There is a lot of information out there about supplementation without much guidance on what to take, when to take it, and why.
One of the first supplements I added to my midlife routine was creatine.
Fortunately, creatine is a very well-studied supplement (as opposed to many that are just out there to be sold without science to back them up).
I can remember in high school when boys started taking creatine it became controversial as to whether they were using steroids or not.
It is NOT an anabolic steroid used for muscle building.
It is something we make naturally, though women make less than men.
We also have fluctuations in our natural creatine due to our menstrual cycle and reproductive phases of our lives. Creatine tends to follow the path of estrogen: lower when estrogen is lower and higher when estrogen is higher.
I’ve discussed the importance of muscle building in midlife and beyond and creatine is a supplement to help to that end.
What does it do?
It has been less than 100 years since the discovery of creatine kinase, the enzyme that breaks down creatine, and the resulting pathway.
In each of our cells, something called Adenosine Triphosphate (ATP) is the energy currency. This is how all processes are completed.
Creatine in the mitochondria, the “powerhouse of the cell”, is turned into phosphocreatine by the enzyme creatine kinase.
This phosphocreatine then travels out of the mitochondria into the main area of the cell, the cytoplasm, where it can be used to generate more ATP.
This process is found in our skeletal muscle, our heart muscle and even our brain.
Who can benefit?
There are fewer studies on creatine supplementation in women than in men, but in the studies for women it has benefits across our lifespan.
This has been studied both in female elite athletes as well as sedentary females starting an exercise program.
It also has been studied in postmenopausal women with a resistance-training exercise program.
Across these stages of life, creatine supplementation plus resistance training has been shown to be beneficial with minimal to no risks.
It is important to note that there is little to no benefit with creatine supplementation alone, but the benefit is gained when we add it to a strength training program of exercise.
What are the benefits?
When it comes to skeletal muscle, creatine supplementation plus resistance exercise improves muscle strength and power across the board.
As we age, we think more of functionality: Can we stand up from a seated position? Can we carry groceries? Can we avoid a hip fracture?
Studies have found the answer to these questions is YES with creatine plus strength training in the post-menopausal population.
There are benefits in addition to the muscular aspect, particularly our brain.
Our frontal cortex is responsible for decision-making, attention and memory. Creatine helps with regenerating ATP, our energy currency, to help with these demanding processes in the brain.
Creatine has also been shown to help with mood itself. Depression rates also track with female hormonal changes: puberty, pregnancy, postpartum, and menopause.
There is a positive correlation between creatine levels in spinal fluid and levels of “happy hormones” like dopamine and serotonin.
Studies of adolescent and adult females have shown that those on anti-depressants had improvement of depression scores with the addition of creatine.
In pre-menopausal women, creatine supplementation can help with sleep and muscle building across the menstrual cycle, but particularly in times of low estrogen. During the follicular phase, just after a period, estrogen is lowest.
This is also a time of poorer sleep. As females, we are more affected by poor sleep than men.
We also get worse sleep because of menstrual cycles, pregnancy, postpartum and menopause. Creatine has been shown to benefit our cognitive capacity during times of stress and sleep deprivation.
How much should we take?
Many studies have looked at different dosing regimens.
Again, many dosing regimens of creatine were NOT shown to benefit skeletal muscle if they weren’t paired with resistance training.
There’s some evidence of benefit of a “loading dose” meaning a higher dose for a short amount of time, such as 20 grams per day for five days.
After that, maintenance dose is 3-5 grams per day.
I use this creatine from Thorne, one scoop a day is 5 grams.
I put this in my water immediately after a workout. It can also be paired with a regular meal or post-workout snack.
What are the risks?
Minimal to none. Previous risks were thought to be kidney and liver injury but these have largely been walked back.
A meta-analysis showed no change in kidney or liver function.
There was also no weight gain
There were no serious adverse events.
Resources:
Some of the information contained in this article is the result of my training, medical knowledge, and personal experience without a specific source to be cited.
This is not medical advice.
https://www.mdpi.com/2072-6643/13/3/877
https://www.ncbi.nlm.nih.gov/books/NBK546624/
https://www.scielo.br/j/eins/a/cP3XYKJMw8kTSQ7XHRNFP9z/
https://www.mdpi.com/2072-6643/12/6/1780
