Are creatine supplements all they're pumped up to be?

Creatine supplements have long been popular among iron-pumping gym bros. But these days, interest in creatine has exploded, as social media influencers tout the benefits of creatine for everything from adding muscle to boosting cognition and even helping to regulate blood sugar.
"It's the supplement of the year," wellness influencer Bobby Parrish said in a recent TikTok post. "Creatine is legit."
It's a compound made from three amino acids that your muscles use as a source of energy. Your body makes some creatine, and it also comes from red meat, chicken, or fish.

But can maximizing your creatine with supplements really deliver all the health benefits influencers claim? Here's what the research shows.

The claim

Creatine supplements can help grow muscle and improve athletic performance. Some claim it could prevent age-related bone and muscle loss, improve brain function when you're sleep deprived and boost cognition in other ways, or even protect against Alzheimer's disease.

The evidence

Decades of research have shown that taking supplements to maximize the amount of creatine stored in muscles can help to add lean muscle mass and improve athletic performance, providing quick bursts of energy to "do a few extra reps on a bench press or finish a little bit stronger in a road race," says Abbie Smith-Ryan, a professor of exercise and sports science at the University of North Carolina, Chapel Hill.
And combining creatine with carbohydrates can help boost endurance and speed recovery from a hard workout, she says.
Now, you could increase your creatine stores by eating more, but "the problem with that is we're talking, like, 2 pounds of raw beef every day, and not many people are willing to do that," says Jose Antonio, a professor of exercise and sports science at Nova Southeastern University in Florida. Hence, supplements.
When it comes to adding lean muscle mass, Antonio says the evidence for creatine supplements is "overwhelming." They work — but Antonio says there's a big caveat: "You can't just take creatine and then you put on lean mass." In other words, you actually have to work out.

A review of 35 studies found that when creatine supplements were combined with resistance training, adult men added around 2 to 3 pounds of lean body mass. For older people especially — since we tend to lose muscle mass as we age — that could be significant, Smith-Ryan says.
There's also some newer research suggesting creatine supplements may help with bone health, though that evidence is still emerging, says Hannah Cabre, a registered dietitian, exercise physiologist, and postdoctoral fellow at Pennington Biomedical Research Center in Louisiana. She notes that exercise in general helps maintain healthy bones.
"Any time we're exercising, moving, lifting weights, the muscles are pulling on the bones, which is what actually increases their bone density. So if you're helping the muscle, you're also helping the bone," she says.
As for other potential benefits of creatine supplements — such as helping regulate blood sugar in people with Type 2 diabetes, improving memory, helping the brain function better when you're sleep deprived, and boosting brain health in other ways? Antonio says the early evidence suggesting those benefits "isn't strong, but it's certainly interesting."
Smith-Ryan agrees, saying, "I would say as a scientist, I would love more data."

Still, she says, if you want to try creatine supplements, go for it.
"Creatine is not going to be the magic bullet," she adds. "But I do think that it's a low-hanging fruit that has minimal side effects."
Antonio notes that vegans and vegetarians are more likely to see a benefit from creatine supplementation because they don't get as much, if any, creatine from their diet.

The nuance

If you are taking creatine supplements to boost your performance at the gym or in the sports field, just know the boost might be small.

"It's not going to make you necessarily a better baseball player or a better football player. But it will help you train harder," Antonio says.
Creatine is considered very safe for adults, though if you have kidney disease, you should talk to your doctor before taking it, says Dr. Pieter Cohen, an associate professor of medicine at Harvard Medical School who researches supplement safety. He recommends buying supplements that contain creatine monohydrate — the most widely studied form — as the only ingredient.
"If someone wants to use supplements, we need to know exactly what ingredient we're getting and exactly the precise dose," Cohen says.
He notes that studies have found that products sold as pre-workout sports supplements can often be adulterated with prohibited ingredients. So he says if you do try a creatine supplement, make sure it's certified by a third-party certification program; he recommends NSF Certified for Sport.
Cohen says while creatine supplements might mean the difference between winning and losing for a competitive athlete, "for recreational activities and certainly to stay healthy for the long term, I don't personally think there's a role for creatine that's been proven as of yet."
And not everyone will see a difference in their performance after supplementing with creatine. Cohen points to research that suggests that due to individual biological differences, as many as 20% to 30% of people won't respond to creatine supplementation.

If you want to try it

There are two strategies for getting started on creatine supplements for muscle-building benefits. One is what's called a loading dose, says Antonio, which involves taking 5 grams of creatine four times a day for seven days. This will quickly build up creatine stores in muscles but might cause some gastrointestinal distress.
That's why Antonio and Cabre both say they often recommend the second strategy, which is to take 5 grams of creatine daily. It will take longer for the creatine to saturate the muscles, so you need to take this daily dose for at least four and preferably eight weeks before noticing a difference in terms of lean muscle mass, says Antonio.
Once someone has been on creatine for a while, 3 to 5 grams a day is generally considered the maintenance dose.

The bottom line

"If you want to try creatine, but you understand what the potential benefit is — that you might be able to do a heavy, repetitive activity a little faster and you choose to try it for that reason — that's reasonable," Cohen says.
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