Creatine

creatine monohydrate · creatine

The most evidence-backed supplement for preserving muscle and strength with age.

TypeSupplement / dietary

Grade

Moderate

Class: Muscle / bioenergetics
Primary use: Muscle, strength & power in aging
Evidence strength: medium
Last reviewed: 2026-07-01

Bottom line

Not an 'anti-aging' pill — but one of the very few supplements with genuinely strong human evidence, for muscle, strength and power in older adults, especially paired with resistance training. Lifespan itself is not the endpoint studied.

What the evidence says

Creatine has a large, consistent randomized-trial base for improving muscle mass, strength and power, and the effect is most reliable when combined with resistance exercise — which matters because sarcopenia and frailty are major drivers of disability in aging. Cognitive benefits (for example under sleep deprivation or metabolic stress) are promising but less consistent. It has no trials on lifespan or age-related disease incidence, so the 'longevity' framing is indirect: creatine targets a mechanism of functional aging (muscle loss), not aging itself. On that functional claim the evidence is strong enough for grade B.

Key studies

[1]
Creatine plus resistance training and muscle in older adults · RCT / meta-analysis
Consistent gains in lean mass and strength when combined with training.
PubMed ↗
[2]
Creatine and cognition · review
Signals mainly under stress (sleep loss, aging); less consistent otherwise.
PubMed ↗
[3]
Safety of long-term creatine supplementation · review
No evidence of harm to kidneys in healthy individuals at standard doses.
PubMed ↗

Mechanism

Raises intramuscular phosphocreatine, buffering rapid ATP resynthesis during short, intense effort; may also support cellular bioenergetics in brain and other high-demand tissues.

Safety

Among the most-studied supplements in existence and well tolerated in healthy people at standard doses. The common fears (kidney damage, dehydration, cramping) are not supported by evidence in those with normal kidney function. People with kidney disease should check with a clinician. A small amount of early water retention is normal and harmless.

Dosage context

Typical protocols use ~3–5 g/day of creatine monohydrate, with or without an initial higher-dose 'loading' week. Monohydrate is the best-evidenced and cheapest form; more exotic forms rarely justify their price.

From the field

In a market full of hype, creatine is almost the opposite problem: cheap, unglamorous, and better evidenced than most 'longevity' molecules. We grade it B for functional aging and stay clear that it isn't a lifespan drug.

How we assign grades → Method