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How Creatine May Help Improve Bone Density (When Paired With Exercise)
Bone density is more difficult to measure than other health metrics: You won't necessarily know your bones are weak or brittle until they break. This makes it vital to take a proactive approach to bone health. The more we can do to strengthen our bones—particularly during key times of life like menopause—the lower our risk of potentially debilitating fractures.
Getting enough calcium and vitamin D, doing resistance training, and limiting tobacco and alcohol are all ways to tend to your bones daily. Research also suggests that supplementing with creatine may benefit your entire musculoskeletal system, protecting bones from damage and decay—particularly in postmenopausal women.
The research on creatine and bone health
Creatine is a naturally occurring compound that assists in energy production. You can find it in certain foods (mostly animal products like herring, pork, beef, and salmon) as well as in dietary supplements.
Historically, most of the research on creatine has studied its effects on muscle health and athletic performance. But in 2015, researchers out of Canada published the first long-term study investigating how supplementing with creatine impacted bone health in a group of postmenopausal women.
For the double-blind randomized trial, 47 postmenopausal women participated in a 12-month resistance training program. During the program, half of the group took a daily creatine supplement (0.1 g/kg/day dose) while the other half took a placebo. The women's bone density was measured using a dual-energy X-ray absorptiometry (DXA) scan at the beginning and end of the study.
Once the 12 months were up, the creatine group experienced less bone degradation in the femoral neck (hip) region, which is particularly susceptible to fracture. The creatine group lost 1.2% BMD at the femoral neck, compared to a 3.9% loss in the placebo group. "This difference approaches clinical significance because 5% decrease in BMD is associated with 25% greater risk of fracture," the study reads.
Creatine supplementation may be particularly beneficial for postmenopausal women1 since the hormonal changes of menopause can contribute to muscle and bone loss. This puts women at a higher risk of developing osteoporosis2. However, separate research has found that supplemental creatine (combined with resistance training) can decrease the rate of bone loss in older men as well.
It seems to do this by increasing the activity of osteoblasts (cells involved in the bone formation), and since creatine can also help increase muscle mass3, it may cause "greater muscle pull" on the bone during strength training, indirectly improving bone density.
What this means for you
It's important to note that these studies had a resistance exercise component. Taking a creatine supplement every day won't have a meaningful impact on bone health if you don't pair it with exercise—as shown in other research4.
That said, there's reason to believe that taking a creatine supplement in tandem with resistance training can have a positive effect on your bones (not to mention, your strength, power, and overall athletic performance). Taking 3-5 grams of the supplement daily (with or without food) is plenty for most people, although for bone health benefits higher doses (8 grams of more a day) are likely needed.
For the exercise component, we can look to research for ideas: The women in the 2015 study completed three sessions of whole-body resistance training a week. In each session, they completed three sets of 10 reps of weighted moves (think squats, hamstring curls, bench presses), adding more weight as they progressed. If you're new to weightlifting, this is a solid protocol to start with, but find a routine that works best for you. This guide can help you get started.
The takeaway
Some research suggests that creatine supplements can support bone health and improve bone mineral density when paired with resistance training. Learn more about the benefits of creatine (particularly for women) here, and check out more tips on how to keep your bones strong as you age here.
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