I can always tell when a supplement is having a moment on TikTok because my inbox will fill up with questions from patients. Unfortunately, most of the time the supplement I am being asked to critique is weirdly overpriced or at a much lower dosage than the therapeutic threshold.
One exception to this is creatine.
Here’s my take:
Creatine is actually pretty great! And it is really well studied. Creatine is a natural molecule made from three different amino acids, protein building blocks.
Many of creatine’s benefits affect muscles. Creatine supplementation, with regular resistance exercise, improves muscle strength, explosive output, and significantly helps muscle recovery after intense exercise. It also helps improve energy, because it acts as a phosphate donor to regenerate ATP.
The other organ that really benefits from creatine is the brain. It helps with memory and reduces mental fatigue.
So creatine makes you ripped and smart? That’s actually what the research says.
But can we just get it from food?
The body actually makes some of its own creatine, but only about 1 g per day. If you are following a carnivorous diet, you may be getting 1 to 2 g per day on average, less if you are following a plant-based diet. Still nowhere near the 5 g per day recommendation to optimize muscle performance, brain function, and cardiovascular health.
Is creatine primarily for gym “bros”?
Twenty-six-year-old dudes doing plyometric exercises at the gym will definitely benefit from creatine. But you know the other group research says creatine can be very beneficial for? Women!
Women in their reproductive years, perimenopausal women, and postmenopausal women all benefit from creatine supplementation. Women tend to get less creatine from their diet, and we produce less as we age. Also, 95 percent of creatine is stored in muscle. If you have less muscle, you store less creatine.
Do I need a specific type of creatine?
Yes. Creatine monohydrate. To get the recommended 5 g, it usually makes sense to take it as a powder. You can get it as a capsule, but you’d have to take five or six capsules.
Look for “micronized” creatine powder, which dissolves easily in water and has better absorption. I do have one patient who found creatine gummies with a 5 g dosage, so you can look for those.
Will it help me lose weight?
Ok, this is where I may lose some of you. No, it will probably not make you lose weight. In fact, you may gain a few pounds, but it is usually from muscle cell hydration. However, as you gain muscle, your metabolism will increase and your body composition will improve.
Can I take it if I am on a GLP-1 like Ozempic?
Yes! In fact, this is a great muscle preservation strategy while on these medications. The rapid weight loss people experience is often half fat and half muscle. Creatine can help make sure you retain your muscle.
Should I take it every day?
Yes, that seems to be how it works best.
Can I take it before my workouts? After my workouts? First thing in the morning? At bedtime?
Yes. The benefits of creatine show up no matter when you take it, so experiment to see what works best for you. If you are using it specifically for muscle recovery after workouts, I would take it before your workout.
Who should not take creatine?
If you have significant kidney disease or liver issues, or are pregnant, talk to your doctor first. It may be that creatine is still a good supplement for you at a modified dosage.
Summary:
Creatine is one of the most cost-effective, evidence-based supplements you can find. You don’t need a complex protocol, a simple daily scoop of creatine monohydrate works fine. Look for a brand that is NSF certified or from a reputable nutraceutical company. See my list of favorite creatine products here:
