Creatine has been a trendy topic in the body-building world for a few decades, and is touted as a supplement for its ability to aid in building muscle. In the 1990s, various Olympic athletes in sprinting and power events in the Barcelona games cited creatine as helping them beat the competition.
Creatine is an endogenous amino acid, found primarily in your muscles and also in your brain.
Your liver and kidneys produce about 1 gram of creatine per day, and most people get creatine in their diets from seafood and red meat. Synthetic creating supplements contain a lot more creatine than dietary sources.
Creatine is stored in muscles as phosphocreatine, and is used for energy. Supplementation with creatine increases your muscles’ supply of phosphocreatine, which is a form of stored energy.
Phosphocreatine is processed to produce ATP, or adenosine-triphosphate, a high energy molecule that is essentially the energy currency of cells.
Phosphocreatine donates a phosphate group to ADP (adenosine-diphosphate), the inactive form of ATP, to create ATP and creatine. More ATP means more energy, and better performance in the gym.
How creatine helps build muscles
Creatine helps build muscles in a couple of ways. First, by providing you more energy during your workout, creatine allows for higher reps, heavier weights and a longer workout. More reps and more weight will help you build bigger muscles faster.
In the short term, creatine makes your cells retain more water. Then, in the medium and long term, creatine can actually aid in muscle building. A 1999 study looked at short term creatine supplementation in men during a strength training program. The study found that body mass gain after medium-term creatine supplementation is likely due to dry matter (muscle) gain, and not just water retention.
Creatine’s effects on ATP can lead to better cellular signaling, which aids muscle repair and new muscle growth. The increase of cellular water content also likely has a beneficial effect on promoting muscle growth. Creatine may also affect levels of anabolic hormones like IGF-1, and may reduce the breakdown of proteins, leading to greater muscle mass by preventing muscle breakdown.
Can creatine supplementation increase brain creatine levels?
There is much evidence that supplementation with creatine increases skeletomuscular creatine levels, but the results have been somewhat mixed for the brain. Oral creatine supplementation can increase brain creatine levels, but the evidence is weaker than for muscular creatine levels.
There is some evidence that suggests oral creatine (from diet or supplements) has little to no effect on brain creatine levels: some studies have found no difference in brain creatine levels between vegetarians and omnivores.
The evidence is mixed. Also, any demonstrated increases in creatine levels following supplementation is much more modest in the brain than in the muscles.
This is partly due to the fact that muscles rely on external sources of creatine, while the brain gets most of its creatine stores endogenously. The enzymes needed to produce creatine are found throughout the nervous system, in the blood-brain barrier, neurons and oligodendrocytes, a type of glial cell.
Aside from dietary intake, other factors have been shown to lead to lower brain creatine levels. Reduced physical and cognitive activity can lead to lower creatine levels, as can depression, schizophrenia and panic disorders.
A 2003 study found that creatine supplementation improved cognitive performance on working memory and intelligence tasks in a group of vegetarian young adults. Since dietary creatine is found in red meat and fish, it would follow that vegetarians consume less creatine than non-vegetarians.
If you do not often consume seafood or red meat, it may be particularly beneficial to supplement with creatine, though the effects of supplementation will likely be more pronounced in your muscles than in your cognition.
Creatine Supplementation and Cognition
Creatine for Older Adults
In older adults, there is sufficient evidence that creatine supplementation can help reduce or prevent cognitive decline, and lead to better overall cognitive function. It may even help prevent the onset of neurological disease.
It has been suggested that creatine levels in the brain decrease as we age, and higher creatine levels in older or elderly adults tend to correlate with better cognitive functioning.
Lower creatine levels found in elderly adults may have more to do with reduced physical and cognitive activity than with the levels decreasing with age– some studies have found the same or similar creatine levels between healthy/active elderly adults and young adults.
This is further supported by the fact that more active elderly adults tend to have better cognitive function for longer, regardless of any supplementation.
Cognitive performance under stress
Some of the strongest evidence for creatine improving cognitive performance comes from a study on sleep deprived young adults. Sleep deprivation served as induced stress. The study concluded that young adults who had received creatine supplementation had better cognitive performance when stressed.
Generally, the best evidence for creatine’s effects on cognition are for cognition under stress. Studies have looked at creatine supplementation and its effects on cognitive performance following induced stress either through sleep deprivation or hypoxia.
One study looked at semi-professional mountain bikers who had supplemented with creatine, and assessed their performance on selected indices of cognitive performance following a time-trial track test– a high-energy consuming activity.
The mountain bikers who had supplemented with creatine had higher performance on the cognition tasks, showing that creatine may help improve cognition by reducing mental fatigue, even without added stress. However, similar studies have provided somewhat mixed results on this.
Creatine and Traumatic Brain Injuries
Another promising effect of creatine on cognition is in the treatment of traumatic brain injuries (TBIs). Traumatic brain injuries essentially cause an energy crisis in the brain by throwing off the brain’s metabolism of ATP, due to decreased blood flow and hypoxia. Brain creatine levels have been shown to drop following a mild TBI.
Creatine may help in recovery from mild TBIs by helping reset the brain’s cellular metabolism. Studies in mice and rats have shown that creatine supplementation following a mild TBI can significantly reduce the brain damage caused by the TBI.
Evidence in humans is more limited, but creatine supplementation in children with mild TBIs has shown that it can improve cognition, communication, self-care and behavior, and reduce many of the unpleasant symptoms of TBIs: dizziness, fatigue, and headaches.
Creatine has also shown activity as an antioxidant. Antioxidants reduce oxidative stress on our bodies by reducing free radicals, and this leads to anti-aging effects. This may contribute to creatine’s suggested potential to reduce risk of neurological diseases like Alzheimer’s or dementia in aging adults, and aid in recovery from TBIs.
How much creatine should I take?
Most online sources say that for athletic performance, most start out with 10-20 grams of creatine per day, and then switching to a “maintenance dose” of 2-5 grams per day. All of the studies mentioned prior used doses ranging from 5 to 20 grams of creatine, some starting at a higher dose and then switching to the lower maintenance dose following an initial period.
For more foods and supplements that may help improve cognition, check out this article!
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Bird S. P. (2003). Creatine supplementation and exercise performance: a brief review. Journal of sports science & medicine, 2(4), 123–132. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963244/
Francaux, M., & Poortmans, J. R. (1999). Effects of training and creatine supplement on muscle strength and body mass. European Journal of Applied Physiology and Occupational Physiology, 80(2), 165–168. https://doi.org/10.1007/s004210050575
Rae, C., Digney, A. L., McEwan, S. R., & Bates, T. C. (2003). Oral creatine monohydrate supplementation improves brain performance: A double–blind, placebo–controlled, Cross–Over Trial. Proceedings of the Royal Society of London. Series B: Biological Sciences, 270(1529), 2147–2150. https://doi.org/10.1098/rspb.2003.2492
Rawson, E. S., & Venezia, A. C. (2011). Use of creatine in the elderly and evidence for effects on cognitive function in young and old. Amino Acids, 40(5), 1349–1362. https://doi.org/10.1007/s00726-011-0855-9
Roschel, H., Gualano, B., Ostojic, S. M., & Rawson, E. S. (2021). Creatine supplementation and Brain Health. Nutrients, 13(2), 586. https://doi.org/10.3390/nu13020586
Sestili, P., Martinelli, C., Colombo, E., Barbieri, E., Potenza, L., Sartini, S., & Fimognari, C. (2011). Creatine as an antioxidant. Amino Acids, 40(5), 1385–1396. https://doi.org/10.1007/s00726-011-0875-5
