Creatine supplementation: Which patients may benefit?

Creatine is one of the most extensively researched and widely used supplements in sports nutrition. Often associated with athletes or bodybuilders, it is best known for enhancing athletic performance, but emerging evidence shows its benefits extend beyond this. For older adults with sarcopenia, vegetarians with lower baseline creatine, or patients aiming to optimise physical and cognitive health, here’s what GPs need to know about creatine to provide informed, evidence-based guidance.

Effects on physical performance and muscle growth

Creatine supplementation consistently enhances muscle strength, power, and fat-free mass, particularly when combined with resistance training [1,2]. Meta-analyses demonstrate significant improvements in both upper and lower body strength and lean tissue mass, with benefits observed in both healthy young adults and older adults engaging in resistance training [3,4].
Additionally, creatine has been shown to:

• Improve high-intensity exercise performance
  
• Support greater training adaptations over time
  
• Accelerate recovery between exercise bouts
  
• Potentially reduce muscle damage and lower injury risk during training

These findings support creatine as an effective and safe adjunct for individuals seeking to optimise strength and functional performance.

Broader health and therapeutic benefits

Beyond muscle health, creatine’s role extends to potentially offering cognitive function, mood, and neuroprotection, particularly in populations with lower baseline creatine levels, such as vegetarians, older adults, and women.

Emerging evidence suggests creatine may also play a supportive role to:

• Enhance cognitive processing: effects may be most pronounced in those with creatine deficits [5]
  
• Improve memory and processing speed: studies suggest benefits for brain health, though limited effects have been observed in neurodegenerative disease; effects may be more noticeable in women [6,7]
  
• Reduce systemic inflammation: current evidence suggests creatine may reduce inflammation [7]
  
• Support bone health and mineral density: some research indicates potential benefits [8]

Safety and practical considerations

Creatine monohydrate remains the gold standard form used in research and clinical practice. It is well tolerated and safe for healthy individuals when used within recommended guidelines (typically 3–5 g/day, following an optional short loading phase) and long-term studies (up to 5 years) have reported no adverse effects on renal or hepatic function in healthy populations [1].

Creatine supplementation is one of the most well-supported and clinically relevant nutrition interventions available. Evidence highlights benefits beyond athletic performance, including muscle function, brain health, and metabolic support. Particularly relevant for older adults, vegetarians, and individuals with reduced muscle mass, creatine can be safely recommended by GPs as part of an evidence-based approach to patient care.

– Sarah Marko, Accredited Practising Dietitian

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References