Article

Creatine Supplementation for Brain Health

Published on Thursday, January 26, 2023
by Alexander Koch

Health & Wellness

Creatine: Beyond Muscle Performance

Many people think of muscle building when they hear the word creatine.

Creatine is a protein derivative composed of three amino acids: arginine, glycine, and methionine. Creatine is naturally obtained from foods—particularly meats, fish, and poultry—and can also be synthesized in the body, primarily in the liver and kidneys.

Creatine is found in all the cells in our bodies, with the largest stores located in skeletal muscle. In muscle tissue, creatine is stored as creatine phosphate (CP), which plays an essential role in metabolism by helping rapidly regenerate adenosine triphosphate (ATP). ATP is the primary fuel used to power many cellular functions, including muscle contraction.

In the early 1990s, pioneering research demonstrated that dietary creatine supplementation could significantly increase muscle creatine stores. In theory, maximizing CP stores in muscles should enhance several aspects of muscular performance. Over the past three decades, strong evidence has accumulated supporting this idea. Research has shown that creatine supplementation can improve muscular performance in several ways, including enhancing power output during repeated high-intensity efforts, increasing maximal strength, and supporting muscle growth when combined with resistance training.

Creatine in the Brain

Brain tissue is highly energetic and constantly uses ATP to carry out its functions. Just as optimizing CP stores in skeletal muscles supports muscle performance, there is growing evidence that increasing creatine stores in the brain may enhance brain function in several ways.

Brain injury and transient stressors such as sleep deprivation may reduce brain creatine levels, potentially impairing cognitive performance. In contrast, higher dietary creatine intake has been associated with improved short-term memory in some populations.

Creatine supplementation has been shown to increase creatine content in the brain. However, research examining measurable effects on cognitive performance is still emerging. Some early evidence suggests that creatine supplementation may serve as a useful adjunct therapy in treating certain mental health conditions, including depression and post-traumatic stress disorder. Additionally, animal studies suggest that creatine supplementation may provide protective effects against traumatic brain injury.

Are There Any Negative Side Effects? What Is the Best Way to Use Creatine?

Creatine has been extensively studied for more than thirty years. Because creatine is naturally produced in the body and obtained through foods we eat, it is generally considered safe for healthy individuals when used at recommended doses.

Supplementing creatine at typical doses—generally around 3–5 grams per day—has not been consistently associated with adverse health risks in healthy adults.

Creatine supplements are available in a variety of forms, including creatine monohydrate, creatine citrate, and creatine alkaline. Creatine monohydrate is the original and most widely studied form. While some products claim superior absorption or effectiveness, current research does not show clear evidence that alternative forms are superior to creatine monohydrate.

If you choose to supplement creatine, a daily dose of about 3 grams per day can increase muscle creatine stores within approximately four weeks. Because skeletal muscle absorbs creatine more readily than brain tissue, slightly higher doses—around 5 grams per day—may be more effective at increasing brain creatine levels.

As with any supplement, it is always best to consult with a healthcare provider before starting creatine supplementation, particularly if you have underlying health conditions or take medications.

_{Amital, D., Vishne, T., Roitman, S., Kotler, M., & Levine, J. (2006). Open study of creatine monohydrate in treatment-resistant posttraumatic stress disorder. The Journal of clinical psychiatry, 67(5), 836–837.}_{https://doi.org/10.4088/jcp.v67n0521c}
_{Amital, D., Vishne, T., Rubinow, A., & Levine, J. (2006). Observed effects of creatine monohydrate in a patient with depression and fibromyalgia. The American journal of psychiatry, 163(10), 1840–1841.}_{https://doi.org/10.1176/ajp.2006.163.10.1840b}
_{Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. Journal of the International Society of Sports Nutrition, 18(1), 13.}_{https://doi.org/10.1186/s12970-021-00412-w}
_{Birch, R., Noble, D., & Greenhaff, P. L. (1994). The influence of dietary creatine supplementation on performance during repeated bouts of maximal isokinetic cycling in man. European journal of applied physiology and occupational physiology, 69(3), 268–276.}_{https://doi.org/10.1007/BF01094800}
_{Delpino, F. M., Figueiredo, L. M., Forbes, S. C., Candow, D. G., & Santos, H. O. (2022). Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: A systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 103-104, 111791.}_{https://doi.org/10.1016/j.nut.2022.111791}
_{Dolan, E., Gualano, B., & Rawson, E. S. (2019). Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. European journal of sport science, 19(1), 1–14.}_{https://doi.org/10.1080/17461391.2018.1500644}
_{Forbes, S. C., Cordingley, D. M., Cornish, S. M., Gualano, B., Roschel, H., Ostojic, S. M., Rawson, E. S., Roy, B. D., Prokopidis, K., Giannos, P., & Candow, D. G. (2022). Effects of Creatine Supplementation on Brain Function and Health. Nutrients, 14(5), 921.}_{https://doi.org/10.3390/nu14050921}
_{Harris, R. C., Söderlund, K., & Hultman, E. (1992). Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clinical science (London, England : 1979), 83(3), 367–374.}_{https://doi.org/10.1042/cs0830367}
_{Kious, B. M., Kondo, D. G., & Renshaw, P. F. (2019). Creatine for the Treatment of Depression. Biomolecules, 9(9), 406.}_{https://doi.org/10.3390/biom9090406}
_{Oliveira, E. F., Forbes, S. C., Borges, E. Q., Machado, L. F., Candow, D. G., & Machado, M. (2023). Association between dietary creatine and visuospatial short-term memory in older adults. Nutrition and health, 29(4), 731–736.}_{https://doi.org/10.1177/02601060221102273}
_{Rawson, E. S., & Volek, J. S. (2003). Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. Journal of strength and conditioning research, 17(4), 822–831.}_{https://doi.org/10.1519/1533-4287(2003)017}
_{Sullivan, P. G., Geiger, J. D., Mattson, M. P., & Scheff, S. W. (2000). Dietary supplement creatine protects against traumatic brain injury. Annals of neurology, 48(5), 723–729.}_{https://pubmed.ncbi.nlm.nih.gov/11079535/}