Once recognized only for its performance enhancing effects, creatine may also be relevant to other health aspects. In fact, Shawn Wells, MPH, RD, CISSN, stated, “creatine may also be relevant to bone health, cardiac health, neurological disorders such as Alzheimer’s disease, dementia, Huntington’s disease, and Parkinson’s disease, traumatic brain injury, and more.” 

Creatine is classified as an ergogenic aid, and an effective one at that. An ergogenic aid is essentially any substance or treatment that is intended to directly improve exercise performance. Creatine is naturally found in red meat and fish. Therefore, vegetarians are expected to have lower levels of creatine. The liver and kidneys manufacture creatine daily, but in small amounts. Creatine helps to build lean muscle mass, increase strength and generate bursts of power. These roles are supported by several studies. Therefore, supplemental creatine can be beneficial for power and strength athletes like bodybuilders or sprinters. 

But how does creatine work? 

In order for cells to use the energy from foods, the body must first convert the energy in foods to adenosine triphosphate, or ATP, a molecule that contains three strongly bound phosphates. During exercise, your body uses ATP for energy. In order to generate energy from ATP, a phosphate is cleaved off which releases usable energy. The end product is adenosine diphosphate, or ADP. The issue is you only have so much stored ATP. The job of creatine is to keep this process going by donating a phosphate to ADP creating more ATP. In short, supplementing with creatine increases the available fuel to power ATP. 

Supplementing with creatine also has a few associated unnecessary practices. The first is the idea that you must ‘load’ creatine. Loading generally refers to taking 20 grams per day for five days to ‘saturate’ the muscles. However, this may not be necessary. Additionally, ‘cycling’ on and off of the supplement is also unnecessary. Current data suggest supplementing with approximately three to five grams of creatine monohydrate per day is safe and effective. 

Aside from its performance enhancing abilities, the research on creatine has expanded into other frontiers. One of those being the brain. 

Cognitive performance is important, especially with aging. To fuel the brain, molecules such as glucose, ketone bodies and creatine are necessary for normal ATP production. When there is a potential deficiency in creatine, cognitive function would likely be impaired. Some studies have found higher resting creatine to be correlated with brain activity and performance. Although further research is necessary before specific recommendations can be made, daily creatine supplementation may have a future role in maintaining cognitive function in older adults and vegetarians. 

Overall, the benefits and roles of creatine may have the ability to expand beyond exercise.