Creatine is one of the most common and most studied supplements. It’s also one of the most useful supplements for any adult age groups. Its benefits include supporting muscle strength, muscle gain, cognition and maybe even improving our overall healthspan. As a longevity doctor, this is one of my favorite supplements and I take it myself on a daily basis.

What is Creatine?

Creatine is a compound stored in muscles, that helps generate ATP; this is the energy your muscles use to perform the short and intense contractions. We make creatine ourselves in our liver and kidneys, and also absorb small amounts from our diet, but only if we eat meat. There is very little creatine in other food groups.

Creatine is different from creatinine which is a measure of your kidney function. And taking creatine does not increase your creatinine (which is a measure of your kidney function), unless if you take it in high quantities; but the same applies to any supplement or medication. Balance is key.

Creatine Benefits for Midlife

Strength and Lean Mass

Perhaps the top benefit of creatine in any age group. But even more important during our midlife as muscle starts breaking down, and we often don’t do enough to increase its mass again. This process is called sarcopenia and is one of the hallmarks of frailty.

Taking creatine regularly in your 40s, 50s, 60s and beyond can help slow down the breakdown of muscle when combined with regular resistance or strength training.

Cognition

The effects of creatine on cognition are still being studied, but multiple studies show a clear link. When I was studying for my medical exams, creatine was one of my main supplements that I ensured I wouldn’t miss.

Meta analyses, such as this review have shown an increase in cognitive performance and memory, especially in those in their 60s and 70s.

Taking creatine may therefore become a key pillar in warding off age related cognitive decline in the near future.

Other studies have also shown that creatine may offer protection against other neurological disorders such as Parkinson’s Disease, Huntington’s Disease and even Alzheimer’s.

Bone Health

Although an indirect effect, by increasing exercise tolerance, creatine may also improve bone density. Enabling heavier lifting/impact work, creatine may aid bone outcomes alongside training and adequate protein.

Creatine can also directly enhance osteoblast activity (those cells that help build bone) and decrease osteoclast activity (the cells that break down bone).

Cardiovascular Benefits

A new pilot study published earlier this year showed that creatine may improve vascular health while also lowering blood glucose levels and cholesterol levels in the older population. This is an early link but certainly something to keep an eye on, especially if you have a family history of cardiovascular disease in the 50s or other risk factors.

Anti Inflammatory Benefits

We know that chronic low grade inflammation contributes to ageing (inflammageing). Studies have shown that creatine has significant anti inflammatory properties by reducing inflammatory markers that we can measure in blood tests, such as CRP. Creatine also acts as an antioxidant so this helps mitigate oxidative stress that otherwise accumulates with ageing.

How Much Creatine Per Day?

Evidence so far shows that about 5g of creatine per day is standard.

The best form of Creatine to take is the powder form. There are creatine gummies or capsules available, but these are a poor choice of supplement as they have much less creatine than the recommended dosage. So you either have to take several of them to achieve the recommended dosage, or you can be chronically underdosing it.

When To Take Creatine?

You can take creatine any time of day. If you have a sensitive stomach, you can try pairing it with a meal.

If you train in the gym or do any exercise, some people also say that it’s best to take it straight after to improve its absorption.

Avoid taking it with coffee, though as some studies show this can impair absorption.

Creatine Loading Phase

This is optional, but recommended if you want to start noticing the effects of creatine sooner.

The best way to load with creatine is to take 10-14 days of 10g per day, after which you go back down to 5g per day.

A further protocol is to take 5-7 days of 20g per day of creatine. This can give faster increases, but it may also not be tolerared by some people with sensitive stomachs. You may notice a slight increase in muscle gain, BUT this is mostly water making the uscle look hypertrophied, rather than muscle tissue.

Does Creatine Cause Hair Loss?

No, the majority of evidence available from research does not support a link between creatine and hair loss or baldness.

This myth usually comes from social media or this study where rugby players were supplemented with a much higher dose of creatine than recommended (25g for 7 days, followed by 5g daily). They subsequently noted that Creatine at this high dosage increases levels of DHT in the blood stream, and high DHT levels has been linked to hair loss. However, this has not been shown to be the case in other reports.

Creatine for Women

Creatine is safe for women to take at the same doses as in men, so 5g per day. If low BMI, you may want to lower this to 2-3g

As is the case with most supplements, we don’t have enough safety data on taking creatine during pregnancy or breastfeeding. The general recommendation is therefore to avoid it in these cases.

Side Effects of Creatine

Creatine is usually well tolerated, but there are some side effect to consider. Most of these apply if you take higher doses of creatine, but they could in theory apply to any doses.

GI/ Abdo problems: Abdo cramps, pain or general discomfort +/- loose stool. More commonly applies if you take more than 10g of Creatine at once.

Kidneys: Avoid taking high doses of creatine for prolonged periods >5-7 days even in healthy people. If you have kidney disease or take any other medication that could affect the kidneys, it’s best to check with a doctor before you start taking Creatine. This is more likely to be the case in the elderly population due to polypharmacy. Say, if you are taking a diuretic and an ACE inhibitor as well (for blood pressure), these are already putting stress on your kidneys, so Creatine may not be recommended.

Lastly, creatine supplementation could technically increase your Creatinine levels on blood tests, so if these are raised, it’s best to inform your doctor.

In conclusion, creatine is a brilliant supplement that has been studied for decades. It already has lots of benefits that we know about, and perhaps in the near future we will be discovering even more. To book a personalised consultation and discuss the optimal supplements for you, or to join our longevity plans, please get in touch!