As I write this, I’m in week 2 of my radiation for stage 1 estrogen+ and progesterone+ breast cancer 🥰.

Things are going well. I’m so grateful I caught this super early and that, with radiation and a 5 year regimen of tamoxifen, my prognosis is excellent. Tamoxifen works by blocking estrogen from signaling cancer cells to grow and multiply, so it’s important to me to figure out other ways to keep my brain and body strong and healthy. 

Do you know what helps with muscle, bone strength and brain health? Creatine. If you’ve thought about supplementing with creatine and have some questions, this is for you. Reminder, this is not medical advice, but food for thought. 

All About Creatine

Creatine is a naturally occurring compound found in both muscle cells and the brain and it helps produce energy during high-intensity activities or mental tasks. Supplementing to ensure maximum stores of creatine are available has been shown to be beneficial: 

💪🏻 Muscle Mass: Loss of muscle mass as we age (aka sarcopenia) is a significant concern as we age, and we need our muscles to protect our bones and help regulate metabolism and insulin resistance. Two meta-analyses from 2017 and 2026 found that creatine supplementation, particularly when combined with resistance training, can significantly increase muscle mass and strength in older adults. 

🩻 Bone Strength: As estrogen levels decline during menopause, we are at increased risk for osteoporosis. While creatine hasn’t been shown to directly improve bone strength (resistance training does), a 2-year randomized controlled trial of 170 postmenopausal women with osteopenia found that creatine (3g/day) helped maintain bone bending strength at the hip, improved walking speed, and modestly increased lean tissue mass — all of which matter for fracture risk.

⚡️ Metabolic Health + Glucose Regulation: Creatine has been shown to improve glucose tolerance, which can be beneficial for preventing insulin resistance and metabolic syndrome.

🧠 Cognitive Function & Protection: Our brain uses a ton of energy, and creatine acts as a recharge system, helping neurons refuel and potentially providing neuroprotection that may reduce the risk of neurodegenerative diseases like Parkinson’s and Alzheimer’s. A small 2026 randomized control trial of 36 perimenopausal and menopausal women found that moderate creatine supplementation improved reaction time and raised frontal brain creatine levels over 8 weeks. More research is needed, but it’s an exciting first step toward brain-specific data. 

🥺 Depression and Anxiety: More research is needed, but a 2012 study found that women with major depressive disorder who added creatine to their antidepressant regimen experienced faster and more significant improvements than those who did not take creatine. A newer systematic review continues to show promise but not consensus, so hopefully more studies are on the way. 

 

Questions you might have…

What kind?

You’ve got two main options: Creatine monohydrate and Creatine HCL.

Creatine monohydrate is affordable and well researched. Creatine HCL is newer to the market and touted as more absorbable and potentially easier on the stomach if you experience discomfort when taking creatine. I am experimenting with a bit of both, trying this one from Costco and these from Optimum Nutrition. 

 

How much should I take?

Consensus is between 3-5 grams, but my functional health doctor told me that I can increase to 10 grams (again, not medical advice 😇). I’ve also seen suggestions of a loading phase of 20 grams per day (split into 4 doses) for the first 5-7 days to saturate muscle creatine stores. All that being said, a daily dose of 3-5 grams can achieve the same results over time.

 

Capsule or powder?

Either, but I recently heard on this podcast that creatine does start to lose efficacy when mixed, so it’s wise to drink it quickly. For example, mix creatine in water and take it to your workout. 

 

Will creatine cause water retention and weight gain?

Not typically. Creatine does increase water content in muscle cells, it does not typically lead to visible bloating. The weight gain associated with creatine is usually due to increased muscle mass and not fat.

 

Will creatine impact my kidneys?

It shouldn’t. Numerous studies have shown that creatine supplementation is safe for healthy individuals when taken at recommended dosages. A 2011 review found no adverse effects on kidney function in healthy adults who took creatine over long periods. 

 

Will creatine cause digestive/GI issues?

Maybe. Some individuals may experience mild digestive issues, such as cramping or diarrhea, when taking creatine. These side effects are often dose-dependent and can be minimized by splitting the daily dosage into smaller amounts throughout the day.

 

When should I take it?

Creatine can be taken at any time of the day. However, some studies suggest that post-workout supplementation might be slightly more effective for muscle growth. I spread my creatine out over the course of a day – a few capsules in the morning, powder in my workout drink, a few later in the day. Creatine can be taken with or without food, but taking it with a carbohydrate-rich meal might enhance its uptake into muscle cells.

 

I know, it’s a lot of info, but I’m always here for you. Let me know if you have any questions! 

XO Tracey

 

P.S. I’m still a fan of HRT for those who can take it, and I’m still cleared for the use of vaginal estrogen which has shown to be safe.  

P.P.S. Want to nerd out more? Here ya go! 

Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause

Creatine Supplementation in Women’s Health: A Lifespan Perspective

Impact of creatine supplementation on menopausal women’s body composition, cognition, estrogen, strength, and sleep

Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials

Vaginal estrogen use and chronic disease risk in the Nurses’ Health Study