Does creatine work for menopausal symptoms? Doctors weigh in

It may seem like creatine is everywhere, with podcasters, wellness influencers and maybe even your neighbour promoting products. In fact, the creatine market is projected to increase in the U.S. and Canada.

The supplement, favoured by some weightlifters and sprinters, is now touted for healthy aging such as memory and cognitive issues during perimenopause and menopause. But the evidence on that isn't solid, doctors say. 

If you're already taking creatine or considering doing so, here are some factors to weigh on who might benefit, what's less clear, as well as the safety of the product. 

Creatine is a nitrogen-containing compound that people can get from their diet by eating meat and fish. Since creatine is not found in plants, scientists say vegetarians and vegans may benefit from supplements, most of which are synthesized without extracting from animals. 

Animals, including humans, store creatine mainly in muscle. The liver and kidneys also synthesize creatine when we get enough amino acid building blocks through diet, such as by eating oily fish like herring.

As for its role, during muscle activity, creatine helps create a short-term supply of energy that is needed to keep the heart beating, and to grow and repair cells. 

Athletes have used creatine supplements to augment resistance training, such as in bodybuilding. Researchers have also suggested it could improve performance in sports that require surges of intense activity.

While studies have looked at creatine supplementation, doctors say factors like the size, length and quality of research into supplements also matter for reliability. It's worth noting that studies on athletes may not apply to the average person who doesn't work out as much, is sedentary or already gets enough creatine from their diet. 

Like protein supplements, creatine is promoted, along with strength training, by some wellness influencers and podcasters both for bulking up and for anti-aging.

Dr. Mark Tarnopolsky, a professor of pediatrics and medicine at McMaster Children's Hospital, studied the effects of creatine with resistance training in men and without in women over age 65. 

Taking creatine supplements "clearly shows significant improvements in muscle creatine levels as well as muscle strength and muscle function," said Tarnopolsky, who owns his own company selling creatine supplements.

A "heaping teaspoon" of four to five grams "is probably a sweet spot," he said. In contrast, some influencers suggest 20 grams a day, he said, which seems like overkill. 

The latest messaging seems to be focused on how creatine can help aging bodies and minds, including those with menopause and perimenopause. That's an extrapolation based on studies that found giving creatine supplements to vegans raised their muscle levels and improved their memory and concentration, Tarnopolsky said. 

Other doctors say the evidence of creatine helping cognition or so-called brain fog is thin. For example, some social media posts recently discussed one trial of 36 perimenopausal and postmenopausal women over two months. The researchers concluded the supplements "may be a promising, safe, effective and practical dietary strategy for improving clinical outcomes and elevating brain creatine concentrations."