The bodybuilding supplement that boosts brainpower

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Creatine is often taken by people looking to build muscle. Now scientists are investigating the effects this chemical has on our cognition and mood.

Creatine helps to manage the energy available to our cells and tissues, and there’s emerging evidence that some people might benefit from creatine supplementation.

From reducing post-viral fatigue to improving cognitive function in people who are stressed, and even boosting memory, creatine supplements may provide some people with a significant cognitive boost. It’s also been speculated that creatine might help to alleviate symptoms in patients with Alzheimer’s disease and improve mood.  So, are you getting enough creatine? And when is it a good idea to take a supplement? 

The birth of creatine research

But over the last two decades, studies have been starting to reveal other potential health benefits of creatine supplements. One of the biggest areas of research is cognitive function, given that creatine plays a role in neogenesis – the formation of new neurons in the brain.  

“It was assumed that the body’s uptake of creatine cells is marginal, therefore it wouldn’t work for only one night of sleep deprivation – until we did our study,” says Gordjinejad, a research scientist at the Forschungszentrum Jülich research centre, in Germany.

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It’s thought that creatine may help to protect unborn babies from a lack of oxygen in the womb (Credit: Getty Images)

Gordjinejad found that processing speed was much faster in the creatine group compared with the placebo group. Gordjinejad doesn’t know exactly why, but he suspects it’s because the sleep deprivation and cognitive tasks put participants’ neurons under stress, and this triggers the body to take in more creatine.

“If the energy demand is high from cells, then phosphocreatine (which provides energy for short bursts of effort) comes in and acts like an energy reservoir,” says Gordjinejad, who explains that dietary creatine can help this reserve to fill up again.

If cells need a lot of energy for a short period of time, phosphocreatine can come in and act as an energy reserve, Gordjinejad explains.

Though Gordjinejad’s study was small, he believes his findings show that creatine could potentially help to overcome the negative effects of sleep deprivation – but only in the short-term, until you sleep.

However, the participants in Gordjinejad’s study took 10 times the recommended daily dose of creatine – they had 35g, which is around half a glass full of the powdered supplement. (Do not try this at home.) This dose, Gordjinejad says, would pose a risk to people with kidney problems, and in the general population it could cause stomach pains.

Gordjinejad plans to conduct a similar trial where he gives participants a smaller dose. He hopes that, in the future, creatine could be used in this way by people who have an unexpected prolonged period of being awake, such as emergency service workers, or students doing their exams.  

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Creatine is primarily stored in muscle tissue and the brain, where it helps to provide a supply of readily accessible energy (Credit: Getty Images)

However, McMorris says this may be because studies he looked at used various different creatine supplement regimens. Also, he explains that many studies relied on outdated cognition tests. “Some date back 1930s – they’re too easy, we don’t push people enough,” he says.

But while McMorris says there’s not enough evidence to draw any conclusions, he believes it’s an area worth more research.

Cognitive performance aside

One recent study involving 25,000 people found that, among participants aged 52 and above, for those who had the highest levels of creatine in their diets, each additional 0.09g of creatine over a two-day average was linked to a 14% reduction in cancer risk.

“One reason creatine might help people with depression is that it’s used to a significant degree for energy production and usage in the brain,” says Douglas Kalman, adjunct professor of graduate sports nutrition at Florida International University. If creatine levels are low, this affects energy production in the brain, but also the levels of neurotransmitters – chemical signals that allow nerve cells to communicate with each other – he says. This, in turn, can affect a person’s mood.

Creatine’s role throughout the whole lifecycle is now being researched

There is even some research suggesting that creatine could even help with chronic conditions. In 2023, Ostojic and colleagues from the University of Novi Sad, Serbia, tested the effects of creatine supplements in 19 patients with long Covid.

The researchers gave 4g of creatine to half the participants, and a placebo to the other half. Then they monitored their symptoms, and the levels of creatine in their brain and muscles. After six months, the team found that those who received extra creatine had improved symptoms, including less brain fog and concentration difficulties. The more severe the disease, the lower levels of creatine in their bodies had been at the beginning of the study.

“The hypothesis was that the brain, under the stress of long Covid, depletes levels of creatine, which is a critical energy-supplying substance,” Ostojic says.

While creatine isn’t a cure for long Covid, Ostojic concludes, it could provide some benefits. But there’s more work to do; he wants to better understand potential gender differences at play when it comes to creatine and conditions such as long Covid.

Ostojic adds that women tend to lose more creatine through their urine and have lower levels of muscle mass compared to men. Since this is where most creatine is stored, it makes sense that women would have less creatine overall. “My preliminary feeling is that women with long Covid might respond better to creatine supplementation [than men],” he says.

The lifecycle

The cells and tissues in our bodies use creatine as an energy source at every stage of reproduction, says Stacey Ellery, an NHMRC Peter Doherty early career research fellow at Monash University Australia. This incudes sperm motility, uterine and placental development, as well as foetal growth and breastmilk.  

Creatine may also have an important role in reducing the damage caused by a lack of oxygen, says Ellery, such as to foetuses during birth or in the womb. A lack of oxygen can restrict the ability of cells to generate sufficient energy in crucial tissues, such as the placenta and foetal brain, which can stunt their growth or impact their long-term health, she explains. But in the very short term, creatine can allow cells to release energy without needing oxygen.

“A creatine supplement can boost the creatine available to cells for energy production during oxygen deprivation,” says Ellery. “Consider it like charging a spare battery for a power outage. Keeping the cells energised lowers the risk of serious harm to the developing baby.”

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Creatine has become a popular supplement for those looking to build muscle – but in some people it might be beneficial for other reasons too (Credit: Getty Images)

A recent study found that six out of 10 women didn’t consume the daily creatine intake recommended by researchers

More creatine seems to be sent from the mother to the baby during long and difficult labours, says Ellery, and lower levels of creatine in mothers’ blood during the final months of pregnancy have been linked to a higher incidence of stillbirth, preterm birth, smaller babies and admission to intensive care. However, it is unclear why this is the case, or whether supplementing with creatine would be helpful.

And at the other end of the lifecycle, creatine may also help with our muscle health as people develop sarcopenia, an age-related condition that reduces muscle strength and mass. “As people get older, they have less muscle tone,” Kalman says. “And studies have shown that creatine could help reduce the amount of sarcopenia.”

The risks of taking creatine

Though some people might benefit from supplementing with creatine, it can come with some side-effects, including water retention, muscle cramping and nausea. Creatine also isn’t suitable for some people, including those with kidney or liver problems or who are taking certain medications. While creatine is thought to be broadly safe and well-tolerated, there have been rare cases of major adverse events associated with the supplement, such as liver failure. 

Are we getting enough creatine?

Most people are able to get creatine from their diets, Ostojic says, but vegans may be at risk of not getting enough.

Creatine is a naturally occurring compound in the body, which means it isn’t defined as “essential”. Essential nutrients can’t be synthesised by the body and, therefore, must be supplied from foods. However, some researchers, including Ostojic, argue that creatine should be categorised as semi-essential, as it appears we can’t synthesise enough.

“A couple of studies suggest people who don’t get any creatine from food have lower levels of creatine in their muscles, suggesting they’re not able get it to the optimum point,” says Ostojic.

Creatine is not a silver bullet, he says, but argues it should be evaluated properly and evidence-based guidance should given to the population.

Despite being the focus of many studies – and lacking in many people’s diets – research on creatine’s health benefits throughout our lives is still in its early stages.

Researchers including Ellery are hopeful, though, that the rising academic interest in creatine will eventually translate into public health interest, so that we know which population groups would benefit from creatine supplements.

* All content within this column is provided for general information only and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you’re in any way concerned about your health.

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