Is there evidence for creatine use in average adults for muscle or cognitive benefits?

Creatine Supplementation for Muscle and Cognitive Benefits in Average Adults

Yes, there is good evidence supporting creatine supplementation for both muscle and cognitive benefits in average adults, with particularly strong data for muscle outcomes and emerging but promising evidence for cognitive function.

Muscle Benefits

Creatine supplementation provides well-established benefits for muscle mass, strength, and functional performance in adults, especially when combined with resistance training. 1, 2

Key Muscle Outcomes:

• Increased lean body mass and muscle strength occur with creatine supplementation (approximately 20 g/day for 5 days or 2 g/day for 30 days), independent of exercise training 1
• Enhanced fatigue resistance and improved performance of activities of daily living are consistently demonstrated 1
• Greater gains when combined with resistance training: Concurrent creatine supplementation and resistance training increase lean body mass, muscle strength, and functional performance to a greater extent than resistance training alone 1, 2
• Bone density improvements: Creatine plus resistance training results in greater increases in bone mineral density compared to resistance training alone 1

The muscle benefits are particularly relevant for older adults experiencing age-related sarcopenia, but the mechanisms apply to average adults seeking performance enhancement 2.

Cognitive Benefits

The evidence for cognitive benefits is promising but more limited than for muscle outcomes, with the most consistent effects seen in memory and attention domains. 3

Current Cognitive Evidence:

• A 2025 systematic review found that 83.3% of studies (5 of 6) reported positive relationships between creatine and cognition in older adults, particularly for memory and attention 3
• The largest randomized controlled trial to date (n=123) showed borderline significant benefits for working memory (Backward Digit Span, p=0.064), though the effect was small 4
• Creatine supplementation increases brain creatine and phosphocreatine levels, which theoretically supports cognitive enhancement 1, 5
• Cognitive benefits appear most pronounced in conditions of brain creatine deficit, such as sleep deprivation, aging, or acute stressors 1, 5

Important Caveats for Cognitive Claims:

• The optimal creatine protocol to increase brain creatine levels remains undetermined 5
• Studies concomitantly assessing brain creatine levels and cognitive function are still needed 5
• Most cognitive studies have methodological limitations, with only one achieving "good" quality rating in systematic review 3
• Vegetarians do not appear to benefit more than omnivores for cognitive outcomes, contrary to some hypotheses 4

Practical Dosing Recommendations

Standard supplementation protocols are 20 g/day for 5 days (loading phase) followed by 2-5 g/day maintenance, or simply 2-5 g/day without loading. 1, 4

• The 2023 RCT used 5 g/day for 6 weeks and showed borderline cognitive benefits 4
• Both protocols effectively increase muscle and brain creatine stores 1

Safety Profile

Creatine is generally safe but side effects occur more frequently than placebo. 4

• Side effects were reported significantly more often with creatine than placebo (p=0.002, relative risk=4.25) in the largest cognitive trial 4
• However, creatine is described as "inexpensive and safe" with decades of research supporting its safety profile 1
• No serious adverse events are typically reported in supplementation studies 1, 2

Clinical Bottom Line

For muscle benefits: Recommend creatine supplementation (5 g/day) combined with resistance training for adults seeking to increase muscle mass, strength, and functional performance. The evidence here is robust and well-established 1, 2.

For cognitive benefits: Creatine supplementation may provide small cognitive improvements, particularly for memory and attention, but the evidence is still emerging. Given the excellent safety profile and low cost, it represents a reasonable option for adults interested in potential cognitive enhancement, with the understanding that effects may be modest 4, 5, 3.

The combination of established muscle benefits plus potential cognitive benefits makes creatine a worthwhile supplement for average adults, particularly those engaged in resistance training. 1, 2