Should I be taking Creatine?
Should I be taking Creatine?
A common discussion I have with my patients and athletes is around the question “Should I be taking creatine?” While every individual will have varying goals and health history, often times our discussion leads us to YES! I always have them check in with their primary care doctor and any specialists they may see to make sure creatine is right for them.
What is creatine?
Creatine is naturally occurring in our bodies, mostly located in muscle, but also in the brain. We actually make some in our liver and kidneys, and the rest we need to get via our diets (things like red meat and seafood usually have a higher concentration).
And what does it actually do?
If you are feeling really nerdy, please check out this article on the nitty gritty. For my condensed version: creatine helps us make ATP, which is the energy source that we use to move our bodies. For anaerobic (without oxygen - think sprints, explosive lifts, etc) our bodies use carbohydrates (glucose and glycogen) to create ATP…while also making lactic acid. During these activities, the body may also use phosphocreatine (the “stored” form of creatine) for immediate energy.
That still feels like gibberish, so in short: creatine is essential in our bodies to help supply energy to our muscles.
ATP is created from carbohydrates/glucose in anaerobic activities (“without oxygen” so sprints, explosive lifts, etc), and oxygen + carbohydrates/glucose + fats for aerobic activities (“with oxygen” so long distance running/cardio). Creatine seems to have the biggest benefit for anaerobic activities (but still has benefit for aerobic!).
How does taking creatine work?
A normal diet generally contains 1-2g of creatine, which fills up 60-80% of the storage the muscles have for creatine. The idea is you are trying to fill in the rest of the stores so you get a little extra energy boost. Creatine can help improve anaerobic energy capacity and decrease protein breakdown - all leading to increased muscle mass and improved performance (reference).
What are some of the benefits of creatine?
There are lots of different performance benefits:
More stored energy leads to greater capacity for output, so more power or more reps available.
It might reduce muscle damage, or maybe increase recovery from intense exercise (reference).
Studies show it can reduce mental fatigue and/or improve cognitive function (reference)
Enhanced heat tolerance (reference)
But also some benefits that are therapeutic or health related:
Creatine has been reported to help lower cholesterol, lower triglycerides, reduce accumulation of fate on the live, enhance glycemic control, reduce progress of some types of cancer, minimize bone loss, enhance cognitive function in older populations, and improve efficacy of some anti-depressant medications (reference).
Women (12 and older) consuming diets higher in creatine had lower risks of irregular menstrual periods, obstetric conditions, and pelvic pathology (reference).
In short, creatine seems to have benefits for heart health, diabetes management, and cognition and memory.
What are the side effects and risks of taking creatine?
Creatine is one of the most studied ergogenic aids for athletes - there are no significant side effects/long term issues. A meta analysis in 2025 found no side effects or risks (reference).
Seemingly there is more of a risk NOT getting enough creatine from your diet. Impacts of low dietary creatine include (for adults over 65) lower cognitive function, children and adolescence had lower bone mineral content and had a higher fat content/lower lean muscle mass than kids who got enough (reference).
For those with pre-existing kidney issues, creatine must be discussed with your doctor. It can put extra strain on the kidneys, so if they are impaired...you want to make sure it is actually safe with your doctor!
Is creatine safe for kids?
Look in different places and find different answers! In my research for this article, I found both yes and no. This article that looked at many other articles basically concluded creatine should be safe for kids. While this doctor argues there aren’t any adolescent specific studies so we can’t really know if it is safe or not, plus the supplements aren’t regulated. While its true that the supplements are not regulated, there are actually studies giving creatine to kids. Many of those studies are for kids with some sort of disorder that causes them not to produce it, but there are ones looking at creatine use for adolescents in sports.
Realistically, what I would tell someone is make sure everything ELSE is optimized before considering supplementing. For a youth athlete that wants to take creatine, make sure they are hydrated, sleeping 8 hours, and eating enough nutrients to support that. Also, their training and rest schedule will play a big role in how they recover and improve. Getting those things better will have more of an impact than a supplement.
How much should I take?
Most of the research points to about 3-5g a day is a good place to start. It's usually one scoop. You can mix it in your coffee, water, etc. Some research suggests doing a "loading phase" where you take a bigger dose (often 0.03 g/kg/day, 20 g/day, or 30 g/day) for about a week. This boosts the stores quickly and then you maintain with the 3-5g per day after that. You can just do 3-5g per day and it will slowly build up...usually the full benefits will hit after about 3-4 weeks vs 1 week. Downside of the loading phase is the bloating and digestion issues that can happen are much more likely to happen with higher amounts taken.
References/Further Reading:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11983583/
https://pmc.ncbi.nlm.nih.gov/articles/PMC7922146/
