Creatine in midlife - Should we all be taking it?
Creatine has been used in athletic populations for decades but it is also now getting it’s time in the menopause spotlight. Here is a breakdown of all you need to know when it comes to whether creatine is worth the hype.
What is creatine and what does it do?
Creatine is a naturally occurring compound that can be both consumed via the diet (primarily from red meat and seafood) or made in your body from the amino acids arginine, glycine and methionine. Creatine is converted into phosphocreatine, which is rapidly broken down to facilitate adenosine triphosphate (ATP) regeneration, thereby serving as a crucial element in energy production in the body.
Possible benefits of creatine supplementation for women
1. Muscle Mass and Strength Maintenance
One of the biggest challenges women face as they age is the gradual loss of muscle mass and strength—a condition known as sarcopenia. From around the age of 30, muscle mass naturally declines, and by the time women reach their 40s, this process accelerates. Hormonal changes, especially a decline in oestrogen during perimenopause and menopause, further contribute to this muscle loss.
There has therefore been interest in whether creatine supplementation, combined with resistance training, can increase muscle mass and strength in middle-aged and older adults.
Research Findings: A systematic review and meta-analysis by dos Santos et al in 2021, found that for women aged over 60, supplementing resistance training with creatine experienced significant gains in muscle strength, especially when their training lasted for at least 24 weeks in duration.
However, the authors highlight that the overall quality of the evidence supporting this statement was low due to small sample sizes and the low number of studies included.
2. Bone Health
As women age, the risk of osteoporosis increases, particularly post-menopause due to a decrease in oestrogen. This led to excitement over early research which suggested that creatine supplementation, when combined with weight-bearing exercises, may have a positive effect on bone mineral density.
However, more recent research has shown no significant effect of creatine on bone health in women over 60.
3. Cognitive Function
Cognitive decline is another concern for women as they get older, and some studies suggest that creatine may offer neuroprotective benefits. Creatine is involved in the production of ATP (adenosine triphosphate), the energy molecule for cells, including brain cells. This energy boost could potentially support brain function, memory, and mental clarity.
However, research here is again mixed with some trials findings it can improve memory and attention time but little good quality evidence that it can improve other aspects of cognitive function. More research is needed specifically in women experiencing perimenopause to know if creatine could be a beneficial supplement for cognitive health.
4. Exercise Recovery
Short-term creatine supplementation is widely associated with improved anaerobic exercise and has the potential to influence exercise recovery by increasing intramuscular phosphocreatine concentrations, helping to maintain pH, and improving glycogen storage.
Research Findings: In a randomized, doubleblind, cross-over study by Gordon et al (2023), creatine supplementation was found to have a greater effect on reducing fatigue in women compared to placebo when completing repeated cycling sprint bouts if they were tested in the luteal phase of their menstrual cycle. However, the findings were not statistically significant and only a sample sample size was recruited to the study.
Are there any risks to taking creatine?
While creatine supplementation may offer some benefits, there are a few considerations to keep in mind.
Water Retention: Creatine can cause the body to retain water, which may lead to a temporary increase in body weight. This is typically due to water being stored in the muscles, which is harmless, but it might be a concern for women who are particularly sensitive to weight fluctuations.
Kidney Function: There is some concern about creatine’s impact on kidney health, particularly in individuals with pre-existing kidney conditions. However, studies have shown that creatine supplementation is safe for healthy individuals when taken within recommended doses. If you have kidney issues, it’s important to consult a healthcare provider before starting creatine.
Possible Gastrointestinal Discomfort: Some people experience mild gastrointestinal discomfort, such as bloating or cramping, when starting creatine. This can often be avoided by starting with a smaller dose or taking creatine with food.
Conclusion: Is Creatine Right for You?
The decision to take creatine ultimately depends on your individual health goals. If you are looking to maintain or increase muscle mass and strength, or if you want to improve your exercise recovery, creatine may be a helpful supplement.
However, as with any dietary supplement, it cannot replace the well evidenced and crucial role of eating a balanced diet and engaging in regular movement as part of your daily habits. You should always ensure these key fundamentals of health (alongside adequate sleep, stress reduction and social connection) are addressed as a priority before looking to supplementation to further enhance your health.
If you feel you want to incorporate creatine into your diet, feel free to reach out and work with me to ensure you are doing so in a safe and effective way, tailored to your individual needs.
References:
dos Santos, E.E.P.; de Araújo, R.C.; Candow, D.G.; Forbes, S.C.; Guijo, J.A.; de Almeida Santana, C.C.; Prado, W.L.d.; Botero, J.P. (2021) Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis. Nutrients, 13, 3757.
Sales LP, Pinto AJ, Rodrigues SF, Alvarenga JC, Gonçalves N, Sampaio-Barros MM, Benatti FB, Gualano B, Rodrigues Pereira RM. Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial. J Gerontol A Biol Sci Med Sci. 2020 Apr 17;75(5):931-938.
Chilibeck PD, Candow DG, Gordon JJ, Duff WRD, Mason R, Shaw K, Taylor-Gjevre R, Nair B, Zello GA. A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health. Med Sci Sports Exerc. 2023 Oct 1;55(10):1750-1760.
Rae, C., & Digney, A. L. (2003). Oral creatine monohydrate supplementation improves brain performance: A double–blind, placebo–controlled cross–over trial. Neuropsychology, 17(4), 349-357.
Avgerinos KI, Spyrou N, Bougioukas KI, Kapogiannis D. Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Exp Gerontol. 2018 Jul 15;108:166-173. doi: 10.1016/j.exger.2018.04.013. Epub 2018 Apr 25.
Xu C, Bi S, Zhang W and Luo L (2024) The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Front. Nutr. 11:1424972
Gordon, A.N.; Moore, S.R.; Patterson, N.D.; Hostetter, M.E.; Cabre, H.E.; Hirsch, K.R.; Hackney, A.C.; Smith-Ryan, A.E. The Effects of Creatine Monohydrate Loading on Exercise Recovery in Active Women throughout the Menstrual Cycle. Nutrients 2023, 15, 3567.
