Creatine supplementation for muscle mass and strength in aging

Creatine monohydrate is among the most evidence-supported supplements for preserving muscle mass and strength, particularly in combination with resistance training.

Why it works

Creatine is stored in muscle as phosphocreatine and regenerates ATP during high-intensity efforts. Supplementation increases phosphocreatine stores, enabling more training volume at higher intensity — and thus a stronger anabolic stimulus. In older adults, where the anabolic response is blunted, the added training capacity from creatine helps overcome anabolic resistance. It also has modest direct effects on muscle protein synthesis pathways independent of training volume.

How to do it

1. Take 3–5 g of creatine monohydrate daily — loading phases (20 g/day for 5 days) speed saturation but are not necessary.
2. Timing does not matter significantly; take it whenever is convenient and consistent.
3. Effects are visible only when combined with resistance training — creatine without training does not build muscle.
4. Effects are most pronounced in older adults and in people who start with lower baseline muscle creatine (typically vegetarians).

Evidence

Creatine monohydrate is the most studied ergogenic supplement in sports science, with meta-analyses consistently showing it increases strength and lean mass gains from resistance training, and with a strong safety profile in healthy adults. (rct)

Benefits are additive with resistance training, not substitutive. High-quality creatine monohydrate is the form with the evidence base; expensive proprietary forms are not better-supported.

Sources

• Lanhers et al. (2017), "Creatine supplementation and lower limb strength performance: a systematic review and meta-analyses," Sports Medicine
• Devries & Phillips (2014), "Creatine supplementation during resistance training in older adults," Medicine & Science in Sports & Exercise

Common mistake

Using expensive creatine variants (HCL, buffered) instead of plain monohydrate, which has the entire evidence base. Monohydrate is the only form consistently supported in the literature.