There are a lot of supplements that come and go. Creatine looks like it is here to stay. It is among the most researched of all supplements. It has clear benefits involving high-intensity exercise and improving strength and lean mass when combined with resistance training. Research into brain function in ongoing and hopeful but not yet convincing.
Understanding what creatine does—and what it can reasonably deliver—helps us understand its utility as opposed to exaggerated promises.
What Is Creatine?
Creatine is a naturally occurring compound that the body makes from amino acids (glycine, arginine, and methionine). It is also found in foods, particularly meat and seafood. It helps supply energy to muscles and other tissues with changing energy demands, including the brain.
The body’s own creatine production and dietary intake maintain basic functioning. Supplementation can increase muscle creatine stores further, which helps people attain greater athletic and health goals. By the way, taking a supplement does not necessarily mean you have a deficiency.
Creatine monohydrate is the most extensively studied form and the type I’ll discuss. The research evidence makes it the standard.
How Does Creatine Work?
Most of the body’s creatine is stored in skeletal muscle, much of it as phosphocreatine. This stored compound helps regenerate adenosine triphosphate, or ATP—the immediate energy source cells use to perform work. With aerobic (oxygen-utilizing) exercise, ATP produces approximately 220 to 260 Kcal/mol of energy. With anaerobic exercise, you only get about 14.6 Kcal/mol of energy.
During a heavy lift or short sprint, muscles use ATP rapidly. Phosphocreatine donates a phosphate group to help replenish it, supporting the muscle’s ability to continue producing force. Increasing muscle creatine stores can strengthen this energy reserve.
This explains why creatine is especially useful for activities involving repeated intense efforts separated by brief recovery periods.
Creatine is not a stimulant and does not produce feelings of alertness. Its effects depend on building muscle stores through consistent use. The initial creatine levels, exercise habits, and individual response all influence results.
What Are Creatine’s Main Benefits?
Supporting High-Intensity Performance
Creatine can improve performance during repeated bouts of demanding exercise, such as weightlifting, sprint intervals, and the accelerations involved in sports such as tennis, basketball, and martial arts.
The practical benefit may be modest: maintaining power through another sprint or completing additional work across several sets. These improvements can matter when repeated over many training sessions. Responses vary, however, and creatine offers less consistent value for steady-paced endurance exercise.
Improving Strength and Lean Mass With Training
Resistance training stimulates muscles to adapt. Creatine can support that, and it may increase training volume. A systematic review found that adding creatine to resistance training improved strength gains in adults younger than 50 compared with training and placebo. Creatine still depends on the wider training program. Progressive exercise, sufficient protein, and adequate recovery remain central to progress.
Supporting Muscle as People Age
Maintaining strength becomes increasingly important with age because it is essential for everyday tasks such as climbing stairs, carrying groceries, and rising from a chair.
Research suggests that creatine combined with resistance training can improve lean tissue mass and strength in older adults. It may therefore be a useful addition to an appropriate exercise program.
Evidence for improvements in physical function is less uniform than evidence for strength and lean mass. Supplementation should complement exercise and an individualized care plan, particularly for people managing frailty, mobility limitations, or chronic illness.
Possible Cognitive Benefits
Because the brain also uses creatine in energy metabolism, researchers are investigating whether supplementation can support cognition.
Some studies and pooled analyses suggest improvements in memory or selected cognitive tasks. However, results differ across populations, doses, and testing methods. A favorable result on one test does not establish a broad improvement in concentration, intelligence, or everyday mental performance.
The European Food Safety Authority’s evaluation concluded that a cause-and-effect relationship between creatine supplementation and improved cognitive function had not been established. Brain-related benefits remain an area of investigation, and readers should be cautious about promises of reliable mental enhancement. Further research is needed.
Recovery and Other Applications
Scientists are also studying creatine’s potential effects on recovery after strenuous exercise and its use in selected clinical conditions. Findings are not consistent enough to promise reduced soreness, faster injury recovery, or benefits across diseases. These applications require evidence specific to the outcome and population being studied.
Is Creatine Safe?
Creatine monohydrate is generally well tolerated by many healthy adults at studied doses. Common effects include water-related weight changes and occasional gastrointestinal discomfort, particularly when large amounts are taken at once.
Kidney health deserves careful explanation. Creatine can increase blood creatinine, a breakdown product used in estimating kidney function. A higher creatinine result during supplementation does not automatically indicate kidney damage. A meta-analysis of randomized trials found no significant difference in estimated filtration rate between creatine and control groups.
People with kidney disease or other relevant medical conditions should discuss supplementation with their healthcare professional. The same applies to those taking medications that may affect kidney function.
Tell your clinician that you take creatine. This information can help evaluate results in context and decide whether further assessment is needed. There is a test called Cystatin-C, which takes creatine into account and can give a more accurate analysis of kidney function if the serum creatinine is elevated.
Evidence during pregnancy and breastfeeding remains limited, so medical guidance is appropriate before use. Safety findings from healthy adults should not automatically be extended to every population.
Does Creatine Cause Weight Gain?
Yes, creatine can increase body weight, especially early in supplementation. Initial changes often reflect additional water stored in muscle rather than increased body fat.
With continued resistance training, longer-term weight changes may also include gains in muscle tissue. Muscle weighs more than fat. This is not necessarily a bad thing.
For someone focused on strength, this change may be acceptable or welcome. Someone competing in a weight-class sport may need to account for it when planning supplementation.
Tracking strength, training performance, and how clothing fits can provide context alongside body weight. The scale alone cannot distinguish water, muscle, and fat.
How Much Creatine Should You Take?
A common maintenance dose for healthy adults is 3–5 grams of creatine monohydrate daily. The appropriate amount can depend on body size, goals, and medical circumstances.
Consistency helps maintain elevated muscle stores. People who eat little meat or seafood may begin with lower stores, although dietary patterns do not reliably predict how much benefit an individual will experience.
Check the amount of creatine per serving rather than assuming every scoop, capsule, or gummy supplies the same dose.
What Is a Creatine Loading Phase?
Loading means taking a higher daily amount for a short period to increase muscle stores more quickly. Research protocols commonly use approximately 20 grams daily, divided into four smaller doses, for 5–7 days, followed by a maintenance dose.
Loading is optional. Taking 3–5 grams daily without loading can also increase stores, typically over several weeks. Larger individual doses may increase gastrointestinal discomfort, making the slower approach more comfortable for some people.
When Should You Take It?
There is limited evidence that a particular time of day produces a meaningful advantage. Research comparing supplementation before and after exercise has not established a clear, dependable winner.
Choose a routine you can sustain, including on rest days. Taking creatine with a meal may be more comfortable for some people and provides a convenient daily reminder.
Who May Benefit From Creatine Supplementation?
Adults who lift weights or regularly perform repeated high-intensity exercise have the clearest reason to consider creatine. Older adults combining supplementation with appropriate resistance exercise would likely also benefit.
People who eat little or no meat receive less dietary creatine, which may make supplementation relevant to their goals. However, a vegetarian or vegan diet does not automatically create a need for it.
Creatine may be particularly important in females, though research has been lacking. There is a potential positive implication for creatine supplementation in females—not just in female athletes, but also during menses, pregnancy, post-partum, perimenopause, and postmenopause. While there have been no human studies evaluating the effects of adding creatine during pregnancy, it may prove beneficial based on an article published in The Journal of the International Society of Sport Nutrition in 2021. Research clearly needs to be done in this area.
Creatine is optional. Its value depends on the person’s activities, expectations, diet, and health. Anyone with kidney conditions, chronic illness, or circumstances affecting supplement safety should seek individualized guidance.
How to Choose a Creatine Supplement
Go with creatine monohydrate. More expensive forms have not consistently demonstrated greater effectiveness, and elaborate marketing does not establish an advantage.
Look for a clearly stated dose, a straightforward ingredient list, and independent quality testing where available. Testing can help assess product contents and contamination; it does not guarantee results.
Proprietary blends and “enhanced” formulas may obscure how much creatine a serving contains. A simple product with a transparent label makes it easier to follow a consistent routine and evaluate whether supplementation supports your goals.
Final Thoughts
Creatine looks like a winner, whether you’re an athlete or not. While a lot more research needs to be done, it appears to be safe and potentially beneficial for a wide range of ages and for many aspects of health.
Wishing you the best of health,
Dr. Spira
References
- Creatine’s function, exercise performance, dosing, and loading: Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition. 2017;14:18. doi:10.1186/s12970-017-0173-z
- Strength gains with resistance training: Wang Z, Qiu B, Li R, et al. Effects of creatine supplementation and resistance training on muscle strength gains in adults <50 years of age: a systematic review and meta-analysis. Nutrients. 2024;16(21):3665. doi:10.3390/nu16213665
- Strength and lean mass in older adults: Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access Journal of Sports Medicine. 2017;8:213–226. doi:10.2147/OAJSM.S123529
- Strength and cognition in older adults: Candow DG, Ostojic SM, Chilibeck PD, Longobardi I, et al. Creatine monohydrate supplementation for older adults and clinical populations. J Int Soc Sports Nutr. 2025 Sep;22(sup1):2534130. doi: 10.1080/15502783.2025.2534130. Epub 2025 Jul 17. PMID: 40673730; PMCID: PMC12272710.
- Water retention, body weight, tolerability, and common safety questions: Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition. 2021;18:13. doi:10.1186/s12970-021-00412-w
- Kidney safety: de Souza e Silva A, Pertille A, Reis Barbosa CG, et al. Effects of creatine supplementation on renal function: a systematic review and meta-analysis. Journal of Renal Nutrition. 2019;29(6):480–489. doi:10.1053/j.jrn.2019.05.004
- Potential memory benefits: Prokopidis K, Giannos P, Triantafyllidis KK, Kechagias KS, Forbes SC, Candow DG. Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews. 2023;81(4):416–427. doi:10.1093/nutrit/nuac064
- Limitations of the evidence for broader cognitive benefits: McMorris T, et al. Creatine supplementation research fails to support the theoretical basis for an effect on cognition: evidence from a systematic review. Behavioural Brain Research. 2024;466:114982. PubMed record
- Creatine in Women: Antonio J, Candow DG, Forbes SC, Gualano B, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021 Feb 8;18(1):13. doi: 10.1186/s12970-021-00412-w. PMID: 33557850; PMCID: PMC7871530.
- Supplement timing: Ribeiro F, Longobardi I, Perim P, et al. Timing of creatine supplementation around exercise: a real concern? Nutrients. 2021;13(8):2844. doi:10.3390/nu13082844
- Choosing creatine monohydrate over alternative forms: Fazio C, Elder CL, Harris MM. Efficacy of alternative forms of creatine supplementation on improving performance and body composition in healthy subjects: a systematic review. Journal of Strength and Conditioning Research. 2022;36(9):2663–2670. doi:10.1519/JSC.0000000000003873
- Emerging applications in aging and clinical care: Candow DG, Ostojic SM, Chilibeck PD, et al. Creatine monohydrate supplementation for older adults and clinical populations. Journal of the International Society of Sports Nutrition. 2025;22(sup1):2534130. doi:10.1080/15502783.2025.2534130
Wishing you the best of health,
Dr Spira
Alan Spira, MD, DTM&H, October 2026
Curious whether creatine is right for you?
The Village Doctor can provide personalized, evidence-based guidance to help Bay Area patients make informed decisions about supplements, strength, and long-term health. Call The Village Doctor at (650) 851-4747 or contact us to learn more about the practice.
