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It’s been studied for decades, and long used by athletes, but creatine is also being touted as a way to help older people avoid frailty and osteoporosis.
What is it?
Creatine monohydrate (its full name) is a compound formed during protein metabolism. Our liver and kidneys make some, and we can get it from foods such as red meat and fish.
Creatine is mainly stored in our muscles, but a small amount is also stored in the brain.
What’s the benefit?
Creatine provides energy for muscular contraction, helping us to perform stronger, faster movements. As we age, these are the movement capacities we lose first.
It’s widely used by athletes, especially in strength and power sports. But it’s also been investigated as a supplement for older people as a way of helping to counteract our menopause-and-age-related loss of muscle and bone.
Another argument for creatine is that it could support brain health. It’s been shown to reduce mental fatigue and improve mood and cognitive function.
Creatine and muscle
One of the foremost researchers in this area is Professor Phil Chilibeck, from the University of Saskatchewan in Canada. He’s studied creatine and its use for improving muscle mass and strength for about 20 years.
Professor Chilibeck has sifted through studies on ageing and muscle that have compared the use of creatine with a placebo.
Resistance exercise should build muscle mass and strength by itself, but if creatine does what it’s supposed to do, it should increase the effect of the exercise.
He believes it also helps to improve function. For example, there’s a standard test often applied to older people that asks the person to stand up from a seated position then sit down again continuously to see how many times they can do it in 30 seconds. Creatine seems to improve results on this test.
Improved function means less risk of falling.
So how does creatine improve muscle mass, strength, and function? As well as increasing the energy stores in our muscle, it has antioxidant and anti-inflammatory properties.
All of this should allow us to train harder and recover faster. It could also improve the capacity of muscle to use protein, and possibly block some pathways that lead to muscle breakdown with age.
Creatine and bone
Professor Chilibeck is an adviser to Osteoporosis Canada, mainly in relation to the most effective exercise for bone, but he’s also investigated whether creatine can boost the effect of bone-building exercise.
In 2015 he did a small study with women over 12 months. They did resistance exercise three days a week. Some took creatine and some took a placebo. After a year the creatine group showed a better bone density response than the placebo group.
He followed that up with a bigger study involving 237 women (average age 59) over two years using the same protocol. This time bone mineral density didn’t change much, but bone geometry (i.e. volume, diameter, and cross-sectional area) did, indicating stronger and more resilient bone.
We have cells that build bone (called osteoblasts) and cells that break it down (called osteoclasts). We lose bone when the balance of these two goes the way of the osteoclasts.
A lot of osteoporosis medications work by blocking the activity of osteoclasts. Creatine seems to do the same thing, but it also stimulates the osteoblasts.
Professor Chilibeck believes men’s bodies might respond better to creatine, simply because women have more difficulty developing muscle. By the time we’re post-menopausal that’s certainly true. But that might also mean we have more to gain from supplementation.
What’s the dose?
Two approaches are usually outlined for taking creatine. The first involves a heavier dose several times a day for about a week to saturate the muscles. But that’s more for athletes preparing to do an intensive training block.
For those of us in the ‘older people’ category looking to use it long-term, 5g a day is an average dose.
Having said that, Chilibeck uses 8-9g in his research, but he acknowledges that body size probably ought to be considered. So a small woman might aim to use 3-4g.
He also thinks the effectiveness of creatine is increased by combining it with protein powder, especially whey.
A lot of people take it just before or after resistance exercise, but as long as it’s in your muscles, you have what you need. It’s a tasteless white powder so it can easily be taken in water; it doesn’t have to be taken with protein powder.
After a month the muscles should have their full quota.
Side Effects
Claims have been made in the past that creatine has negative side effects, from liver and kidney damage to digestive problems and weight gain. Anything used by athletes seems to get a shady reputation.
But it’s been heavily studied over a long period of time, and none of these arguments has been shown to be valid.
As far as weight gain goes, an athlete’s body could retain water for a few days during the loading phase, but that’s short-term. And it’s not what most older women would be doing anyway.
Perhaps one thing to be mindful of for diabetics is that creatine improves glucose control (as does exercise), so appropriate tweaks would be needed to medication.
Supplement safety
It’s a jungle out there — with supplements in general — and creatine is no different. You want a product that’s been tested for purity and quality. A way of ensuring you get this is to look for ‘Creapure’ on the label.
It’ll be packaged under other brand names but check that you’re buying Creapure and not any old creatine.
Cost
I pay $64 for 500g.
In summary
In conjunction with regular resistance exercise, creatine appears to increase muscle mass, increase muscle quality (e.g. less fat in the muscle), improve strength by enabling us to train harder, provide small increases in function, and improve bone geometry.
If you’re not doing resistance training, can it still provide benefits for muscle and bone? The answer to that seems to be no.
It’s worth considering if you’re doing at least a couple of solid training sessions per week, and you already include protein in each meal. We can’t build muscle and bone unless we’re eating enough protein, and creatine isn’t a substitute for that.
My own experience
By the end of July 2023, I felt I’d read enough to be ready to try it. I currently do three resistance sessions a week.
Mostly I’ve just taken a teaspoon in water, but lately I’m adding it to my breakfast smoothie (which contains whey powder).
I’d probably been taking it for four months, thinking it’d made no difference, before it occurred to me that I was using heavier weights and doing more repetitions on some exercises. I’m still managing small increases.
It’s not easy to know what to put these things down to though. Initially I assumed I’d just had a good few months (no down time with colds, covid, and so on). I’ve also wondered whether the thought that I might have a bit more capacity encourages me to work harder, i.e. it’s a placebo effect.
I’ve done resistance training for most of my adult life, but I’ve never been endowed with much muscle tissue so it’s not as though I can look in the mirror and see that I have more on my frame than I did eight months ago (my main aim is to hang on to what I’ve got). And my weight has stayed about the same.
If I’d thought ahead, I could’ve done a scan before I started to give me a baseline measurement of lean muscle, fat, and water. These days that technology is available in gyms and it’s not expensive.
I’m also not due for a DEXA scan until next year so I’m 12 months out from knowing whether it’s making a difference to my bones. In any case, according to Professor Chilibeck’s observations, improvements won’t necessarily show up as an increase in bone density.
Given the supposed cognitive benefits of creatine, I’d love to tell you that my brain function has gone through the roof, but no changes there I’m afraid.
As you can tell, at least in someone with my build and a long history of resistance exercise, in a few months the impact hasn’t been dramatic. Nor was it instant. But I’ve made gains and I’m pleased with that, and like most things related to ageing, you have to be in it for the long haul.
For now I’m sticking with it.
Photo Source: ABC News
