Creatine is most commonly taken by people looking to build muscle mass. However, scientists are now investigating how this substance affects our cognitive abilities and mood.
If you've already heard of creatine, it's probably because it's one of the most thoroughly researched supplements.
It has long been associated with improved endurance and performance during exercise, and bodybuilders most often take it in the form of creatine monohydrate.
But this substance is not only useful for those who want to increase muscle mass.
Creatine is an essential substance in our body, where it is naturally produced in the liver, kidneys, and pancreas, and stored in the muscles and brain.
The amount of creatine that the body produces on its own is usually not enough to meet all our needs, so most people also rely on dietary sources of creatine.
Certain foods like meat and fatty fish are rich in this nutrient.
Creatine helps regulate the energy available to our cells and tissues, and there is growing evidence that some people may benefit from additional creatine intake through dietary supplements.
Creatine supplements can provide some people with a significant cognitive boost - from alleviating fatigue after viral infections, to improving cognitive function under stress, and even boosting memory.
There is also speculation that creatine may alleviate symptoms of Alzheimer's disease and elevate mood.
So, are you getting enough creatine and when is it necessary to take supplements?
The beginning of creatine research
The benefits of creatine were first discovered by Professor Roger Harris of the University of Aberystwyth, Wales, back in the 1970s.
Since then, creatine has been widely accepted in the sports world, and much research has been conducted confirming its connection with improving physical performance.
But in the last two decades, research has increasingly pointed to other possible health benefits of creatine.
One of the biggest areas of interest is cognitive function, as creatine plays an important role in the formation of new neurons in the brain.
When Ali Gorjinedjad began examining studies linking creatine supplementation to working and short-term memory in people who don't get enough sleep, he found that benefits were usually seen only after weeks or months of creatine supplementation.
"It was assumed that creatine intake was very limited, so it was thought that it would have no effect after just one night of sleeplessness, until we conducted our study," says Gorjinedjad, a researcher at the Forschungszentrum Jülich in Germany.
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Gordzhinejad decided to examine how a dose of creatine affects cognitive abilities after just one sleepless night.
He gathered 15 volunteers and gave them either creatine or a placebo at 18 p.m.
Every two and a half hours until 9 a.m., he tested their cognitive abilities, including reaction time and short-term memory.
He found that the speed of information processing was significantly higher in the group that took creatine, compared to the placebo group.
Gordžinedjad doesn't know exactly why, but he assumes that due to lack of sleep combined with demanding mental tasks, neurons were under stress, which triggered increased creatine uptake into the cells.
“If cells have a high energy demand in a short period of time, then phosphocreatine or creatine phosphate (which provides energy for short, intense efforts) acts as an energy reservoir,” explains Gordzhinejad, adding that dietary creatine supplementation can help refill this reservoir.
Although the study was conducted on a small sample, Gordzhinejad believes his findings show that creatine can mitigate the negative effects of sleep deprivation, but only in the short term, until sleep is replenished.
However, participants in this study took ten times the recommended dose—a whopping 35 grams, which is about half a cup of creatine powder. (Don't try this at home.)
This dose, says Gordžinedjad, could pose a risk to people with kidney problems, while it could cause stomach upset in others.
Gordžinedjad plans to conduct similar research, but using a lower dose of creatine.
He hopes that in the future, creatine could be used in this way by people who stay awake for long periods, such as emergency workers or students during exam periods.
However, Terry McMorris, an emeritus professor at the University of Chichester, England, reviewed 15 studies in 2024 and concluded that there is currently insufficient evidence that creatine improves cognitive function.
However, McMorris says a possible reason is that the studies he reviewed used different approaches to creatine supplementation.
He adds that many studies have relied on outdated cognitive tests.
"Some date back to the 1930s, they're too easy, they're not challenging enough for the participants," he says.
Although he believes there is currently insufficient evidence to draw firm conclusions, he believes this field deserves further research.
Other health benefits
Studies also point to a wide range of other possible health benefits of creatine, including slowing tumor growth in some animal studies, as well as alleviating menopausal symptoms.
One possible reason is that creatine acts as an antioxidant, which can mitigate the physiological response to stress.
A recent study, which included 25.000 people, showed that those with the highest levels of dietary creatine intake among participants aged 52 and older had a 14 percent lower risk of cancer for every additional 0,09 grams of creatine consumed over two days, on average.
Creatine may also have a positive impact on mental health.
In another study, people suffering from depression were given creatine powder along with cognitive behavioral therapy (CBT).
Researchers found that over eight weeks, their symptoms significantly decreased compared to those who underwent CBT alone, without creatine.
"One of the reasons creatine may help with depression is that it is used to a significant extent for energy production and is used in the brain," says Douglas Kallman, associate professor of sports nutrition at Florida International University, in the United States (USA).
If creatine levels are low, it not only affects energy production in the brain, but also levels of neurotransmitters, the chemical signals that allow communication between nerve cells, explains Kalman.
This can also affect mood.
This discovery could be particularly significant for vegans, says Professor Sergej Ostojić from the University of Agder, in Norway.
According to some research, vegans are at higher risk of depression, and creatine supplementation could be beneficial for them, as it has been found that vegans have lower levels of creatine in their muscles compared to people who eat a mixed diet.
There is even research suggesting that creatine may be helpful for chronic conditions.
In 2023, Ostojić and colleagues from the University of Novi Sad tested the effects of creatine supplements in 19 patients with long-term Covid.
Researchers gave half of the participants four grams of creatine per day and the other half a placebo.
They then monitored their symptoms and creatine levels in their brain and muscles.
After six months, the team found that those taking creatine had reduced symptoms, including less brain fog and better concentration.
The more severe the disease, the lower the creatine levels in the body were at the start of the study.
"Our hypothesis was that the brain, under stress caused by long-term Covid, uses up reserves of creatine, which is crucial for energy supply," says Ostojić.
Although creatine is not a cure for long-term Covid, Ostojić concludes that it could be beneficial.
But more research is needed, especially to better understand possible gender differences in the impact of creatine on conditions like long-term COVID.
Women have a higher risk of developing long-term COVID than men and have different creatine metabolism.
Due to hormonal changes, the transport, bioavailability, and synthesis of creatine in a woman's body are thought to change throughout life.
Ostojić adds that women usually excrete more creatine in their urine and have less muscle mass compared to men.
And given that most creatine is stored in the muscles, it makes sense that women have smaller total creatine reserves.
"My preliminary opinion is that women with long-term COVID may respond better to creatine supplementation than men," says Ostojić.
Life cycle
One of the new trends in creatine research is to look at its importance throughout the human life cycle, says Douglas Kalman.
For example, there is a growing body of research indicating the important role of creatine from conception to early childhood.
Cells and tissues in the body use creatine as an energy source during all stages of reproduction, says Stacey Ellery, a researcher at Monash University in Australia.
These include sperm motility, uterine and placental development, fetal growth, and milk secretion.
Creatine may also play an important role in reducing damage caused by lack of oxygen, which can be crucial for a baby during labor or in the womb, says Ellery.
A lack of oxygen limits the ability of cells to produce energy, especially in tissues such as the placenta and fetal brain, which can slow development or negatively affect the child's long-term health, she explains.
But keratin allows cells to release energy without the need for oxygen for a very short period of time.
“Creatine supplementation can increase the amount available to cells for energy production during periods of oxygen deprivation,” says Ellery.
“Think of it like charging a backup battery in case of a power outage.
"Providing sufficient energy to the cells reduces the risk of serious fetal damage."
Creatine may be key to complicated pregnancies.
In her research, Ellery notes that in pregnant women who have potentially fatal preeclampsia (a complication characterized by high blood pressure, swelling, and
high levels of protein in the urine), the placenta can adapt to increase the level of creatine in the mother's body.
However, there is still not enough research on whether creatine supplementation is safe during pregnancy, so it is recommended to consult a doctor before using any dietary supplements.
Ellery adds that during long and difficult labors, the mother's body appears to transfer increased creatine to the baby.
Also, lower levels of creatine in the blood of mothers in the last months of pregnancy are associated with a higher risk of stillbirth, premature birth, lower birth weight, and admission of the newborn to intensive care.
However, it is still not clear why this happens, nor whether creatine supplementation could help.
Although research in this area is still in its early stages, Ostojić recently published the first estimates of the recommended daily intake of creatine for infants up to 12 months.
According to estimates, exclusively breastfed babies should consume about 7 milligrams of creatine per day for up to six months, and about 12 milligrams per day from the seventh to the 8,4th month.
Ostojić points out that additional data is needed.
And in older age, creatine can play an important role in maintaining muscle health, especially in combating sarcopenia, the loss of muscle mass and strength.
"As people age, they have less muscle mass," says Kalman.
"Studies have shown that creatine can help reduce the symptoms of sarcopenia."
Risks of creatine supplementation
Although creatine supplementation may be beneficial for some people, side effects can occur, including fluid retention, muscle cramps, and nausea.
Creatine is not suitable for all people, including those who suffer from kidney and liver problems, as well as those who use certain medications.
Although creatine is generally considered safe and well-tolerated, rare cases of serious side effects, such as liver failure, have been reported.
Are we getting enough creatine?
Evidence is emerging that most women who eat a Western diet don't get enough creatine, says Elery.
One study showed that six out of ten women do not consume the recommended amount of creatine (13 milligrams per kilogram of body weight per day), while almost a fifth of pregnant women do not consume creatine at all.
Preliminary studies indicate that adults need about a gram of creatine per day.
Data collected so far from population studies show that depression, cardiometabolic disorders, and cancer are more common in people who consume less than a gram of creatine per day.
However, there are no official recommendations on the required daily intake of creatine.
Most people can get creatine through their diet, but vegans are at greater risk of not getting enough, says Ostojić.
Creatine is naturally present in the body, so it is not classified as an "essential" nutrient.
Essential nutrients are those that the body cannot synthesize on its own, so they must be ingested through diet.
However, some researchers, including Ostojić, argue that creatine should be considered a semi-essential nutrient, as the body does not seem to be able to synthesize sufficient amounts.
"Several studies show that people who do not consume creatine through their diet have lower levels of creatine in their muscles, indicating that they are not reaching the optimal amount," says Ostojić.
Creatine is not a miracle cure, but it should be properly evaluated and clear guidelines for the population should be provided based on evidence, adds Ostojić.
Despite the large number of studies conducted and the fact that many people do not consume enough creatine, research on its health benefits throughout all stages of life is still in its early stages.
However, researchers like Ellery hope that as the interest in creatine grows among experts, public health will also take an interest in it, so that we can learn which population groups may benefit from creatine supplementation.
*The content of this text is for informational purposes only and should not be considered a substitute for the advice of your doctor or other healthcare professional. The BBC is not responsible for any diagnosis that a user may make based on the content of this site. The BBC is not responsible for the content of any linked website, nor does it endorse any commercial product or service mentioned or recommended on such websites. If you have any concerns about your health, please consult your GP.
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