Creatine: What It Is, How It Works, and Why People (Should Maybe) Take It
Originally published in Ukrainian in March 2026. This English version was translated and adapted by the author.
Disclaimer: ‼️ The following article is for informational purposes. What you do with that information is ultimately your responsibility. Any supplement—no matter how safe, well-studied, or generally wonderful the research makes it look—may still not be right for you or may affect you differently. If you have any doubts about whether supplementing with creatine is a good idea for you personally—especially if you’re pregnant or breastfeeding, or have a history of bipolar disorder—please talk to your healthcare provider before taking it.THE BASICS
So what exactly is creatine?
In Greek, κρέας (kreas) means meat. Since Michel Eugène Chevreul first isolated this new organic compound back in 1832 from meat, that is what it was called: creatine.
Naturally, it wasn’t immediately packed into tubs with little five-gram plastic scoops and sold in sports nutrition stores to anyone hoping for bigger, stronger muscles. Although one of the early creatine researchers, the German chemist Justus von Liebig, did manage to secure rather decent funding for his laboratory by manufacturing and selling his famous “Liebig’s Extract of Meat,” or Fleischbrühe, which contained about 8% creatine [1].
Phosphocreatine—the form in which creatine is stored in the human body, mostly in skeletal muscle (our own “meat,” if you will)—wasn’t discovered until 1927, independently by Eggleton and Eggleton [2] and Fiske and Subbarow [3]. That happened nearly a century after creatine itself had first been isolated.
Skeletal formula of the neutral form of creatine
Mechanism of action
Since around that time—in other words, for almost a century now—we’ve known that creatine is an important part of human bioenergetics: basically, where we humans get the energy to do all that bio, put simply—to live.
So, a very short detour into bioenergetics. It matters, because it will make the whole point of taking creatine much easier to understand.
The universal energy currency that all living cells use for basically any expression of living is called ATP—adenosine triphosphate. As the name suggests, it consists of adenosine with a phosphate group attached—or, more precisely, three phosphates linked in a chain:
Structure of adenosine triphosphate (ATP)
When that third phosphate breaks away from the group, you get a tiny nano-bada-boom: energy is released, and that energy powers the processes that keep us alive. Thus ATP becomes ADP—adenosine diphosphate—meaning there are now only two phosphates left on the chain.
This is where our old friend phosphocreatine can step in. Molecularly, phosphocreatine is simply creatine bonded to a phosphate. It generously hands over its one and only phosphate to ADP, turning it back into fully fledged energy currency—ATP—so life can keep life-ing.
Put very simply, adding creatine to your diet helps saturate body tissues with it—mostly skeletal muscle—giving them a kind of boost when it comes to rapid energy regeneration. This matters particularly during short, especially during powerful muscular efforts, when there simply isn’t time to wait for oxygen-dependent pathways to manufacture enough ATP from carbohydrates, proteins, and especially fats. Fat may ultimately yield the most energy, but it also takes the longest to turn into usable fuel.
And here is where supplements become rather practical: to get the standard recommended 3–5 g dose of creatine [4] from food alone, you would need to eat more than a kilogram—possibly closer to a kilo and a half—of raw beef. I love a good steak (not raw, for the record), but even when I’m extremely hungry, 300 grams is probably my upper limit in one sitting.
It is likely this combination of concentration and bioavailability that helped creatine, as we know it today—a white powder with the approximate mouthfeel of sand—find its way into thousands of studies investigating its effects across different systems of the body.
A long research history—and a stellar safety profile
The grown-up kind of research—serious randomized, double-blinded, placebo-controlled trials of creatine supplementation—started in the early 1990s [1]. Two foundational papers looked at increasing muscle creatine levels at rest and during exercise through supplementation [5], and at the effects of oral creatine on muscle performance during repeated bouts of maximal voluntary effort [6].
And from there, as they say, things took off. Today, we have hundreds—if not thousands—of good-quality studies on creatine supplementation in an astonishing range of contexts. If the 1990s were largely about studying creatine in athletes, we now have increasingly interesting data across very different populations, including children [9].
All of this makes creatine arguably one of the most extensively studied dietary supplements in history, with a remarkably reassuring safety profile. According to recent evidence, creatine supplementation does not appear to increase the prevalence or frequency of adverse effects compared with placebo; claims to the contrary are currently considered unsupported [7].
Creatine has been given to children with traumatic brain injury [9], is being investigated as a potential intervention in Alzheimer’s disease [10], and has of course been used for decades by people who take muscle mass and strength seriously—including me.
At least theoretically, we currently have no strong reason to think creatine would be inherently unsafe during pregnancy either. But—and this is an important but—we do not yet have direct supplementation studies in pregnant humans. Conducting experimental research in pregnancy is complicated for many reasons, including obvious ethical constraints [8].
YOUR LIFE ON CREATINE (POTENTIALLY)
Muscular capacity
The first—and probably most obvious—beneficiary of supplemental creatine in the body (usually taken as a powder, though tablets and chewables exist too) is muscle [4]. That is where the body stores most of its creatine in the first place—roughly 95%, tucked away in all those biceps, triceps, and the rest of our skeletal muscle.
When skeletal muscle is well saturated with creatine, it can generally do more—specifically, it can produce more power, meaning express force quickly. That follows directly from what we just discussed: phosphocreatine helps regenerate ATP, the universal energy currency behind muscular work.
In practice, that can mean a few extra reps or sets in the gym, a faster and more successful sprint for the bus, and, more broadly, a better capacity to move with speed and force.
At this point, one might reasonably play devil’s advocate and ask: “But why do I need power? I’m not planning to throw shot put at the Olympics or run the 100 meters.”
My counter-question would be: Would you like to be able to catch yourself when you fall?
That is also power: producing enough force against gravity, fast enough to matter. The whole thing unfolds in seconds. If your muscles cannot respond quickly enough, the result is a fall—with consequences that tend to become more serious as we age.
I realize I have just wandered well beyond what creatine itself can promise, so let me pull us back to reality. Taking creatine does not automatically make anyone strong or fast. Strength and power are adaptations built through months and years of regular training. Creatine’s potential role is much more modest: helping you squeeze out those extra reps, sets, or bits of high-intensity work that, accumulated over time, can contribute to more prominent and favorable adaptations in muscular size, strength and power.
Cognitive function
The brain confidently leads the “second line” of potential beneficiaries of creatine supplementation. I wouldn’t be surprised if, a few years from now, creatine gets crowned the brain’s favorite supplement: over the past decade, research on creatine and cognitive function has opened up a remarkable range of potential therapeutic applications for our “main computer.”
When you think about it, this isn’t particularly mysterious. The brain is running biological processes 24/7 and, like every other living tissue, needs energy—ATP. And by now we know exactly where creatine enters that picture. It is therefore not surprising that creatine has repeatedly emerged as a potentially important player in cognitive performance [11, 12].
There is, however, a catch.
The brain is rather elegantly protected from whatever happens to be circulating in the bloodstream. Scientifically, this protective border is called the blood-brain barrier. It is an evolutionarily refined checkpoint system designed, among other things, to prevent something like E. coli from casually wandering into your cortex.
Some substances—including certain forms of magnesium, caffeine, alcohol, and a wide range of antidepressants—can cross this barrier. You can think of them as having a kind of molecular access pass that gets them through the brain’s internal checkpoints.
Creatine appears to have a pass too, but not a particularly powerful one. The specific transporter responsible for moving creatine across the blood-brain barrier, SLC6A8, is present at relatively low density. In practical terms, that means creatine levels in the blood generally need to be higher before substantially more of it makes its way into the brain [12]. This is one reason researchers discussing cognitive effects often work with doses around 10 g per day or higher, rather than the more familiar 3–5 g used for muscle-related purposes [8, 12].
And because creatine is looking increasingly interesting for cognitive performance, researchers have begun testing it in a much broader range of neurological and psychiatric contexts. It has shown promise as an adjunct in depression [13], in mitigating some of the cognitive effects of sleep deprivation [14], and in recovery following traumatic brain injury [9], including in children.
More recently, creatine has even been investigated as a potential therapeutic tool in neurodegenerative conditions such as Alzheimer’s disease [10].
Reducing symptoms of depression
A 2025 study of 100 participants (average age: 30) found that taking 5 g of creatine per day alongside cognitive behavioral therapy (CBT) produced significantly greater improvements in depression symptoms than CBT alone. Participants in the creatine + CBT group scored about 5 points lower on the PHQ-9 depression scale than those receiving therapy alone. Clinically, that is a substantial difference—the kind that can separate “I feel a bit better” from a meaningful improvement in quality of life [13].
The study also adds to a growing challenge to the old idea of depression as simply a neurotransmitter “chemical imbalance,” drawing attention instead to the possible role of brain energy metabolism. Metabolism, after all, is something every living tissue has to do—including the smartest one.
"Cleaning up" after sleep deprivation
Another study, conducted in Germany, found that a single high dose of creatine—0.35 g/kg of body weight, which comes to about 25 g for someone weighing 70 kg—improved memory, cognitive performance, and brain creatine levels after 21 hours of sleep deprivation [14].
I sincerely hope your takeaway from this is not: “Excellent, now I can stop sleeping and eat creatine by the bowlful.”
Nothing replaces getting enough good-quality sleep. But expecting 100% of our nights to deliver that is equally unrealistic. And for those occasions when sufficient sleep simply isn’t on the menu, high-dose creatine may turn out to be one useful tool for softening some of the cognitive consequences.
Recovery after traumatic brain injury
One of the more intriguing potential uses of creatine is in rehabilitation after traumatic brain injury, including in children.
In one pilot study, 39 children and adolescents aged 1–18 were given creatine for six months at a dose of 0.4 g/kg of body weight per day. For a 30 kg child, that works out to 12 g daily—a dose we would usually think of as fairly high, but one that was used here in the context of significant brain injury.
Compared with the control group, the children receiving creatine had a shorter stay in intensive care, less time requiring intubation, and a shorter period of post-traumatic amnesia. Researchers also reported improvements in cognitive and behavioral outcomes.
In other words, creatine appeared to support not only survival and acute recovery, but also the restoration of important cognitive functions—including abilities related to learning and social interaction.
And despite the relatively high dose and six months of supplementation, no adverse effects were reported in the study [9].
(Attempts at) treating neurodegenerative disease
Alzheimer’s disease is often described as a kind of metabolic crisis in the brain, in which neurons gradually lose their ability to produce enough energy—ATP—to function and communicate properly. A 2025 study by Smith et al. was the first clinical trial to show that it may be possible to meaningfully “refuel” the brains of these patients from the outside [10].
Using a distinctly brain-sized dose—20 g of creatine per day for eight weeks—the researchers increased total creatine levels in brain tissue by about 11%. Perhaps the most encouraging finding was an improvement in fluid intelligence: the ability to reason and solve unfamiliar problems independently of prior knowledge. Participants also performed better on tests of working memory and on the Flanker task, which measures the ability to stay focused while ignoring distracting information [10].
It is important to emphasize that this was only a small pilot study involving 20 people, so we are very far from being able to say that creatine treats—or let alone cures—Alzheimer’s disease. But given creatine’s mechanism of action and its reassuring safety profile, these early findings suggest that it may eventually prove useful as one tool for supporting cognitive reserve.
WHO SHOULD TAKE CREATINE, WHICH KIND, AND HOW MUCH
If you’ve honestly made it this far, I imagine it’s already pretty clear that creatine is a remarkably versatile supplement—one that can be useful in very different contexts for two rather important organs: muscle and brain. (And yes, it is indeed quite useful to think of skeletal muscle as a single organ.) The dose, however, depends largely on what you’re trying to achieve. For saturating muscle stores, 3–5 g per day, or roughly 0.1 g/kg of body weight per day, appears to be sufficient [4, 16]. The brain, on the other hand, seems more likely to show measurable cognitive effects when doses reach 10 g per day or more [8, 12].
As for exactly how much you should take, that is a question worth discussing with someone you trust to help you make important decisions about your health.
So who might have the most to gain from creatine supplementation—setting aside specific therapeutic uses such as traumatic brain injury or neurodegenerative disease? Two groups come to mind first: people who were assigned female sex at birth, and people who eat little or no meat.
The first group generally appears to have 20–30% lower endogenous creatine stores than people assigned male at birth [15]. The second simply has fewer opportunities to replenish creatine through food. Fish does contain some creatine, but generally less than red meat. And when those two factors overlap—say, someone who was assigned female at birth and also eats little or no meat—the result may be relatively low creatine stores.
If anything, I’d argue that this group has a stronger case for supplementation than the stereotypical “gym bros,” for whom adding creatine can sometimes amount to adding another modest drop onto an already respectable pile.
Then there’s the practical question: which creatine should you actually buy?
The most extensively studied form is creatine monohydrate [16]. Within that category, the German brand Creapure is often treated as a kind of gold standard for purity and quality [8].
You may also hear claims that some of the unpleasant side effects people attribute to creatine—particularly gastrointestinal discomfort—have more to do with supplement quality than with creatine itself. Manufacturers can take a perfectly simple ingredient, mix it with an assortment of extras, give the formula an impressive proprietary name, and sell it as “creatine that works better than regular creatine.” Creatine is creatine. Please don’t accidentally confuse it with the added snake oil someone has sprinkled into the formula and is now trying to sell you as something superior to creatine itself.*
*One important caveat here: there is some evidence that adding guanidinoacetic acid (GAA) to creatine may improve its uptake into the brain [12]
MYTHS AND CAVEATS
Can creatine make you puffy—or make you lose your hair?
You would think creatine is so thoroughly studied and useful that most people could simply take it and move on with their lives—subject, of course, to the caveats below. But no. People worry that creatine will make them dramatically retain water, cause them to lose hair they very much want to keep, or, worse, damage their kidneys. In other words, creatine has accumulated quite a collection of horror stories—most of them poorly supported. One of the classics is that creatine somehow works like an anabolic steroid. It does not [16].
There are, in fact, so many myths about creatine that a group of leading researchers in the field got together and published an entire paper devoted to them: Common Questions and Misconceptions About Creatine Supplementation: What Does the Scientific Evidence Really Show? It is open access, by the way, if you feel like going straight to the source (reference 16 below).
Here is the short version:
Creatine may cause some water retention—but mostly inside muscle cells, particularly in the short term. Other data suggest that over longer periods, creatine does not meaningfully change total body water, either intracellular or extracellular. Bottom line: creatine supplementation does not necessarily make you generally “puffy.” Speaking purely from my own several years of taking creatine, systemic bloating during the luteal phase is far more noticeable to me than even taking 20 g of creatine.
Creatine is not an anabolic steroid. Its chemical structure is entirely different.
Creatine does not appear to damage healthy kidneys when taken at recommended doses. Experimental and controlled studies do not show kidney damage or impaired renal function in healthy people using creatine appropriately.
Current evidence does not support the idea that creatine raises total testosterone, free testosterone, or dihydrotestosterone (DHT), or that it causes hair loss or baldness.
Creatine does not increase fat mass. Creatine itself contains essentially no calories. Fat mass increases primarily when there is a sustained energy surplus—for example, when someone consistently consumes more energy than they expend. And, as we already know, creatine may actually help you expend a little more by supporting higher training output.
And while we are clearing out old gym folklore, we should also mention the persistent claim that caffeine somehow “cancels out” creatine. According to the current scientific consensus, the two can coexist just fine—unless, perhaps, you are taking both in very large doses, repeatedly, at the same time, while also having a particularly sensitive stomach [18].
Caveats
After everything above, you could be forgiven for thinking that creatine is some kind of miracle supplement. It isn’t. And it cannot—nor should it—replace the basics that good health actually rests on: adequate nutrition, good sleep, the right amount and quality of physical activity, supportive social relationships, and the ability to regulate yourself under stress. Creatine is a supplement, not the foundation.
I also don’t want to leave you with the impression that everyone needs it. Some people will notice very little—or nothing at all—from adding creatine to their diet. In other words, you may be what researchers sometimes call a non-responder. One small study of just 11 participants found that people tended to respond better when they started with lower muscle creatine levels and had a higher proportion of type II muscle fibers (we go into what those are in detail in my course The Guide to Human Muscles) [17].
And finally, I definitely don’t want you to conclude that everyone should start eating creatine by the spoonful. The disclaimer at the beginning of this article is there for a reason. In particular, if you have significant kidney disease, a history of bipolar disorder, or take medications that could be relevant here, please talk to a healthcare professional who knows your medical history before prescribing creatine to yourself.
CODA
At this point, it's fair to say that I’ve put just about everyone I possibly could onto creatine—possibly even you.
And no, it’s not because some creatine tycoon is paying me on the side, although that would be nice. It’s simply that the more we learn about creatine—and the more I learn about it personally—the fewer reasons I can find not to recommend it to almost anyone who happens to have both muscles and a brain.
The important thing is to remember to switch the latter on before taking creatine—or, for that matter, any other biologically active substance.
Sources:
1 — Theo Wallimann, PhD. Creatine History: Discovery and First Trials with Creatine Supplementation. https://creatineforhealth.com/creatine-history/#:~:text=creatinine%20,1996 (Fragment taken from: Wallimann, T. (2007). Introduction – Creatine: Cheap Ergogenic Supplement with Great Potential for Health and Disease. In: Salomons, G.S., Wyss, M. (eds) Creatine and Creatine Kinase in Health and Disease. Subcellular Biochemistry, vol 46. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-6486-9_1)
2 — Eggleton P, Eggleton GP. Further observations on phosphagen. J Physiol. 1928 Mar 30;65(1):15-24. doi: 10.1113/jphysiol.1928.sp002457. PMID: 16993934; PMCID: PMC1515019.
3 — Simoni, Robert & Hill, Robert & Vaughan, Martha. (2002). The Determination of Phosphorus and the Discovery of Phosphocreatine and ATP: the Work of Fiske and SubbaRow. The Journal of biological chemistry. 277. 21e. 10.1016/S0021-9258(20)70222-X.
4 — Buford, T. W., Kreider, R. B., Stout, J. R., Greenwood, M., Campbell, B., Spano, M., … Antonio, J. (2007). International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4(1). https://doi.org/10.1186/1550-2783-4-6
5 — Harris RC, Söderlund K, Hultman E. Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci (Lond). 1992 Sep;83(3):367-74. doi: 10.1042/cs0830367. PMID: 1327657.
6 — Greenhaff PL, Casey A, Short AH, Harris R, Soderlund K, Hultman E. Influence of oral creatine supplementation of muscle torque during repeated bouts of maximal voluntary exercise in man. Clin Sci (Lond). 1993 May;84(5):565-71. doi: 10.1042/cs0840565. PMID: 8504634.
7 — Kreider RB, Gonzalez DE, Hines K, Gil A, Bonilla DA. Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports. J Int Soc Sports Nutr. 2025 Sep;22(sup1):2488937. doi: 10.1080/15502783.2025.2488937. Epub 2025 Apr 8. PMID: 40198156; PMCID: PMC11983583.
8 — Patrick, R. (Host). (2025, Mar 15). The Optimal Creatine Protocol for Strength, Brain, and Longevity | Darren Candow, PhD [Video podcast episode]. FoundMyFitness. https://youtu.be/ICsO-EHI_vM?si=zP95030ELzbqqaEB
9 — Sakellaris G, Kotsiou M, Tamiolaki M, Kalostos G, Tsapaki E, Spanaki M, Spilioti M, Charissis G, Evangeliou A. Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. J Trauma. 2006 Aug;61(2):322-9. doi: 10.1097/01.ta.0000230269.46108.d5. PMID: 16917445.
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11 — Rae C, Digney AL, McEwan SR, Bates TC. Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proc Biol Sci. 2003 Oct 22;270(1529):2147-50. doi: 10.1098/rspb.2003.2492. PMID: 14561278; PMCID: PMC1691485.
12 — Roschel, H., Gualano, B., Ostojic, S. M., & Rawson, E. S. (2021). Creatine Supplementation and Brain Health. Nutrients, 13(2), 586. https://doi.org/10.3390/nu13020586
13 — Sherpa NN, De Giorgi R, Ostinelli EG, Choudhury A, Dolma T, Dorjee S. Efficacy and safety profile of oral creatine monohydrate in add-on to cognitive-behavioural therapy in depression: An 8-week pilot, double-blind, randomised, placebo-controlled feasibility and exploratory trial in an under-resourced area. Eur Neuropsychopharmacol. 2025 Jan;90:28-35. doi: 10.1016/j.euroneuro.2024.10.004. Epub 2024 Nov 1. PMID: 39488067. https://pubmed.ncbi.nlm.nih.gov/39488067/
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