Creatine and Cognitive Health: more than just a gym supplement?

Creatine is well-loved in the fitness world for its ability to enhance performance, support muscle growth, and facilitate recovery by helping cells regenerate energy during brief periods of exercise. Recently, there has also been a buzz around creatine for its potential as a brain booster for supporting cognition. So, should we believe the hype?

Some studies have found promising results, suggesting creatine supplementation may support cognitive functions like memory in certain situations, but others find no effect,

and our understanding is still developing. We delve into the evidence and main unanswered questions below!

What is creatine, and what has it typically been used for? 

Creatine is a compound made in our bodies from amino acids and mainly stored in muscles, with smaller amounts elsewhere, like the brain. We can also source it externally from food like meat and fish, or take it as a supplement, usually in the form of creatine monohydrate. 

Creatine plays an important role in rapid energy production, particularly when demand is high, helping regenerate adenosine triphosphate (ATP), our body’s main energy currency. This makes it perfect for supporting exercise performance – helping you to push for that extra rep or sprint - as well as supporting muscle building and recovery. 

What is creatine’s role in the brain? 

But, creatine doesn’t just fuel our muscles; emerging evidence suggests that it may also support some aspects of cognitive health. Creatine also helps meet the fluctuating demands of energy-hungry neurons, regenerating ATP to maintain energy balance and brain bioenergetics. It may also support mitochondrial function and protect against harmful processes like oxidative stress, excitotoxicity, and programmed cell death. Creatine is synthesised in the brain, but it can also pass through the blood-brain barrier, and supplementation has been shown to increase brain creatine levels. So could this translate into a benefit for our cognition?

What’s the current status of cognitive research? 

Although animal studies have found cognitive improvements from creatine supplementation, human studies present a more mixed picture. Whilst some Randomised Controlled Trials (RCTs) suggest modest benefits for functions like memory, attention, executive function, and tests of intelligence/reasoning, others haven’t found effects. A closer look may be needed, as outcomes might depend on who is taking the supplements and under what conditions. 

"Creatine also helps meet the fluctuating demands of energy-hungry neurons, regenerating ATP to maintain energy balance and brain bioenergetics"

People with lower creatine levels

Those with the lowest creatine levels seem to have the largest increase in blood and muscle levels with supplementation, and evidence suggests they may get the biggest brain boost too. Some research suggests creatine might offer particular benefits for vegetarians/vegans, who are likely to have lower levels, although other trials haven’t confirmed this, so it’s not yet clear. 

Situations of high demand or stress

Supplementation might be especially helpful when the brain is under high mental/physical stress, helping buffer increased energy demand; cognitive benefits have also been found following sleep or oxygen deprivation, although results are mixed. 

Older adults

Older adults may be a promising group, as creatine levels and neural energy processes likely decline with age. Muscular and bone benefits have been identified from supplementation, and higher creatine dietary intake has been associated with cognitive protection. There have been some encouraging findings; however, trials investigating this are scarce, and with mixed results. 

Neurodegenerative diseases

Based on creatine’s probable role in brain function and protection, there is growing interest in creatine as a neuroprotective therapy for neurodegenerative disease. In Alzheimer’s Disease, brain energy processes (such as glucose metabolism, blood flow and ATP levels) are disrupted. There may also be a disruption in creatine pathways, and lower creatine levels are found in those at higher genetic risk. Animal studies have suggested neuroprotective benefits, although results are mixed. Human studies are urgently needed to understand whether there are clinical effects, although an early-stage pilot study has provisionally indicated potential cognitive benefits – so watch this space! 

Moreover, Parkinson’s Disease is associated with the harmful neural processes that creatine may help protect against. Animal studies suggest it could help slow neurodegeneration; however, RCTs looking at Parkinson’s progression following creatine supplementation have been disappointing, and trials haven’t yet investigated cognition directly. Whilst some initial evidence suggests potential benefits for daily tasks or delaying cognitive decline in those with Mild Cognitive Impairment, findings remain tentative.

Younger, cognitively healthy people

One group where creatine’s cognitive effect remains especially unclear is young, cognitively healthy individuals. Although positive results exist, especially with more cognitively demanding tasks, studies have been inconsistent, which may not be unexpected if brain energy processes are working optimally. 

…and what about women's health?

Whilst most creatine research has focused on men, research hints at potential sex differences, with women’s physiology and hormones possibly influencing response to supplementation. Women tend to produce less creatine naturally and get less from their diet. Conversely, they seem to retain more in their muscles, potentially meaning the optimal dose might be different for women than men. Sex hormones, such as estrogen, may also influence how the body processes creatine, meaning needs may shift across women’s lives, including during the menstrual cycle, pregnancy, and menopause. 

"As creatine can support the brain’s energy buffering system, could it hold promise as a way to help [the brain fog or fatigue in menopause]?"

So how might this impact cognitive health? An animal study found female-only cognitive benefits of supplementation, and a study in young women showed memory and reaction-time improvements. However, meta-analyses have reported mixed results, and a small study in postmenopausal women didn’t find cognitive benefits. Overall, research is lacking and hasn’t directly tested cognition through the menstrual cycle or menopause, so there is a lot more work to be done. Closing this gap may be particularly relevant for hormonal transitions such as perimenopause/menopause, when many women experience brain fog or fatigue, and changes in the brain’s energy use. As creatine can support the brain’s energy buffering system, could it hold promise as a way to help? This is currently unanswered, but there are a lot of exciting questions for researchers to investigate in future! 

What is next for creatine and cognition?

Overall, the evidence on how creatine affects cognitive health is mixed, with any benefits likely to be modest. Still, even small improvements might be meaningful in everyday life, so it’s worth investigating further. 

Key questions remain, such as what cognitive benefits creatine supplementation has in different populations, and whether it might be especially beneficial for women or those with neurodegenerative disease. We also don’t know how much creatine might be best for brain health. As uptake is lower in the brain than elsewhere, could higher doses or longer interventions have different cognitive effects? There are also some limitations, such as small sample sizes and the fact that many studies don’t measure brain creatine levels. Plus, as there is evidence that more cognitively demanding tasks show benefits of supplementation, the choice of test might matter, especially in cognitively healthy individuals. 

So, we may not be able to say that creatine is doing all the heavy lifting in our brains just yet, but it’s an exciting and developing topic. With more high-quality research, we can continue building the picture of how it might support cognitive health across different stages of life.   

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This article was written by Emily Budden and edited by Julia Dabrowska, with graphics produced by Ishika Joshi. If you enjoyed this article, be the first to be notified about new posts by signing up to become a WiNUK member (top right of this page)! Interested in writing for WiNUK yourself? Contact us through the blog page and the editors will be in touch.