Is Creatine Just for Bodybuilders? What the Evidence Actually Says

Creatine is having a moment.

For years, most people associated it with bodybuilders and gym bros. Now I'm hearing about it everywhere, especially for women, healthy aging and even brain health.

As both a pharmacist and a personal trainer, I love seeing people interested in something that actually has a substantial amount of research behind it.

But I also think we need to separate what we know from what we're still learning.

So, what does the evidence actually say?

First, what is creatine?

Creatine is a compound our bodies naturally make, and we also get some through foods like meat and fish.

Most of it is stored in our muscles, where it helps us rapidly regenerate ATP, the energy our cells use during short, intense efforts like lifting weights or sprinting.

Taking creatine increases those stores.

Pretty simple.

Where is the evidence strongest?

Muscle, strength and exercise performance.

Creatine is one of the most extensively studied sports supplements available.

When combined with resistance training, it can help improve strength and lean body mass beyond resistance training alone. One 2024 meta-analysis found about 1.1 kg more lean body mass in adults taking creatine while resistance training compared with resistance training alone.

But that last part matters.

Creatine doesn't replace strength training. It can help you get more out of it.

And that's a message I think gets lost online.

What about women?

This is where I want to be careful.

There is growing interest in creatine for women, particularly as we age, but women have historically been underrepresented in sports nutrition research.

Studies in older and postmenopausal women are encouraging, particularly when creatine is combined with resistance training. But the evidence specifically in women is smaller and less consistent than the overall creatine literature.

So yes, I'm interested.

No, I'm not ready to call creatine a miracle supplement for every woman over 40.

Now, what about the brain?

This may be the most interesting part.

The brain uses a tremendous amount of energy and also relies on the creatine-phosphocreatine system. So researchers have been asking whether increasing creatine availability might influence cognition.

The answer so far?

Maybe, for some things.

A 2024 meta-analysis found a benefit for memory, but not for overall cognition or executive function. The certainty of the evidence also varied considerably depending on the cognitive outcome being studied.

Other reviews have found the cognitive evidence to be mixed, although certain groups or situations, including periods of metabolic stress such as sleep deprivation, are particularly interesting areas of research.

So when I hear:

"Creatine boosts your brain!"

I think that's ahead of the evidence.

A better statement is:

Creatine has promising emerging evidence for some aspects of cognition, particularly memory, but we still have a lot to learn.

Not quite as catchy. Much more accurate.

Will it make me gain weight?

It can increase your weight, particularly when you first start taking it.

But that doesn't mean you're gaining body fat.

Creatine draws water into muscle cells, and increased water associated with muscle creatine storage can contribute to early weight gain. Longer-term changes can also reflect increases in lean mass when creatine is paired with resistance training.

So if the scale moves, context matters.

And what about your kidneys?

This is probably the question I get asked most as a pharmacist.

Creatine can cause a small increase in serum creatinine, which happens to be one of the markers we use to estimate kidney function.

That can sound alarming.

But an increase in creatinine does not automatically mean the kidneys have been damaged.

Current evidence in healthy people taking recommended amounts of creatine has not demonstrated impaired kidney function.

Still, tell your healthcare provider if you're taking creatine, especially when they're interpreting bloodwork. And if you have kidney disease or another medical condition that could affect whether supplementation is appropriate for you, speak with your healthcare provider first.

Okay, so what do you actually take?

If you decide to use creatine, this part doesn't need to be complicated.

Creatine monohydrate.

It's the form with the largest body of evidence behind it.

For most adults, 3 to 5 grams daily is a commonly studied maintenance dose.

You can do a loading phase to saturate muscle stores more quickly, but you don't have to. Taking it consistently will get you there more gradually.

And you don't need the fanciest container on the shelf.

I would look for a reputable product with independent third-party testing.

So, do I think everyone needs creatine?

No.

Good nutrition, adequate protein, resistance training, sleep and recovery still matter far more than any supplement.

But if you ask me which supplements have enough evidence behind them to make me pay attention, creatine is absolutely on that list.

I'm confident in the evidence supporting its role in strength, exercise performance and helping support gains in lean mass when combined with resistance training.

I'm interested in the emerging research around women, healthy aging and cognition.

And I'm not ready to tell you that it prevents dementia, treats osteoporosis or that everyone should be taking it.

That's where I think good wellness information should live.

Not in the hype. Not in the fear. In the evidence.

Sandra Tadros Guirguis is a clinical pharmacist, Menopause Society Certified Practitioner, personal trainer, author and TEDx speaker. Through STG Wellness, she translates health research into practical strategies people can actually use.