Should You Take Creatine Supplements to Build or Retain Muscle?

Doctors say it’s key to consult a health care provider before introducing any pill or powder to your routine

Kimberly Goad,

AARP

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Published April 10, 2025

illustrated flexing arm with pill capsules

AARP Staff

Muscle loss is like death and taxes: Pretty much inevitable.

Beginning around age 30, we all begin to lose muscle mass and — depending on overall health and level of activity — will continue to lose 3 to 8 percent per decade. By age 50, most of us have likely lost up to 10 percent of our muscle mass, according to the American College of Sports Medicine.

That steady decline accelerates, increasing to as much as 15 percent per decade after age 70. While everyone loses muscle over time, people with age-related muscle loss, a condition known as sarcopenia, lose it more quickly. People on Ozempic, Wegovy, and other GLP-1 weight loss drugs are also at risk for greater muscle loss, since reduced muscle mass is a side effect of these medications.

Here’s why that’s a big deal: “If you lose too much muscle mass, you become weaker, you lose your balance, which leads to injuries from falls,” says Richard Kreider, director of the Exercise & Sport Nutrition Lab at Texas A&M University. What’s more, he adds, people with sarcopenia who end up in the hospital are at a higher risk of mortality. “So keeping muscle is critical to maintain effective aging and quality of life," he says.

To that end, there’s plenty you can do about shrinking muscles. You likely already know about the importance of strength training. Lifting weights, practicing yoga, doing Pilates, or some other form of muscle-strengthening exercise two to three times per week can help maintain muscle mass. The same goes for getting enough protein in your diet. To stimulate protein synthesis, the process for building and maintaining muscle, women 50 and older need at least 25 grams of protein at every meal; men need 30.

You may be wondering whether the popular supplement creatine plays a role. Is it essential for anyone looking to retain and regain muscle? Or is it just another over-hyped health fad? Here’s what you need to know about supplementing with creatine.

What is creatine?

If you know about creatine only from the creatine-labeled bottles and jars lining drugstore shelves or from bodybuilders talking it up at the gym, you might be surprised to discover that creatine is a substance made naturally by the body.

“It’s synthesized from three amino acids and primarily found in muscles, with a small quantity in the brain,” says Kathryn Porter Starr, a registered dietitian and an associate professor in the division of geriatrics at Duke University School of Medicine. It’s essential for producing and regenerating ATP (short for adenosine triphosphate), the main carrier of energy in our cells, she adds. And even though we get creatine from our diet, we only really observe improvements in physical performance when we consume it in higher amounts, typically through supplements, Starr says.

In fact, your body produces enough creatine to supply about half of what you need, while the rest comes from your diet — through protein-rich foods like red meat, chicken and fish — or through dietary supplements.

Are creatine supplements safe?

Extensive research has demonstrated that creatine supplements are generally safe, Starr says. “However, individuals with chronic health conditions or those taking medication,” which is the vast majority of older adults, “should consult their health care provider before starting any supplement to rule out possible adverse risks or interactions between drugs and supplements.”

Potential side effects include bloating or diarrhea, weight gain related to water retention in muscle cells, and muscle cramps, says Kenneth Koncilja, M.D., a geriatrician at Cleveland Clinic.

“The largest concern regarding creatine supplementation in older adults is renal (kidney) function,” he says. “For healthy people, even with long-term use, creatine supplements don’t cause kidney disease. But patients with chronic kidney disease or those with diabetic nephropathy or difficult-to-control hypertension should avoid creatine supplementation altogether. Adequate hydration mitigates the risks to kidneys somewhat, but the benefit of supplementation doesn’t outweigh the risk.”

Another consideration to note: Like all dietary supplements, creatine isn’t subjected to the same rigorous approval process of over-the-counter medications and prescription drugs. The Food and Drug Administration doesn’t evaluate the safety or effectiveness of dietary supplements before they’re sold, but it does regulate them after they’re on the market.

For this reason and others, including potential side effects, “it’s crucial for consumers to research any supplements they’re considering,” Starr says. The first step, she adds, is to “thoroughly investigate the evidence supporting the claims made about the supplement." And the best way to do this, she says, is by consulting resources from the Office of Dietary Supplements, which is part of the National Institutes of Health.

The second step, Starr says, is to look for third-party certifications from NSF International, USP (United States Pharmacopeia) or ConsumerLab. These certifications “indicate that the product has been tested for purity, potency, and safety,” Starr says.

Still, creatine is no newcomer to the supplement scene. “We’ve been doing research on creatine since the early ’90s,” says Kreider, who studies the supplement, including in older adults. “We started out with athletes as a way to build muscle and increase power and strength. As the research evolved, we realized these things apply to older folks, as well — probably more so.”

Kreider says as you age, you tend not to retain as much creatine in the muscle. And “we now know from studies that older folks who have a lower creatine content in their muscles have greater problems with bone fractures, falls, and even cognitive decline.”

Especially poised to benefit from supplementing with creatine are vegetarians, vegans, and others on meat-free diets. In one study, meat eaters who switched to a vegetarian diet saw a distinct drop in their creatine levels after three months.

Does creatine work?

The short answer: It depends.

A small study of healthy adults aged 18 to 50, just published in the journal Nutrients, found no difference in muscle gains between those who took the supplement and those who didn’t. But Kreider says that’s because they weren’t given the recommended dosage.

“While there are health benefits to low-dose creatine supplementation, you don’t get the same effects on muscle mass changes during training from low-dose creatine supplementation,” he says. “Most low-dose studies over the last 30 years showed little training effect unless testing was much longer.”

The strongest evidence suggests creatine boosts muscle mass, muscle strength, and athletic performance in young, healthy, physically active people. As for whether the same is true for older people, “evidence indicates that creatine supplementation with resistance training may enhance muscle mass and strength in older adults,” says Starr, echoing the results of a number of studies, including a recent one published in Current Osteoporosis Reports, suggesting creatine works best when taken in tandem with strength training.

Outside the gym, meanwhile, researchers are exploring a number of potential health benefits that have little to do with retaining and regaining muscle mass. Although experts agree more research needs to be done, there are early signs that creatine may play a therapeutic role in diabetes, cancer, cardiovascular disease, rehabilitation, and cognitive decline.

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Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Prevention, Health and Reader's Digest.