Creatine: Not just for muscle heads

Even if you’re not interested in building big muscles like a bodybuilder, there are health benefits to increasing muscle mass: increased bone density, better balance, and fewer injuries. Greater muscle mass means higher metabolic rate, improved insulin responsiveness, lower blood sugar. The inevitable loss of muscle mass of aging can lead to frailty, an increasingly common situation for the elderly. Muscle loss be reversed, health improved as a result.

Since its introduction in 1994, creatine has exploded in popularity, particularly among bodybuilders and athletes interested in gaining muscle mass and strength. But creatine is not just for young weight lifters. If you are just interested in increasing muscle mass for its health benefits, then creatine is something to consider.

A study of creatine supplementation in men, average age 70 years, demonstrated that, when creatine was combined with strength training, it increased muscle mass 250% better than placebo (7.26 lb muscle vs 2.86 lb muscle), along with improved leg strength and endurance. The same group also demonstrated 3.2% increased bone density (measured using dual energy X-ray absorptiometry) after 12 weeks in participants taking creatine with strength training, while the control (no strength training, no creatine) group decreased by 1.0%.

Benefits are not confined to men. Similar results were observed in another study that included women (age 65 and older), with outcomes in females comparable to males. This is especially important for females, given the common development of osteopenia and osteoporosis in postmenopausal females.

Other studies have shown that benefits are maintained after stopping creatine supplementation.

The most popular form of creatine is the monohydrate, generally taken as a “loading” phase of 15-20 grams per day (generally split into 3-4 doses of 5 grams) for 5-7 days, followed by weeks to months of 2-5 grams per day.

An alternative form, polyethylene glycosylated creatine (PEG-creatine) provides similar effects at one-fourth to one-half the dose of creatine, i.e., 1.25-2.5 grams per day.

Despite previous concerns about kidney toxicity with prolonged use, another study showed that athletes taking creatine for up to 21 months have shown no adverse effects on kidney function, lipid (cholesterol) values, or other basic health measures.

Having healthy muscle mass doesn't make you bulge like a bodybuilder. With modest efforts at strength training, augmented with creatine supplementation, you have a wonderful tool to feel better, reduce injury, increase bone density, and combat abnormal insulin resistance, not to mention accelerate weight loss, since lean muscle mass consumes energy.

Comments (29) -

  • Chris

    7/5/2009 7:57:53 PM |

    I go thorugh phases of taking creatine every now and again and it does make me feel stronger and look better....but it also makes me get cramps and urinate a lot and I am not sure if that is healthy?

  • Lena

    7/5/2009 10:00:12 PM |

    There is also good evidence that for people who have kidney disease and are on a low-protein diet, supplementing with carnitine, amino acids and keto acids significantly improves health and slows kidney function decline. Some nephrologists had been recommending against a low-protein diet for kidney patients as on its own it decreases health basically due to wasting, but with the supplements this risk is removed and overall health improves.

    There is an American doctor working in Malaysia with people who can barely afford dialysis who is a big advocate of this approach, since the supplements are cheap and can delay the start of dialysis by years.

  • Lynn M.

    7/5/2009 10:32:19 PM |

    Too bad there wasn't a control group of strength training but no creatine to separate out the effects of strength training vs. creatine.

  • Anonymous

    7/5/2009 10:58:21 PM |

    My husband gained massively in strength and size by taking creatine and weightlifting so I'm convinced that it works. However, he says that it takes a lot glucose to activate it and since I was low carbing with the hopes that it might improve my Crohn's,  I wanted to avoid drinking all the juice, a pint or more, that he disolves the creatine in when he takes it.


  • Fitness-Diet-Info!

    7/5/2009 11:15:36 PM |

    Nice looking blog. Great article on Creatine.

  • kris

    7/6/2009 1:46:49 AM |

    I wonder if any positive/negative effects for hypo/hyper thyroid?

  • Anonymous

    7/6/2009 2:43:57 AM |

    Dr. D,

    I think you made a typo in paragraph 6. I believe you meant to say grams (not milligrams).

    Also, I think you left out the word, "can" in the last sentence of your first paragraph.

    Keep up the good work!


    P.S. I hope someday you will share a story if any of your patients have ever reversed their scan all the way down to zero. I know you have mentioned big reductions, but I am assuming those are people with pretty big scores to begin with. I was always curious if any of them ever made it all the way back down to zero..

  • dr j

    7/6/2009 12:17:03 PM |

    I maybe am wrong....
    read this loading as
    0.3-g body weight per day for the first week
    for a 70 kg male, 70x0.3=21 g per day
    could someone correct me pls?

  • Anonymous

    7/6/2009 3:35:47 PM |

    Dr Davis:
    Thought that Creatine needed to be taken with carbs/sugar.  what is the corect way to take it

  • Joe E O

    7/6/2009 3:36:04 PM |

    Dr Davis,
    I can't agree more. Not taking creatine while strength training (especially for folks over the age of 40 who may be taking a statin ) is like going out in the the rain without an umbrella.

    Personally - I would put strength training while using creatine right up there with the normalization of Vitamin D as far as improving my quality of life.


    Joe E O

  • Anonymous

    7/6/2009 3:48:23 PM |

    Typos: In the monohydrate paragraph, you say mg where you mean grams.

  • karl

    7/6/2009 3:52:40 PM |

    Yes - I think your units are off -- should be g - not mg.

  • Dr. William Davis

    7/6/2009 4:15:07 PM |

    Thanks for catching the typos.

    Yes: Creatine doses should be in grams, not milligrams.

  • pmpctek

    7/6/2009 6:45:52 PM |

    To those asking if creatine must be taken with carbs, in one word, no.

    Yes, creatine taken w/simple carbs has proven to cause faster and more complete absorption. But, when we're talking 15-20 grams/d during the loading phase, we're going to maximize our body's stores within an extra day or two anyway, without having to spike our insulin.

    My only concern with creatine is that it causes initial weight gain to be almost entirely due to increased water volume within the muscles and blood vessels.  That may be concerning for people trying to lower their blood pressure. The studies I've read have proven it does not increase bp.  But I have also read anecdotal reports that it may have caused acute elevated bp in some people after starting creatine.

  • Dr. William Davis

    7/6/2009 10:39:26 PM |

    By the way, I've also written a full-length article for Life Extension Magazine called Superhuman that will detail creatine use, along with HMB, BCAA, and other performance-enhancing supplements for non-bodybuilders.

  • darnoconrad

    7/7/2009 5:29:46 AM |

    Dr. William Davis,

    Does the increased production of creatinine cause concern?

    There was a product created to subvert the production of Creatinine called Kre-Alkalyn which fused ash with creatine-monohydrate in order to produce a pH balanced Creatine product which would not breakdown into Creatinine in the body. The pH of Kre-Alkalyn is at around 14. According to the company that holds the patent, as little as only 1-3g is needed in place of the 15-20g of creatine-monohydrate. According to studies posted on their own site, the Kre-Alkalyn users out perform the creatine-monohydrate users.

    I would like you to comment critically or share any information that you have on these subjects please.

    Thank You!

  • Zach

    7/8/2009 2:03:06 AM |

    Dr. Mike,
    I had kidney stones last year.  I am on the paleo diet/EF diet.  Once a week or so, in addition to supplements of a multivitamin, antioxidants, and vitamin D I take some ginger extract, which really makes my whole kidney area feel cleaned out.  I'm going to have to try out the creatine.
    Best Regards,

  • Andrew

    7/8/2009 7:39:14 AM |

    Two comments as an avid creatine user:

    It's not necessary to load creatine.  All the loading phase does is saturate your body more quickly.  However, many people, myself included find the loading phase not only annoying, but also causes a significant amount of bloat.  IMO, you can just take it in 5g doses to start and kind of ease into it.  There's no real reason not to do it this way, as loading is just faster, not better.

    There are a few forms of creatine.  I prefer supplements made with Creapure, as it seems to go down more smoothly.  I also use powder for quicker absorption, instead of pills.  I generally just put the creatine dose in my mouth and then chug some water.  Creatine doesn't have any taste, so it's really just a matter of texture if you can stand it.  The primary thing I aim for is about 1 gal of water per day.  This isn't as daunting as it sounds, as you should be drinking close to that amount, anyway.

    Dr. Davis - If possible, could you do a post about Beta Alanine?

  • Anonymous

    7/15/2009 5:39:18 PM |

    Supplementation with creatine greatly increases ones chances for developing rhabdomyolysis. Beware, especially if you are taking it in combination with a statin.

  • Anonymous

    7/16/2009 2:03:57 AM |

    quitting the statin for a few months is a good idea anyhow.  I am lucky to have the support of an enlightened PCPhys.  She provides guidance and support when I ask to make changes to my Statin or add a supplement.  I don't need her permission to stop taking it but in consultation, she will ask what my goal for the change is and tell me what to look out for.  Get y'rself one of these consultative Docs, they are true gems.

  • william Trumbower

    8/25/2009 9:01:40 PM |

    After reading your post I added creatine along with D-Ribose twice a day.  I do an Ultrafit work out twice weekly and was astonished at the increase in my strength.  I had no side effects at all.  I eat lowcarb-gluten free.

  • Anonymous

    12/5/2009 6:19:03 PM |

    Hey are you a professional journalist? This article is very well written, as compared to most other blogs i saw today….
    anyhow thanks for the good read!

  • Jolly

    2/16/2010 1:16:21 AM |

    Any idea when your Superhuman article will be published?

  • Anonymous

    4/1/2010 1:56:55 AM |

    The doc should compare kre-alkalyn to all studies compaired to creatine are very promising.

  • Anonymous

    7/22/2010 7:21:34 AM |

    Im 16 yrs old and i have osteoperosis. i go to a world class doctor who specializes in kidneys. i took a bone density test and 24hr urine test. i took creatine for weightlifting trying to get bigger. when he told me the results he said everything was normal except one thing. i was excreting too much calcium and not retaining too much citrate. (or something). this leads to kidney stones and other problems. creatine is horrible for you. it lowers bone density long term and puts stress on your kidneys. same with shakes. if you have a good diet thats enough protein already. when you take more protein it sits in your stomach waiting to be processed and is terrible for your kidneys. all this info is from my doctor.....just a heads up. i thought it was safe. but i was wrong.

  • Scott

    9/13/2010 6:28:50 PM |

    Good post.

  • buy jeans

    11/3/2010 9:15:01 PM |

    Benefits are not confined to men. Similar results were observed in another study that included women (age 65 and older), with outcomes in females comparable to males. This is especially important for females, given the common development of osteopenia and osteoporosis in postmenopausal females.

  • David

    12/23/2010 6:38:46 PM |

    ATP is a long name for a phosphate that increases muscle contraction. Creatine in NO way is harmful, as you can find Creatine in red meats like the steak you eat after your workout. If taken properly (5mg a day), you will notice increases in size, power, as well as weight.

  • Harry

    12/28/2010 12:05:53 PM |

    I took a supplement containing creatine one evening and the next morning I woke up with chest pounding arrythmia. I went to the ER, was diagnosed with Atrial Fibrillation with rapid ventricular response and Rhabdomyolysis (creatine kinase 17000 u/L with a normal range 40-170 u/L) and got admitted to the hospital. The A-Fib lasted 24 hours and the rhabdomyolysis lasted 7 days. I had not associated the creatine with this episode, until a few months later I came across an article titled "Lone atrial fibrillation associated with creatine monohydrate supplementation"
    So, before you supplement with creatinine, keep in mind the danger of atrial fibrillation.