Across the board, creatine is one of the most researched supplements in sports science, and its brain and muscle benefits are well established. Creatine helps you train harder, recover better, and build lean muscle more efficiently, all the while clearing up any brain fog and cognitive slug. So should it become a new staple in your wellness routine? A trusted member of the Medical Advisory Board, Dr. Pero gave us the rundown on everything we need to know RE: creatine.
O Positiv Health: First question, what is creatine and how does it work within the female body?
Dr. Pero: Creatine is a molecule that's made up of three amino acids. These amino acids are the building blocks for our proteins, so you're going to find that higher fish diets have more creatine compared to plant-based. Our bodies do make some creatine, but about 95% of what we make as well as what we ingest is stored in our skeletal muscle. It acts almost like a recycler for energy.
Everything that we do in our body externally and internally requires an energy source. Our energy source is something called ATP, which is adenosine triphosphate. Creatine helps our bodies to recycle ATP quicker, especially in times where our energy is depleted and those big organs need more energy, like our muscle and our brain.
O Positiv Health: You mentioned creatine being found naturally through fish and meat, is it possible to get an optimal amount simply through diet?
Dr. Pero: It's difficult to get an optimal amount through food. When we think about high red meat diets, it's not necessarily beneficial just for getting creatine in. There's so much evidence behind the safety of creatine as a supplement, so that's usually how I'm encouraging my patients who are all women to get their creatine.
O Positiv Health: What would you say is the benefit outside of athletic performance for a woman taking creatine?
Dr. Pero: It’s an energy source for the areas our body uses the most, like the brain and the muscle, especially in times of energy depletion. We're thinking pregnancy, postpartum, times of sleep deprivation and high stress. These are things that the majority of women at some point in their lives will have gone through, so it's really beneficial for so many stages and ages in our lives as women. We know that perimenopause makes our hormones decline, which impacts our bone health. We know that muscles can help to support the strength of bones. Creatine is very helpful for muscle support in that time period.
O Positiv Health: The narrative around creatine, especially on social media, is that it is solely for body builders, but it seems like the full spectrum of womanhood could find benefit from taking creatine.
Dr. Pero: Absolutely. Even thinking about it as far as brain health, there's so much emerging data that's showing that it may be neurodegenerative protective. In times of stress and sleep deprivation, we see that creatine can help to support brain health as far as attention, memory, cognitive function.
O Positiv Health: Wow. It’s so commonly associated with fitness and muscle mass, which is so important and helpful, but I think many don't know what it can do for your brain health as well.
Dr. Pero: It’s still emerging with newfound benefits, but the dose needs to be higher because it has to get through that blood brain barrier. So you really want to be shooting for 10 grams, sometimes even 20 grams, depending on how you tolerate it, if you're looking to see some brain health benefits.
O Positiv Health: And for those women on a weight training path, would you say that creatine is almost imperative in terms of muscle definition?
Dr. Pero: Absolutely. We know that it helps with muscle maintenance. We know that it helps with quicker recovery between sets, stamina, perseverance. Hopefully our culture is changing to where we're not looking at the thinnest person being the ideal body type, but rather, someone who actually has muscles that are capable of doing strong things. If we're thinking about longevity, our muscles are definitely an organ for longevity.
O Positiv Health: I totally agree, the ideal body image should be geared towards your vessel being a good home for yourself. Are there any side effects one would need to be aware of when it comes to taking creatine?
Dr. Pero: I think there's a lot of noise out there about, “Oh my gosh, creatine made me bloat, I felt like I gained weight and once I stopped it, that went away.” Creatine pulls water in. It's osmotic. If you're going hard and heavy initially with creatine, it can make you feel that way. But if you're doing it right, if you're starting up at a lower dose, going slower with increasing the dose, it should not cause that issue. Look for products that are clean, that don't have a whole lot of additives, fillers, sweeteners that may contribute to that bloating.
O Positiv Health: For anyone embarking on their creatine journey, how should they navigate dosing and which additives to avoid?
Dr. Pero: You want to look for creatine monohydrate. That's the one that's the most studied and evidence-based. The powder form is usually the most easily digestible, and it's also usually the one that will get you more bang for your buck, because one scoop can have five grams of creatine, whereas you have to take seven capsules or five gummies to get that amount. 5,000 milligrams or five grams is what's usually been studied for the muscle benefits. 10 grams, so five grams twice daily, is the emerging data for brain health. The unflavored powder doesn't necessarily taste great, it can taste chalky and might give you a little bit of nausea. But you don't have to chug it, you can sip on it throughout the day. If taste is a barrier to compliance, then think about doing one that may have a little bit of monk fruit. Just be mindful of how you personally react to some of those sweeteners.
O Positiv Health: Are there any supplements that you would have to be mindful of taking alongside creatine? Or any health conditions or hormonal imbalances to be aware of?
Dr. Pero: In general, creatine is well tolerated. We usually say for people with kidney disease, you might want to discuss with your kidney specialist. And then there is a condition called small intestinal bacterial overgrowth, a certain subtype called the hydrogen sulfide which may have more bloating related to creatine intake, but they can still take it, just going at a lower dose.
O Positiv Health: Is creatine safe to be on a long-term basis or is it something you need to taper on and off?
Dr. Pero: No, you don't have to cycle it. It's actually best used consistently and daily. I can't stress enough how extensively studied and safe creatine is. Even the most conventional doctors can see the value in this. I'm excited for more people to be aware of it and to try it.
About the Doctor
Dr. Pero was born and raised in Baton Rouge, Louisiana. She is triple board certified through the American Board of Obstetrics and Gynecology, the American College of Lifestyle Medicine and the Institute of Functional Medicine. She is currently in private practice at Alive&Well Health in Dallas, TX and is an active member of O Positiv Health's Medical Advisory Board.
