This decades-old supplement is quietly revolutionizing the longevity space. While fitness enthusiasts have sworn by creatine for building muscle and strength, emerging research shows it may be connected to aging in other surprising ways.
In this article, I’ll break down the cutting-edge studies transforming our understanding of creatine’s powerful effects beyond just muscle building.
Table of Contents
We already know about creatine’s muscle effects. That’s not the focus of this article. Our bodies can make creatine, but our diet is also a key source. It plays an important role in energy production in our muscles, and that’s where most of our creatine gets used. And that’s also why the traditional focus for creatine has been related to things like muscle growth and performance.
What’s new?
But it’s also found in the brain. And its potential role here is what has been driving fresh excitement about other new uses which I’ll cover later. The research even convinced my grandma to start taking it.
So let me explain what we’re finding out.
Our brains need a lot of energy to function properly. Creatine, which we get from foods like red meat and seafood, helps produce this energy quickly, supporting crucial brain processes like memory and thinking. It acts like a backup battery system that can instantly deliver energy when demand spikes.
Research shows that taking creatine supplements can increase the amount of creatine in the brain [1]. Multiple studies have investigated whether boosting brain creatine can improve memory and cognitive performance.
But it’s not all smooth sailing when analyzing this research. Some studies found that creatine helps memory, especially in older adults and vegetarians. Other studies did not see much effect [2].
Here’s where things get particularly interesting. There’s good evidence showing that certain factors, such as lack of sleep or aging, can decrease brain creatine levels [3]. The different results between studies might be due to factors like varying dosages and durations of treatment. But it’s also possible that the mixed results are because some people have lower levels of creatine in their brains than others. In other words, supplementation increases creatine levels in the brain only when it’s low.
It’s like filling a gas tank. If your tank is already nearly full, adding fuel won’t make much of a difference in how far you can drive. Similarly, creatine may only noticeably boost cognitive performance when our brain's natural reserves are low to begin with.
To cut through these conflicting results, scientists conducted a large review of all the studies, called a meta-analysis, to determine if creatine really helps with memory. Ten studies were included in the systematic review. They used different tools to evaluate memory. The main analysis showed that creatine supplementation improved memory performance compared to a placebo, particularly in older adults [4].
When I told my grandma about this study, she was very intrigued and wanted to start taking creatine.
But we have an even more recent meta-analysis, including 16 trials, published last year. It found once again that creatine supplementation had a significant positive impact on memory. It also improved attention time and sped up processing [5]. So this analysis uncovered additional ways creatine seems to help our brains function.
It also had one other intriguing finding. Subgroup analysis showed creatine supplementation was particularly beneficial for females [6]. I highlight this because I have spoken with many of my female patients who think of creatine as just a supplement for men. But the research clearly indicates it can be a useful supplement for women, too.
Let’s look at one more study that provides a suggestive link between creatine and our brains. This one was published in January. It investigated joining creatine supplementation to cognitive behavioral therapy to treat depression. The group taking creatine improved a lot more than the group taking a placebo [7].
What’s going on here? There is growing evidence that disruptions in our brains’ processes for producing, storing, and using energy are connected to depression [8]. And, as we’ve seen, creatine plays a crucial role in energy. Supplementation can increase the creatine available in the brain. So this study on depression gives us one more piece of evidence that creatine can powerfully improve aspects of brain health.
Now it’s obvious that brain health is important for healthy aging and longevity. But there are two additional areas, also connected to aging, where we have growing evidence of creatine’s potential.
One is osteosarcopenia. This is a condition found in older patients where both bone and muscle health are declining. It leads to increasing frailty and can result in fractures. A recent analysis called it an “emerging geriatric giant, which poses a serious global health burden” [9].
With an aging population, finding therapies that can help is a top priority. The authors of a review article published just three weeks ago propose creatine supplementation as a promising intervention for osteosarcopenia [10]. Their reasoning? We have evidence of creatine’s effectiveness in older adults for both muscle mass and bone health when paired with resistance training [11].
And here’s one last way creatine supplementation might help us attain a longer, healthier life, then we need to talk about side effects and dose. A small pilot study published at the end of 2024 examined creatine’s impact on blood vessel health in older adults. After four weeks, creatine significantly improved several aspects of blood flow. It also reduced fasting glucose levels and triglycerides [12].
These factors are all tied to heart disease, one of the biggest contributors to early deaths. This early evidence that creatine can have a positive impact here, too, is a big deal.
Now all of the research we’ve looked at is in the early stages. The results we have so far are very encouraging. But the authors of all these studies call for further randomized controlled trials to give us a better understanding of the effects and mechanisms of creatine supplementation in these areas.
If this is all we had, I would personally still add creatine to my supplement stack for reasons I’ll explain in a minute.
The old in a new light
But the traditional use of creatine supplements — for muscle and performance gains — also connects to aging in an important way.
Here’s why:
A growing body of evidence shows that as muscle strength declines, total death rates increase [13]. On average, human muscle mass declines by about 1% per year from the age of 40 [14].
Therefore, to prevent muscle loss, we want to maximize muscle strength in youth, maintain that muscle in middle age, and minimize loss as we get older.
And this is where the established benefits of creatine supplements are relevant. One recent analysis of multiple studies concluded creatine helps increase muscle strength, muscle mass, and athletic performance when combined with exercise [16]. The evidence the authors looked at, however, only showed a clear benefit in a younger population [17].
Let’s pause here for a moment. Even if creatine didn’t improve muscle mass for older adults, it would still make a positive contribution to aging. Remember, the strategy is to build more muscle when we’re younger so we can afford more loss as we age. It’s like fortifying the foundation of a home so it can better withstand a storm that’s coming years down the road.
But is there evidence that creatine can help with muscle maintenance and growth in older populations, too?
This has been an area of intensive study. One meta-analysis pulled together the results of 22 trials. The authors found a clear result. Creatine supplementation increases lean mass and both upper and lower body strength when used with resistance training in older adults [18].
An international team of experts drafted a more recent article to answer common questions about creatine. One of the questions they addressed was this: Is creatine beneficial for older adults? They answer that its power to increase muscle with exercise has been confirmed in older populations, too [19].
So here’s what the evidence we have now shows: Creatine, combined with resistance training, builds and maintains muscle throughout our lives.
But there are some misconceptions about creatine and its side effect profile that hold people back. And one of them is about water. You’ll see the objection that the muscle mass gains with creatine are just about absorbing more water.
There’s a grain of truth here. Studies have found that creatine supplementation can lead to increased water retention for some people when they first start taking it [20]. Crucially, though, a number of studies have shown there does not appear to be any water retention over the longer term [21]. The studies we’ve already looked at clearly show that using creatine with exercise promotes real muscle gain, and this is what ultimately accounts for lean mass increases.
People also worry about hair loss.
This concern came from a 2009 study of rugby players, where creatine supplements appeared to increase levels of a hormone called DHT. DHT contributes to hair loss [22]. But it’s important to note that it was just DHT. No study has ever shown that creatine accelerates hair loss.
There was also some statistical trickery in that 2009 study. There was a small increase in DHT levels in the creatine group. But in the placebo group there was a small decrease in DHT. So combined, that explains the statistically significant result [23].
Now those results have never been replicated. There have been five other studies that looked at hormone levels, including DHT. And there were no increases seen. In summary, our current evidence does not indicate that creatine supplementation increases total testosterone, free testosterone, DHT, or causes hair loss [24].
So I want to put that concern to rest. There’s no evidence that creatine causes hair loss. Instead, what’s likely happening is that people start taking creatine and working out at the same time. Testosterone levels go up when we work out. And testosterone gets converted into DHT [25]. It’s far more likely that creatine supplements are getting blamed for hair loss, when it’s actually because of the resistance exercise people are doing.
Another safety concern is about uric acid. We used to think creatine increased uric acid levels. High uric acid can cause painful gout attacks in the joints. But creatine appears to do the opposite. It decreases uric acid [26].
Overall, creatine is very safe. Though there’s an important caution I’ll cover in a moment. A statement from the International Society of Sports Nutrition summarized the weight of the evidence so far. Existing studies show that short and long-term supplementation with creatine is safe and well-tolerated in healthy individuals in a range of patient populations [27].
And that’s why I personally take creatine. Some of the benefits related to brain health and aging aren’t well-established yet. But the early evidence is promising. Other benefits, particularly for muscle gain, are backed by plenty of data. Since it has such a strong safety profile, I think it’s definitely worth it.
How to use
But if we want to take creatine, what’s the best approach? What form and dose are optimal for reaping its benefits?
Let’s talk about the form first. Almost all studies of creatine supplementation use creatine monohydrate. The reason is simple. At this point, it’s the most cost-effective and best understood. We know it’s effective and has strong bioavailability [19].
And how much is needed? There used to be an idea that people who are starting creatine should have a loading dose of about 20 grams a day for a few weeks. This dose would rapidly saturate their muscles and offer a faster rate of improvement.
But doing that increases the chance of tummy upset. I recommend 5 g a day to my patients. That’s the same dose my grandma and I both take. For most people, that’s the perfect dose. It will also saturate the muscles, just over a longer time horizon and with less chance of tummy upset [19].
It’s also the dose I include in the new MicroVitamin+ Powder. But just because I (and my grandma!) take a supplement, that in no way means you have to also.
Now let me return to the caution I mentioned above. There is one type of patient in my clinic for whom I don’t recommend creatine. And that’s when someone has severe kidney problems. Early on, there was a worry that creatine could damage our kidneys.
Here’s why. Creatine is converted into creatinine. Testing the blood levels of creatinine is one way to measure kidney function.
If a person starts taking creatine, their blood creatinine levels will go up. This makes their kidney function appear worse than it actually is.
Think of your kidneys like a traffic officer. Creatine is converted into creatinine, which is like extra cars on the road. When you check the road, the extra cars make it look like there’s a traffic jam and the officer isn’t doing their job well. But the officer is still managing traffic just fine. Taking creatine adds more cars (creatinine) to the road (blood), making it look like there's a problem with traffic control (kidney function), even though everything is actually okay.
For those with normal kidney function, the evidence suggests creatine isn’t a problem [28]. But for patients that I see in the clinic with significant kidney disease, we either reduce the dose or stop supplementing.
References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912287/
2. https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuac064/6671817
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912287/
4. https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuac064/6671817
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC11275561/
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC11275561/
7. https://pubmed.ncbi.nlm.nih.gov/39488067/
8. https://www.mdpi.com/2218-273X/9/9/406
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC7296259/
10. https://pubmed.ncbi.nlm.nih.gov/40014064/
11. https://pubmed.ncbi.nlm.nih.gov/40014064/
12. https://pubmed.ncbi.nlm.nih.gov/39796490/
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772850/
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772850/
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322506/
16. https://pmc.ncbi.nlm.nih.gov/articles/PMC8949037/
17. https://pmc.ncbi.nlm.nih.gov/articles/PMC8949037/
19. https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w
20. https://pubmed.ncbi.nlm.nih.gov/23851411/
21. https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w
22. https://pubmed.ncbi.nlm.nih.gov/19741313/
23. https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w
24. https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w
25. https://link.springer.com/article/10.2165/11536910-000000000-00000
26. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-13-115
27. https://www.tandfonline.com/doi/full/10.1186/s12970-017-0173-z
28. https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z
