From helping cells produce energy to its possible role in treating certain health conditions, creatine has become an increasingly important focus of research.

Dr. Mehdi Boroujerdi, a pharmaceutical researcher and former professor, has conducted an in depth review of creatine in the Handbook of Creatine and Creatinine In Vivo Kinetics. His work offers valuable insight into how this compound works and what it may be capable of.

How Creatine Works in the Body

Creatine is naturally produced by the body in the liver, kidneys and pancreas using amino acids such as glycine, arginine and methionine.

Once made, it travels through the bloodstream to tissues that need energy, especially muscles. Around 95% of the body’s creatine is stored in skeletal muscle, while smaller amounts are found in the brain, heart and other organs.

Inside cells, creatine is converted into phosphocreatine (PCR), a high energy molecule that helps regenerate adenosine triphosphate (ATP), the body’s main energy source.

This rapid ATP regeneration is essential for tissues with high energy demands, including muscles, the heart and the brain. It allows cells to keep functioning during intense physical activity or stress, which explains why creatine has become so popular in sports.

After it has been used, creatine breaks down into creatinine, a waste product that is filtered out by the kidneys and removed through urine.

However, the body can only store a limited amount of creatine, and individual levels vary. This means people may respond differently to supplementation.

Despite common misconceptions online, creatine is not a steroid. “Creatine’s role in muscle development is solely to provide energy for contraction and respiration, it is certainly not a substitute for steroids,” Dr. Boroujerdi explains.

Creatine Supplements and Performance Benefits

Creatine monohydrate is the most widely studied and commonly used form of creatine supplement.

Research shows that it increases creatine and phosphocreatine levels in muscle, which improves the body’s ability to regenerate ATP during short bursts of high intensity activity. This can lead to better power output, faster sprint performance and increased training capacity.

In addition to physical performance, creatine may also support certain aspects of brain function. Studies suggest potential benefits for memory, mood and processing speed, particularly in people with naturally lower creatine levels, such as older adults.

Researchers are also exploring creatine’s possible role in health conditions including Parkinson’s disease, depression and menopause related muscle and bone loss. While early findings are promising, more evidence is needed before firm conclusions can be made.

“Creatine’s anti-inflammatory and antioxidant properties further underscore its promise in clinical settings, though more robust trials are needed to confirm these benefits,” he explains.

“With sufficient justification, appropriate dosage form, and dosing regimen, creatine may eventually be recognized as an over-the-counter therapeutic agent rather than merely a dietary supplement.”

Dosing, Absorption and Bioavailability

A common supplementation approach begins with a loading phase of 20 grams per day (split into four doses) for 5-7 days. This is usually followed by a maintenance dose of 3-5 grams per day.

“This approach rapidly saturates muscle creatine stores, but a lower daily dose of 3-5 grams can achieve similar saturation over a longer period (approximately 28 days),” Dr. Boroujerdi says.

Not all consumed creatine is absorbed by the body. Factors such as digestive stability and how much creatine muscles can store influence how much is retained. Taking creatine with carbohydrates may improve uptake by increasing insulin related transport.

Who Benefits Most From Creatine

Responses to creatine can vary depending on factors such as sex, age and diet.

Men and women may experience different effects due to differences in muscle mass and baseline creatine levels. Women, who often have lower stored creatine, may see greater relative improvements.

Older adults may benefit from creatine’s potential to help maintain muscle mass, bone density and cognitive function as they age.

Vegetarians and vegans, who typically consume little or no creatine through diet, often start with lower levels and may respond more strongly to supplementation. However, dietary patterns vary, so effects are not the same for everyone.

“There is a pressing need for well-designed research projects in humans, utilising labelled creatine to generate relevant data and illuminate the grey areas of our knowledge about these compounds,” Dr. Boroujerdi explains.

Creatine is sometimes combined with other supplements, such as the amino acid beta-alanine, to enhance its effects. Still, the effectiveness of these combinations varies, and more research is needed to determine the best approaches.

Safety, Limits and What Science Says

Creatine is one of the most extensively studied dietary supplements and is generally considered safe for healthy individuals. Its range of potential uses continues to grow, but it is not without limitations.

“Despite its many benefits, creatine is not a magic bullet. It does not directly build muscle or replace the need for proper training and nutrition. Additionally, the belief that larger doses yield greater benefits is unfounded, as muscle creatine stores have a saturation limit. Excess creatine is simply excreted as creatinine, offering no additional advantage,” Dr. Boroujerdi says.

Concerns about kidney damage have largely been dismissed for healthy people. However, individuals with existing kidney conditions should speak with a healthcare provider before using creatine.

The benefits of creatine are not the same for everyone and depend on factors such as baseline levels, dosage and individual biology.

“For now, creatine is best viewed as a supplement with significant potential, but not a panacea,” Dr. Boroujerdi says. “Whether you’re an athlete, a student, or simply someone looking to support your health, understanding the science behind creatine is key to making informed decisions.”