The supplement that boosts your muscles and your brain

Is creatine just the preserve of beefy bodybuilders or could we all get a boost from taking it?

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The health benefits of creatine supplements seem almost too good to be true. Popular with sports fans and gym buffs since the 1990s, they are known to boost athletic performance in high intensity, short duration exercise, by improving strength and lean muscle mass. However experts now also say that it can transform menopausal symptoms such as brain fog, and generally can enhance cognition and fight fatigue. But before every middle-aged person reading this dashes off to the nearest health food shop and load up with supplements, what are the facts behind these claims?
Creatine is a substance produced by the human body in the liver, kidneys and pancreas, which helps with transporting energy around the body. It can be boosted through diet, as it is present in meat and fish, particularly game, lean red meat, herring, salmon and tuna, but it’s difficult to absorb high levels of it – the average daily human intake of creatine from food is about one gram per day.
The most well-known health benefits include improving muscle strength, high-intensity exercise performance and muscle recovery.
Creatine supplements remain popular with athletes and bodybuilders who use them to gain weight and muscle mass, and to improve performance in intense situations such as lifting weights. Dr Linia Patel, a performance nutritionist and women’s health dietitian, says: “Creatine is the primary energy source for a muscle contraction, and it produces explosive amounts of what we call ATP (Adenosine triphosphate). By increasing the availability of ATP we can delay fatigue and allow our athletes to train at a higher intensity.”
So how does it work? Dr Patel explains: “It takes a while for glucose and oxygen to get to the muscles but before that even gets there, creatine is [naturally] in the muscles generating that energy. So it’s the first gear to get you going.” Without supplements the natural creatine can run out, creating a lag in energy. If you are saturated, however, it means a seamless transition from first gear through to fifth. “It’s going to give you the edge,” says Dr Patel.
Uses of creatine have evolved over the past two decades. “Twenty years ago when I trained as a sports dietitian, I would have recommended creatine just for people who are doing muscle power and strength work,” says Dr Patel. “Now it has evolved and we have also found some research saying that it allowed endurance athletes to maintain higher intensities during training, and could also help them recover more quickly.”
This all depends on the individual however – people who tend to have naturally high stores of creatine in their muscles don’t get an energy-boosting effect from extra creatine.
Creatine is one of the few supplements that has been statistically shown in studies to improve memory. In 2022 a meta-analysis by Oxford University showed “overall, creatine supplementation improved measures of memory compared with placebo”. The improvements were much more pronounced in older people – aged 66-77 – than their younger counterparts aged 11-31. Meanwhile a 2018 study showed evidence “that short term memory and intelligence/reasoning may be improved by creatine administration.”
“We know that women have 70 to 80 per cent lower creatine stores than men, even more exacerbated in menopause or the perimenopause,” says Dr Patel. So how can supplements help?
“In the last five years, results show that if we supplement perimenopausal women with creatine, they get such benefits from it, not just from energy levels and fatigue, but also positive impacts in terms of brain and mental cognitive function.” She adds: “Less brain fog, basically.” A 2021 study confirms this, saying “creatine supplementation appears to provide many potential benefits for females.” Creatine supplements were also shown to improve mood and cognition.
More good news for women – taking these supplements prompted consistent improvements in strength and exercise capacity, and when combined with resistance training, better body composition and bone mineral density, particularly in post-menopausal females.
Decreasing levels of oestrogen in perimenopause have an impact on muscle mass. Creatine is stored in muscle, so we’re seeing a decline in general [during menopause].
But, says Dr Patel: “you can’t just take creatine and expect your muscles to grow overnight. You still need to be combining that with resistance exercise to stimulate your muscles.”
People with kidney disease, high blood pressure, or liver disease should not take creatine, say health experts at Mount Sinai hospital New York. Dr Patel explains: “If you have pre-existing liver and kidney conditions, then you absolutely do want to speak to your healthcare provider before you start taking it.”
Older people should be cautious too.“Older people are not very good with hydrating, and older people’s kidney function also decreases over time,” says Dr Patel. This coupled with the risk of it combining adversely with other medications means extra caution would be needed – in other words, ask your doctor.
People wishing to improve their performance in sports, which involve short bursts of energy, such as bodybuilding or sprinting, would benefit from taking creatine. Vegetarians and vegans would also benefit.
“Creatine is found in animal products and is virtually absent in plant-based foods, so you’ll find vegetarians and vegans typically having lower creatine levels in their muscles compared to those who eat meat,” say Dr Patel. Even so it’s not one size fits all. “If you’re young and you’re not exercising a lot, maybe you don’t need it, but if you are plant-based and doing intensive exercise you may.”
Dr Linia recommends a daily dose of three to five grams a day dissolved in water in the morning and then being rigorous about drinking plenty of water.
Dr Linia says: “It is suitable for athletes performing at a high level who want to maximise energy. Also women who are experiencing perimenopausal symptoms that are impacting cognition and mood, might want to dabble with it. And if you’re on a plant-based diet, and you’re going to maximise energy levels and muscle mass, consider it. But it’s a tool. It is not a magic bullet.”
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