What happens to your heart when you take creatine

Creatine is one of the most popular supplements on the market. It is best known for its ability to support strength and athletic performance, and it has also generated buzz for its potential brain benefits. There is growing discussion that creatine may also benefit your heart. But is it just hype that precedes research? We spoke with dietitians and a cardiologist to find out what the current science says.

How Creatine May Affect Heart Health

It can support blood vessel function

Your body contains billions of blood vessels. In fact, they would span about 60,000 miles if laid end to end. They carry oxygen and nutrients, remove waste, and help regulate blood pressure.

Your arteries are lined with endothelial cells, which act like a smart thermostat for blood flow, telling vessels when to relax and widen, says Michelle Cardel, Ph.D., RD. “These cells carry their own creatine transporters and their own creatine kinase machinery, so they appear to rely on the same rapid-release energy system as muscle.”

Cardel points to a small pilot study of 12 older adults who took creatine for four weeks. Participants showed improvements in flow-mediated dilation (the widening of their arteries) and faster microvascular reperfusion (how quickly blood flowed back into their small vessels). Their fasting blood sugar and triglycerides also dropped.

“Poor flow-mediated dilation is a warning sign of vascular aging, so it’s a smart place to look,” says Cardel. “Note that this is only a small pilot study, so this is promising preliminary data but no proven effect yet.”

It can help fuel your heart muscle

Many parts of your body rely on creatine for energy, including your muscles, brain, and heart (which is also a muscle!). But unlike your other muscles, which sometimes rest, your heart never takes a break. It beats about 3 billion times during its life, so it needs a lot of energy every day.

“The heart has high energy needs, and creatine helps cells maintain energy availability by promoting the regeneration of adenosine triphosphate (ATP), which fuels cellular functions,” explains Brannon Blount, MS, RDN, LDN.

“Creatine at the cellular level improves muscle function and efficiency, including your heart. Many studies have shown higher levels of available creatine correlate with improved cardiac contractility,” adds Madhav Upadhyaya, MD.

Much of this research has focused on people with heart failure, who tend to have lower creatine stores in their hearts. Lower levels are associated with weaker pumping function and worse outcomes. It is still unclear whether creatine supplements can change. Small studies in people with heart failure found gains in muscle strength and endurance, but no improvement in how well the heart pumps.

“One study indicates that creatine restoration may be particularly relevant for people whose levels are low due to illness or diet, such as vegetarians and vegans, pending further trials,” says Cardel. “Science is still trying to understand whether correcting this energy deficit actually improves patient outcomes, and there is currently no evidence that supplements improve heart pump health.”

It may help reduce oxidative stress and inflammation

Chronic inflammation and oxidative stress are among the main, and often hidden, factors of cardiovascular disease.

Creatine can act as an antioxidant, explains Upadhyaya. “Some believe that this antioxidant property could help reduce free radicals formed during oxidative stress in inflammatory conditions. These free radicals essentially lead to a breakdown in cellular function,” he explains.

However, human evidence is limited, Cardel points out. The antioxidant effects of creatine have primarily been observed in exercise studies. One review found that creatine reduced some inflammatory markers, but only in certain populations.

So the jury is still out on whether creatine can reduce inflammation and oxidative stress enough to protect your heart, and more research is needed.

How much creatine do you need?

Because research on creatine is still emerging, there is no established “heart-healthy” dose. The general recommendation is 3 to 5 grams of creatine monohydrate per day, says Briana Butler, MCN, RDN, LD. For athletes seeking performance benefits, up to 10 grams per day may be recommended.

“However, it is always important to discuss any new supplement with your doctor before taking it. Creatine should not replace medications prescribed for heart problems,” notes Butler.

Creatine is generally considered safe for most healthy adults. “Possible side effects include water-related weight gain and gastrointestinal discomfort. People with kidney disease or other medical problems, or those taking medications that may affect kidney function, should consult their healthcare professional before taking a supplement,” notes Blount.

Other Tips to Promote Heart Health

Beyond creatine, there are many research-backed ways to support your heart health. Experts share their best tips:

• Follow a heart-healthy eating pattern. Eat more fruits, vegetables, whole grains, beans, nuts, fish and unsaturated fats. Limit sodium, saturated fats, fried and heavily processed foods. The Mediterranean and DASH diets are two good examples, Blount says.
• Increase fiber. Focus on fiber-rich foods like fruits, vegetables, whole grains, and legumes to help you meet your daily goal. Soluble fiber can support healthy cholesterol levels by binding to LDL (“bad”) cholesterol and bile, helping to lower your overall levels.
• Be active. Aim for at least 150 minutes of moderate-intensity activity per week, says Blount. Walking, cycling, swimming, jogging, dancing, or playing a sport like tennis or basketball all count, so choose the activities you enjoy. Also include at least two days of strength training, linked to improved heart health.
• Keep a consistent sleep schedule. Research suggests that an irregular sleep schedule may be linked to a higher risk of major cardiovascular events, including heart attack, stroke, and heart failure. Try going to bed and waking up within a similar window each day, Cardel advises.
• Avoid or quit smoking. Smoking is strongly linked to an increased risk of cardiovascular disease, including coronary heart disease and stroke.
• Limit or reduce your alcohol consumption. Excessive alcohol consumption is linked to poorer health outcomes, including a higher risk of heart disease.

Our expert opinion

Creatine plays an important role in cellular energy production, including in the heart. Preliminary research suggests it may also support blood vessel function and reduce oxidative stress and inflammation. However, the evidence that creatine supplements actually improve heart health is still limited and more research is needed.

There is no established dose for heart health, but 3 to 5 grams per day is generally recommended for general supplementation. To support your heart, focus on a heart-healthy diet, regular physical activity, consistent sleep, and avoid smoking and consuming too much alcohol.