Does creatine help with weight loss?
Creatine is not a slimming aid and is not recommended for fat loss as a primary goal. If you combine it with strength training, your body composition improves modestly: slightly less fat, more muscle mass.
Creatine does not help with weight loss in the classical sense. On average, your weight increases slightly by around 0.86 kg, because you retain more muscle mass and fluid. If losing weight is your goal, creatine is not designed for that purpose, and LongevityWatch does not recommend it for that goal: it has been studied too little as a slimming aid, and it does not work that way either.
What creatine does do is change your body composition when you also train alongside it. If you combine creatine with strength training, you build on average 1.14 kg of additional muscle mass, your body fat percentage drops by an average of 0.88 percentage points, and you lose on average 0.73 kg more fat mass than with training alone. That is modest but measurable. Creatine does not burn fat directly: the effect works through muscle mass, because more muscle tissue increases your energy expenditure over the longer term. There is also animal research showing that creatine is involved in a heat-producing cycle in fat cells, but whether this makes any difference to weight loss in humans has not yet been established.
For people aged 45 to 65 who are losing weight through diet and training, a twelve-week study showed that creatine helps preserve muscle mass while losing fat. This is particularly relevant for people as they age, because muscle breakdown during a diet occurs easily. If you combine strength training with creatine and also pay attention to your body composition, that is a more meaningful goal than simply 'losing weight'.
On the label, choose 'creatine monohydrate': this is the most researched and least expensive form. A more expensive variant such as creatine hydrochloride offered no additional benefit in research. For body composition in combination with strength training, use 3 to 5 grams per day for at least 8 to 12 weeks. There is no evidence of kidney damage, hair loss, dehydration or muscle cramps at that dosage. Whether you take carbohydrates at the same time makes no difference to the effect on muscle mass.
This answer is based on two large summaries of hundreds of randomised studies, supplemented by two smaller randomised studies and a review article on safety. The researchers behind one of those summaries rated more than 40% of the individual studies as limited in reliability due to methodological concerns, and 7% as high risk of bias. This makes the effect sizes less certain than the numbers suggest, but the direction of the findings (more muscle mass, slightly lower body fat percentage with training) is broadly supported.
Does creatine speed up muscle recovery?
Creatine (3 to 5 grams per day) can probably speed up muscle recovery after intense training and improve strength and muscle mass, but for the recovery effect specifically the research findings are not fully consistent.
Does creatine work better with carbohydrates?
Carbohydrates probably increase the uptake of creatine into the muscle cell via insulin, but when compared against a placebo in research this does not translate into better performance. Add carbohydrates if you want to load, but do not automatically count on extra training results.
Does creatine also help ordinary people, not just athletes?
Creatine also helps ordinary people, especially older adults who combine it with some strength training: more muscle mass, more strength, and in those aged 66 and over, better memory as well. Combining at least 5 grams per day with strength training gives the best results.
What is the best way to use creatine?
Creatine works best in combination with strength training: optionally start with a loading phase of 20 grams per day for 5 days and then maintain with 2 to 5 grams per day. If you have a kidney condition, discuss it with your doctor first.
Does creatine do anything to your immune system?
Creatine influences immune cells via a specific switch, but whether the outcome is favourable or unfavourable depends strongly on the situation. For boosting immunity or preventing infections, there is too little evidence in humans to recommend it.
Does creatine cause hair loss?
Current research shows that creatine does not raise DHT and has no effect on hair follicle health. There is no need to avoid creatine out of fear of hair loss.