Beyond Muscle: Could Creatine Play a Role in Brain and Bone Health?

Exploring the emerging science connecting creatine, Alzheimer's disease, osteoporosis and healthy ageing.

When we hear the word creatine, most of us think of gyms, athletes and muscle-building supplements. But what if this familiar compound has a much bigger story to tell?

Emerging research is exploring creatine's potential beyond physical performance, particularly its role in brain energy metabolism, cognitive function and healthy ageing.

Scientists are investigating whether creatine supplementation could offer benefits for people living with Alzheimer's disease, while other researchers are examining its effects on muscle and bone health in postmenopausal women.

So, could one compound have implications for both brain and skeletal health?

The science is fascinating, but the answer requires a closer look.

First, what exactly is creatine?

Creatine is a naturally occurring compound produced by the body and obtained through foods such as meat and fish. It plays an important role in maintaining cellular energy availability, particularly in tissues with high energy demands, such as muscles and the brain.

Think of creatine as part of the body's energy backup system.

Our cells rely on adenosine triphosphate (ATP) to function. Creatine, through its conversion to phosphocreatine, helps rapidly regenerate ATP when energy is needed.

While creatine's benefits for exercise performance have been extensively studied, researchers are increasingly interested in its potential applications in neurological health and age-related physical decline (Smith et al., 2023).

The brain connection: Creatine and Alzheimer's disease

Alzheimer's disease is commonly associated with the accumulation of amyloid-beta plaques and tau proteins in the brain. However, researchers have identified another important feature of the disease: impaired brain energy metabolism.

Long before noticeable memory difficulties develop, changes in mitochondrial function and cellular energy production may already be occurring.

This is where creatine becomes particularly interesting.

Smith et al. (2023) reviewed evidence suggesting that the brain's creatine system is disrupted in Alzheimer's disease. Because creatine plays a role in maintaining cellular energy availability, researchers proposed that supplementation might help support brain function.

Animal studies have produced encouraging findings, including improvements in certain measures of learning, memory and mitochondrial function.

But what about humans?

A promising step forward in 2025

A pilot study published in 2025 investigated creatine monohydrate supplementation in 20 people living with Alzheimer's disease.

Participants received 20 grams of creatine monohydrate daily for eight weeks.

Researchers reported:

• An approximately 11% increase in brain creatine concentrations.

• Improvements in several cognitive assessments, including measures of memory-related and executive function.

• Good adherence to the supplementation programme among most participants.

These findings suggest that creatine supplementation can increase brain creatine levels in people with Alzheimer's disease and may warrant further investigation as a supportive intervention (Smith et al., 2025).

However, the study was small and did not include a placebo control group. Consequently, it cannot establish that creatine caused the cognitive improvements.

The important distinction: Creatine is not an established treatment or preventive therapy for Alzheimer's disease. Larger, controlled clinical trials are needed before clinical recommendations can be made.

The bone connection: Creatine, menopause and osteoporosis

Now let's shift our attention from the brain to the skeleton.

Osteoporosis is characterised by reduced bone strength and an increased risk of fractures. It becomes particularly relevant as people age, especially among women following menopause.

Declining oestrogen levels contribute to accelerated bone loss, while age-related reductions in muscle mass and strength can further affect mobility, balance and physical independence.

This creates an important relationship between muscles and bones.

Stronger muscles support movement, stability and the mechanical loading that helps maintain skeletal health.

Because creatine can support muscular adaptations to resistance training, researchers have investigated whether it could also benefit bone health.

What does the research show?

In a two-year randomised controlled trial, Chilibeck et al. (2023) investigated creatine supplementation combined with exercise in 237 postmenopausal women.

Interestingly, creatine supplementation did not significantly improve bone mineral density at the hip or lumbar spine compared with placebo.

However, researchers observed favourable differences in certain measures of hip bone geometry, which are associated with the bone's ability to withstand mechanical forces.

These findings suggest that creatine may influence some structural characteristics of bone, even without measurable improvements in bone mineral density.

Nevertheless, the study did not establish that creatine prevents osteoporosis or reduces fracture risk.

What does the latest evidence tell us?

A 2026 systematic review and meta-analysis examined seven randomised controlled trials involving 608 postmenopausal women.

The researchers found that creatine supplementation, particularly when combined with resistance training, was associated with modest improvements in lean muscle mass and strength.

However, there was no overall improvement in bone mineral density (Naddafha et al., 2026).

This is an important finding.

Creatine may have a useful role in supporting muscle health during ageing, but the current evidence does not support using creatine alone to prevent or treat osteoporosis.

Connecting the dots: Brain, muscle and bone health

Although Alzheimer's disease and osteoporosis affect different body systems, they share an important broader context: ageing, declining physical function and the need to maintain independence.

Creatine is of interest because its biological functions extend across several tissues.

In the brain, creatine supports cellular energy metabolism, which may be relevant to neurological conditions associated with impaired mitochondrial function (Smith et al., 2023).

In muscles, creatine supplementation can enhance certain adaptations to resistance training, potentially supporting strength and lean muscle mass in older adults (Naddafha et al., 2026).

In skeletal health, muscle strength and physical activity are important components of maintaining mobility and reducing fall-related risks. However, evidence that creatine directly prevents osteoporosis remains insufficient (Chilibeck et al., 2023).

The potential connection is therefore not that creatine has been proven to treat both Alzheimer's disease and osteoporosis.

Rather, it is that creatine may support biological processes relevant to maintaining physical and cognitive function as we age.

Could creatine become part of a healthy-ageing strategy?

The emerging research raises an exciting possibility: Could creatine eventually become one component of a broader strategy to support healthy ageing?

Perhaps.

But healthy ageing is rarely about one supplement or one intervention.

For brain health, early identification of cognitive changes, appropriate clinical assessment and management of modifiable risk factors remain essential.

For skeletal health, osteoporosis risk assessment, bone mineral density testing when indicated, appropriate nutrition, resistance and balance training, and evidence-based treatment remain central to prevention and management.

Creatine may eventually complement certain interventions, particularly those focused on muscle function. However, it should not replace established medical care.

Supplementation should also be discussed with a healthcare professional, particularly for older adults, people with kidney disease, or individuals taking multiple medications. The higher creatine doses used in some research studies should not be interpreted as general supplementation recommendations.

The bigger picture: Healthy ageing starts with understanding the whole person

Perhaps the most interesting lesson from this research is not simply about creatine.

It is about the growing importance of looking at health more holistically.

Brain function, muscle strength, bone health and mobility are interconnected aspects of maintaining independence and quality of life as we age.

As research continues to explore these relationships, healthcare professionals have an opportunity to adopt increasingly integrated approaches to assessment, prevention and patient care.

At Diagno United Health, we believe that informed healthcare starts with understanding the science and recognising the value of early, appropriate diagnostic assessment.

Because supporting healthy ageing is not only about adding years to life.

It's about helping people maintain their health, mobility and independence throughout those years.

References

Chilibeck, P. D., Candow, D. G., Gordon, J. J., Duff, W. R. D., Mason, R., Shaw, K., Taylor-Gjevre, R., Nair, B., & Zello, G. A. (2023). A 2-yr randomized controlled trial on creatine supplementation during exercise for postmenopausal bone health. Medicine & Science in Sports & Exercise, 55(10), 1750–1760. https://doi.org/10.1249/MSS.0000000000003202

Naddafha, S., Antonio, J., Kreider, R. B., & Stout, J. R. (2026). Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: A systematic review and meta-analysis. Journal of the International Society of Sports Nutrition, 23(1), Article 2668435. https://doi.org/10.1080/15502783.2026.2668435

Smith, A. N., Morris, J. K., Carbuhn, A. F., Herda, T. J., Keller, J. E., Sullivan, D. K., & Taylor, M. K. (2023). Creatine as a therapeutic target in Alzheimer's disease. Current Developments in Nutrition, 7, Article 102011. https://doi.org/10.1016/j.cdnut.2023.102011

Smith, A. N., et al. (2025). Creatine monohydrate pilot in Alzheimer's: Feasibility, brain creatine, and cognition. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 11(2), Article e70101. https://doi.org/10.1002/trc2.70101

Medical disclaimer: This article is intended for educational purposes and does not constitute medical advice. Creatine supplementation has not been established as a treatment or preventive intervention for Alzheimer's disease or osteoporosis. Patients should consult a qualified healthcare professional before starting supplementation or changing their treatment.