Creatine has earned its reputation as the go-to supplement for strength and power—most likely because it actually delivers. Its job is simple: it boosts the quick-access energy your muscles rely on during intense exercise. That means you can push harder, recover faster between bursts of effort, and get more out of every workout. Here’s the short version of how it works:
Our muscles naturally store creatine, which can easily bond with a phosphate group to form phosphocreatine— a kind of quick-access energy reserve. When you exercise, your muscles rely on ATP (adenosine triphosphate) for energy. As ATP is used, it loses a phosphate group and becomes ADP (adenosine diphosphate). That’s when phosphocreatine steps in, donating its phosphate group to turn ADP back into ATP, giving your muscles the instant energy they need to keep going.
During intense exercise, your body burns through ATP fast— up to 1,000 times faster than at rest. If ATP isn’t replenished quickly, performance drops. Because your muscles can only store a limited amount of creatine and phosphocreatine, this energy system runs out quickly. That’s where creatine supplementation comes in. By increasing your muscles’ creatine stores, you enhance their ability to rapidly regenerate ATP. Creatine has also been shown to support lean muscle growth by improving training performance and drawing more water into muscle cells.
We already know creatine reliably improves strength and power in short, intense efforts—hundreds of studies have shown it. What’s more interesting now are the lesser-known benefits that this article will dig into next.
We’ve known for a while that creatine matters for the brain, not just the muscles. Even though the brain only holds about 5% of the body’s creatine, low levels can cause major issues. In rare genetic conditions where the brain can’t make or use creatine properly, kids can develop serious cognitive and developmental problems. Low brain creatine has also been linked to things like traumatic brain injury, Parkinson’s, Huntington’s, and ALS. Research shows that taking creatine can raise brain creatine levels by about 10%, which is why more scientists are paying attention to its mental benefits (Dolan, 2018).
The brain burns through ATP nonstop—whether it’s keeping you alive or keeping you awake at 2 a.m. analyzing your climbing beta (just me?). When ATP drops, neurons struggle, and mental performance dips. Creatine seems most helpful during mentally demanding tasks or when the brain is under stress from things like sleep loss, fatigue, or low oxygen. One review found fairly consistent improvements in short-term memory and reasoning (Avgerinos, 2018). It also seems to help older adults more than younger ones. It’s also been shown to be more beneficial for vegetarians than meat-eaters, likely because they start with lower creatine stores (Benton, 2011).
Because many brain disorders involve poor mitochondrial function or trouble making ATP, researchers are exploring creatine as a potential helper. Animal studies suggest it might protect the brain after injuries like concussions and reduce the impact of certain neurodegenerative diseases. Human research is mixed—creatine clearly helps people with genetic creatine deficiencies, but it hasn’t shown strong results for ALS, and results for Parkinson’s and Huntington’s disease have been modest.
Big picture: creatine may not do much when the brain is running perfectly, but it does seem to help when the brain is stressed—by aging, lack of sleep, dietary habits, or neurological challenges. More studies are needed, but the early signs are promising.
How Does Creatine Work With Bones?
Bones don’t get enough credit. They’re active, living tissue—just like muscle—and they respond to training. Recently, researchers have started looking into how creatine might support bone health. The logic is simple: lifting puts more strain on your bones, which encourages them to build up. And because bone cells rely on ATP, creatine’s role in boosting quick energy might help them form new bone and slow down bone breakdown.
Some studies show that adding creatine to resistance training can reduce markers of bone loss (Forbes, 2018). A meta-analysis of older adults found mixed results overall, but a closer look revealed some important patterns. The one study that lasted a full year did find a clear benefit—no surprise, since bones change slowly and need time to show measurable improvements (Chilibeck, 2015). Training frequency also mattered: studies with three strength workouts per week saw positive effects, even when the trials were as short as three months (Chilibeck, 2005). These studies also used body-weight–based creatine dosing (~0.1g/kg), while studies using a flat 5g dose showed no benefit. This is likely because larger participants were underdosed.
In short, creatine seems most helpful for bones when paired with consistent strength training (three days a week or more) and taken at about 0.1g/kg of body weight. Its main effect appears to be reducing bone loss rather than dramatically boosting bone formation, meaning it may be especially useful during times of high bone turnover—like aging, intense training, or chronic dieting.
Can Creatine Improve Inflammation, Oxidative Stress, and Immunity?
To study inflammation, researchers often trigger swelling in a rodent’s paw and measure the response. In these models, creatine—whether injected or taken orally—reduced several markers of acute inflammation (Riesberg, 2017). It also helped in rodent models of chronic inflammation like arthritis. And similar patterns have shown up in humans: creatine has been found to reduce inflammation after a 30 km race, a half-Ironman, and intense anaerobic training.
Creatine might also help with oxidative stress. Cell studies show protective effects, and rat studies report antioxidant benefits after a few weeks of supplementation. Human results are mixed—some studies see reduced oxidative stress after resistance training, others don’t (Rahimi, 2011).
Creatine even seems to influence immune activity. In lab settings, it reduces the tendency of immune cells to stick to blood vessel walls, which might theoretically help slow plaque buildup (Riesberg, 2017).
Of course, tweaks to inflammation and immunity aren’t always universally good. A few researchers have raised the possibility that creatine’s combined effects could be mildly immunosuppressive, though long-term studies rarely track illness rates. One three-year study in college football players found no increase in sickness among creatine users (Greenwood, 2003). Rodent studies suggest creatine can worsen airway inflammation in asthma, but exercise seems to counteract that (Vieira, 2007). On the flip side, small human studies in people with COPD or cystic fibrosis show modest training benefits without changes—positive or negative—in lung function (Fuld, 2005).
Overall, creatine does seem to influence inflammation, oxidative stress, and the immune system. People with asthma, major allergies, or immune issues may want to be cautious. For most healthy adults, though, its effects appear to be mildly helpful or neutral.
Creatine may be best known for boosting strength and performance, but its story goes far beyond the weight room. From supporting brain energy and cognitive resilience, to helping bones adapt to training, to influencing inflammation and oxidative stress, creatine touches more systems than most people realize. While some of these areas—especially neurological health and immune function—still need more research, the overall picture is clear: for most healthy adults, creatine is a well-studied, safe, and versatile supplement with benefits that extend well past muscle.
References:
Avgerinos, K. I., Spyrou, N., Bougioukas, K. I., & Kapogiannis, D. (2018). Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Experimental gerontology, 108, 166–173. https://doi.org/10.1016/j.exger.2018.04.013
Benton, D., & Donohoe, R. (2011). The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores. The British journal of nutrition, 105(7), 1100–1105. https://doi.org/10.1017/S0007114510004733
Chilibeck, P. D., Chrusch, M. J., Chad, K. E., Shawn Davison, K., & Burke, D. G. (2005). Creatine monohydrate and resistance training increase bone mineral content and density in older men. The journal of nutrition, health & aging, 9(5), 352–353.
Chilibeck, P. D., Candow, D. G., Landeryou, T., Kaviani, M., & Paus-Jenssen, L. (2015). Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women. Medicine and science in sports and exercise, 47(8), 1587–1595. https://doi.org/10.1249/MSS.0000000000000571
Dolan, E., Gualano, B., & Rawson, E. S. (2019). Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. European journal of sport science, 19(1), 1–14. https://doi.org/10.1080/17461391.2018.1500644
Forbes, S. C., Chilibeck, P. D., & Candow, D. G. (2018). Creatine Supplementation During Resistance Training Does Not Lead to Greater Bone Mineral Density in Older Humans: A Brief Meta-Analysis. Frontiers in nutrition, 5, 27. https://doi.org/10.3389/fnut.2018.00027
Fuld, J. P., Kilduff, L. P., Neder, J. A., Pitsiladis, Y., Lean, M. E., Ward, S. A., & Cotton, M. M. (2005). Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary disease. Thorax, 60(7), 531–537. https://doi.org/10.1136/thx.2004.030452
Greenwood, M., Kreider, R. B., Melton, C., Rasmussen, C., Lancaster, S., Cantler, E., Milnor, P., & Almada, A. (2003). Creatine supplementation during college football training does not increase the incidence of cramping or injury. Molecular and cellular biochemistry, 244(1-2), 83–88.
Rahimi R. (2011). Creatine supplementation decreases oxidative DNA damage and lipid peroxidation induced by a single bout of resistance exercise. Journal of strength and conditioning research, 25(12), 3448–3455. https://doi.org/10.1519/JSC.0b013e3182162f2b
Riesberg, L. A., Weed, S. A., McDonald, T. L., Eckerson, J. M., & Drescher, K. M. (2016). Beyond muscles: The untapped potential of creatine. International immunopharmacology, 37, 31–42. https://doi.org/10.1016/j.intimp.2015.12.034
Vieira, R. P., Duarte, A. C., Claudino, R. C., Perini, A., Santos, A. B., Moriya, H. T., Arantes-Costa, F. M., Martins, M. A., Carvalho, C. R., & Dolhnikoff, M. (2007). Creatine supplementation exacerbates allergic lung inflammation and airway remodeling in mice. American journal of respiratory cell and molecular biology, 37(6), 660–667. https://doi.org/10.1165/rcmb.2007-0108OC
