Creatine monohydrate is the most studied sports supplement in existence, with hundreds of trials and decades of safety data. It costs a few cents a day. It is a white powder with no taste.
And its most interesting population is not 22-year-old rugby players. It is people over 65.
What creatine actually does
Your cells run on ATP. When ATP is used, it becomes ADP, and it has to be regenerated — fast. The phosphocreatine system is the fastest regeneration pathway you have, buffering ATP over the first several seconds of intense demand.
Creatine is stored in muscle as phosphocreatine. Supplementation increases those stores by roughly 20 to 40%, depending on your starting point. Vegetarians, who get little dietary creatine, respond most.
Meaning: more available energy for rapid, high-demand efforts. Which turns out to matter far beyond the gym.
The muscular case
The most consistent finding in the literature is that creatine combined with resistance training produces greater gains in lean mass and strength in older adults than resistance training alone.
Meta-analyses in this population have found meaningful additional lean mass gains — commonly around an extra kilogram or more over a training block — plus improvements in upper and lower body strength and in functional tasks like sit-to-stand performance.
The critical word is combined. Creatine is not a substitute for training. It is a multiplier on training. Taken by someone who does not lift, its effect on muscle is negligible.
This matters because sarcopenia is one of the central problems of ageing. Muscle mass is a reservoir — of strength, of glucose disposal, of amino acids during illness, of the capacity to survive ten days in a hospital bed without losing your independence.
The cognitive case
Here is where it gets more interesting.
The brain uses enormous amounts of ATP and contains its own creatine and phosphocreatine system. Brain creatine can be raised by supplementation, though less readily than muscle.
Meta-analyses of creatine supplementation and cognition have reported improvements in memory, particularly in older adults, and in reasoning tasks. The effects are more apparent under conditions of metabolic stress — sleep deprivation, hypoxia, mental fatigue — which fits the mechanism: creatine helps most when energy supply is challenged.
The honest summary: the cognitive evidence is genuinely promising, moderate in effect size, and less mature than the muscle evidence. It is not a dementia treatment and nobody should present it as one. Research in Parkinson’s disease, depression as an adjunct, and traumatic brain injury is ongoing and mixed.
The neurological angle
Creatine is being investigated across a range of neurological conditions on the same energetic logic. Results have been variable — a large trial in Parkinson’s disease was disappointing, for instance.
What is reasonably established is that creatine crosses into the brain, raises brain phosphocreatine, and appears well tolerated. Whether that translates into disease modification remains unresolved.
Dosing, honestly
Form: creatine monohydrate. Not HCl, not buffered, not liquid. Monohydrate is the form used in essentially all the research, it is the cheapest, and there is no good evidence any alternative is better.
Dose: 3 to 5 grams per day. Some researchers argue older adults and larger individuals may benefit from the upper end, and for cognitive outcomes higher doses have been trialled.
Loading: unnecessary. Loading (20g/day for a week) fills stores faster but the endpoint is the same in three to four weeks at a standard dose, with fewer gastrointestinal complaints.
Timing: irrelevant. Consistency matters, timing does not.
Safety
Creatine has been studied extensively, including in long-term trials, and in healthy individuals has not been shown to impair kidney function. It does raise serum creatinine — which is a laboratory marker, not evidence of harm — and this can cause confusion if your GP is not told you are taking it. Tell them.
Anyone with existing kidney disease should discuss it with their doctor first. Water retention of a kilogram or so early on is common and is intracellular, not bloating.
This article is general information and not personal advice. Speak with your GP or pharmacist before starting any supplement, particularly if you take medication or have kidney disease.
The part that actually matters
If you are over 65 and you take creatine but do not do progressive resistance training, you have bought a very cheap supplement and very little else.
If you do progressive resistance training and add creatine, you get more from every session.
At Longevity Physio Studio in Eagle Heights, Mt Tamborine, we measure the things creatine is supposed to help: grip strength, sit-to-stand, lower limb power, functional capacity. If you are going to take it, it is worth knowing whether it — and more importantly, your training — is working.
Book an assessment
Book a strength and sarcopenia assessment at Longevity Physio Studio, Eagle Heights, serving Tamborine Mountain, North Tamborine, Canungra and the Gold Coast hinterland.
