Creatine Supplementation for Brain and Cognitive Function- What does the research say?

Creatine has long been regarded as one of the most extensively studied and scientifically validated supplements, particularly for its ergogenic effects in athletes. It is primarily known for enhancing physical performance by increasing lean muscle mass, strength, and energy availability during high-intensity exercises. However, the focus has expanded beyond the gym, with creatine now being explored as a potential therapeutic agent in medical conditions like Alzheimer’s and Parkinson’s diseases. Let’s dive into the biochemistry of creatine and its growing role in brain health and cognitive function.

Creatine’s Role in Energy Production

At its core, creatine works as a major player in the body’s energy system. Biochemically, creatine phosphate (PCr) stores in muscle tissue donate a phosphate group to adenosine diphosphate (ADP) to regenerate adenosine triphosphate (ATP), the body’s primary energy carrier. This process is especially critical during short bursts of high-intensity exercise. As PCr stores become depleted, the body’s ability to rapidly resynthesize ATP diminishes, which is why intense, maximal-effort activities become harder to sustain. Supplementation with creatine monohydrate can boost these PCr reserves, leading to improved performance during high-intensity exercise and faster recovery between bouts.

Creatine and Brain Health: A Cognitive Connection

The brain, though far less discussed, also relies on creatine to meet its high energy demands. Roughly 20% of the body’s energy is used by the brain, and creatine helps support the synthesis of ATP within brain cells. As with muscles, creatine supplementation may improve the brain’s ability to perform cognitive tasks that require quick and efficient energy, such as decision-making, problem-solving, and memory retention.

Recent studies suggest that creatine monohydrate supplementation can enhance short-term memory and intelligence, particularly under conditions of mental fatigue or sleep deprivation. (McMorris et al, 2007) This makes it an attractive option for professionals, students, and athletes alike who seek to maintain mental sharpness under stress. For older adults, creatine supplementation has been proposed as a way to mitigate the natural decline in cognitive function associated with ageing, as creatine supports energy production in brain cells.

Creatine as a Neuroprotective Agent

Beyond cognitive enhancement, creatine is also being evaluated for its neuroprotective effects. Conditions such as Alzheimer’s, Parkinson’s, and Huntington’s diseases are linked to mitochondrial dysfunction and oxidative stress in the brain. Creatine’s ability to act as an antioxidant, reducing harmful reactive oxygen species (ROS), could make it a valuable tool in slowing the progression of these diseases. Preliminary studies have shown that creatine supplementation may help preserve neuron function and slow cognitive decline by maintaining energy stores in the brain and protecting against oxidative damage.

Additionally, research cited in Nutrients suggests that creatine could aid in recovery from brain injuries, such as concussions. In these cases, creatine has been associated with reduced symptoms of dizziness, headaches, and mental fatigue, likely due to its role in restoring energy levels in injured brain tissue. (Roschel et al., 2021)

Therapeutic Applications in Medical Conditions

As we know creatine is intricately involved in numerous metabolic pathways, it is now being explored in various patient populations. For instance, in neurodegenerative diseases like Alzheimer’s and Parkinson’s, creatine monohydrate supplementation may help support brain energy metabolism, potentially slowing disease progression. Similarly, its antioxidant properties can mitigate oxidative stress, a factor linked to neuronal damage in these conditions.

Research is also being conducted on creatine’s role in addressing cognitive impairments linked to ageing, poor lifestyles, and traumatic brain injuries. (Marshall et al., 2022) The restoration of cellular energy levels through creatine supplementation has shown promise in alleviating cognitive decline and improving quality of life in affected individuals.

Supplementation Protocols: What Works Best?

Creatine monohydrate (CrM) is the most widely used and researched form of creatine supplementation. The most common method is the “loading phase,” where individuals consume approximately 0.3 grams of creatine per kilogram of body weight per day (roughly 20 grams total) for 5-7 days, followed by a “maintenance phase” of 3-5 grams per day. This protocol has been shown to increase muscle creatine stores by 10-40%, depending on the individual’s baseline creatine levels. For those who consume little to no meat or fish (common dietary sources of creatine), the increase in creatine stores can be even more significant.

Alternatively, a number of studies in the Journal of the International Society of Sports Nutrition suggest that smaller daily doses of creatine monohydrate (around 3 grams per day) can also be effective, though it may take longer to see the same results as with the loading phase. (Antonio et al., 2021) Regardless of the protocol, creatine supplementation has been consistently shown to increase creatine and PCr stores in both muscle and brain tissue.

Safety of Creatine Supplementation

Despite lingering myths about creatine’s safety, it is one of the most well-researched and safest supplements available. Long-term studies show that creatine monohydrate is safe, even at high doses (up to 30 grams per day) over extended periods. (Andres et al., 2016). It has been approved by the FDA (Food and Drug Administration, US) as a dietary supplement and, when used correctly, has not been associated with any harmful side effects. In the UK, The Food Standards Agency does not provide specific guidance on creatine, rather it emphasises that all food supplements, including creatine, should be used responsibly and in line with manufacturer recommendations. However, The UK Nutrition and Health Claims Committee (UKNHCC) does point out that consuming more than 5 grams of creatine at once can result in gastrointestinal issues and that a cause-and-effect relationship has not been established between the consumption of ≤3g per day creatine and improved cognitive function, meaning further research is needed in this specific arena.

While creatine supplementation is widely recognised for its benefits in physical performance, its potential impact on brain health and cognitive function is an exciting area of emerging research. The evidence suggests that creatine may not only support cognitive tasks and enhance mental sharpness, especially under stress or fatigue, but it also holds promise as a neuroprotective agent in conditions like Alzheimer’s and Parkinson’s diseases. Additionally, its antioxidant properties and ability to restore energy levels make creatine a candidate for therapeutic applications in neurodegenerative diseases and brain injuries. However, while the current findings are promising, more research is needed to fully understand creatine’s effects on cognitive function, especially regarding long-term supplementation and its broader application in clinical settings.