Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial.
Level 2 - randomized trial
Double-blind, randomized, placebo-controlled trial
PubMed 31257405 · doi:10.1093/gerona/glz162
What was done
A double-blind, parallel-group, randomized placebo-controlled trial was conducted in Sao Paulo, Brazil, between 2011 and 2017. Two hundred postmenopausal women with osteopenia were randomly allocated to receive either creatine monohydrate (3 g/d) or placebo for 2 years. Outcomes assessed at baseline, 12 months, and 24 months included areal bone mineral density (aBMD via DXA; primary outcome), lean and fat mass, volumetric BMD and bone microarchitecture, biochemical bone markers, physical function and strength, and incidence of falls and fractures.
What was found
Areal BMD significantly decreased across 2 years at the lumbar spine (p < .001), femoral neck (p < .001), and total femur (p = .032), with no interaction effect observed between creatine and placebo (all p > .050). Bone markers, microarchitecture parameters, and falls/fractures did not change with creatine (all p > .050). Lean mass and appendicular skeletal muscle mass increased across time in the whole cohort (p < .001), but without an additive effect of creatine (p = .731 and p = .397, respectively). Exact baseline and endpoint point estimates were not reported in the abstract.
Why it matters
This trial shows that standalone daily creatine supplementation (3 g/day) for 2 years does not prevent bone loss or improve muscle mass in postmenopausal women with osteopenia, challenging hypotheses that creatine alone possesses osteogenic or anabolic effects in this group.
Limits
The study evaluated only one dose (3 g/d) without structured concurrent resistance training and was conducted in a single geographic population of postmenopausal women with osteopenia, limiting generalizability to men, non-osteopenic cohorts, or exercise-paired interventions. The abstract does not provide absolute numbers or effect sizes with confidence intervals.
Cited by
- supports The lowest daily creatine monohydrate dose shown to positively influence bone health outcomes is 8 grams per day, whereas trials administering 1 to 3 grams per day for two years showed no skeletal benefit.