Creatine: No Longer a Body-Builder Thing

Creatine is an organic compound that is in your body, your food, and supplements. It is osmotic (water-based), and it can increase energy in your body. As explained by Dr. Darren Candow, a globally known researcher of creatine, creatine monohydrate speeds up mitochondrial recovery, increases lean body mass, and is being touted as a new neurotransmitter (Patrick, 2025).

What is it exactly?

This is one of the first things that puzzled me as a nurse, because I was not familiar with creatine. Why are they calling it creatine and not the term I knew, creatinine? Is it the same? 
Now I know that creatine is an osmotic compound our bodies use, and creatinine is the waste product of this compound that is not used by the body and is filtered through our kidneys.

For several years, creatine supplementation was solely focused on muscle strength and endurance. In the last decade, creatine has shown that it is not only for muscle but also for bone strength and stability, brain health, and cardiovascular health (Patrick, 2025). What is amazing is that the body will prioritize where creatine is needed most, and it will go there first.

For example, if you are under extreme stress, the body will increase saturation in the brain to activate a high-powered stress response. Your body is always working to maintain homeostasis.

How does it work?

When energy (ATP) is broken down, due to needs in the body, to ADP, creatine provides the phosphate (that it lost in the breakdown) to make more energy.

Creatine monohydrate, the most studied form with the most replicated results, has an exceptional safety profile for children and adults, and it is almost 100% bioavailable for the body to use (Patrick, 2025). On her podcast, @FoundMyFitness, Dr. Rhonda Patrick asked Dr. Darren Candow, “Why all the hype around creatine monohydrate?” His response: “Because it works.”

Why should the general public consider use?

• Strength, power, and faster recovery between sets
• Increase calcium levels and reabsorption of calcium
• Decreases the breakdown of bone
• Faster recovery for traumatic brain injury
• Improves brain fatigue and brain bioenergetics
• Improves sleep duration and recovery (Patrick, 2025)

Creatine is NOT creatinine

The most important point to share with you is to inform your medical provider if you are taking creatine as a supplement, so they have this information when they check your creatinine level with other metabolic labs. It should not negatively impact this lab (I know it does not affect mine), but it may artificially elevate your result.

What must you do to realize results?

Dr. Candow’s recommendations for dosage options begin with a loading dose of 20 grams a day for 7 days, with muscle saturation in about 2 days (but more risk for GI distress and fluid retention). 

Attention, women! You only have about 75% of the creatine stores of men, so you don’t need as much to saturate — Dr. Stacy Sims, renowned exercise physiologist, nutrition scientist, and advocate specializing in female physiology and performance, recommends 3–5 grams a day (2026).

A maintenance dose of 5 grams a day is the global recommendation, and you can split it up. Key point: use it during exercise, or within 1 to 2 hours before or after your workout. 
Per Dr. Candow (2025), the recommendation for dosing is 0.1 to 0.14 grams per kilogram. Even if you want 10 g/day to be your target, lean into it. When we give our body more time to build into use, the fewer negative symptoms you will have (Patrick, 2025).

As supplements go, the great thing about creatine monohydrate is that it is not very expensive, and it has the most studies showing sound results. There are pricier options, but they do not have as much science behind them. I checked in with numerous national and international health and fitness scientists, and they all agree stick with creatine monohydrate.

This all sounds great! What is the evidence? Let's start with what Dr. Candow says about Cardiovascular & Power benefits (2025)

• Creatine has a direct impact on Volume (the load of reps or exercise capacity and cardiac load).
• Creatine increases lean body mass which is connective and soft tissue and muscle
• With Power (i.e. squat), creatine benefits muscle recruitment and has shown to bring a big difference at 2nd, 3rd, and 4th set of reps
• Creatine will speed recovery between sets AND in between contractions!
• If you are doing aerobic activity (ex. running, spinning) which causes increased inflammation and the release of cytokines and are using creatine supplementation, you will have more allowance for recovery, faster calcium reuptake in the muscles that will allow greater relaxation

Wow! Creatine is a catalyst for my strength and endurance. What about my bones? Did Dr. Candow mention these benefits?

• No studies to date have evaluated Creatine at a dose lower than 8 grams per day
• Weight training will still be #1 for bone density and bone health. Creatine does NOT increase bone density.
• Creatine does inhibit the breakdown of bone. One big reason is that Creatine brings Calcium levels up. There have been 15 studies to support Creatine’s role in inhibiting bone density loss.
• Most exciting is the studies investigating creatine's possible benefit of bone health, targeted bone loss in the hip region. What does that mean for people over 50? Less risk of hip fractures (Patrick, 2025).

I am SO excited to read this! I have heard the Brain is tricky, something about the 'blood-brain' barrier? What did Dr. Candow say about the Brain? Is Creatine a 'welcome guest' of the Brain?

• 20% of all energy is consumed by the actions of the Brain
• The studies about brain health have used the highest doses of 20 grams per day for 7 days.
• Recent results have shown a positive impact on mental fatigue associated with sleep deprivation, hypoxia (ex., sleep apnea), even “jet lag”,
• The aging brain also is under more stress, so greater benefit is being realized with creatine monohydrate supplementation.
• A recent study showed improved sleep duration and recovery on “workout days” with use of creatine monohydrate.
• More creatine is used when the brain is in “stress” mode; it has shown it will take in more to combat the stress response (i.e. inflammatory response, increase release of cytokines, oxidative stress) (Patrick, 2025).

Want to get into the details and learn more? Check out these links!

Bikman, Ben (2025 June 16). [Session 106: Creatine Demystified: Brain, Muscle & Metabolic Benefits with Dr. Ben Bikman] YouTube. https://www.youtube.com/watch?v=Z7TRG6em3DA&t=218s

Patrick, Rhonda (2025 March 31). Foundmyfitness. [The Optimal Creatine Protocol for Strength, Brain, and Longevity] YouTube. https://www.youtube.com/watch?v=ICsO-EHI_vM&t=4s

Sims, Stacy (2026 Jan 31). [Dr. Stacy Sims: Should women take creatine? A physiology-based masterclass for midlife hormones]. YouTube. https://www.youtube.com/watch?v=0odXU5bQojE