 Creatine is one of those supplements that gets misunderstood because of where it came from.
For a long time, it lived in the “gym bro” category. Big tubs. Loud labels. Something people associated only with muscle and strength. But when you actually step back and look at the research, creatine turns out to be one of the most well-studied, most versatile supplements we have. And its benefits go far beyond the gym. I’ve been getting more questions about creatine than almost any other supplement lately. So let’s walk through what it actually does, what the science says, and how it might fit into your life. What creatine actually is Creatine is not a stimulant. It’s not a hormone. And it’s not synthetic in the way many people assume. Your body already makes creatine. You also get it from food, especially animal-based protein like beef, chicken, and fish. What creatine does, at a very basic level, is help your cells produce energy. Specifically, it helps regenerate ATP, which is the energy currency every cell in your body runs on. Muscle cells use it heavily. Brain cells use it heavily. Nerve cells use it heavily. Anywhere energy demand is high, creatine matters. Creatine and muscle. This is the obvious one. This is where creatine earned its reputation, and the data here is extremely strong. A 2024 meta-analysis looking at multiple randomized controlled trials found that creatine supplementation consistently increased lean muscle mass while also reducing body fat percentage. Across studies, the effect was real and repeatable. In practical terms, creatine helps your body respond better to training. It does not replace training. You still have to show up and do the work. But when creatine is on board, most people see somewhere in the range of a 5 to 15 percent improvement in strength over a training cycle. Most research points to a daily dose somewhere between 5 and 20 grams, depending on body size, training volume, and goals. For most people, 5 grams a day is a solid starting point. Where it gets really interesting. Creatine and the brain. This is the part most people don’t know about. In 2024, a double-blind crossover study looked at what happens when people are sleep deprived. Participants underwent about 21 hours of partial sleep deprivation and were then given a single high dose of creatine, around 20 to 25 grams. What they found was striking. Creatine significantly improved cognitive performance and processing speed in these sleep-deprived individuals. In other words, it helped offset many of the cognitive effects we normally see when someone doesn’t sleep well. This does not replace sleep. Sleep is still one of the most important foundational health pillars you have. But it does tell us something important. Creatine can act like an emergency fuel reserve for the brain. If you had a poor night of sleep and you still need to function, think clearly, and make good decisions, increasing your creatine intake that day may help support brain energy and performance. Beyond acute sleep deprivation, longer-term studies suggest creatine may improve overall brain function, memory, attention, and processing speed. Some of this data points toward higher doses than the traditional 5 grams a day, especially when brain health is the goal. Hydration matters here. If you’re taking creatine, drink your water. Creatine, nerves, and aging There’s growing evidence that creatine may play a protective role in the nervous system. Several systematic reviews suggest creatine may help reduce neuronal loss with aging and support nerve health under stress. This is why it’s showing up more frequently in conversations around traumatic brain injury, post-concussion symptoms, and neurodegenerative conditions. Is it a miracle? No. Is it an adjunct that may improve outcomes by 10 to 20 percent? In many cases, yes. And when you’re stacking small advantages over time, that matters. Creatine and mental health This is one of the more underappreciated areas of research. As far back as 2012, a study in women with major depressive disorder found that adding just 5 grams of creatine per day to an SSRI led to faster and greater improvements in depressive symptoms compared to medication alone. More recent follow-up research has supported this idea. Creatine appears to improve the brain’s ability to produce and manage energy under stress, which may help reduce depressive symptoms, particularly as an add-on strategy. This does not replace therapy. It does not replace medication when those are needed. But as part of a broader approach to mental health, creatine shows meaningful promise. How to actually use creatine For most people, the simplest approach works best. Start with 5 grams per day. Take it consistently. You don’t need to cycle it. You don’t need to overthink timing. In special situations like acute sleep deprivation, brain injury recovery, or periods of extreme mental stress, doses in the 15 to 25 gram range may be useful for short periods. If you’re considering higher doses long term, do it with guidance from a healthcare professional. Pay attention to hydration. Pay attention to how your body feels. One final note on quality. Creatine monohydrate is the form that’s been studied the most. Look for products that use Creapure, which is sourced from Germany and has stricter manufacturing standards. The label may not always make this obvious, so sometimes it takes a little digging. The bottom line Creatine helps muscles. Creatine helps the brain. Creatine helps nerves. Creatine may support mental health. If something can improve physical performance, cognitive performance, and resilience to stress by even 10 to 20 percent, that’s a multiplier worth paying attention to. For most people, creatine deserves a place in daily life. Do one small thing today to get a little healthier. This might be it Derrick Hines, D.P.T., MS O.M.T. Acadiana Pain & Performance Rehab PS: Here is a YouTube video where I explained more about creatine. Click HERE
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 Most people look at strength training like a checklist:
This is where something called Rate of Perceived Exertion (RPE) becomes a far more useful tool than reps, sets, or minutes on a timer. It’s not about what you count. It’s about what your body experiences. If you want to get stronger, faster, or more resilient, especially as you get older, understanding effort is one of the most impactful pieces of information you can use. Let’s break down what RPE is, why it matters, and how it changes the way your body adapts to strength training. What RPE Really Measures RPE - the Rate of Perceived Exertion, is simple in concept but powerful in practice. It’s a subjective scale that answers one question: How hard did that effort feel? Instead of tracking numbers printed on a machine, RPE focuses on how many reps you felt like you had left in the tank. For example:
Effort Drives Adaptation, Not Activity Alone Your body doesn’t adapt because you moved a weight. It adapts because it experienced a stress it needs to adapt to. Movement for the sake of movement is fine if you’re maintaining, but if you want to build strength, preserve muscle, and improve function, your effort threshold matters. Think about it this way: A study tracking older adults — individuals who were considered frail by conventional standards — showed dramatic improvement after eight weeks of strength training where the working sets consistently reached an RPE above 7:
Why RPE Matters More with Age As we get older, most people’s training shifts toward comfort zones. It’s understandable; the body aches, life gets busy, and pushing hard doesn’t feel appealing. But here’s the reality: muscles respond to demand, not age. Your body can still make gains, even late in life, as long as you challenge it appropriately. The difference is in how you gauge that challenge. RPE allows you to work within your capacity, without having to chase exact percentages, complex programming, or external metrics. It’s your internal measure of effort; personal, practical, and meaningful. Integrating RPE Into Your Workouts Here’s how to use RPE in a way that actually leads to progress: 1. Define a “working set” A working set is one where you reach an RPE of 7 or higher meaning you’re close enough to your limit that you could only do a few more reps. 2. Accumulate enough effort per week Research suggests aiming for about 3–5 working sets per muscle group per week. Not just any sets, but sets with meaningful effort. 3. Track it Apps and logs that include RPE allow you to see patterns over time. When your RPE drops at the same weight, you know you’ve adapted. 4. Train smart Technique and safety matter, especially for larger lifts. RPE is not an excuse to toss form aside, it’s a guide to how hard you train, not how recklessly you train. A Practical ExampleLet’s say you’re doing a lat pulldown:
Why This Works Across All AgesYour muscles don’t care how old you are. They care about:
Whether you’re in your 20s, 50s, or 80s, that same principle applies. Closing Thought Strength is not measured by external numbers alone. It’s measured by the internal experience of effort. If you go through the motions without ever feeling truly challenged, your body never receives the signal to change. But if you train with intention, reaching that RPE threshold that tells your body it needs more capacity, that’s when strength gains, improved function, and better movement actually happen. Strength then becomes less about age and more about opportunity to adapt. And that’s a message worth hearing. Derrick Hines, D.P.T., MS O.M.T. Acadiana Pain & Performance Rehab PS: Here is a YouTube video where I explained more about RPE and its importance. Click HERE |
AuthorDerrick Hines, D.P.T. is the owner of Acadiana Pain and Performance Rehab. The information in this blog is personal opinion and not to be used as medical advice. Archives
April 2026
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