Body-building creatine could help brain health. Should we all be taking it?

There are a lot of facts and myths surrounding creatine, including fears about it causing hair loss, or damaging the kidneys and liver, and even a link with cancer. At the same time, it’s hugely touted by fitness fans and is one of the most popular supplements around.

What is creatine?

Creatine is a naturally occurring compound that our bodies produce in our liver and kidneys. In fact, the liver makes about 1g of creatine every day, and we also get creatine from the food we eat – about another 1-2g. We store the majority of creatine in our skeletal muscle as ‘phosphocreatine’, with a small amount stored in the brain and heart. When we’re active – lifting weights, running, sprinting and even using our brains – we use up energy in the form of ATP (adenosine triphosphate); creatine helps restore this energy when it starts to run low, so it’s a bit like adding wood to top up a fire. No surprise then that creatine is one of the most studied and widely used sports supplements.

The benefits of creatine include:

• May support energy production
• May support high-intensity and maximum-intensity exercise
• May support muscle mass
• May strengthen muscles and improve performance and recovery
• May support brain function and health
• May support the brain after neurological damage
• May support those with Parkinson’s
• May lift mood

Discover our full range of health benefit guides, and check out how to fuel your body like an athlete and what’s worth trying for sports nutrition.

How to take creatine

Creatine monohydrate is the most well-studied form and is stable and absorbs easily. It is available as powder, capsules, tablets, gummies, liquids and also as a component of functional foods, like energy bars. Combining creatine with carbs is thought to improve muscle glycogen storage compared to consuming carbs alone.

Experts now believe that a creatine loading phase – a period of high-dose supplementation to saturate muscles – is not necessary, and that a daily dose of 3-5g or 0.3g/kg of body mass is effective.

Thinking about supplementing? Learn more about creatine, how it works and which brands to consider in our review of the best creatine supplements to buy.

Top 8 benefits of creatine

1. May support energy production

Creatine supplements increase our stores of creatine in its phosphorylated (phosphocreatine) form; this helps produce ATP energy and prevent its depletion so we remain energised.

2. May support high-intensity and maximum-intensity exercise

Creatine’s role in supporting ATP production is especially useful during high-intensity exercise, such as sprinting, and to maintain performance at maximum intensity.

3. May increase muscle mass

Creatine supplementation has long been used for its ability to add muscle mass. It appears to do this in a number of ways, including boosting the formation of proteins that increase muscle fibre size, and altering cellular pathways that promote muscle growth. Creatine also increases levels of a hormone called insulin-like growth factor 1, which promotes muscle mass.

4. May strengthen muscles and improve performance and recovery

When you lift heavy weights or exercise, you create tiny tears in your muscle fibres. During recovery, these tears heal and your muscles get stronger. Supplementary creatine can help to activate satellite cells, a type of stem cell that help the micro-tears heal; as a result, your muscles recover more efficiently and get stronger.

5. May support brain function and health

Creatine appears to play an important role in both brain function and health, including improvements in memory and intelligence. We know that nerve tissue, including brain tissue, uses a lot of ATP energy relative to its size. In fact, about 20% of the body’s total ATP is used by the brain. Supplementary creatine can increase phosphocreatine stores, therefore helping the brain produce more ATP. It can also support the brain by enhancing how energy producing mitochondria work.

6. May delay neurological damage

A key contributor to neurological dysfunction is a reduction in the production of phosphocreatine in the brain. Given that creatine can increase brain levels, it has been hypothesised that supplementary creatine may help reduce or slow the progression of conditions like Alzheimer’s and Huntington’s as well as ischaemic stroke. Much of the research to date has involved animal models, but there is hope that creatine may play a useful role alongside conventional treatment. More high-quality clinical trials are needed.

7. May support those with Parkinson’s

Characterised by reduced levels of brain chemical dopamine, Parkinson’s can present with tremors, loss of muscle function and speech impairment. In rodent studies, supplementing with creatine prevented the typical drop in dopamine levels, however to date there is no evidence that creatine has the same effect in humans.

8. May lift mood

By increasing brain energy and mitochondrial function, providing protection and modulating the brain chemicals that regulate mood, supplementary creatine may be useful for those with low mood and depression. Studies are encouraging, including when using creatine as an adjunct to conventional drug therapy. That said, further research is needed to establish optimal dosing and long-term efficacy.

Creatine benefits for women

Supplementing with creatine appears to hold a variety of benefits for women across their lifespan. These include improving levels of creatine in the brain, which may help minimise low mood and depression. Post-menopause, supplementation in combination with a resistance training programme appears to improve muscle mass as well as upper and lower body strength, while crucially reducing the rate of bone loss.

Can you take creatine every day?

This depends on your circumstances. Those likely to benefit the most are vegans and vegetarians, who can be prone to lower creatine stores. In general, creatine is considered safe for healthy adults when taken at doses of about 3-5 grams daily. However, if you’re pregnant, breastfeeding, have a diagnosed condition such as kidney or liver disease, are diabetic or have bipolar disorder, there is insufficient evidence to say that creatine is safe for you, and you should speak with your GP or healthcare practitioner.

Potential side effects

Although creatine is a relatively safe supplement, some people do report side effects. The most common is gastric discomfort, including nausea and diarrhoea. Other reported side effects include weight gain due to increased water retention, and dizziness. If you experience these side effects try dividing the amount of creatine you take into smaller doses and take throughout the day.

Some of the myths surrounding creatine – such as it causing hair loss or damaging healthy kidneys when ingested at recommended doses – can be easily dispelled. However, a more complex picture exists when it comes to cancer. While some studies show creatine can enhance anti-cancer immune responses and even be used as a complement to cancer therapy, others, particularly those using mouse models, indicate it can promote cancer metastasis. However, it should be noted that much of the findings suggesting that creatine promotes cancer come from laboratory and animal models, and the same findings have not been confirmed for humans. Nevertheless, if this is a concern, or you have been diagnosed with cancer, you should consult with your doctor or oncologist before adding creatine to your regime.

If you’re scheduled to have a blood test to assess kidney function, it’s important to tell your GP if you’re supplementing with creatine, because it can elevate levels in your blood of a marker called creatinine.

Overall, is creatine safe?

Creatine monohydrate is one of the most studied supplements, with decades of research behind it. However, there are circumstances where supplementation may be inappropriate, such as during pregnancy and for those with certain diagnosed health conditions. That said, clinical trials lasting up to 5 years suggest no adverse effects when used in moderate amounts by healthy individuals.

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Kerry Torrens BSc. (Hons) PgCert MBANT is a BANT Registered Nutritionist with a postgraduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including Good Food.

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