Creatine is often linked to gym performance, but its real impact goes much deeper.
Creatine is widely recognized as a supplement used by athletes and fitness enthusiasts to improve performance. But its effects extend beyond the gym. Scientists have been studying how this naturally occurring compound influences both physical and mental function, revealing a more complex picture than many people expect.
From supporting energy production to its possible role in future medical treatments, creatine continues to attract attention from researchers.
Dr. Mehdi Boroujerdi, a pharmaceutical researcher and former professor, conducted a detailed review of creatine in the Handbook of Creatine and Creatinine In Vivo Kinetics. His analysis helps clarify how creatine works and what current evidence suggests about its benefits.
How Creatine Works in the Body
Creatine is produced naturally in the liver, kidneys, and pancreas using amino acids such as glycine, arginine, and methionine.
After it is made, creatine enters the bloodstream and is delivered to tissues that require energy, especially muscle. About 95% of the body’s creatine is stored in skeletal muscle, while smaller amounts are found in the brain, heart, and other organs.
Within cells, creatine is converted into phosphocreatine (PCR), which plays a key role in restoring adenosine triphosphate (ATP), the body’s primary energy source.
This rapid recycling of ATP is essential for tissues that use large amounts of energy, including skeletal muscle, the heart, and the brain. It allows cells to continue functioning during periods of intense activity or stress, which explains why creatine has become so popular among athletes.
Once creatine has been used, it breaks down into creatinine. This waste product is filtered by the kidneys and eliminated through urine.
The body can only store a limited amount of creatine, and individual levels vary. As a result, responses to supplementation can differ from person to person.
Despite frequent claims online, creatine is not a steroid. “Creatine’s role in muscle development is solely to provide energy for contraction and respiration; it is certainly not a substitute for steroids,” Dr. Boroujerdi explains.
Creatine Supplement Benefits and Performance Effects
Creatine monohydrate is the most researched and commonly used supplement form.
Studies summarized in the book show that supplementation increases creatine and phosphocreatine levels in muscle. This supports faster ATP regeneration during short, intense bursts of activity, which can improve strength, sprint performance, and overall training capacity.
Creatine may also have effects beyond physical performance. Research suggests it could support cognitive function, including memory, mood, and processing speed, particularly in individuals with lower baseline creatine levels, such as older adults.
Scientists are also exploring whether creatine could play a role in managing conditions such as Parkinson’s disease, depression, and menopause related muscle and bone loss. While early findings are encouraging, more studies are needed before firm conclusions can be drawn.
“Creatine’s anti-inflammatory and antioxidant properties further underscore its promise in clinical settings, though more robust trials are needed to confirm these benefits,” he explains.
“With sufficient justification, appropriate dosage form, and dosing regimen, creatine may eventually be recognized as an over-the-counter therapeutic agent rather than merely a dietary supplement.”
Creatine Dosage and Absorption
A common supplementation strategy starts with a loading phase of 20 grams per day (split into four doses) for 5-7 days. This is typically followed by a maintenance dose of 3-5 grams per day.
“This approach rapidly saturates muscle creatine stores, but a lower daily dose of 3-5 grams can achieve similar saturation over a longer period (approximately 28 days),” Dr. Boroujerdi says.
Not all creatine that is consumed is absorbed by the body. Absorption depends on factors such as digestive stability and the capacity of muscle tissue to store creatine. Taking creatine with carbohydrates may improve uptake by increasing insulin-mediated transport.
Factors That Influence Creatine’s Effects
Research indicates that the effects of creatine can vary based on sex, age, and diet.
Men and women may respond differently due to differences in muscle mass and starting creatine levels. Women often have lower baseline levels, which may lead to greater relative improvements with supplementation.
Older adults may benefit from creatine’s potential to help preserve muscle mass, bone density, and cognitive function.
Vegetarians and vegans, who typically consume little creatine through their diets, often have lower baseline levels and may experience stronger responses to supplementation. However, dietary patterns vary, so individual results differ.
“There is a pressing need for well-designed research projects in humans, utilizing labeled creatine to generate relevant data and illuminate the grey areas of our knowledge about these compounds,” Dr. Boroujerdi explains.
Creatine is sometimes combined with other supplements, such as the amino acid beta-alanine, to enhance its effects. However, the effectiveness of these combinations varies, and more research is needed to determine optimal approaches.
Safety, Limitations, and What to Expect
Creatine is one of the most extensively studied dietary supplements and is considered safe for healthy individuals. Its potential uses continue to expand, but it is not without limitations.
“Despite its many benefits, creatine is not a magic bullet. It does not directly build muscle or replace the need for proper training and nutrition. Additionally, the belief that larger doses yield greater benefits is unfounded, as muscle creatine stores have a saturation limit. Excess creatine is simply excreted as creatinine, offering no additional advantage,” Dr. Boroujerdi says.
Concerns about side effects such as kidney damage have largely been dismissed in healthy individuals. However, people with existing kidney conditions should consult a healthcare provider before using creatine.
The benefits of creatine are not the same for everyone. Outcomes depend on baseline levels, dosage strategies and individual physiology.
“For now, creatine is best viewed as a supplement with significant potential, but not a panacea,” Dr. Boroujerdi says. “Whether you’re an athlete, a student, or simply someone looking to support your health, understanding the science behind creatine is key to making informed decisions.”
Reference: “Handbook of Creatine and Creatinine In Vivo Kinetics: Production, Distribution, Metabolism, and Excretion” by Mehdi Boroujerdi, 2026, CRC Press.
ISBN: Paperback: 9781032995281 | Hardback 9781032995274 | eBook 9781003604662
DOI: 10.1201/9781003604662
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