What Does Creatine Do? Here’s How the Mass-Boosting Supplement Actually Works

If you’re hitting the gym regularly, you likely want to become a better athlete — faster, stronger, more muscular, and even sharper mentally. Yes, you’ve got to eat, train, and sleep right. But the darling of everyone’s supplement stack helps amp those gains up. But how? What does creatine do?

Creatine gives you a boost of energy for high-intensity exercise and can help you pack on muscle mass, increase strength, and enhance exercise performance and cognitive function. Here, we’ll explain how it works and dive into the research on what creatine does to help you reap each and every benefit it offers.

Editor’s Note: The content on BarBend is meant to be informative in nature, but it should not be taken as medical advice. When starting a new training regimen and/or diet, it is always a good idea to consult with a trusted medical professional. We are not a medical resource. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional.

What Is Creatine?

Creatine is simple and powerful — it’s a naturally occurring amino acid in your skeletal muscles and brain. Fifty years of research shows that getting more creatine can bolster gym performance and brain health.

[Read More: 9 Types of Creatine: Which One Should You Choose?]

You can get more creatine by taking oral creatine supplements or eating foods with creatine, like red meat. Vegetarians can get some creatine by eating foods with arginine, glycine, and methionine — the amino acids needed for creatine synthesis. There are a few forms of creatine, but research shows that creatine monohydrate is the most effective for gym gains. (1)

How it Works

When you ingest creatine through a dietary supplement or food source, it becomes creatine phosphate and gets stored in your muscle cells. Creatine phosphate, or phosphocreatine, is a phosphagen that boosts energy storage. Phosphocreatine directly impacts your body’s ability to create and replenish ATP, or adenosine triphosphate. 

If ATP sounds familiar, you may know it as the “energy currency of the cell.” You need it for short-duration, high-intensity exercises like sprinting, weightlifting, plyometrics, and power-based sports and activities. Beyond athletic performance, your brain also needs ATP for healthy cognitive function. (2)

[Read More: BCAA Vs. Creatine Supplements — Which to Take and When?]

Your muscle cells already have ATP, but ATP out quickly after one to three seconds of effort. Taking creatine increases your stored phosphocreatine, which helps to replenish ATP quicker. Higher creatine stores lead to faster ATP replenishment and can increase your time to fatigue. (2)

[Read More: The 9 Best Creatine Supplements for Men]

Having the energy for a few more quality, heavy reps can rack up more significant strength gains over time. 

When it comes to speed, more ATP can also help you beat your time on your favorite CrossFit benchmark workout.

And if you can crank out just one more heavy deadlift each week? Over time, you’ll be adding a lot of volume and skill to your routine, leading to bigger lifts.

What the Science Says About Creatine

The International Society of Sports Nutrition (ISSN) states that over 50 years and hundreds of studies have shown that creatine supplementation is a safe, ergogenic aid for increasing lean body mass and muscle strength and improving exercise performance. (3)

Research shows creatine supplementation is effective for people across genders, ages, and fitness levels — from everyday gymgoers to elite athletes. (4) 

[Read More: 6 Creatine Benefits All Lifters Should Know About]

Let’s take a deeper dive into what the science says about each of the benefits of creatine. 

For Muscle Growth

Creatine doesn’t build muscle on its own; you also have to do resistance training and eat enough calories and macros.

• A scoping review of clinical trials from 2012 to 2021 was done on creatine supplementation and muscle growth in young adults. It found that creatine increased muscle growth more in healthy young adults than older adults. Sufficient training stimulus was required. One study in the review found creatine was equally as effective in older adults by increasing muscle mass in their lower legs. (5)
• A systematic review and meta-analysis on 35 clinical trials of over 1,000 participants was published in 2022. All participants took creatine, some did resistance training, some did mixed exercise, and some did not exercise. The resistance training group added two pounds of lean body mass; the others did not. In summary, make sure you’re training instead of relying on creatine to do the work for you — it won’t. (6)
• Creatine supplementation may particularly benefit people assigned female at birth, as they can have 70 to 80 percent lower creatine stores than people assigned male at birth. Research shows creatine can help pre- and post-menopausal people increase their skeletal muscle size and improve muscle strength and performance. It may also help preserve bone health for post-menopausal people. (7)
• Though creatine may be more effective for younger adults, multiple studies show that creatine supplementation benefits older adults of different genders. Creatine helps increase muscle mass and strength, fight sarcopenia, and improve resilience against falls. In some cases, creatine without resistance training helps older adults as well. (8)
• When combined with resistance training, creatine helps older adults increase skeletal muscle, build strength, reduce fatigue, and improve performance in activities of daily living. (9)

[Read More: 8 Best Creatine Supplements for Women, 2024]

For Strength Gains

Most (but not all) studies find that creatine supplementation increases muscle strength (in people of all genders and fitness levels) due to higher phosphocreatine levels. (4)

• Higher creatine levels give you a higher power output and quicker recovery as your ATP replenishes. You’ll be able to do more volume and better quality work in each resistance training session, helping to increase strength over time. (4) 
• In 2020, a study was done on young adults doing resistance training five times a week for six weeks. One group took a creatine supplement, and the other took a placebo. At the end of the six weeks, the creatine group increased their muscle strength in the chest and leg press. They also had more endurance in the leg press and greater total-body strength. The placebo group did not see any changes. (10)
• In addition to muscle growth, the review of studies from 2012 to 2021 also found that young adults taking creatine while resistance training greatly increased their strength and exercise performance. (5)
• A systematic review and meta-analysis was done on 22 studies of over 700 older adults (age 57 to 70) taking creatine supplements. They performed resistance training twice a week for seven to 52 weeks. They all had increased lean body mass. Participants greatly improved their muscle strength on the leg press and chest press. (11)

For Athletic Performance

Higher creatine stores help regenerate ATP faster. In addition to increasing your strength over time, creatine can improve your athletic performance during training sessions or sports.

• With more stored phosphocreatine, your muscle cells expand, improving exercise performance in short-duration, high-intensity activities. It increases maximal strength (lifting heavy at a low speed), power output (lifting at high speed), and tolerance to higher training volume. Since your ATP replenishes faster, your muscles can recover quicker, and there may be less muscle damage. (4) 
• Creatine increases your overall exercise capacity, which can apply to different types of high-intensity activity. It can improve your agility and performance in plyometric exercises and sprinting. Studies show it can also improve athletic performance in multiple sports, including soccer, rugby, tennis, football, swimming, and track and field. (4) 
• In clinical trials on young adults, creatine improved athletic performance in resistance training, soccer, canoeing, and plyometrics. (5)
• Much research focuses on creatine’s impact on anaerobic exercise, but some studies show that creatine may also help with recovery from long-duration aerobic training. Creatine supplementation with carbohydrates and protein helps replenish muscle glycogen faster than carbohydrates alone. Endurance athletes and sports players may have faster muscle recovery and less muscle damage by using creatine. (12)
• Vegetarians have naturally lower creatine stores than omnivores. Researchers hypothesized that vegetarians may have better athletic performance from creatine supplementation, but results have been mixed. Anyone with lower creatine stores may respond quicker to creatine supplementation. More research on vegetarian athletes is required. (13)

For Brain Health

Eighty percent of creatine is stored in your skeletal muscles, and 20 percent is in your brain, which led researchers to investigate the potential benefits of creatine for brain health. (14)

• Research shows that creatine supplementation increases brain creatine. Higher creatine levels in the brain can improve neurological performance. When cognitive processing gets impaired — by lack of sleep, specific syndromes, traumatic brain injury, or naturally due to aging — higher creatine can help. (15)
• Better cognitive processing is beneficial to athletes. Strength training and certain sports require quick decision-making, reaction time, motor control, skill accuracy, and coordination. Creatine may also reduce mental fatigue, helping to improve performance. Studies show creatine may improve cognitive processing more when athletes are stressed or sleep-deprived. (14)
• Older adults also benefit from better cognitive processing and brain health from creatine supplementation. Studies show older adults aged 68 to 85 who took 20 grams of creatine daily for seven days had improved memory. Older adults with Alzheimer’s disease may also have some improvement in cognitive processing with creatine supplementation. (14)(16)
• Some research shows that increasing brain creatine may help people with a concussion or traumatic brain injury. Brain creatine decreases after a traumatic brain injury, and ATP production slows down. Creatine supplementation may help to improve recovery or reduce symptoms. (14)
• There has been ongoing research to see if creatine supplementation can improve brain health in people with neurodegenerative diseases like Parkinson’s Disease and muscular dystrophy. There seems to be little to no effect. (16)

How to Take Creatine

Ready for gains? It’s always best to check with a healthcare provider before trying creatine or another dietary supplement. When you’re ready to go, here’s what to do.

The ISSN (and other research) recommends the following instructions for creatine supplementation. (1)

• Take 0.3 grams of creatine monohydrate per kilogram of body weight every day for five to seven days.
• Consume three to five grams of creatine per day. Within four weeks, your creatine stores should increase.

[Read More: Should You Take Creatine Before or After a Workout?]

It was initially recommended to go through a creatine loading phase to increase your creatine levels slowly. A 2021 study on creatine research found the loading phase unnecessary. The study confirms the ISSN’s recommendation of taking a maintenance dose of three to five grams daily instead. (12)

Remember that creatine monohydrate is the most-studied and effective type of creatine. You can take it at any time of day; it matters that you take it consistently to keep it in your muscle cells.

Potential Side Effects of Creatine

Creatine is widely regarded as safe. There are currently no scientifically backed detrimental adverse effects. (1)

• The main potential side effect of creatine supplementation is short-term water retention, thought to occur when you first start taking creatine as your muscle cells fill. Water retention may lead to temporary weight gain. Creatine has not been found to lead to long-term weight gain, as was initially reported. (12)
• Like any dietary supplement, creatine may cause gastrointestinal symptoms. 
• Creatine was initially said to cause kidney damage, but research has shown this to be false. When taken at the recommended dosage, creatine is safe for people without kidney disease. People with kidney disease should consult their healthcare provider. (12)
• Most studies on creatine side effects are based on short-term use. The ISSN notes that there needs to be more research on long-term side effects of creatine supplementation. (1)

Your Takeaways

Whether you’re aiming to boost your bodybuilding game or get some overall health benefits, here’s the breakdown on creatine:

• Taking creatine increases your stored phosphocreatine, which helps replenish your energy supply (ATP) quicker.
• Research shows that when combined with resistance training, creatine supplementation helps increase muscle strength, build muscle mass, and improve athletic performance.
• It also can boost brain health in young and older adults.
• Including foods with creatine in your diet or trying creatine monohydrate supplementation can majorly boost your hard work in the gym or on the field. 

FAQs

Let’s wrap up by answering your common questions about what creatine does.

References

1. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Jun 13;14:18. 
2. Dunn J, Grider MH. Physiology, Adenosine Triphosphate. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 
3. Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. 2007 Aug 30;4:6. 
4. Wax B, Kerksick CM, Jagim AR, Mayo JJ, Lyons BC, Kreider RB. Creatine for Exercise and Sports Performance, with Recovery Considerations for Healthy Populations. Nutrients. 2021 Jun 2;13(6):1915. 
5. Wu SH, Chen KL, Hsu C, Chen HC, Chen JY, Yu SY, Shiu YJ. Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021. Nutrients. 2022 Mar 16;14(6):1255. 
6. Delpino FM, Figueiredo LM, Forbes SC, Candow DG, Santos HO. Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: A systematic review and meta-analysis of randomized clinical trials. Nutrition. 2022 Nov-Dec;103-104:111791. 
7. E, A., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients, 13(3), 877. 
8. Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J Clin Med. 2019 Apr 11;8(4):488. 
9. Rawson ES, Venezia AC. Use of creatine in the elderly and evidence for effects on cognitive function in young and old. Amino Acids. 2011 May;40(5):1349-62. 
10. Mills S, Candow DG, Forbes SC, Neary JP, Ormsbee MJ, Antonio J. Effects of Creatine Supplementation during Resistance Training Sessions in Physically Active Young Adults. Nutrients. 2020 Jun 24;12(6):1880. 
11. Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. 2017 Nov 2;8:213-226. 
12. Antonio, J., Candow, D.G., Forbes, S.C. et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr 18, 13 (2021).
13. Kaviani M, Shaw K, Chilibeck PD. Benefits of Creatine Supplementation for Vegetarians Compared to Omnivorous Athletes: A Systematic Review. Int J Environ Res Public Health. 2020 Apr 27;17(9):3041. 
14. Roschel H, Gualano B, Ostojic SM, Rawson ES. Creatine Supplementation and Brain Health. Nutrients. 2021 Feb 10;13(2):586.
15. Rawson ES, Venezia AC. Use of creatine in the elderly and evidence for effects on cognitive function in young and old. Amino Acids. 2011 May;40(5):1349-62. 
16. Forbes SC, Cordingley DM, Cornish SM, Gualano B, Roschel H, Ostojic SM, Rawson ES, Roy BD, Prokopidis K, Giannos P, Candow DG. Effects of Creatine Supplementation on Brain Function and Health. Nutrients. 2022 Feb 22;14(5):921.

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