Creatine Supplementation for Brain HealthPublished on Thursday, January 26, 2023 by
Many people think of muscle building when they hear the word creatine.
Creatine is a protein derivative. It is composed of three amino acids, arginine, glycine, and methionine. Creatine is naturally obtained from foods (highest quantities in meats, fish, and poultry) and can be synthesized in our bodies (mostly in the liver and kidneys).
Creatine is found in all the cells in our bodies, with the largest stores of creatine found in skeletal muscles. We store creatine as creatine phosphate (CP) which plays an essential role in metabolism, allowing us to very quickly recharge adenosine triphosphate (ATP). This is vital, as ATP is the primary fuel used to directly power many cellular functions, including muscle contraction.
In the 1990s, pioneering research found that supplementing creatine to the diet could significantly increase muscle CP stores. In theory, maximizing CP stores in muscles should enhance several aspects of muscular performance. Over the past three decades, good evidence has accumulated to support this theory, finding beneficial effects of creatine supplementation on numerous aspects of muscular performance, including enhancing power retention over repeated sprints, maximum strength, and muscle gain from weight training.
Creatine in the brain
Brain tissue is highly energetic, and constantly uses ATP stores to carry out its functions. Just as optimizing CP stores in the skeletal muscles helps muscle function, there is gathering evidence that increased brain CP stores can enhance brain function in a variety of ways. Brain injury or transient stressors such as sleep deprivation lower brain CP stores. In contrast, higher dietary creatine intake has been associated with better short-term memory.
Creatine supplementation can increase brain CP content. In terms of available measurable performance effects on brain function, research is still in the early stages. So far there is some promising evidence that creatine supplementation may be a useful adjunct therapy for treating depression and PTSD. Animal studies have found that creatine supplementation may be protective against traumatic brain injury.
Are there any negative side effects? What is the best use of creatine?
Creatine has been exhaustively studied for over thirty years. Remember, creatine is synthesized in your body and you obtain some creatine naturally in foods you eat (even trace amounts from plant sources). Supplementing creatine at recommended doses, namely 3-5g/day, has not been associated with any adverse risks.
Creatine dietary supplements come in a variety of formulae (creatine monohydrate, creatine citrate, and creatine alkaline), with creatine monohydrate being the original, and most-studied version. Competing versions of creatine are marketed to provide greater absorption than their competitors, though no evidence supports the superiority of one form of creatine over another.
If you choose to supplement creatine, a daily dose of 3g per day has been found to increase muscle creatine content within 4 weeks of supplementation. Creatine is taken up more easily in skeletal muscles than in the brain, so a higher dose, perhaps 5g/day, might be more effective at enhancing brain CP levels. Of course, it is always best to consult your medical provider before starting any new supplements.
- Amital, D., Vishne, T., Roitman, S., Kotler, M., & Levine, J. (2006a). An 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. (2006b). 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, Edimar & Forbes, Scott & Borges, Elvis & Candow, Darren & Machado, Lacy & Machado, Marco. (2022). Association between dietary creatine and visuospatial short-term memory in older adults. Nutrition and health (Berkhamsted, Hertfordshire). 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<0822:eocsar>2.0.co;2
- 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://doi.org/10.1002/1531-8249(200011)48:5%3C723::AID-ANA5%3E3.0.CO;2-W
Alexander KochPhD, CSCS