This article, and episode 731 of the podcast (listen in the player above), was prompted by an email from Sandi, who wanted to know if I’d ever done a podcast on creatine.
Sandi is 75 years old and apparently something of a “super senior.” She says that her personal trainer has recommended creatine for both its muscle-building benefits as well as for cognitive function.
Creatine is one of the few topics I haven’t covered over the course of the last 15 years. To be honest, I thought of it primarily as a supplement for bodybuilders—so I left it for my colleagues on the Get-Fit Guy podcast to answer. (Which they have.)
But I have to give Sandi’s personal trainer credit for being aware of newer research on its potential benefits for older adults.
The creatine basics
Creatine is an amino acid that we get from meat and fish. Our liver also makes creatine. It’s stored in our muscles, where it is used to power short bursts of high-intensity muscle work—such as the effort involved in lifting, carrying, or pushing something very heavy, or perhaps jumping from a standing position.
Bodybuilders and weight lifters have used creatine to improve performance gains for decades. And, unlike many of the things that bodybuilders might use to enhance performance, this one is both legal and supported by pretty solid research.
One important thing to note is that creatine doesn’t build muscle directly. Rather, it allows you to squeeze a little bit of extra effort out of your muscles. That effort is what builds muscle. And that little bit of extra effort that creatine makes possible during a workout can result in a little bit of extra muscle. Without the workout though, creatine doesn’t really do anything for you.
That small incremental gain might be meaningful to a competitive weightlifter, but I didn’t really see it as important to those of us who are lifting weights or working out for general health and wellness.
Research on creatine
However, in recent years, there have been some interesting studies on the benefits of creatine specifically in older adults, who are at increased risk of muscle loss. And to be perfectly honest, I wasn’t aware of the research on creatine and cognitive function until Sandi (and her trainer) brought it to my attention.
Creatine for cognitive health
Let’s start with the research on cognitive function. We already know that things like sleep deprivation can negatively impact our ability to think straight. Interestingly, decreased levels of creatine in the brain are associated with sleep deprivation and other stressful situations. And there’s some preliminary evidence to show that taking creatine supplements can both raise creatine levels in the brain and also reduce some of the cognitive processing deficits that accompany those brain-stressing situations.
I think what’s more relevant to Sandi’s situation (and probably, most of us) is research on cognitive function as we get older. And here, I think the best we can say is that the research is promising. Creatine appears to have beneficial effects on short-term memory and reasoning. For other aspects of cognition, including long-term memory, attention, reaction time, and things like the ability to find the word you’re searching for, there’re only a handful of studies and the results have been inconsistent.
Benefits of creatine supplementation were more apparent in vegetarians, which makes sense, because they presumably get very little creatine from their diets. And that suggests that older people, who may also have lower creatine levels, could also get more benefits than younger folks. At least one of the studies that looked specifically at older people did find some boost in cognitive power. But all of these studies were quite short in duration—most of them only a few days long.
Although I think there’s certainly enough here to merit more research, in my opinion, what we have so far isn’t strong enough to support a recommendation for ongoing creatine supplementation specifically for brain health. That may change. And if it does, I’ll update you!
Creatine for muscles
There have also been a handful of studies looking at the effects of creatine supplementation on muscle mass and strength, specifically in older adults. A typical protocol starts with a “loading dose” of about 20 grams a day, spread out in 4 doses. You do that for 5-7 days, and then you go back down to 2.5 to 5 grams a day.
In most of the studies, supplementation did have a measurable benefit on strength and muscle tissue. But as with body-builders, the benefits of creatine supplementation are completely dependent on you also doing significant strength training, on an ongoing basis.
But, it’s important to note that dedicated strength training without supplementation also results in increased strength and muscle tissue in older adults. So, is that incremental boost that you get from creatine actually necessary? Does that extra little bit of muscle make any meaningful difference in your health and well-being? Or can you get the benefits that you want and need simply by doing strength training? (My educated guess is: yes.)
When to take creatine
Of course, there may be scenarios where that extra boost (either in muscle or cognition) would be more meaningful. Perhaps in recovering from an injury or surgery or some other stressor? I wonder whether the true promise of creatine isn’t so much as a supplement that everyone over 50 needs to take, but as a supplement that might be used in more targeted situations. We’ll have to see where the research takes us.
I know some of you think if something like this helps even a little, it might be worth it, as long as it doesn’t pose any risks. And the downsides appear to be few.
Creatine side effects
Creatine is cheap and appears to be safe, even at relatively high doses. That said, there are some common side effects, including stomach cramps, nausea, and diarrhea—especially with the higher doses. These can often be reduced by lowering the amount and spreading it out in smaller doses throughout the day. Taking creatine with food (and plenty of water) is also recommended.