have indicated that creatine helps memory, particularly in older adults – who are often highly concerned with memory as they age – and in vegetarians, who don't necessarily get as much dietary creatine as those who habitually consume meat and fish.

Is that good? Well, other studies didn't see the same results. A systematic review of studies on the cognitive impacts of creatine showed mixed results; some studies found benefits, while others found no difference between creatine and placebo or no change between before and after supplementation.

Creatine Affecting the Brain

But there's good news.

There's more significant evidence that certain physical challenges, like a lack of sleep or growing older, decrease brain creatine levels. It's possible that the brain relies primarily on the creatine the body produces naturally unless you experience these kinds of challenges.

These challenges can be both acute and chronic.

  • Acute: Sleep deprivation, intense exercise, and similar short-term consumption of available creatine.
  • Chronic: Aging, depression, Alzheimer's Disease, traumatic brain injuries, or deficiencies in creatine synthesis enzymes.

How is this good news? This means that the studies that found little or no impact might have confounding variables in play. For example, varying dosages in creatine and other supplements are always an issue, but even when you control for those, you might still find that some people have lower levels of creatine for one or another reason, acute or chronic.

That's the overall purpose of the meta-analysis: to examine different trials in different circumstances and varying results, to look for patterns, and to see if creatine can truly help with memory or other cognitive impacts.

The biggest result of the meta-analysis was that creatine supplementation improved memory performance compared to placebo and had a larger impact on older adults than on younger adults.

Before you run out to buy creatine, though, you need to consider two things: which form of creatine provides the best potential benefits and what side effects to look out for with a creatine supplement. My grandma may have decided to take it, but that doesn't necessarily mean it's the best decision for you and your circumstances.

Side Effects and Drawbacks of Creatine Supplementation

Making a change to the nutritional profile of your body will have an impact. That's the basis behind all diets, all supplements, and even many medications. When you get right down to it, everything is chemicals, after all.

Creatine has two famous safety concerns.

The first is the kidney discussion. If you're familiar with creatine as a workout supplement, this is one of the primary discussions in fitness circles. I say "the kidney discussion" because whether or not creatine is dangerous for your kidneys is often unclear.

To understand why, you need to know how your body processes creatine. When your body digests protein, or you work out, and your muscles break down, creatine is consumed to provide energy and the amino building blocks to heal and rebuild. A byproduct of that process is called creatinine. Creatinine is a waste product your body doesn't need and is filtered out by your kidneys.

One of the most common tests used to measure your kidney function is a blood or urine test that measures creatinine levels. High creatinine levels are typically associated with kidney disease, under the assumption that your kidneys aren't properly filtering it out.

It's an accurate and effective test for people who aren't supplementing creatine. But for those who are not, excess creatine is broken down, and excess creatinine is generated. You can have increased creatinine levels in your tests, indicating worse kidney function.

Side Effects

But are your kidneys actually being damaged? Or is the test simply not calibrated for such a higher intake of creatine?

The International Society of Sports Nutrition performed their own studies and found that as much as a whopping 30 grams per day of creatine, over 5 years, showed no detrimental effects on otherwise healthy individuals. You take creatine and your creatinine levels go up, but that doesn't mean it's damaging your kidneys, just that you have more creatine passing through your system.

It's important to note that this is for otherwise healthy people. If you already have issues with your kidneys, like chronic kidney disease or kidney failure requiring dialysis, you should discuss creatine supplements with your doctor. While the "new normal" effect may be real and creatine may not harm your kidneys, you still want to a) avoid anything that could cause harm and b) avoid anything that skews the test results that are used to determine your treatment.

I said there were two famous safety concerns. One is kidney function; what's the other?

Hair loss. This side effect can be traced back to a 2009 study of rugby players. In that study, creatine supplementation appeared to increase the levels of the hormone DHT, which is commonly believed to be correlated with hair loss.

There are a couple of issues with this, though.

  • The first is that no study has ever shown an actual correlation between creatine and hair loss.
  • The second is that the 2009 study had some issues. For one thing, there was a bit of statistical trickery going on. For another, no other study attempting to replicate it has shown the same results. As far as the evidence shows, creatine supplementation doesn't impact your hair loss at all.

But hair loss has been observed in people taking creatine, right? So what's going on? Well, it's actually a lot more likely that the cause is testosterone. Testosterone is elevated after heavy exercise in men, and higher testosterone levels are associated with hair loss. That, and the natural impact of aging on men, seems to explain it all.

There are a few other potential safety concerns, many of which have been debunked over further study. For example:

  • There was a concern for some time that creatine would increase uric acid levels, which can cause gout, but further study indicates the opposite: that creatine actually decreased uric acid levels.
  • Another is that creatine causes dehydration, which causes muscle cramping. Again, further study found this doesn't seem to be the case.

In fact, going back to that International Society of Sports Nutrition study, the only consistently reported side effect of creatine supplementation was weight gain, and that makes sense since the primary benefit of creatine is to assist in muscle growth, and muscle is dense and heavy. It's lean muscle mass, not unhealthy fat.

No wonder my grandma is happy to give creatine a try!

How and How Much Creatine to Take?

There's one more major question to ask, and that's what form of creatine is best for the effects you're seeking and how much of it you should be taking.

As usual, I'll preface this with caution: my goal is to look over the science from these studies, not to give you any specific recommendations. My goals, my grandma's goals, and your goals may all be different, so what works for her and for me might not align with what you need. You should visit your doctor to get some personalized advice on your creatine dosage.

The most common form of creatine you'll find is creatine monohydrate, and the usually-cited recommended dose is 5 grams per day. For a while, people recommended starting out at 20 grams per day – spread out across meals – to saturate your muscles and quickly bring you to a "new normal." Unfortunately, this seems to cause more digestive upset and related issues and only really benefits you for the first week or so of supplementation, so it seems generally better to just stick with 5 grams a day.

How Much to Take

Other forms of creatine are hitting the market as well, again usually marketed as workout supplements. These include creatine ethyl ester, creatine hydrochloride, and creatine magnesium chelate. Research is still ongoing for these, so I don't recommend them over creatine monohydrate.

It's also important to know what you're getting in a creatine supplement. Many workout supplements are loaded with more than just creatine, ranging from carbohydrates, vitamins, or other nutrients to stimulants like caffeine. If your goal is cognitive benefits and not muscle growth, beware of these supplements.

Should you consider taking creatine?

The International Society of Sports Nutrition determined that creatine monohydrate is the most effective ergogenic supplement currently available to build body mass during training, and improve muscle recovery and thus muscle growth.

The impact on cognitive performance and memory, as well as how it might affect conditions like Alzheimer's Disease, are still being studied. There are some promising results, but further study is always warranted.

As a younger and healthier individual, I've elected to take creatine as part of my routine, primarily for muscle benefits. My grandma has also decided to take it in case the cognitive benefits pan out. As for you, well, that's up to you. Does creatine align with your goals? Let me know in the comments.

Sources

  1. Timing, optimal dose, and intake duration of dietary supplements with evidence-based use in sports nutrition: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545206/
  2. Effects of Creatine Supplementation on Brain Function and Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912287/
  3. Effects of creatine supplementation on memory in health individuals: a systematic review and meta-analysis of randomized controlled trials: https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuac064/6671817
  4. International Society of Sports Nutrition position stand safety and efficacy of creatine supplementation in exercise, sport, and medicine: https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z.
  5. Three weeks of creatine monohydrate supplementation affects the dihydrotestosterone to testosterone ratio in college-aged rugby players: https://pubmed.ncbi.nlm.nih.gov/19741313/
  6. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871530/
  7. Effects of dietary creatine supplementation on systemic microvascular density and reactivity in healthy young adults: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277830/

About Dr. Brad Stanfield

Dr Brad Stanfield

Dr. Brad Stanfield is a General Practitioner in Auckland, New Zealand, with a strong emphasis on preventative care and patient education. He runs a YouTube channel with over 240,000 subscribers, where he shares the latest clinical guidelines and research to promote long-term health. Dr. Stanfield is also involved in clinical research, having co-authored several papers, and is a Fellow of the Royal New Zealand College of General Practitioners.

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