Creatine is beloved by all types of athletes, from bodybuilders to Premier League footballers. Even Hollywood stars, the likes of Ryan Reynolds and Mark Wahlberg, are known to include it in their ‘get-ripped-for-the-camera’ regimes.
Thanks to the muscle-boosting benefits it’s said to provide, creatine is one of the most widely used supplements on the market.
But why? What does creatine actually do? How does it work and what makes it one of the few supplements that genuinely seems to make a difference, when so many others offer you nothing you’re not already getting from your diet?
More interestingly, why is this supplement, which is so heavily linked to physical improvements, suddenly said to have benefits for your brain as well?
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What does creatine do?
Creatine is nothing new; it’s been used by athletes for decades. Footballer Ian Wright once described it as his ‘wonder drug’ and British sprint and hurdle stars Linford Christie and Sally Gunnell were fans of the supplement, too.
Its benefits are down to basic exercise physiology.
Creatine is found naturally in your muscles and brain. It increases your stores of phosphocreatine, which helps to make adenosine triphosphate (ATP). ATP provides the energy your muscles need to contract. Creatine is produced in your body (you make around 1–2g of it a day) and consumed in your diet, but not to significant levels.
“Stores of phosphocreatine in the muscle are limited to supporting 5–10-second maximal efforts [very short, intense bursts of activity],” says Dr Marc Fell, nutritionist and scientific officer for the Ineos Grenadiers pro cycling team. Therefore, increasing the amount of creatine through supplementation, allows your body to start a workout with full stores of phosphocreatine and keep them topped-up during exercise.
“Creatine is usually found in red meat and shellfish, but only in small amounts. That’s why creatine supplementation is so popular – it’s a more convenient way of increasing stores in the muscle in a relatively quick timeframe.”
A review performed in 2003 revealed that 500 studies had been done into creatine. 70 per cent of them reported statistically significant results, while the remaining studies reported “non-significant gains in performance.” But what are these ‘gains’ exactly?
“Because creatine is involved in the most immediate energy system, it’s of particular benefit for athletes who sprint and weight train. It helps them increase muscle mass and strength,” says Fell.
Just how much of an increase? A study from 1999 showed a 32-per-cent increase in weight lifted compared to a placebo group over a 12-week training period. Meanwhile research carried out in 2017 showed an increase in muscle mass of 7.2 per cent over an eight week period.
Sounds great, right? But not everyone can expect to get the same results. “For endurance athletes [who perform less intense efforts over longer periods], the benefits of creatine are less, but there are still rewards for them if they include repeated short, high-intensity efforts in their training,” says Fell.
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How can it help your brain?
But what if setting new personal bests at the gym or athletics track isn’t your goal? Does creatine have any uses for ‘regular’ folk? It just might, as accumulating evidence suggests that creatine supplementation may have benefits for your brain as well. And in a similar way to how it benefits your body – by enabling you to tap into more energy when demand is high.
That’s important because the brain is a fuel-guzzling machine, burning through 20 per cent of your resting energy, despite accounting for around two per cent of your body mass.
“The research in this area is in its early stages so it’s difficult to draw conclusions. Nonetheless, high doses of daily creatine supplementation may improve cognitive functions, such as memory, processing speed, executive and sports skill execution,” says Fell.
“Additionally, preliminary data also suggests that creatine has some ability to enhance recovery following concussion in young adults.”
Julia Fabienne Sandkühler is a PhD student at the University of Bonn, Germany, and co-authored a 2023 study examining the effects of creatine supplementation on cognitive performance. While measuring small improvements in cognition generally, she suggests there are bigger benefits for specific demographics.
“For people with cerebral creatine deficiency syndromes, the effect of supplementing creatine has large and well-supported cognitive benefits. Conditions causing brain creatine deficiency result in profound intellectual disability, which can be reversed by creatine supplementation,” she says.
“There’s also evidence that brain creatine levels might decrease with age. This happens with muscle creatine levels, although it’s unclear if this is an effect of ageing or a result of other reasons, such as dietary choices or reduced physical activity.”
Should you take creatine?
There are hundreds of studies showing that creatine can boost your strength and power, and a growing evidence base that it can benefit your brain, but how much should you take? “There are different options [if you’re looking for physical improvements] and it’ll depend on how quickly you wish to increase your creatine stores,” says Fell.
“One option is to start with a ‘loading’ dose of 20g of creatine per day (split into 4 x 5g doses) for five days, followed by a daily maintenance dose of 3–5g. Or simply take a prolonged maintenance dose of 5g per day. The key is to be consistent with it on a daily basis.”
That figure rises to around 10g per day for potential cognitive benefits due to the difficulty of crossing the blood-brain barrier. If you do decide to try it, use creatine monohydrate, as that’s the most proven, and take it with water.
When used correctly, creatine does have benefits, then. So, what’s the catch?
“[It] does have some side-effects,” says Fell. “The most common is weight gain, which occurs because creatine causes retention of water in muscles that can reach as much as 1–2kg (2–4lbs), depending on dosage. This varies and not everyone will experience it, plus this often levels out quite quickly.”
Water retention isn’t the only adverse effect associated with creatine, though; being so widely used means it has been linked with a host of others. But, after caffeine, creatine is arguably the most studied supplement on the planet, and a 2021 review looked at the common beliefs surrounding the potential side effects of creatine supplementation.
For example: creatine causes kidney damage. According to the review: “When taken at recommended dosages, it does not.” Creatine causes hair loss; “the current body of evidence does not indicate that creatine supplementation causes hair loss or baldness.” Creatine causes cramping? “No.” It increases fat mass? “No.” And on and on, but all with the caveat of, “when taken at the recommended dosage.”
Creatine does have some merits then, especially if you’re looking to speed up your sprinting or increase your ability to lift heavy weights. And when it comes to your brain, the evidence is building that it could help you think more clearly and remember things more quickly, albeit when you’re under a lot of mental stress or as you age.
Nevertheless, that all comes with the “when taken at the recommended dose” caveat, because there’s no getting around the fact that creatine is a supplement – a substance that, if you’re healthy and eating a balanced diet, you’re probably getting enough of already.
Remember to seek advice from your doctor before adding any supplements to your diet or embarking on a new exercise programme.
About our experts
Dr Marc Fell is a nutritionist and scientific officer for the Ineos Grenadiers pro cycling team.
Julia Fabienne Sandkühler is a PhD student in experimental psychology at the University of Bonn, Germany. Her work has been published by medRxiv, BMC Medicine, and Scientific Data.
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