As we’re seeing more and more research focused specifically on women (yay!) creatine has finally been given its due as a great support for strength, power, performance, mood, blood sugar regulation and brain health – with real benefits for women specifically.
“Creatine supplementation among pre-menopausal females appears to be effective for improving strength and exercise performance. Post-menopausal females may also experience benefits in skeletal muscle size and function when consuming high doses of creatine (0.3 g·kg−1·d−1); and favorable effects on bone when combined with resistance training.” (1)
I’ve personally been using it daily this year (age 46) to see how I felt, and the research I’ve been doing combined with positive personal experience makes me want to share this with you so you can consider how to take advantage of the benefits.
What is creatine?
First and foremost, creatine is a naturally occurring compound that’s stored in your muscle cells. Your body makes about 1 gram of creatine daily by combining three amino acids (glycine, arginine and methionine) in your kidneys, liver and pancreas (2).
You can also eat foods that contain creatine, like meat, fish and some dairy, and/or take it in a supplemental form.
About 95% of your creatine is stashed in your muscle cells in a form called “phosphocreatine,” and when you’re doing a high intensity exercise like heavy lifting or explosive cardio (sprinting, jumping, plyometrics, speed intervals) it separates to help generate an energy-producing ATP molecule – giving you more power.
Strength and Power
More power means you can go harder just a little longer in your workouts.
With good creatine stores in your muscle tissue, you have more energy from more ATP and the quality of your training improves – which adds up to better results for you like being able to strengthen your muscle tissue more effectively.
Both short and long-term studies of creatine use in active women have shown significant improvements in strength and power, as well as lean mass development.
There’s less fatigue to the muscles when there is sufficient creatine present as well – meaning you recover more quickly.
Benefits for women post-menopause
That’s great news for women post menopause too. With the decline in estrogen production as we approach and enter menopause, there is a direct correlation with bone and muscle mass loss.
But with the regular practice of strategically timed resistance training and explosive cardio (discussed here) and upping your protein intake, you can bypass the muscle loss and actually gain strength and lose body fat during this life stage.
Creatine supplementation can give you an edge in this process with its support for ATP by helping to reduce inflammation and oxidative stress.
When combined with resistance training, creatine supplementation shows real promise in supporting lean mass production for post menopausal women (1).
Brain Health and mood
The other 5% of your creatine stores are concentrated in the central nervous system, and have important roles to play in mood and neural function.
There is research that suggests that the neurotransmitters (messengers that carry information between your brain cells and impact mood) are very reliant on the phosphocreatine system functioning as it should (3), and evidence that creatine supplementation can support depression symptoms in women (4,5,6).
“Pre-clinical and clinical evidence indicates positive effects from creatine supplementation on mood and cognition, possibly by restoring brain energy levels and homeostasis. Creatine supplementation may be even more effective for females by supporting a pro-energetic environment in the brain.” (1)
Creatine supplementation may be especially beneficial for women in general, partly because it’s been reported that women have 70-80% less stores of creatine than men do and are reported to consume lower amounts of dietary creatine compared to men.
With women showing higher instances of depression than men and the correlation between creatine stores and their impact on neural function and mood, it leads me to wonder if women were prioritizing the amino acids from protein in their dietary intake (or in supplemental form) more consistently, could we impact those numbers?
Times in life when we make less natural creatine
Due to the cyclical nature of our hormones during our reproductive years, we may synthesize (make) less creatine during our periods, during pregnancy, and post-partum.
We also make less creatine post-menopause. This is one of the reasons supplementation may really benefit us by bolstering those levels we have access to at key life stages.
During pregnancy, there’s an increased demand for creatine from the placenta (7). There is research being done on the impact creatine plays in fertilization, the use and role of creatine during development, and I expect we’ll see follow up research and studies being done in the coming years about the safety of creatine use during pregnancy (I don’t have the answer on that yet).
Recommendations for supplementation
Whether you are getting it from dietary sources or not, creatine supplementation may be something to consider – especially if you’re active (8).
Studies have not shown adverse response for women using supplemental creatine (9), but always listen to your body when you’re adding something new. Because we’re continuously using our creatine stores, it’s easier to become depleted without any dietary input.
Personally, I have tried a couple different kinds or creatine currently on the market, and had better results with one over the other.
I tried creatine HCL because there was a lot of compelling marketing around it, but it was incredibly salty and I got really dehydrated while I was testing it. There is less research on this form of creatine than there is on the better-known creatine monohydrate.
After more use, I found that creatine monohydrate had the best impact on my body when I included it daily.
It has the greater quantity of supportive research (10,11), and more recently, research that is women-specific. I had no symptoms and only noticed that my body was responding to my training efficiently. I use the creatine monohydrate made by Thorne.
I put it in with my Rock and Restore aminos during a workout, and mix it into water on non-training days (so yes, you can take it daily).
The general recommendation is a serving (5g) per day. When you first start using it, you have the option to “build up” a reserve in your muscle tissue the first week by using 20g per day, either spread out into 4 servings, or divided into 2 servings of 10g. Then you can just go to 5g per day.
I did this, and didn’t notice anything adverse from using the higher amounts. I continue to take the 5 gram serving daily now, as I’m currently in perimenopause and training regularly with an aim to preserve muscle. You could just stick to the daily 5 gram serving and skip the build up if you prefer.
Stay hydrated
It is important to stay hydrated if you’re using creatine (and if you’re training regularly in general!), as creatine drives some additional water into your muscle cells. There was a case of a man using creatine at higher than recommended doses for an extended period of time who then began restricting water for weight loss purposes. As a result, he developed retinal nerve pressure (12).
While this is an extreme case, I was interested to see if creatine had any studies about dehydration (as I mentioned I experienced that with the HCL type). This study (13) was done on men only, and they were not able to find any dehydration with creatine supplement use. I haven’t experienced any dehydration since using only creatine monohydrate, and the general consensus is that it does not cause it. With that being said, stay hydrated!
With all supplements, if you have a medical condition or are on medication be sure to consult with your doctor before starting any new supplements.
A note on your body's need for amino acids
This information about creatine echoes my recommendations about paying attention to dietary protein in your (balanced) meals in general, because the body uses the amino acids from protein for so many important functions like cognitive function, hormone and enzyme function, your immune system and muscle protein synthesis.
And 2 of the 3 aminos that your body uses to make creatine (arginine and methionine) are essential aminos, meaning you need to get them from food.
Here’s a quick recap of what the body uses the amino acids from your dietary protein to do:
- Hormone function: protein rich foods provide our body with the building blocks (amino acids) to make some of our hormones. Hormones with important signaling roles in the body like insulin, glucagon, HGH (human growth hormone) help communication between organs and cells are made with amino acid.
- Enzyme function: protein helps construct enzymes which help speed up chemical reactions in the body like muscle contraction, respiration, digestion, nerve function, protein synthesis and more.
- Cognitive function: protein provides the amino acid building blocks that make neurotransmitters, which are messengers carrying information between brain cells. The better the messengers are fed, the better they do at delivery of important information – supporting better memory and mental alertness.
- Mood regulation: without enough protein, your brain can’t produce enough neurotransmitters like serotonin and dopamine, and this is essential for boosting energy, mental clarity and making you feel happier – plus regulating pain, anxiety and initiating sleep.
- Immune function: the amino acids in protein activate the NK (natural killer) cells that limit the spread of microbial infections, and identify and eliminate harmful bacteria. They also help regulate your response to oxidative stress and chronic inflammation and speed up the rate at which your body produces lymphocytes (disease fighting cells).
- Muscle protein synthesis: the amino acids are necessary for the growth and repair of your muscle tissue. A workout breaks down muscle tissue. You rebuild and repair it when you rest and refuel around your training. If you’re sore a lot of the time after your workouts, check in with your protein intake and make sure you’re not skimping in your meals.
When the body doesn’t have access to circulating amino acids from your last meal for any of the above functions, it breaks down your muscle tissue to access the stored aminos there, further depleting your muscle tissue.
As we age, we tend to absorb less of the aminos from our dietary intake as well, which is why I frequently advise women over 40 to start paying attention to the quantity they’re taking in per meal and consider upping it a bit.
While you can safely eat up to 1 gram per pound of your bodyweight (and more) in protein daily, it’s fine to eat a range of grams of protein, anywhere from 0.7-1.2 grams per pound of your ideal bodyweight per day. Just as a start point, see what’s in the meals you’re eating now by looking up the grams of protein in the foods you’re eating and the amounts you’re currently including.
You can easily boost your daily protein intake with a protein shake (and if the serving is 20 grams consider doing a serving and a half, or two servings as needed), by adjusting recipes you’re making to have more than the amount of protein they call for, or by ordering extra of the protein source in the meal when you’re eating out. Pay attention to non-meat sources of protein and what else they contain (in the form of fat and carbs) so you’re not inadvertently overeating just to get protein.
The great thing about protein is that it’s even more satisfying than fat or carbs, so when you include a decent serving of it alongside the other nutrient-dense foods in your meals, you feel more full, you give your body the needed amino building blocks for all those important functions we discussed, and you are less likely to reach for high carb snacks or sugary treats later on.
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References:
- Smith-Ryan, Abbie E et al. “Creatine Supplementation in Women’s Health: A Lifespan Perspective”. Nutrients. March 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998865/
- Da Silva, Robin P. et al. “Creatine synthesis: hepatic metabolism of guanidinoacetate and creatine in the rat in vitro and in vivo”. Am J Physiol Endocrinol Metab. Feb 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645018/
- Wallimann, T et al. “Intracellular compartmentation, structure and function of creatine kinase isoenzymes in tissues with high and fluctuating energy demands: the ‘phosphocreatine circuit’ for cellular energy homeostasis”. Biochem J. Jan 1992. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1130636/?page=1
- Lyoo, In Kyoon et al. “A Randomized, Double-Blind Placebo-Controlled Trial of Oral Creatine Monohydrate Augmentation for Enhanced Response to a Selective Serotonin Reuptake Inhibitor in Women With Major Depressive Disorder”. American Journal of Psychiatry. Sep 2012. https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2012.12010009
- Albert, Paul R. “Why is depression more prevalent in women?”. Journal of Psychiatry and Neuroscience. July 2015. https://pubmed.ncbi.nlm.nih.gov/26107348/
- Agren, H and Niklasson, F. “Creatinine and creatine in CSF: indices of brain energy metabolism in depression. Short note”. Journal of Neural Transmission. 1988. https://pubmed.ncbi.nlm.nih.gov/3171573/
- Muccini, Anna Maria et al. “Creatine Metabolism in Female Reproduction, Pregnancy and Newborn Health”. Nutrients. Feb 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912953/
- Brosnan, John T and Brosnan, Margaret E. “Creatine: endogenous metabolite, dietary, and therapeutic supplement”. Annual Review of Nutrition. 2007. https://pubmed.ncbi.nlm.nih.gov/17430086/
- De Guingand, Deborah L et al. “Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis”. Nutrients. June 2020. https://pubmed.ncbi.nlm.nih.gov/32549301/
- Antonio, Jose et al. “Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?”. Journal of the International Society of Sports Nutrition. Feb 2021. https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w
- Kreider, Richard B. et al. “International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine”. Journal of the International Society of Sports Nutrition. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5469049/
- Moussa, Omar and Chen, Royce W.S. “Central retinal vein occlusion associated with creatine supplementation and dehydration”. American Journal of Ophthalmology Case Reports. Sep 2021. https://www.sciencedirect.com/science/article/pii/S2451993621001377
- Watson, Greig et al. “Creatine Use and Exercise Heat Tolerance in Dehydrated Men”. Journal of Athletic Training. 2006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421496/
