"Does Creatine Supplementation in Middle Aged and Older Adults Have Positive Impacts on Cognition, Lean Body Mass, Bone Health and Markers of Health?" An Interview With Richard B Kreider, PhD

Richard B. Kreider, PhD, Professor

Director, Exercise & Sport Nutrition Lab and Clinical Core Service Center Department of Kinesiology & Sport ManagementTexas A&M University, College Station, TX 77843Tel. 979.458.1498 │ Fax. 979.847.8987rbkreider@tamu.edu

“Effects of creatine supplementation with and without exercise and diet intervention on body composition, cognitive function, and markers of health in middle-aged and older adults.” J Int Soc Sports Nutr. 2026 Aug 21;23(sup1):2716273. (10/2026)

Interview Summary

Dr. Kreider’s Backround…

Richard B. Kreider, PhD, has spent approximately 40 years as a professor researching the effects of exercise and nutrition on health, athletic performance, disease, and rehabilitation. He and his colleagues have studied creatine for more than 30 years.

Creatine Monohydrate…

In this interview, he explains why creatine monohydrate remains the best-supported form of creatine (mentions creatine from German manufacturing being of high quality), noting that most clinical trials have used it and that alternative forms have not demonstrated superior benefits. He recommends 10 grams daily for older adults, typically divided into two 5-gram doses. Sometimes he will recommend a loading dose of 5 grams four times a day for a week otherwise it may take a month at the 10 gram per day dose to see the physiological effects of the creatinine.

Creatine’s Mechanisms of Action…

He describes several potential mechanisms through which creatine may benefit muscle, including improving cellular energy availability, supporting greater exercise capacity, and promoting protein synthesis through cellular hydration. He also discusses creatine’s potential role in brain energy metabolism, antioxidant activity, and the preservation of bone mineral content, particularly when combined with resistance training.

The Study…

The featured study investigated whether creatine supplementation could benefit middle-aged and older adults, including those who did not participate in a structured exercise program. Participants followed a calorie-restricted diet intended to reduce daily intake by approximately 300–500 calories. They were divided into four groups: placebo without structured exercise, creatine without structured exercise, placebo with exercise, and creatine with exercise. The creatine groups received 10 grams daily for 12 weeks. The dietary guidance emphasized reducing calories, particularly from fat, eating whole foods, and maintaining adequate protein and carbohydrate intake. The researchers evaluated body composition, cognitive performance, blood chemistry, cardiovascular-related health markers, glucose management, physical activity, sleep, and quality of life. Dr. Kreider reported improvements in blood lipids and HbA1c, as well as cognitive performance and some measures of body composition. Exercise generally produced stronger and more consistent benefits, but one of the surprising findings was an increase in muscle mass among participants taking creatine even without structured exercise. The researchers did not observe a substantial change in bone health during the relatively short 12-week study.

Benefits Beyond Athletic Performance…

Dr. Kreider emphasizes that creatine’s potential applications extend well beyond athletic performance to healthy aging, physical function, and cognitive health. He describes creatine monohydrate as an inexpensive, extensively studied supplement and reports that large reviews of clinical trials have not supported common concerns about dehydration, muscle cramping, or adverse effects on the kidneys in the studied populations. He notes that creatine can increase blood creatinine, which may affect creatinine-based estimates of kidney function and should be discussed with a healthcare professional. Future research interests include combining creatine with other nutritional interventions, investigating its effects on the gut and microbiome, and studying ways to preserve muscle during weight loss, including weight loss associated with GLP-1 medications. His overall message is that middle-aged and older adults may benefit from combining appropriate nutrition, creatine, and regular physical activity, especially resistance training—to help maintain physical function and quality of life as they age.

Interview Questions and Answers

Kirk Hamilton: Can you please share with me your educational background and current position?

Richard Kreider: I began as a college football player at Liberty University, where I became interested in weightlifting, resistance training, nutrition, and performance enhancement. I initially studied physical education because I wanted to become a strength coach. During my master’s degree, a professor encouraged me to pursue research because I could make a broader impact by studying exercise and nutrition. I have now been a professor for approximately 40 years. At Texas A&M University, I direct the Exercise & Sport Nutrition Lab and Clinical Core Service Center. My research focuses on exercise and nutrition in relation to health, performance, disease, and rehabilitation. My colleagues and I have studied creatine for more than 30 years, and I continue to lift weights, exercise, and take creatine daily.

KH: What got you interested in studying creatine supplementation in adults between 45 and 65, with and without exercise?

RK: I wanted to investigate whether creatine could help middle-aged and older adults maintain muscle mass, improve cognitive function, and obtain better results from exercise. Most creatine studies had focused on younger people and athletes, particularly those participating in resistance training. However, as people age, they tend to lose muscle mass, gain body fat, and experience declines in cognitive function. Many older adults also need to lose weight, but calorie restriction can cause them to lose muscle along with fat. I wanted to determine whether taking 10 grams of creatine daily could help preserve or increase muscle mass during weight loss and whether it could provide cognitive benefits even without a structured exercise program.

KH: How does creatine affect lean body mass? What are the proposed mechanisms of action?

RK: Creatine increases energy availability in muscle. When people exercise, this can enable them to perform more work, and the workload placed on the muscle is an important stimulus for muscle protein synthesis and growth. Creatine also increases intracellular hydration, which may stimulate protein synthesis. When someone takes creatine while resistance training, the person may be able to perform more work and achieve better training adaptations. In someone who is not following a structured exercise program, increased energy and physical capacity may encourage greater daily activity. Our study found that muscle mass increased even in participants who were not training, which was one of our surprising findings. The gains are not simply water; the research also supports increases in muscle tissue and protein.

KH: How does creatine supplementation affect cognition? What are the proposed mechanisms of action?

RK: Creatine helps provide energy to the brain through the phosphocreatine system. When brain phosphocreatine levels are low, cognitive capacity can be reduced. Aging, fatigue, injury, and inadequate oxygen availability can affect energy availability in the brain. Approximately 20% of the creatine consumed is absorbed across the blood-brain barrier, which is one reason we investigated a higher daily intake of 10 grams.

I believe improving brain energy availability is an important potential benefit of creatine. We also see evidence of mild antioxidant and anti-inflammatory effects, which may provide additional support. In our study, participants taking creatine demonstrated improvements in cognitive testing, including those who were not following a structured exercise program. The exercise groups generally had stronger and more consistent findings. We are also investigating whether combining creatine with other nutrients, including creatine precursors, antioxidants, anti-inflammatory compounds, and nootropics, might provide additional benefits.

KH: How does creatine affect bone health? What are the proposed mechanisms of action?

RK: Creatine may help preserve bone mineral content, particularly when combined with resistance training. When you train with resistance, you place a load on your bones as well as your muscles. If creatine enables you to train harder or perform more work, that may help maintain bone mass. There are also studies suggesting that creatine may influence bone turnover, potentially helping to reduce bone breakdown or support the processes involved in bone remodeling.

Some longer-term studies, including studies involving postmenopausal women, have found that creatine combined with resistance training may help slow bone loss. However, creatine does not necessarily make bones bigger or stronger, and the findings are not uniform across all studies. In our 12-week study, we did not see much change in bone health. I think any meaningful bone benefit may require longer intervention.

KH: Do we know whether creatine supplementation affects inflammation?

RK: Yes, there is evidence that creatine has some antioxidant and anti-inflammatory effects. I would not describe these effects as being as strong as those of some other compounds we investigate, but they may still be beneficial. Creatine may help recovery after strenuous exercise that damages muscle, such as downhill running. Reducing oxidative stress and inflammation may also benefit the brain. I think combining creatine with other antioxidants and anti-inflammatory compounds is worth investigating.

KH: What were the weight-loss diet guidelines used in this study?

RK: We asked participants to reduce their daily calorie intake by approximately 300–500 calories. We provided nutritional education, suggestions for foods to reduce or eat less frequently, and guidance on how to make lower-calorie choices. We primarily encouraged reducing dietary fat while maintaining adequate protein and carbohydrate intake. We did not prescribe a tightly controlled, specific macronutrient diet; participants were allowed to eat their usual foods while working toward the calorie-reduction goal.

Our general recommendations emphasize healthy whole foods, including fruits, vegetables, and leaner meats, while reducing excess dietary fat. We also wanted participants to maintain adequate nutrition while losing weight so that they could better preserve muscle mass, particularly if they were exercising.

KH: Are all creatine products the same regarding absorption and utilization? What type did you use in your study? Is creatine monohydrate delivered in lipid nanoparticles better, or is that hype? How do you choose a good creatine supplement?

RK: We have reviewed the research on different forms of creatine, including creatine monohydrate, creatine nitrate, buffered creatine, creatine ethyl ester, and liquid forms. Approximately 95% of the nearly 700 clinical trials we discussed have used creatine monohydrate. Some alternative forms have shown benefits, but none has been demonstrated to be superior to creatine monohydrate.

We used creatine monohydrate in our research. I recommend choosing a high-quality, highly purified creatine monohydrate, preferably one with a well-established manufacturing and quality-control record. Some products are marketed as revolutionary improvements, but their claims are not necessarily supported by clinical research. I have not established in this interview that lipid-nanoparticle creatine is superior, so I would want to see convincing comparative clinical evidence before recommending it over conventional creatine monohydrate.

KH: Why did you choose 5 grams twice daily? Is that the gold-standard dosing regimen? Should creatine be taken with meals or away from meals, and what type of fluid is best?

RK: We used 10 grams daily, divided into two 5-gram doses, because we wanted to investigate whether a higher intake could provide physical and cognitive benefits in middle-aged and older adults. We believe 5 grams twice daily is a reasonable approach for supporting muscle mass, training adaptations, and potentially cognition.

Studies have compared taking creatine before exercise, after exercise, and at different times of the day. We have not seen convincing evidence that one time of day is consistently superior. The important thing is to consume it regularly. Research also indicates that taking creatine with carbohydrates or a combination of carbohydrates and protein can improve its uptake into muscle. I generally recommend mixing creatine powder into a beverage, smoothie, or other convenient drink. It does not have to be taken at a particular time or with a particular fluid.

KH: Do you recommend a loading dose of 5 grams four times daily? If so, why? Does it saturate the muscles more quickly?

RK: Yes. When someone wants to achieve the effects of creatine more quickly, I recommend a loading phase of approximately 20 grams daily, divided into four 5-gram doses, for about one week. This helps raise muscle creatine levels more quickly. If someone takes only 5 grams daily, it can take approximately 30–40 days to reach a comparable level of saturation.

In our featured study, we used 10 grams daily for 12 weeks rather than a separate loading phase. We expected it to take a week or two to raise creatine levels, which we considered acceptable for this study. In many of our other studies, we use a loading phase during the first week and then move to a maintenance dose.

KH: Can you tell us about your study and its basic results?

RK: We designed the study to determine whether creatine supplementation could improve body composition, cognitive function, and markers of health in middle-aged and older adults, both with and without structured exercise. All participants followed a calorie-restricted diet, aiming to reduce their daily intake by approximately 300–500 calories. We divided them into four groups: placebo without structured exercise, creatine without structured exercise, placebo with exercise, and creatine with exercise. The creatine groups received 10 grams daily for 12 weeks.

We assessed body composition, cognitive function, blood chemistry, glucose management, lipids, physical activity, sleep, and quality of life. We found improvements in blood lipids and HbA1c, as well as improvements in cognitive function among participants taking creatine. We also saw improvements in muscle mass, including among participants who were not participating in structured exercise. The exercise groups generally had stronger results, demonstrating the importance of physical activity. We did not see much change in bone health during the 12-week period.

KH: Where do you get funding for these creatine studies?

RK: The studies in this particular research series were funded by the WoodNext Foundation, established by Anthony and Susan Wood. They were interested in healthy aging and approached the university about supporting research in this area. The funding allows us to pursue studies we believe are important without having to design them around the commercial interests of a supplement company.

I do not sell supplements or receive profits from the products we study. I am interested in understanding how nutrition and exercise can improve health and well-being. Industry funding has also been important in this field because federal funding has historically been difficult to obtain for some creatine studies. I believe it is beneficial when responsible companies support research that provides consumers with credible evidence about the effects of their products.

KH: Could a pharmaceutical company turn creatine into a drug that could be patented by adding some component or unique delivery system to the product?

RK: Creatine is a naturally occurring compound found throughout the body, so it is difficult to patent the basic compound itself. There have been pharmaceutical efforts involving different forms of creatine, including creatine derivatives. Patents may be possible for a particular formulation, manufacturing process, application, or unique method of delivery, but that is different from patenting creatine itself.

One reason pharmaceutical companies may have limited interest in funding creatine research is that the basic nutrient is inexpensive and difficult to protect through a conventional patent. I would like to see more responsible supplement companies fund research so consumers can understand what benefits to expect under specific conditions.

KH: What was the effect on cardiovascular disease risk factors and which markers did you measure?

RK: We performed a comprehensive metabolic assessment, including blood lipids, glucose, liver-related markers, protein markers, and other standard blood chemistry measurements. We assessed approximately 50 blood markers, including a range of routine laboratory values. We also examined physical activity, sleep habits, and quality-of-life measures.We saw general improvements in blood lipids, consistent with findings from other creatine studies. Overall, the health markers improved, particularly among participants who exercised, although we also saw some favorable changes in participants who were not exercising. These findings are encouraging, but they do not establish that creatine prevents cardiovascular disease.

KH: What was the effect on HbA1c levels?

RK: We included HbA1c because it provides information about glucose management over a longer period than a single blood glucose measurement. We saw some improvement in HbA1c. The improvements were not limited to participants who exercised; we also saw evidence of improvement among those who were not participating in structured exercise. The overall findings were generally more favorable when creatine was combined with exercise.

KH: What happens to homocysteine levels with creatine supplementation?

RK: I would need to review the specific results in this paper to give you a definitive answer about homocysteine in this particular study. I do not recall a clear reduction in homocysteine from the study results discussed during this interview.

In related studies involving guanidinoacetic acid, or GAA, which is a precursor to creatine, we have observed a slight increase in homocysteine that normalized over approximately 12 weeks. That change occurred alongside a slight increase in creatinine, and the homocysteine values remained within normal ranges in the studies I described. I would not assume that these findings apply directly to the creatine intervention in this study without checking its published results.

KH: What markers of cognitive function did you measure, and what were the results?

RK: We used a battery of cognitive tests to assess different aspects of cognitive performance, including memory, attention, vigilance, and psychomotor reaction. The tests included word recall, picture recall, vigilance testing, and the Stroop color-word test. We use a consistent battery across our studies so we can compare the effects of different nutritional interventions.

We also considered mental fatigue during repeated testing. We found that the creatine groups generally performed better than the placebo groups across most of the cognitive measures, although there was at least one measure on which a placebo group did somewhat better. Both creatine groups showed cognitive benefits, and the exercise groups generally had stronger or more consistent results. These findings suggest potential benefits for cognitive performance, but they do not establish that creatine prevents or reverses dementia.

KH: Did you see changes in the DEXA test scores for bone health after this 12 week study? How quickly can improvements be detected?

RK: Our study assessed participants over 12 weeks, and I do not recall a meaningful change in bone health during that period. Bone effects may require longer interventions. Some studies examining bone health have used creatine supplementation for one to two years.

KH: Did you see changes in muscle mass over this 12 week study? How quickly can improvements be detected?

RK: For muscle mass, however, changes can occur relatively quickly when creatine is combined with resistance training. In one of our earlier studies, we measured participants at baseline, 14 days, and 28 days and observed significant increases in muscle mass among people participating in resistance training. Across the literature, changes in lean mass can be detected over approximately four to 12 weeks, particularly when creatine is combined with resistance training. The response depends on the person’s activity and training program.

KH: Were there any side effects with creatine supplementation? What precautions should people consider, particularly regarding kidney function?

RK: Our reviews of clinical trials have found that creatine monohydrate has a strong safety record in the populations studied. In the large analysis I discussed, involving approximately 26,000 participants in each of the creatine and placebo groups, the incidence of reported side effects was low. The analyses did not support common claims that creatine causes dehydration, muscle cramping, or kidney damage.

One important point is that creatine supplementation can increase blood creatinine because creatinine is a natural breakdown product of creatine. That can affect estimates of kidney function calculated from creatinine alone. I encourage people to tell their healthcare providers that they take creatine so their laboratory results can be interpreted appropriately. Other kidney markers, including cystatin C, may help distinguish a change related to creatine metabolism from an actual decline in kidney function. People with kidney disease or other medical conditions should discuss supplementation with their healthcare professionals rather than assuming that findings from healthy study participants automatically apply to them. It is noted that creatine has been used in individuals who are on dialysis without issues.

KH: If creatine increases blood creatinine, how can healthcare professionals distinguish that effect from an actual decline in kidney function?

RK: Creatinine is a natural breakdown product of creatine, so taking creatine can cause a modest increase in blood creatinine. Because estimated glomerular filtration rate, or eGFR, is often calculated using creatinine, that increase can make the estimated kidney function appear lower even when kidney function has not actually deteriorated.

I encourage people to tell their healthcare providers that they are taking creatine. Research has used other measures, including cystatin C and urine-based assessments, to evaluate kidney function more directly. The studies I discussed did not demonstrate a negative effect on kidney function from creatine supplementation in the populations studied. However, laboratory results need to be interpreted in context, particularly in people with existing kidney disease.

KH: How was compliance with the study protocol?

RK: Compliance was good, and we had relatively few participants drop out. We used supervised exercise sessions, regular participant check-ins, phone applications for dietary monitoring, email, and other communication methods. Participants in the exercise groups trained at our research facility, where we could monitor attendance, sets, repetitions, and other aspects of their workouts.

We also emphasized motivation and accountability. Participants had to maintain their exercise and walking routines for 12 weeks or longer, which requires considerable commitment. Having a supervised program helped us monitor adherence and support participants throughout the study.

KH: Are you doing any studies on creatine and the microbiome?

RK: Yes, we are interested in the relationship between creatine, intestinal metabolism, and the microbiome. We have investigated prebiotic approaches during weight-loss and exercise programs, and we have several studies involving probiotics. We are also interested in short-chain fatty acids and their potential effects on appetite regulation and metabolism.

Creatine plays an important role in the metabolic function of the intestine, and we have published work on Crohn’s disease. There are also studies in irritable bowel syndrome and preliminary reports involving Crohn’s disease that are examining creatine’s potential effects. We are interested in whether improving energy availability in the gut may improve gut function and whether this could interact with the gut-brain connection. Combining creatine with a probiotic is one approach that warrants further investigation, but more research is needed to determine its benefits.

KH: Were there any surprises or unexpected results from your study?

RK: The biggest surprise was that we saw an increase in muscle mass among participants taking creatine who were not participating in structured exercise. We initially expected that creatine would be most beneficial when combined with training, and that it might help people maintain muscle during calorie restriction. Instead, we observed some improvement in muscle mass even without structured exercise.

Some of the early change could involve water because muscle contains a large proportion of water, but we also observed other favorable changes. The findings suggest that creatine may have benefits for people who cannot participate in a structured exercise program, although the best results still occurred when creatine was combined with exercise.

KH: What results from this study give you the most satisfaction or excitement about the potential public benefit?

RK: I am encouraged by the possibility that creatine may help people preserve muscle while losing weight and may also provide cognitive benefits. When people follow calorie-restricted diets, we want them to lose fat rather than muscle. If creatine can help maintain muscle mass, support physical function, and improve some aspects of cognitive performance, it could be useful as part of a broader healthy-aging approach.I am particularly interested in the potential benefit for middle-aged and older adults, because the loss of muscle mass and cognitive function can affect quality of life as people age. We need more research, but these findings are encouraging.

KH: What other creatine studies are you looking forward to doing?

RK: We are interested in studying combinations of creatine with other nutritional interventions and investigating whether these approaches can improve physical function, cognition, and healthy aging. One area we are exploring is whether nutritional interventions can help people preserve muscle mass during substantial weight loss, including weight loss associated with GLP-1 medications.

We are also interested in studies involving creatine precursors, antioxidants, anti-inflammatory compounds, and other nutrients that might complement creatine’s effects. We want to understand whether these combinations can improve the outcomes we see with creatine alone.

KH: Can creatine help people lose body fat while preserving muscle mass, particularly during calorie restriction or GLP-1 medication use?

RK: I think creatine may be helpful in this situation. Our study found that muscle mass increased and fat mass decreased somewhat, including among participants who were not participating in structured exercise. The greatest improvements in percentage body fat occurred when creatine was combined with training. Other studies and analyses have also suggested that people taking creatine during training may lose more body fat.We are interested in investigating whether creatine, HMB, and protein could help people preserve muscle mass when taking GLP-1 medications. When people lose substantial weight, we want them to lose fat rather than muscle. I think combining appropriate nutrition with resistance training and these nutritional interventions deserves further study.

KH: Do you have plans for creatine combination studies aimed at cognitive decline?

RK: Yes. We are conducting a series of studies that begin with creatine and then examine the addition of other compounds. One of the compounds we are studying is GAA, a precursor to creatine that may enter the brain more readily. We are also investigating combinations with antioxidants, anti-inflammatory compounds, and nootropics.The goal is to determine whether improving brain energy availability while addressing oxidative stress, inflammation, and other aspects of brain function can produce greater cognitive benefits than using a single compound. We are trying to develop a more comprehensive nutritional approach to supporting cognition as people age.

KH: Why do you believe creatine may be especially important for healthy aging rather than just athletic performance?

RK: I think creatine may be particularly valuable as people age because they face several challenges at once: losing muscle mass, gaining body fat, and experiencing declines in cognitive function. Creatine may help support muscle energy, exercise capacity, and brain energy availability. When combined with resistance training and appropriate nutrition, it may help people maintain strength and physical function.

Our research suggests that there may also be benefits even for people who are not following a structured exercise program. However, exercise generally produces stronger and more consistent results. The ultimate goal is to help people maintain their independence, physical capabilities, cognitive function, and quality of life throughout their lives.

KH: Are there any other comments you would like to make on this important subject?

RK: We used to think of creatine primarily as a supplement for athletes and sports performance. I believe its potential applications extend throughout the lifespan, particularly for middle-aged and older adults. Combining appropriate nutrition, adequate protein, resistance training, creatine, and other evidence-based nutritional approaches may help people maintain strength, physical function, and cognitive health.

It is never too late to start exercising or lifting weights. We want people not only to live longer but also to maintain their health span and quality of life. If we can help people preserve muscle mass, maintain better glucose control, and support cognitive function as they age, we can make a meaningful contribution to healthy aging.

20 Key Takeaways from the Interview with Richard Kreider, PhD…

1. Creatine is not just for athletes. Dr. Kreider believes creatine supplementation may benefit middle-aged and older adults by supporting muscle mass, physical function, and cognitive performance.

2. Creatine monohydrate is the preferred form. He explained that it has been used in the overwhelming majority of clinical trials and that alternative forms have not demonstrated superior benefits.

3. The study used 10 grams of creatine daily. Participants in the creatine groups received 5 grams twice daily for 12 weeks.

4. Creatine may help preserve or increase lean body mass. One surprising finding was an increase in muscle mass among participants taking creatine even without participating in a structured exercise program.

5. Exercise enhances the benefits of creatine. The study generally found stronger and more consistent results when creatine supplementation was combined with exercise.

6. Creatine may support brain energy metabolism. Dr. Kreider explained that creatine helps the brain maintain energy availability through the phosphocreatine system.

7. Cognitive performance improved in the creatine groups. The study reported favorable changes in cognitive testing, including among participants who did not participate in structured exercise.

8. Cognitive testing covered several areas. Assessments included memory, attention, vigilance, psychomotor reaction, word recall, picture recall, and the Stroop color-word test.

9. Creatine may have antioxidant and anti-inflammatory effects. Dr. Kreider described these as potential additional mechanisms that warrant further investigation.

10. Bone health benefits may take longer to appear. The 12-week study did not show substantial changes in bone health. Dr. Kreider noted that longer-term studies may be needed to assess possible benefits.

11. The study included a calorie-restricted diet. Participants were encouraged to reduce daily calorie intake by approximately 300–500 calories while maintaining adequate protein and carbohydrate intake.

12. Creatine may be useful during weight loss. Dr. Kreider is interested in whether creatine can help preserve muscle mass while people lose weight, including those using GLP-1 medications.

13. Blood lipid markers showed favorable changes. The interview reported improvements in blood lipids, although the findings do not establish that creatine prevents cardiovascular disease.

14. HbA1c also showed some improvement. The study reported favorable changes in this marker of longer-term glucose management, with generally stronger findings when creatine was combined with exercise.

15. The homocysteine findings require verification. Dr. Kreider did not recall a clear reduction in homocysteine in this particular study and indicated that the published results should be checked.

16. Creatine has a strong safety record in studied populations. Dr. Kreider cited research that did not support common claims that creatine causes dehydration, muscle cramps, or kidney damage in the populations studied.

17. Creatine can affect blood creatinine measurements. Because creatinine is a breakdown product of creatine, supplementation may influence creatinine-based estimates of kidney function. Healthcare professionals should know when someone is taking creatine.

18. A loading phase can raise muscle creatine levels more quickly. Dr. Kreider described a commonly used approach of approximately 20 grams daily, divided into four 5-gram doses for about a week. The featured study instead used 10 grams daily without a separate loading phase.

19. Creatine and the gut microbiome are areas of research interest. Dr. Kreider discussed potential relationships among creatine, intestinal metabolism, probiotics, short-chain fatty acids, and the gut-brain connection. Further research is needed to establish clinical benefits.

20. The broader goal is to improve health span, not just lifespan. Dr. Kreider emphasized combining appropriate nutrition, resistance training, physical activity, and evidence-based supplementation to help people maintain muscle, physical function, cognitive health, independence, and quality of life as they age.

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