Is creatine useful or just a fad? Expert answers

In recent years, creatine supplements have established themselves as a staple in the fitness world, especially among bodybuilders. They've filled supermarket and pharmacy shelves, caught the attention of influencers, and become a regular topic in gyms, attracting an audience beyond professional athletes.

But, after all, is creatine an essential supplement for those who train, or just another fad? The answer isn't so simple—and involves biochemistry, science, and, most importantly, professional guidance. To better understand the supplement's role, we spoke with Gustavo Starling Torres, a sports physician and director of the Brazilian Society of Exercise and Sports Medicine (SBEEM), and Erick P. de Oliveira, an associate professor of Nutrition at the Federal University of Uberlândia and a member of the Brazilian Association of Sports Nutrition (ABNE).

Natural creatine

Endogenous creatine (naturally produced by the body) is a substance formed from three amino acids: arginine, glycine, and methionine. It is synthesized in the liver, kidneys, and pancreas and is stored primarily in skeletal muscle.

Its main function is to provide faster energy during high-intensity, short-duration exercises, such as sprints, jumps, or weightlifting. This occurs through the phosphagen system, in which a type of creatine called phosphocreatine (or creatine phosphate) helps regenerate ATP (adenosine triphosphate), a molecule that provides energy for various cellular processes. In other words, creatine thus ensures greater strength, muscular explosiveness, and performance in vigorous physical activities.

In addition to endogenous production, the substance can also be found in foods such as meat and fish.

Why creatine supplementation became popular

The body's natural production and intake of creatine through food may not be sufficient to saturate muscle stores, making creatine supplementation welcome for many types of people, such as high-performance athletes, the elderly, and people with vegan and vegetarian diets, according to the director of SBEEM.

The supplement increases intramuscular levels of creatine and phosphocreatine, accelerating ATP synthesis during exercise. This allows for more intense workouts and higher repetitions, promoting muscle hypertrophy (increased muscle mass).

The benefits are varied, especially when accompanied by exercise and a healthy diet: increased performance, muscle gain, improved muscle recovery, and combating sarcopenia (loss of muscle mass due to age).

According to the expert, the supplement's popularity has both scientific and practical explanations: "it is a substance with well-proven efficacy, affordable cost, long-term safety, and widespread dissemination both on social media and among health and sports professionals."

Who can supplement?

Initially associated with elite athletes and bodybuilders, today creatine is also recommended for recreational athletes, as well as for the elderly, people with neuromuscular diseases and patients with sarcopenia (age-related loss of muscle mass).

Even sedentary individuals have benefited from supplementation, according to Gustavo Torres, director of SBEEM. "This is because creatine not only improves physical performance but has also shown positive effects on cognitive function, bone health, and blood glucose control," he explains.

For athletes and regular bodybuilders, creatine enhances results and improves muscle recovery. For older adults, when combined with resistance training, the benefits of supplementation extend beyond the gym: creatine helps prevent falls and improve quality of life.

Furthermore, creatine can benefit people with vegetarian and vegan diets, since natural creatine intake is higher in those who consume meat and fish. "These groups tend to have lower muscle stores and, therefore, respond well to creatine," says Torres.

How to supplement safely

The most recommended form for use, according to the SBEEM specialist, is creatine monohydrate. It is the most studied, safe, and effective form: " Other forms, such as creatine HCl, micronized, or ethyl ester, have been marketed, but do not demonstrate significant superiority in efficacy or absorption," he adds.

The standard dose is 3 to 5 grams per day and should preferably be taken with carbohydrates and protein, as absorption can be slightly increased when accompanied by a meal, according to Erick P. de Oliveira of ABNE. "When consumed with these nutrients, there is an increase in insulin release, which facilitates the entry of creatine into muscle cells, contributing to increased muscle storage," he says. According to Oliveira, it is important to consume creatine daily, as the effect is cumulative.

" The maximum safe dose in the long term is not clearly defined, but in general, studies evaluating consumption of up to 10 g/day for several months have not shown toxicity. Increasing the dose above the recommended dose does not potentiate the effects after muscle stores are saturated, as the excess will be excreted," adds the SBEEM director.

Another important point is to pay attention to the quality of supplements available on the market. Some products may contain lower doses than stated, impurities, or contamination. In April of this year, Anvisa (Brazilian Health Regulatory Agency) analyzed the regularity of 41 creatine supplements, assessing creatine content, labeling adequacy, and the presence of foreign matter. All products tested satisfactory for the presence of foreign matter. However, of the 41 brands analyzed, only one had proper labeling. To know what to look for, the SBEEM specialist recommends products with purity certification, such as the Creapure® seal.

Overall, creatine is safe for most people, but it should be used with caution by those with kidney disease or an increased risk of nephropathy (conditions affecting the kidneys), as it is excreted by the kidneys. "Ideally, its use should be guided by a nutritionist, who will order tests to ensure the supplement is safe and consider each person's needs and health," recommends Erick P. de Oliveira, from ABNE.

Is it possible to get results without proper exercise and diet?

The effects of creatine supplementation are intensified when combined with physical activity and adequate nutrition.

However , there are also benefits even without intense training: "Creatine can indeed provide benefits even without exercise, especially in the elderly and people with neurodegenerative diseases. For these groups, there is robust evidence that creatine improves strength, prevents sarcopenia, and contributes to healthy aging," explains physician Gustavo Torres.

Erick P. de Oliveira emphasizes, however, that it's not worth exchanging supplements for a balanced diet. "A diet with adequate amounts of carbohydrates, proteins, fruits, and vegetables is essential for training to produce the desired effects on body composition and physical performance," he states.

Useful or just fashionable?

Creatine has proven beneficial in many cases, but its use depends on the context, individual goals, and lifestyle. For those seeking to improve physical performance, gain strength and muscle mass, prevent muscle loss with aging, or supplement a restrictive diet, creatine can be an ally. However, as mentioned, it is not a substitute for a balanced diet, an exercise routine, and, most importantly, the supervision of a healthcare professional.