Creatine used to be thought of as something bodybuilders took to add muscle, but today, people of all ages—and exercise intensity—are taking creatine supplements.
Yes, some people continue to use it for the physical benefits, but others are now turning to the supplement to improve their cognitive function.
But does creatine actually improve brain health?
Does it help reduce fat?
Is it safe?
Those are just some of the questions tackled in the new AMA podcast “Health vs. Hype”—produced in partnership with iHeartRadio.
"Health vs. Hype" takes on medical misinformation, viral health trends, DIY medicine, and common health myths to help listeners understand what’s real, what’s risky, and what’s backed by science. Host Trace Dominguez fact-checks popular health claims, explains how medical misinformation spreads, and reveals the real-world consequences of getting it wrong.
In the most recent episode, listeners hear from Jason Mitchell, MD, executive vice president and chief medical officer at Geisinger, about facts and fiction related to creatine.
Geisinger is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Creatine can help you build additional muscle mass
"When you take creatine monohydrate in conjunction with strength training, you actually do build additional strength and do build additional muscle mass," Dr. Mitchell said. "You have increased exercise capacity, you're likely to build muscle [and] more rapidly develop more strength to be able to do more reps. It is a safe supplement that's been studied really, really well."
"It's kind of fun to have a supplement that lives up to the hype, because there's a lot of them that don't," he added. As a physician, Dr. Mitchell often talks with patients about products that offer "too-good-to-be-true" solutions. Many times they are, in fact, too good to be true. Creatine, though, isn't one of those.
"It's pretty safe," he said. "I can tell that to my patients who are 20, and I can tell that to my patients who are 80. It's nice to have supplements that can do that type of thing."
Not all types of creatine are the same
"You have to look for creatine monohydrate," Dr. Mitchell said. "All the other creatines—where something's added to it or you hear something after the word creatine—those do not have the studies and so I would not recommend those."
Creatine users will gain weight at first
"Don't get disappointed because you start the creatine and two weeks later you weigh two or three pounds more," he said. "You will gain weight, but it's muscle weight and it's some water weight. So don't be disappointed. Know that that extra muscle is going to burn calories and ultimately that's going to help you burn fat later on."
Creatine alone doesn't make you lose fat
"If you're taking creatine while doing weight training, you increase lean body mass and that ultimately decreases fat," Dr. Mitchell said. "Creatine alone will not make you lose fat at all."
Creatine can be good for older adults
"As we age, you do lose lean body mass, you lose muscle," he said. "There are some really good studies that show that folks that are elderly, that are doing strength training along with creatine, maintain more lean body mass. They maintain more muscle, which is great, because you really want to maintain mobility. You think about [older] people and you watch as they have trouble getting out of a chair. They lose some of that leg strength and body strength. If you can maintain that, it improves our quality of life, improves our ability to live the life we want."
"There was a meta-analysis done in 2023, and in that particular analysis, although it wasn't a large number, it was statistically significant," Dr. Mitchell said. "In older adults—66 to 76 years old—they really did have improvement in memory. Folks younger than that, they couldn't see any difference."
Creatine can have side effects
"The most common side effects that you get from creatine," he explained, "can be a little bit of nausea or GI [gastrointestinal] discomfort, and then the other one is weight gain."
If kidneys are healthy, creatine’s OK
A laboratory test for serum creatinine "is something that we use to measure kidney function,” Dr. Mitchell said. "As you see those levels go up, you worry about kidney function. There was a worry that, in fact, this could impact the kidneys negatively. The data has shown that it does not if you are healthy and don't have a kidney problem."
Connection to cognitive function unclear
The link between taking creatine and improved cognitive function is not clear yet. "It's not definitive at this point," Dr. Mitchell cautioned. "Certainly, there's nothing that shows improvements with dementia. Creatine is in the brain. It's used there in those pathways as well for energy. The brain uses a lot of energy, so there's a natural extrapolation to what it could do in the brain. We don't have the data to say, yeah, this is something you should be taking for your brain. But I don't want to discount that there are some studies out there."
Better brain-health options than creatine
"Good cardiovascular health—exercising, treat your high blood pressure, treat diabetes, stay active—that's the best thing you can possibly do for brain health. Don’t drink alcohol," Dr. Mitchell said. "If you're really looking to maximize your brain and your longevity, creatine would be low on the list and as an interesting thing versus things we know really help."
