Creatine: The Supplement I Give My Own Mother
Let me tell you about my mum.
She turned 60 last year, and six months ago I convinced her to start taking creatine every morning. Not because she wants to bench press more. Not because she's chasing a PB. Because I genuinely believe, based on what the research now shows, that it is one of the most useful things she can do for her brain, her bones, and her long-term health.
I've been taking 5g of creatine monohydrate every morning myself (when I remember) for the past 2 years. I'm not a bodybuilder and I never claimed to be. I'm an NHS pharmacist and father-of-two who reads the evidence and makes decisions accordingly. If I had to curate a list of supplements to recommend to almost anyone - creatine would sit near the top of that list.
Here’s why.
What creatine actually is
Creatine is a compound your body produces naturally, mostly in your liver and kidneys — about 1–2 grams per day. You also get a small amount from meat and fish, which is why vegetarians consistently show lower baseline creatine levels than omnivores. Supplementation closes the gap between what your body makes and what diet alone can't always provide.
Creatine helps to regenerate ATP - the main energy currency of the body - providing rapid energy to muscle tissue during high-intensity exercise. It does this by increasing phosphocreatine concentrations intracellularly which then acts as a donor of a phosphoryl group back to ADP (adenosine diphosphate) so that it may become ATP (triphosphate) again.
Here's the thing that tends to surprise people: creatine is one of the most researched supplements in the world. Hundreds of peer-reviewed trials. Decades of safety data. [1] Independent review after independent review all pointing in the same direction. It has been sitting in the shadow of the protein shake and tarnished by the gym-bro association for too long. Science has now truly moved well beyond that context.
The muscle case, and why it matters after 40
The muscle evidence is where creatine has been established for the longest, and it remains the most robust. Creatine supplementation helps users get extra performance in the gym due to delaying muscle fatigue by improving energy availability during intense exercise. But newer evidence is emerging which suggests it may also support muscle protein synthesis through pathways like mTOR. In studies, creatine combined with resistance training consistently increases lean muscle mass, improves upper body strength, and supports faster recovery between sessions. These aren't small effects, and they're not limited to elite athletes. Everybody can benefit from this adaptation.
After 40, you lose around 1% of your muscle mass each year. That doesn't sound dramatic until you picture it accumulated over a decade, then two, then three. In the pharmacy, I see the downstream consequence of that loss: people who are less mobile, more prone to falls, slower to recover from illness or surgery.
This isn’t about gym performance. It’s about staying independent in your 70s. Muscle mass is not a vanity metric. It is a health metric. Creatine, used consistently alongside resistance exercise, is one of the most studied tools we have for slowing that decline. Muscle truly is the organ of life.
What the emerging evidence says about your brain
This is the part that changed my thinking about creatine beyond the gym. I accept that the evidence is still new in this area and I am going to lay out what the evidence does and doesn’t yet show. But I think you’ll agree, it looks promising.
Your brain uses approximately 20% of your daily energy despite accounting for only about 2% of your body weight. The human brain is what won us the evolutionary race. It makes sense that it is the most energy demanding organ in the body. The brain produces its own creatine, but when placed under the pressure of chronic stress, sleep deprivation, high cognitive demand, ageing - it cannot always keep up.
A 2024 German randomised controlled trial found that during 21 hours of sleep deprivation, creatine supplementation came close to restoring rested baseline performance. [2] That is, it corrected for the cognitive effect of sleep deprivation on daytime performance. It's worth noting that the dose used in that trial was considerably higher (0.35g/kg body weight) than a typical daily maintenance amount, which points to where the most active research is currently heading.
There is early pilot work emerging in Alzheimer's disease, depression, and traumatic brain injury. Small studies, promising preliminary findings, early days. [3] But the direction is consistent across these early investigations, and the mechanism makes biological sense: a fast-access fuel source for the most energy-hungry tissue in your body. The brain under stress is where creatine seems to do its most interesting work.
Quick word of caution for anyone who reads this and plans to immediately start taking 20g creatine - you may experience gastrointestinal bloating and upset at this dosage. Build up gradually. Higher doses are currently being explored in research settings, but are not standard practice. I’d reserve the higher doses for mornings where you haven’t slept well only.
What it might do for your bones
Creatine alone does not appear to improve bone mineral density in the studies that have looked at this directly. If you take it and don't do anything else, the bone evidence is not convincing. What the research does suggest is that creatine combined with resistance training may slow bone loss in combination with resistance training — particularly at the femoral neck, one of the most fracture-prone sites in older women. Like most things in life, you need to put the work in. Heavy weight needs to be moved against a resistant force to stimulate the turnover and production of bone. A two-year randomised controlled trial in 237 postmenopausal women pointed in this direction, though larger trials have returned more mixed results. [4]
The picture is promising, the mechanism makes sense, and the large-scale proof is still building. I encourage all my patients to do resistance training at least twice per week anyway. The evidence of its benefits is almost irrefutable but for certain patient groups; women approaching menopause, or anyone with a family history of osteoporosis. I now believe resistance training to be an essential part of staying healthy.
The fears worth putting to rest
Three myths follow creatine around and they deserve a direct response.
Kidney damage. Long-term studies in healthy individuals consistently show no adverse effect on kidney function.[5] If you have pre-existing kidney disease, speak to your GP or pharmacist before starting. Like any supplement, if you can source professional guidance before taking then that is always the preferred option.
Hair loss. Based on a single small study that linked creatine supplementation to elevated levels of DHT, a hormone associated with male pattern baldness.[6] That study has never been reliably replicated. [7] In clinical practice, this is not a concern I take seriously as a reason to avoid creatine, and I'd encourage you to view it in the same way.
It's only for athletes. Probably the most damaging myth of the three. Women, older adults, vegetarians, people under chronic cognitive load — these groups may benefit most of all. The gym-bro association has done real harm here by keeping a genuinely useful compound away from the people who arguably need it most.
How to take it
Form: Creatine monohydrate. That is the form. Don't be sold on anything fancier. All of the research is based on the monohydrate form. [1] This form also happens to be the cheapest option, and nothing else has a comparable evidence record.
Dose: 3–5g daily. No loading phase is required. At a consistent maintenance dose, your body reaches full tissue saturation in approximately three to four weeks, which is also why a two-day trial tells you nothing useful. Give it a month. It needs to be taken daily otherwise you will never reach true saturation.
Timing: Doesn't matter. Morning, evening, with food or without — pick the routine you will actually maintain, because consistency is everything with this one. It can feel grainy in the mouth for first time users, so mix it into a drink you enjoy and take it quickly
Final message
My mum takes 5g every morning in a glass of water. She has done for six months. I don't expect to be able to measure the difference in her working memory or bone density any time soon. That's not how evidence works for individuals, and I'd be suspicious of anyone who promised otherwise. But the risk-to-benefit ratio here is about as favourable as you will find in any supplement: low cost, an excellent safety profile, and a growing body of research that reaches well beyond the weights room.
If you have been waiting for a reason to start, this is probably it. And if you know someone who has written creatine off because it sounds like it belongs to someone else, please send this to them and encourage them to think differently about creatine.
Jake Groves MPharm PGDip IP
NHS Pharmacist & Independent Prescriber
References
Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18.
Gordji‑Nejad A, Matusch A, Kleedörfer S, Patel HJ, Drzezga A, Elmenhorst D, et al. Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Sci Rep. 2024;14(1):4937.
Xu J, Bi Z, Zhang Y, Luo X. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta‑analysis. Front Nutr. 2024;11:1424972.
Chilibeck PD, Candow DG, Gordon JJ, Duff WRD, Mason RS, Shaw K, et al. A 2‑yr randomized controlled trial on creatine supplementation during exercise for postmenopausal bone health. Med Sci Sports Exerc. 2023;55(10):1750–60.
De Souza e Silva A, Pertille A, Reis Barbosa CG, de Oliveira Silva JA, de Jesus DV, Vilela Ribeiro AGS, et al. Effects of creatine supplementation on renal function: a systematic review and meta‑analysis. J Ren Nutr. 2019;29(6):480–9.
Van der Merwe J, Brooks NE, Myburgh KH. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college‑aged rugby players. Clin J Sport Med. 2009;19(5):399–404.
Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021;18(1):13.
