Should you be taking creatine? Possibly.

Every day, people ask family medicine physician Dr. Brian Ingold which supplements are worth the money.

One that he recommends many adults consider? Creatine.

The supplement, which is having a moment in health news and social media, can have a positive impact for many of us. And new research suggests there are benefits beyond building muscle.

What is creatine?

Creatine is a naturally occurring energy compound made by your liver, kidneys and pancreas. You also get creatine from the food you eat. Most adults use about 2 to 3 grams of creatine daily, with about half coming from food like meat and fish.

Some people supplement the creatine their body makes with creatine products like powders, pills, capsules, gummies and drinks

What does creatine do?

Imagine you’re a few cents short of a purchase — and someone hands you the change you need. That’s creatine.

Creatine is primarily stored in your muscles, with smaller amounts in your brain, heart and other tissues. Adenosine triphosphate (ATP) is the main cellular energy source powering your muscles.

When you sprint or lift heavy and your muscles use up ATP, creatine steps in and helps regenerate more ATP so your body can complete the exercise.

“It acts like a backup battery for your muscles, and potentially your brain as well under certain conditions,” Ingold said. “It helps you push harder, particularly during short intense kind of efforts, and it can support recovery.”

It does not, however, replace the need for eating healthy and regular exercise. Creatine is a supplement, not a replacement.

What are the possible benefits of supplementing with creatine?

“Creatine is one of the most-researched nutritional supplements and seems to be safe for most adults,” Ingold said. Researchers have found the following benefits of supplemental creatine in healthy adults:

• Improved high-intensity performance.
• Increased strength and muscle mass.
• Improved recovery.
• Reduced inflammation and muscle damage.
• Improved muscle mass and mobility in aging populations.

It may also reduce symptoms of depression when used on top of standard-of-care medication and therapy, but isn’t a replacement for them.

Emerging research also suggests it may improve cognitive performance.

Who could benefit from supplementing with creatine?

It’s a common misconception that creatine is just for bodybuilders. Ingold recommends supplemental creatine to many other groups, including:

• Adults 50 and up: “When you look at the data in our aging population, sarcopenia — the loss of muscle tissue — and functional decline are linked to poor health outcomes,” Ingold said. “Very few things cause you to not live as well, and to not live as long, as being weak relative to your peers.”

To counteract sarcopenia, Ingold recommends strength training at least twice a week — even chair-based exercises count. Creatine can enhance these efforts, building strength and lean mass beyond training alone.

• Women: Women tend to have slightly lower creatine stores in their muscles than men on average, which may mean they respond particularly well to supplementation. At age 30, women begin losing 3-5% of muscle mass every decade — and lose strength and bone density even more rapidly once they enter menopause.

“If you want to live as well as you’d like to, you can’t be weak,” Ingold said.

If you’re a woman, he recommends that you start strength training — starting now if you haven't already (here are some basic strength training exercises for women). Supplementing with creatine can enhance your efforts to build muscle mass.

• Vegetarians and vegans: The best food-based sources of creatine are fish, red meat and poultry. Since vegetarian and vegan diets do not include those products, vegetarians and vegans often have lower-than-average creatine stores and can benefit from supplementation.

• Those with chronic sleep deprivation: This group includes new parents, workers on night shift whose families operate with daytime schedules, and those with insomnia. While improving sleep habits is most important, some research suggests creatine may help offset some cognitive effects of sleep loss.

• Older adults with cognitive decline: Research suggests it can improve short-term memory and cognition in older adults.

Who shouldn’t try creatine?

• Pregnant or breastfeeding women, due to limited safety data.
• People with kidney disease, or those taking medications that affect kidney function, consult with their nephrologist before trying creatine.
• Patients with bipolar disorder, due to rare reports of worsening symptoms.
• Children and adolescents — research is still limited. However, Ingold said, research shows that creatine is safe and potentially beneficial for certain groups of children, including those with rheumatology conditions and muscular dystrophy, so more research is likely coming.

How do I pick a good creatine product?

No. 1. Talk to your doctor first. Before starting any supplement, ask your doctor if it’s appropriate and at what dose. Remember, there are possible interactions with other prescriptions and supplements to consider.

Most adults do well with 3 to 5 grams daily. Higher doses like 10 grams per day have been studied for cognitive and neurological goals, but these doses should be discussed with a physician.

You may have heard about “loading” or “cycling.” Ingold keeps it simple: Start at your intended dose, and stay there.

(One exception: if your gastrointestinal system tends to be sensitive, you can start at 3 grams and increase slowly once you know how it’s going.)

No. 2. Check the label before purchasing and make sure that the active ingredient is “creatine monohydrate."

There are multiple forms of creatine, but “almost all of the data on safety and performance involves creatine monohydrate,” Ingold said. “There’s no evidence at this time that any other form of creatine has the safety track record of creatine monohydrate, nor does it have the track record of benefit.”

And beware of marketing gimmicks, Ingold said: “There are a lot of supplement companies that will sell you something 10 times more expensive than creatine monohydrate, claiming their version has ‘better delivery’ — but I’m not aware of any strong evidence for it.”

No. 3. Powder is usually the most budget-friendly. Creatine pills or capsules are fine, but powder is usually the cheapest — usually 25 to 50 cents per serving. To use, dissolve the powder into water or the drink of your choice, and drink. (One asterisk: Ingold does not recommend dissolving creatine powder in a caffeinated beverage out of an abundance of caution, but said there’s no strong evidence showing that normal caffeine intake negates the benefits of creatine.)

No. 4. Buy a creatine product that has been independently tested. The Food and Drug Administration does not test supplements before they are sold, so Ingold recommends buying a product that has undergone voluntary independent testing.

A product that has the United States Pharmacopeia (USP) or NSF International seal on its box has been tested for safety and has been verified to contain listed ingredients. Ingold cautions that sometimes brands will test some — but not all — of its products, so don’t just trust the brand name; look at the specific product.

Ingold recommends the site consumerlab.com to research supplements (you’ll have to create a free account to access the reviews).

No. 5. Buy creatine from a trusted source. Since some websites sell counterfeit supplements, Ingold recommends purchasing your creatine from a store or a trusted online vendor. Inspect it before using, and make sure that the packaging and seal are intact and haven’t been tampered with. (Do you really want to roll the dice with your health in the name of a “bargain”?)

What side effects can I expect with creatine?

People with sensitive stomachs may have some gastrointestinal discomfort like diarrhea, gas or bloating.

When you start using creatine, you may notice “fuller” muscles and a 1 to 3 pound increase on the scale. This is water weight — not fat gain — because creatine increases water retention in muscle. “There’s usually an early acclimation period, then it fades into the background and isn’t an ongoing issue,” Ingold said.

Taking supplemental creatine can also increase the levels of a waste product called “creatinine” in your blood. Although there’s no evidence that taking supplemental creatine can cause kidney problems in a healthy adult, your doctor will need to know that you started supplemental creatine to interpret your blood work correctly.

You usually won’t see changes until after four weeks or so of continuous use, Ingold said. Higher doses may require longer to impact mood, focus and memory.

Do I have to take creatine to be healthy?

Absolutely not, Ingold said.

“When we talk about quality of life, what we’re saying is we want to live as well as we possibly can,” Ingold said. “Mentally, I want to stay sharp — I want to remember all of my grandchildren’s names and birthdays, and take care of myself. And physically, I want to do all the things I want to do.”

Exercise, great nutrition, and adequate sleep are still the foundation to get there. But if you’re doing those things well already, Ingold said, “we might as well have the conversation about other things we can add on top of your regimen to advance your goals.”

Creatine supplementation isn’t necessary for good health — “but it can provide additional benefits beyond what nutrition and exercise can provide,” Ingold said.

Still, talk to your doctor before starting any supplement to make sure it’s the right fit for you.