Could Creatine and HMB Improve Functional Muscle Strength?

This article taken from Dr. Benjamin Bikman’s "Research Reviews Podcast".

Bikman is a scientist and professor known for his research on metabolic health, insulin resistance, and their connection to obesity, diabetes, and dementia. He holds a Ph.D. in Bioenergetics, is a professor at Brigham Young University, and is the author of the book, "Why We Get Sick". 

Professor Bikman

Dr. Bikman reviews a 2023 study published in JRO Science titled "Combined Creatine and HMB Supplementation Improves Functional Strength Independent of Muscle Mass in Physically Active Older Adults."

Conducted as a double-blind, placebo-controlled crossover trial, the study showed that six weeks of daily creatine (3g) and HMB (3g) supplementation significantly improved strength and endurance in older adults -- even without substantial gains in muscle size. Performance increases included 25–40% improvements in leg, arm, and core strength.

The strength gains were largely attributed to neuromuscular adaptations rather than muscle growth, suggesting that creatine and HMB (beta-hydroxy beta-methylbutyrate) enhanced how muscles functioned, not just how big they were.

Bikman emphasizes that for aging populations, improving muscle quality -- via better motor unit recruitment and energy metabolism -- may be just as important as preserving muscle quantity.

Details of the Podcast

Today we're looking at a fascinating paper that was published very recently in the journal, JRO Science. It's titled, combined Creatine and HMB cos Supplementation Improves Functional Strength independent of Muscle Mass in physically Active Older Adults. The study was conducted in Spain at the University of Bergos. Now most of us know that muscle strength and mobility are critical for healthy aging, the gradual decline of muscle, what we call sarcopenia is one of the biggest contributors to frailty and loss of independence in older adults, exercise helps of course, but as we age, our muscles don't respond to training as effectively as they used to.

This phenomenon called anabolic resistance means we need to do more or perhaps combine strategies to preserve strength and independence.

That's where the study comes in. The researchers tested whether supplementing with creatine, monohydrate and beta hydroxy, beta methyl butyrate, or HMB could enhance strength and function in older adults, not just by adding muscle mass, but by improving muscle quality and neuromuscular performance.

Let's set the stage with a quick refresher on these two compounds. Creatine, as any athlete would know, helps muscles generate rapidly a TP, the molecule that powers something like muscle contractions. It supports high intensity efforts, speed recovery, and even stimulates protein synthesis through the mTOR pathway. In older adults, creatine has been shown to help maintain lean mass and strength and may even improve energy metabolism and reduce inflammation.

HMB on the other hand, is a metabolite of the amino acid leucine, the same leucine that triggers muscle building pathways. HMB has strong anti catabolic effect, meaning it helps prevent muscle breakdown. It stabilizes muscle cell membranes and can reduce markers of muscle damage.

The theory behind combining them is simple. Creatine helps muscles generate more power and recover faster. While HMB helps preserve and protect that muscle tissue. So together, they might provide a double benefit, especially in older adults who are much less responsive. Maybe to exercise alone.

The researchers designed a randomized double blind, placebo controlled crossover trial that is the gold standard for this kind of work. 30 active older adults aged 60 and up went through two six week intervention periods. In one. They received daily supplements of three grams of creatine and three grams of HMB in the other a placebo. Each phase was separated by a three week washout period to clear any residual effects. During both periods, participants followed an integral physical conditioning program that's just a well-structured exercise routine with four supervised sessions per week.

So what did they find? First when it came to body composition, the changes were subtle after six weeks of creatine plus, HMB participants showed slight increases in lean and muscle mass and small decreases in fat mass, but these differences weren't statistically significant.

In other words, the supplements didn't necessarily build bigger muscles, but here's where things get interesting.

Despite the minimal changes in muscle size, functional strength improved dramatically. Participants taking creatine and HMB became significantly stronger in multiple performance measures, including leg and back strength, arm flexion strength, and several endurance tests like pushups, crunches, dumbbell curls, and even holding a pull-up position. For example, their leg and back strength increased by nearly 25% arm flexion strength by around 30%, and pushup performance improved by more than 40% compared to placebo. That is a striking result for just six weeks of supplementation.

But perhaps the most important finding was why this happened. When the researchers ran regression analysis, which is just them essentially trying to determine whether these improvements were due to more muscle mass or something else, they found that the gains in strength were largely independent of muscle growth.

This suggests that the benefits were driven not by bigger muscles, but by smarter or more efficient muscles.

The team concluded that neuromuscular adaptations were likely the key driver, things like improved motor unit recruitment, better synchronization of muscle fibers and enhanced neural drive from the brain to the muscle.

In simpler terms, creatine and HMB didn't just build muscle. They helped the body use the muscle it already had more effectively, and that's an incredibly valuable insight for older adults. We often assume that muscle size equals strength, but this study reinforces the idea that quality matters as much as quantity.

Improving how muscles fire coordinate and respond can significantly enhance function even without large increases in mass. Mechanistically, creatine likely supported rapid energy regeneration and a TP recycling helping muscles perform more repetitions before fatigue sit. In. Meanwhile, HMB may have reduced muscle breakdown and improved recovery between workouts.

Together, they seem to have created an optimal environment for the nervous system and muscles to adapt synergistically to training.

Now, the authors note that there are some limitations. The sample size was relatively small, just 30 participants, and the study was only six weeks, and they didn't include groups that took creatine or HMB alone. So it's not clear how much each supplement contributed independently.

Still, for a carefully controlled double-blind crossover study, the results are compelling. It provides strong evidence that combined creatine and HMB supplementation alongside structured exercise can significantly enhance strength and endurance in older adults, even in the absence of large muscle gains.

From a practical perspective, this could be a game changer. Maintaining functional strength means reducing fall risk, improving mobility and preserving independence goals that are central to healthy aging. And since both creatine and HMB have excellent safety profiles, this combination appears to be a promising accessible strategy for older adults who want to stay strong and active.

I'm Professor Benjamin Bikman and this has been a research review. Thanks for joining me to explore the cutting edge of exercise and nutritional science for healthy aging. Stay curious and stay healthy.

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