What does creatine do? The muscle-maintaining supplement explained
Creatine is a great supplement to take if you regularly work out. Here, experts explain what it is, how it works, and the many benefits for women
There are so many benefits of creatine for women - especially those over 40 and those going to menopause. But unless you've spent time in professional sports and bodybuilding spaces, or researched fitness supplements online, you wouldn't be blamed for never having heard of it.
Creatine should sit in the kitchen cupboard next to vitamins, your pick of the best protein powder for women, and all the other must-haves. It's one of the most researched and popular supplements in the world, and one nutritionists may recommend to those looking to improve their experience of menopause.
"As a performance nutritionist with over 15 years of experience, I have been recommending creatine to be used to improve strength and exercise performance. However, in the last few years there has been some interesting research showing that creatine benefits extend to brain health, energy levels, bone density and muscle retention," says Dr Linia Patel, an award-winning dietitian and performance nutritionist.
Here, to reveal all you need to know about creatine, from what it is and its benefits to when and how to take it, woman&home speaks to Dr Patel and other specialists in women's nutrition.
What is creatine?
Creatine is a compound naturally found in the muscles, brain, and gut, consisting of three amino acids (L-arginine, glycine, and L-methionine). Its main role is supplying energy to the muscles when we lift heavy objects and do high-intensity activity.
After digesting protein, the body produces just under 1g of creatine in the liver, but many people supplement an artificial form called creatine monohydrate to reap various health benefits. There are many types of artificial creatine you take, but this is the one most researched and most widely used.
You can also find creatine in many common foods - especially animal products like meat and fish - but you'll likely never be able to hit the amount available in creatine supplements, which is why so many people take it.
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What does creatine do?
Put simply, creatine helps to maintain a continuous supply of energy to our muscles during intense exercise and heavy lifting - but to understand how it works on a deeper level, we have to delve into how our body produces energy.
"Adenosine triphosphate (ATP) is a molecule that carries energy within cells - often referred to as the 'energy currency' of our cells," says Abi Roberts, sports nutritionist with Bulk. "This is our main fuel source for high-intensity activity and explosive movements but we only have a limited supply of this fuel, so creatine is the substance involved in the re-synthesis of ATP, providing us with a more constant supply."
When we supplement creatine, she explains, we "increase the stores of creatine in the muscles, which accelerates the recycling of ATP and allows us access to fuel for more high-intensity exercise".
Having more energy means we can work harder, encouraging our bodies to adapt and change for the better - especially in terms of strength, power, and muscle mass, all of which are required to live an active lifestyle.
Who is creatine suitable for?
Creatine is suitable for most adults who regularly exercise. Research from several institutions, including those by the University of North Carolina, says it's most effective for women engaging in high-intensity exercise over short durations, or repeated sets of high-intensity exercise with shorter rest periods. That means strength training for women in all forms from dumbbell workouts for beginners to weightlifting, treadmill sprints, hill repetitions, and HIIT workouts.
It's not the best for longer-distance runners, cyclists, and walking enthusiasts without this high-intensity component. However, Dr Patel says there is "some preliminary evidence highlighting the potential cardiovascular health benefits of creatine supplementation too. It may improve blood vessel function and blood pressure regulation as it impacts nitric oxide production."
It's also been proven to be particularly beneficial for women over 40 and those going through menopause, as the same research from the University of Carolina shows it can prevent age-related muscle, bone, and strength loss by reducing inflammation and oxidative stress and increasing bone formation. But that's not all...
Benefits of creatine for women over 40
1. Stronger bones
Women tend to lose about 2% of their bone density each year during perimenopause and in the two years post-menopause, thanks to the dropping levels of oestrogen in the body. Creatine may help to prevent this, says Rachael Sacerdoti, a certified nutritionist and personal trainer specialising in women's health and the founder of the It's So Simple method.
"Some research suggests that creatine supplementation may positively affect bone density [as it increases metabolic activity and helps with bone cell development], which is important for reducing the risk of osteoporosis, a condition more common in postmenopausal women," she says.
2. Helps prevent muscle loss during menopause
Another common result of menopause is muscle loss, again thanks to the declining levels of oestrogen in the body, but "creatine supplementation can help combat age-related muscle loss, also called sarcopenia, by increasing muscle strength and promoting lean muscle mass maintenance," says Sacerdoti.
"While the direct link between oestrogen and creatine in the female body is not well-established, we know that the decreasing levels of oestrogen in perimenopausal women have an influence on muscle mass, fluid balance, bone health and hormonal interactions, which may directly impact creatine metabolism," adds Dr Patel. "This means perimenopausal women have even lower amounts [of creatine] which, in turn, is why we are seeing such positive results with supplementation in this age group."
3. May positively impact mental health
The benefits of creatine for women have been largely focused on the physical over the years, but research in recent years shows that creatine may be able to influence how the brain works.
"Creatine may support brain function, memory, and overall cognitive performance, promoting mental wellbeing as we age," notes Sacerdoti.
While no supplement is a replacement for proper mental health aid, there's good research to suggest that creatine may help those diagnosed with depressive disorders. For example, a review by Seoul National University College of Medicine and College of Natural Sciences found that women who took their daily medication with 5g of creatine responded twice as fast as those who took the antidepressant alone.
4. Creatine can improve exercise performance
The main use of creatine is to improve exercise performance - and for good reason. In a study from Universidad Europea de Madrid, female participants had a 15% increase in exercise performance after taking creatine for 10 weeks, compared to just 6% of men, suggesting it's double as effective for women.
The improvements are caused by the body's improved ability to produce ATP (as mentioned above), in all likelihood. Normally, ATP starts to drop after just 10 seconds of high-intensity exercise - as Penn State Milton S. Hershey Medical Center research reveals - but as supplementing with creatine means we can produce more ATP, we can maintain an excellent exercise performance for longer.
Even if you're not interested in performing at an 'excellent' level during exercise, this is a huge advantage with real-world impact. For example, the stronger your bones and muscles and the longer you can exercise, the more muscle you have. The more muscle you have, the faster your metabolic rate, and the faster your metabolic rate, the easier it is to maintain a certain body weight and ward off adverse health conditions like heart disease and diabetes.
5. It may reduce tiredness
All this talk of more exercise may make you worry about getting through the week without feeling tired all the time. Well, even just one dose of creatine can help with this, according to new research by Forschungszentrum Jülich.
In this study, the sleep-deprived participants were given a single dose of creatine monohydrate and asked to complete various cognitive tests. Compared to the placebo group, there were improvements in brain performance and processing speed - meaning participants felt more awake and alert after taking a creatine supplement.
Other older research backs this up too - University College Chichester loaded participants with 5g of creatine monohydrate, four times a day, for seven days immediately before an experiment. They then went through 24 hours of sleep deprivation, and researchers found that the supplementation positively affected their mood and performance in tasks requiring a lot of brain activity compared to the placebo group.
Another study by the University of Tokyo produced similar results - 8g of creatine per day for 5 days was shown to reduce mental fatigue in participants repeatedly doing mathematical equations.
What is the best creatine for women?
When choosing a creatine to buy, you want to look for creatine monohydrate in its purest form. "Consider factors such as purity, form, and additional ingredients, and look for reputable brands that offer pure creatine monohydrate, which is the most studied form and often the most cost-effective," says Sacerdoti.
"Other forms like creatine hydrochloride or buffered creatine may have different absorption rates but lack extensive research. Avoid products with unnecessary additives or fillers," she warns.
As unflavoured creatine doesn't taste of anything, you might find it easiest to take the supplement in capsule form along with your other daily vitamins. There are 3g of creatine (3000mg) in each of these capsules, so they are perfect for those new to the supplement and starting on the lower dosage.
A cheaper way to take creatine is in powder form, where you can also choose your own dosage. I'd suggest mixing this in with your breakfast, a protein shake or a smoothie to get rid of any gritty creatine texture. Alternatively, you can buy a flavoured creatine - this one from proteinworks comes in unflavoured, berry, and orange varieties.
Micronised creatine monohydrate is a good option for those who find regular creatine irritates their stomach - a typical side effect. The process increases molecule surface area 20 times on average, which makes it more soluable and easier to digest. Although, this comes at a price.
Creatine tablets vs powder
- Easier to measure your intake with tablets: It's important to know how much creatine you're taking, especially in the loading phase, so you don't take too much or too little. Having a pre-packed tablet is easier to monitor than scooping a powder out for yourself.
- Tablets complement other daily routines: It's easier to add another tablet into your rotation of vitamins every day than something new like a powder.
- Powder is cheaper: If you're new to creatine and want to give it a try, it's best to opt for a powder (as all pure creatine monohydrate is the same, no matter the brand you buy) and save your money until you know you like it.
- Powder absorbs into the system quicker: The jury is out on how soon pre- or post-workout you should take creatine and whether it makes any difference - but if you want to take it as quickly as possible, a powder is a better option. Stomach acid has to break down a tablet before the body can access the creatine, whereas powder doesn't have this barrier to contend with.
When should you take creatine?
There's no rule for when you should take creatine so you can take it at any time of day. While plenty of studies have reviewed this supplement, they all offer conflicting conclusions about how effective it is to take creatine shortly before or after a workout versus in the hours around your session. Essentially, it doesn't make any difference. You also take creatine on rest days, when you don't do any exercise at all.
How often should you take creatine?
To get the most out of this supplement, it's recommended that you take it every day - even on days when you don't exercise. This keeps a good supply of creatine in your muscles throughout the week.
What happens if you miss a day? "The impact of missing a day will depend on the dosing strategy you choose," says Dr Patel, but largely, it won't make too much of a difference - provided you don't do it very often.
Should you take creatine on rest days?
Yes, you should take creatine every single day - and that includes the days when you don't exercise at all. Unlike other fitness supplements, creatine does not have an immediate effect so you need to keep the load up in your muscles constantly for it to be effective over time.
Creatine is very similar to vitamin supplements in this way - you wouldn't take a single vitamin D tablet and expect an immediate result. The same goes for creatine.
But again, it doesn't matter what time of day you take it. Some people take their creatine monohydrate in the morning to get it out of the way, while others supplement it with their meal in the evening to reduce the chance of any digestive discomfort throughout the day.
How much creatine should you take?
3 to 5g of creatine monohydrate daily is the general recommended amount. Before this, many experts recommend starting with a loading phase to saturate the muscle stores.
Dr Patel says one way to load creatine is to take 5g of creatine monohydrate, every four hours, four times a day, for five days. Then, maintain your intake with 3 to 5g daily as noted.
"However, I recommend that you take these recommendations and make them bespoke to you by seeing a women’s health dietitian who can gauge the most effective dose for you," she notes.
You can also avoid the loading phase and take 3 to 5g of creatine per day - but research from Texas A&M University suggests it'll take up to four weeks to get the same amount of creatine in your muscle stores, i.e. it'll take a month to start reaping the benefits.
How to take creatine
Creatine is a very versatile supplement - you can take it with anything and reap the benefits. Some people add the powder to their morning coffee (or a healthy alternative to coffee) as the warm water improves solubility and the caffeine offers an extra kick. Others just scoop it into a glass of water.
Powdered creatine, unlike tablets, has a grainy texture and slightly acidic taste that can make it unpleasant to drink when diluted in water, which is why many people choose to add it to their protein shake, smoothie, or sprinkle it on top of their food.
PhD Nutrition Diet Whey: £21 at Amazon
Looking for a protein powder to complement your creatine supplement? The PhD Nutrition Diet Whey is a new favourite of Health Editor Grace Walsh. It blends incredibly well with water, milk, and yoghurt, and the flavours don't taste artificial.
Can you mix creatine with protein powder?
Yes - whether you're drinking one of the best protein shakes for losing weight or a shake with 20g of your favourite protein powder, you can add creatine to the mixture.
Some studies, including those by Texas A&M University and the University of Wisconsin-La Crosse, suggest that taking your creatine with a high-protein and/or high-carbohydrate mixture can improve digestion and absorption. However, the jury is still out on whether this is truly effective, with other studies suggesting it makes no difference at all - so it's up to you.
What happens if you take too much
If you take slightly too much creatine, you'll likely experience a little discomfort - such as bloating, dehydration, dry mouth, and muscle cramps. However, if you continue to take above the recommended amount over a long period, you could experience more serious side effects, like hair loss and liver and kidney damage.
Only take as much creatine as is recommended on the packet. If you are unsure how much to take, consult your doctor or another certified health professional and start with a lower dosage of up to 3g daily.
Some people also experience side effects even when they take the recommended dose - especially at the beginning.
Typical side effects include:
- gastrointestinal discomfort
- headaches
- muscle cramps
- dehydration
- diarrhoea
- dizziness
- weight gain due to water retention
Grace Walsh is woman&home's Health Channel Editor, working across the areas of fitness, nutrition, sleep, mental health, relationships, and sex. She is also a qualified fitness instructor. In 2024, she will be taking on her second marathon in Rome, cycling from Manchester to London (350km) for charity, and qualifying as a certified personal trainer and nutrition coach.
A digital journalist with over six years experience as a writer and editor for UK publications, Grace has covered (almost) everything in the world of health and wellbeing with bylines in Cosmopolitan, Red, The i Paper, GoodtoKnow, and more.
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