Why vegetarians and vegans may benefit most from creatine

If you eat a vegetarian or vegan diet, you get hardly any creatine from food. Your body does make its own, but the stores in your muscles are usually smaller than in people who eat meat and fish. A supplement could therefore do more for strength, short bursts of intense effort and certain kinds of memory. How large the benefit turns out to be depends, among other things, on how full those stores are to begin with. The studies so far offer hints, but they leave open questions about how far their results can be generalized.

Why creatine stores are lower on vegetarian and vegan diets

Creatine is a compound the body builds from three amino acids: arginine, glycine and methionine. This happens mainly in the liver and kidneys and yields roughly 1 gram of creatine a day. The body’s own production covers basic needs, but it does not fill muscle stores to the same degree as additional intake from food. Meat, especially red meat, and fish contain about 2 to 5 grams of creatine per pound, or per roughly 454 grams. People who eat these foods regularly therefore tend to have larger creatine stores in their muscles.

On a vegetarian or vegan diet, by contrast, almost no creatine reaches the body through food. Plants do not make creatine, so there is no plant food that supplies it in meaningful amounts. The body keeps producing its own, but it does not reach the combined supply of self-made creatine plus dietary intake that a mixed diet with meat and fish provides. In studies, the creatine content of muscle in vegetarians was 10 to 30 percent lower than in people who eat meat.

Creatine acts as a fast-access energy buffer. During short, intense efforts, muscles use phosphocreatine to regenerate ATP. ATP, short for adenosine triphosphate, supplies the energy for muscle contraction. Smaller creatine stores mean less of this buffer is available. That can limit performance in sprinting, strength training or repeated high-intensity intervals. The same phosphocreatine system supports energy metabolism in nerve cells. Creatine supply may therefore also play a role in cognitive performance during mental fatigue or sleep deprivation.

What studies show about creatine’s effects on a vegetarian diet

Several studies suggest that vegetarians may respond more strongly to a creatine supplement than people on a mixed diet. A study published in 2003 in Medicine & Science in Sports & Exercise is said to have found the following: after eight weeks of creatine combined with strength training, total muscle creatine and phosphocreatine rose considerably more in vegetarian participants than in participants who ate meat. The mixed-diet group also saw increases, but smaller ones. Their stores were already higher at the outset because of their diet. Where this finding comes from is unresolved, however: the link given for it leads to a publication described as a 2017 randomized study.

A similar pattern is described for physical performance:

Vegetarians who take creatine show larger improvements in maximal strength, sprint performance and capacity for repeated high-intensity efforts.
In one study, lean body mass and work performed increased more in vegetarian participants than in participants on a mixed diet, even though both groups followed the same dosing schedule.
The usual explanation is the lower starting stores: when stores that begin less full are topped up to saturation, the available energy can change more noticeably.

Studies also point to differences in mental performance. A study published in 2011 in the British Journal of Nutrition examined how creatine affects memory and intelligence in vegetarians and in people on a mixed diet. It reportedly found significant improvements on working memory tasks after five days of supplementation in the vegetarian group, while the mixed-diet group did not improve. Working memory holds information for short periods, for example when you do mental arithmetic or follow a set of instructions. According to the report, the authors interpreted the result as showing that the cognitive benefits were most pronounced when starting creatine stores were lower. The length of supplementation and the exact attribution of the memory results are, however, not clearly settled.

Many of these studies include only a few participants and look at supplementation over short periods. The fact that several studies point in a similar direction across different outcome measures supports the idea that vegetarians may benefit more, physically and cognitively, than people on a mixed diet. Given the small studies and short observation periods, it is not yet possible to say with confidence how generally this holds.

How creatine works in muscle and brain

Creatine’s main job is to help regenerate ATP when energy demand is high. When a muscle contracts, ATP is split into ADP (adenosine diphosphate) and inorganic phosphate, releasing energy. Phosphocreatine then transfers a phosphate group to ADP and quickly turns it back into ATP. This is faster than glycolysis (breaking down sugar for energy) or oxidative phosphorylation (ATP production in the mitochondria). For efforts lasting about 1 to 10 seconds, this fast energy system is therefore especially important.

In the brain, creatine supports the energy metabolism of nerve cells in a similar way. Their energy needs are high and fluctuate, especially during tasks that demand attention, storing new information or executive functions, such as planning and controlling actions. Phosphocreatine buffers energy demand in space and time: it carries energy-rich phosphate groups from the mitochondria to the sites where ATP is used. This mechanism is offered as an explanation for reported improvements in working memory, reaction time and resistance to mental fatigue. The evidence cited is a paper described as a 2022 meta-analysis; whether it supports all of these findings is unresolved.

Creatine also affects how much water cells hold. When muscle cells take it up, it draws water in with it and increases cell volume. This swelling is thought to stimulate protein synthesis and reduce protein breakdown, which could contribute to building lean mass over time. The altered cell environment could favor building-up, or anabolic, signaling pathways. These include activation of mTOR, a central regulator of cell growth and protein synthesis.

Possible protective effects on nerve cells are also being studied. These include stabilizing mitochondrial membranes, reducing oxidative stress and possibly protecting against excitotoxicity during nerve cell injury or metabolic stress. Excitotoxicity is damage caused by excessive excitatory signals reaching nerve cells. No established clinical benefit in neurological diseases can be drawn here from these proposed or studied mechanisms.

Dose, form and timing on a vegetarian or vegan diet

Form

Creatine monohydrate is the best-studied form and is considered effective. It is made synthetically by combining sarcosine and cyanamide, so in principle it is suitable for a vegan diet. Whether the finished product is vegan also depends on the capsule shell and other ingredients. Other forms, such as creatine ethyl ester, buffered creatine or liquid creatine, have not shown better efficacy in clinical trials and are often more expensive.

Dose

The usual maintenance dose is 3 to 5 grams a day. That is enough to saturate muscle creatine stores over time and then keep them at that level. A loading phase of 20 to 25 grams a day, split into 4 to 5 separate doses over 5 to 7 days, speeds up saturation but is not necessary. Because of their lower starting stores, vegetarians and vegans might notice changes sooner with a loading phase. With the daily maintenance dose, however, the same state of saturation is reached after 3 to 4 weeks.

Some sources calculate the dose by body weight, especially for the loading phase:

For the loading phase, 0.3 grams per kilogram of body weight per day for 5 to 7 days is given.
For the maintenance phase, it is 0.03 grams per kilogram of body weight per day.
For a body weight of 70 kilograms, that works out to 21 grams a day during loading and 2.1 grams a day for maintenance.

The underlying information does not say when to use which of these dosing schedules.

Timing

Consistency matters more than the exact time of day. Creatine does not have to be taken right before or after training to work. With daily intake, creatine stores rise gradually and then stay full. There is some evidence that taking it with carbohydrates, or with a meal of carbohydrates and protein, may improve uptake through insulin-mediated transport. The extra effect is small, though. A 2022 literature review is cited for this.

No additional cofactors (supporting substances) are needed to absorb creatine. The body’s own production, however, depends on enough methionine being available. This amino acid comes from dietary protein or is recycled through the methylation cycle. In vegetarians and vegans with low vitamin B12 status, methionine metabolism may be impaired. In theory, this could also reduce the body’s own creatine production. An adequate B12 intake supports this metabolic pathway and could help the body make use of creatine.

Who might benefit most, and when caution is needed

Vegetarians and vegans are among the groups most likely to benefit from a creatine supplement. Their lower starting stores allow a larger absolute rise in muscle creatine content, so improvements in strength, power and cognitive performance may be more pronounced. This relationship has been described across different age groups. Older adults might benefit additionally, because muscle creatine content and mitochondrial function can decline with age.

Supplementation can also help people with higher starting stores, for example from eating red meat regularly, but the effect size may be smaller. Women may respond differently from men because hormones influence creatine metabolism. Estrogen appears to promote the body’s own creatine production. That could explain why some studies see smaller performance gains in women than in men. This explanation is offered with reference to a 2021 literature review. Women with low starting stores, including vegetarian and vegan women, can still benefit.

People with kidney disease should seek medical advice before taking creatine. The statement that creatine does not cause kidney damage in healthy people applies to that group and is not an unconditional guarantee for every dose and situation. Creatine can increase creatinine production and so make kidney test results harder to interpret. If kidney function is already impaired, creatine should be taken only under medical supervision.

Creatine is generally well tolerated. The main changes to be aware of are these:

The most common issue is mild digestive discomfort during a high-dose loading phase. It can often be reduced by splitting the daily amount into several servings or by skipping the loading phase.
In the first week, a weight gain of 1 to 3 pounds (about 0.45 to 1.36 kilograms) is typical, due to increased water stored inside cells.
This gain comes from water, not from extra body fat, and fits the mechanism described above.

Putting nutrient status in context before taking creatine

Whether a creatine supplement makes sense also depends on the rest of your nutrient status and on your metabolism. Outside of research settings, there is no widely available direct test for muscle creatine content. Various lab values can, however, give clues about the metabolic pathways involved in making and using creatine.

Vitamin B12 status is especially relevant on vegetarian and vegan diets. A B12 deficiency impairs the methylation cycle, which converts homocysteine back into methionine. Methionine is one of the three amino acids needed to make creatine. Low B12 levels occur on plant-based diets, especially when intake is not adequately secured. Serum B12 and methylmalonic acid (MMA) can be used to assess it. MMA is described as the more sensitive marker.

Homocysteine is another possible marker. Raised levels can point to impaired methylation. Possible causes include a deficiency in vitamin B12 or folate, as well as genetic variants in enzymes of this pathway. Raised homocysteine may be linked to altered creatine metabolism. If existing B12 and folate deficits are corrected and homocysteine returns to normal as a result, that could support the body’s own production and use of creatine.

Kidney function markers include creatinine and the estimated glomerular filtration rate (eGFR). The eGFR estimates how well the kidneys filter the blood. Recording these values before starting creatine can provide a baseline for later comparison. Creatine is converted to creatinine, which the kidneys excrete. Supplementation can raise creatinine levels. If the baseline values and the supplement use are not known, this can be misread as a decline in kidney function.

Inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP), along with metabolic markers such as hemoglobin A1c (HbA1c) and fasting insulin, add context about energy metabolism. HbA1c reflects average blood sugar levels over a longer period; fasting insulin measures insulin levels without prior food intake. Creatine is no substitute for treating underlying metabolic disorders. It is, however, described as a possible complement to measures aimed at better insulin sensitivity, less inflammation and more favorable energy availability. How to assess this role clinically remains open.

None of these lab values directly shows creatine stores, and none reliably predicts how much someone will benefit from a supplement. There is no evidence that all of these tests are needed before anyone takes creatine.

A supplement strategy that fits your starting point

Creatine is one of the most thoroughly researched dietary supplements. Whether taking it makes sense, however, depends on your starting point. Vegetarians and vegans typically have lower creatine stores, so in their case a supplement may be more likely to bring noticeable improvements in strength, exercise capacity and certain cognitive functions. For physical performance, the results described here relate mainly to short and repeated intense efforts. For endurance performance, the picture remains unclear.

A well-founded decision takes into account diet, training goals and health status, plus any medically relevant findings. Objective data can help. The lab values described here, however, do not directly measure muscle creatine stores and are no substitute for an individual assessment.

Frequently asked questions

Why are muscle creatine stores lower in vegetarians than in people on a mixed diet?

Vegetarian and vegan foods supply practically no creatine, because plants do not make any. The body produces roughly 1 gram a day on its own from arginine, glycine and methionine. This self-production, however, does not reach the combined supply of the body’s own creatine plus additional dietary intake that is possible when red meat and fish are eaten regularly. These foods contain about 2 to 5 grams of creatine per pound, or per roughly 454 grams.

Is creatine monohydrate suitable for a vegan diet?

Yes, the active ingredient itself is in principle suitable for a vegan diet. Creatine monohydrate is made synthetically from sarcosine and cyanamide, and no animal-derived starting materials are needed. As a pure ingredient, it contains no meat, fish or animal by-products, so it fits vegetarian and vegan diets. It is also the best-studied and an inexpensive form of creatine. With a finished product, it is still worth checking the other ingredients and, where relevant, the capsule shell.

How much creatine should vegetarians take per day?

A maintenance dose of 3 to 5 grams a day is given as an effective standard regimen for vegetarians and vegans. It gradually saturates muscle stores over about 3 to 4 weeks. An optional loading phase of 20 to 25 grams a day for 5 to 7 days speeds up saturation and may lead to changes sooner when starting stores are low. With consistent daily intake, both approaches ultimately reach the same state of saturation.

What cognitive benefits might creatine offer on a plant-based diet?

There are hints of improvement in certain kinds of memory. For a study published in 2011 in the British Journal of Nutrition, significant improvements on working memory tasks are described in vegetarian participants after six weeks of creatine. People on a mixed diet, by contrast, reportedly showed no significant change. The length of supplementation and the exact nature of the memory improvement are, however, unresolved in the account given here.

The phosphocreatine system in the brain buffers nerve cells’ energy needs during attention, storing information and executive functions such as planning and controlling actions. Such benefits might be larger when starting brain creatine stores are lower. Whether people on plant-based diets typically have lower brain stores is not established here, though. It cannot simply be inferred from lower muscle stores.

Can low vitamin B12 status affect how well the body uses creatine on a vegan diet?

A link is biochemically plausible. How strongly it affects the response to a creatine supplement remains open. Vitamin B12 is needed for the metabolic pathway that converts homocysteine back into methionine. Methionine is one of the three amino acids the body uses to make its own creatine. A B12 deficiency, which is common on vegan diets without adequate supplementation, impairs this pathway and could reduce the body’s own creatine production. B12 and homocysteine levels can help assess disturbances in this pathway. Testing them before starting creatine is therefore suggested; whether it makes sense in an individual case depends on that person’s health situation.

Does creatine help vegetarians build strength?

Yes, creatine can support strength gains. The studies described suggest larger gains than in people on a mixed diet. Because starting stores are lower, muscle phosphocreatine content can rise more after supplementation. In these studies, vegetarian participants improved their maximal strength, sprint performance and lean body mass more than people on a mixed diet following the same dosing schedule. The lower starting stores are offered as the explanation. The small studies, short supplementation periods and open questions about source attribution also limit how much these results can tell us.

Does a creatine loading phase make sense on a vegan diet?

A loading phase is optional. When starting stores are low, it may produce results sooner. The schedule described is 20 to 25 grams a day, split into 4 to 5 separate doses, for 5 to 7 days, followed by a maintenance dose of 3 to 5 grams a day. Anyone who wants to avoid possible digestive discomfort from the high starting dose can skip the loading phase. With the daily maintenance dose, muscle stores reach the same saturation after 3 to 4 weeks.

Which lab values are worth considering before taking creatine on a plant-based diet?

Vitamin B12 and methylmalonic acid help assess B12 status and possible effects on methylation metabolism. Then there is homocysteine, which can rise when this pathway is disturbed. Creatinine and the estimated glomerular filtration rate help assess kidney function. They can provide baseline values before creatine changes creatinine levels.

Fasting insulin, HbA1c and hs-CRP can add context about metabolism and inflammatory activity. They do not, however, directly show whether creatine will improve an individual’s energy supply or performance. Which tests make sense depends on the person’s health situation. The sources presented do not show that all of these tests are generally necessary.

References and sources

Solis MY, Artioli GG, Otaduy MCG, Leite CDC, Arruda W, Veiga RR, Gualano B (2017). Effect of age, diet, and tissue type on PCr response to creatine supplementation. Journal of applied physiology (Bethesda, Md. : 1985), 123(2), 407-414. https://doi.org/10.1152/japplphysiol.00248.2017. PubMed
Prokopidis K, Giannos P, Triantafyllidis KK, Kechagias KS, Forbes SC, Candow DG (2023). Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutrition reviews, 81(4), 416-427. https://doi.org/10.1093/nutrit/nuac064. PubMed
Candow DG, Forbes SC, Roberts MD, Roy BD, Antonio J, Smith-Ryan AE, Rawson ES, Gualano B, Roschel H (2022). Creatine O’Clock: Does Timing of Ingestion Really Influence Muscle Mass and Performance?. Frontiers in sports and active living, 4, 893714. https://doi.org/10.3389/fspor.2022.893714. PubMed
Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG (2021). Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients, 13(3). https://doi.org/10.3390/nu13030877. PubMed
Benton D, Donohoe R (2011). The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores. British Journal of Nutrition, 105(7), 1100-1105. https://doi.org/10.1017/S0007114510004733. PubMed

Further linked background information:

Editorial status: The German version translated here is based on the supplied source text. Independent clinical review is pending. The inconsistencies flagged above, and the claims that go beyond the directly attributed evidence, still need expert clarification.