Creatine is one interesting substance to study. Very familiar to a lot of people, but its real health potentials and benefits are very far-reaching, much more so than the average layperson would like to think.
The market around creatine monohydrate is huge. According to one estimate, it brings around $400 million per year. Regardless of this huge market, not many people actually know what creatine is. This is what will be explored in the article.
Creatine is an organic acid, synthesized out of amino acids (arginine, glycine, and methionine), which buffers energy concentrations in different bodily tissues. Moreover, its presence is dependent on the energy needs of these tissues. And as you might imagine, muscles and our brain are two components of our body which are the biggest energy sinks.
For me, the brain is especially interesting. It accounts for around 25% of our daily energy expenses, an astonishing number when we think about its size, relative to other body parts. But less astonishing when we think about all the computations which it has to do.
The monohydrate part of the name, usually found in creatine and other supplements, simply means it has one molecule of water per molecule of the compound. Not very hard to grasp, I think.
Interestingly, the creatine content of meat, compared to all the protein found in it, can be used as one of the indicators of meat quality. 
Furthermore, it has become increasingly clear that creatine plays a huge role in a number of cognitive functions such as memory, learning, language, and others. 
Knowing all of that, it comes to no surprise creatine can be found in abundance in our brain. And while research done with creatine was originally centered on its role in sport performance, it’s becoming an increasingly studied substance in terms of its therapeutic potentials for our brain, one prominent area of research being psychiatric disorders. I’m going to dive into them in my next article.
There are a few caveats about its practical applications. Not everyone is aware of them, which is why I’ve decided to mention them.
First, lower doses of creatine, less than 5 g in humans, will be more bio-available than higher doses such as 10 g and above. 
The reason for this is a thing called (over)saturation. Larger amounts of creatine saturate target sites, where creatine could usually exert its effects, faster. Thus rendering these sites less effective. Moreover, a high amount of creatine a short time period can slow down its absorption. 
It’s also interesting to note that areas where less creatine is usually found will benefit more from supplementing with it, as it accumulates there faster.
Second, it’s important to continuously supplement with creatine, because only after continuous supplementation with creatine will its levels be raised substantially. 
Third, the way how we take creatine is important as well. Different dosage forms can influence how fast it gets absorbed . A solution, powder, or creatine found in capsule form all have different peak concentrations.
For example, consuming creatine through meat increases your levels of plasma creatine, however, it requires further digestion through your digestive tract to become available as a useful source. Therefore, if it is in your interest to have it available immediately, taking it either in powdered form or as a solution is a better idea.
The current recommended dose without any side effects is 5g/day. 
However, there are some studies which show the negative effects of creatine supplementation. These include abdominal discomfort, increases or decreases in appetite, weight gain, and stomach distress 
Moreover, two studies have observed results which have interesting implications as far as mood disorders go. According to one study, people who started supplementing with creatine exhibited increased negative mood and anxiety. In the other study, people who were diagnosed with bipolar disorder showed manic symptoms after being supplemented with creatine. [7, 8]
Two people who participated in the first study even reported feeling more aggressive and nervous after one week of 25g/day supplementation, which is a lot of creatine admittedly.
The current idea is that creatine could influence/change mood through altering the transporter function which is used to exert its effects.
Overall, the consensus about creatine is that it’s a safe and healthy supplement. The noted side effects are only from a small fraction of studies. And even in these studies not everyone reported the mentioned side effects.
The health benefits are pretty straightforward this time, creatine has been thoroughly studied in controlled (clinical) settings where we can be more sure of its causal effect.
But first, I’d like to mention one particular finding from a study in contrast to others. Lower phosphocreatine levels were associated with better performance at a task which involves decision-making . But this was only a correlational study, so we will remain skeptical of this.
On the other hand, there is significant evidence showing the positive effects of creatine supplementation. It includes:
- Less mental fatigue after a stressful calculation test where the participants were timed.
- Better scores on working memory and intelligence tests in vegetarians and vegans.
- Less fatigue, an improved mood, and less performance decline on a task measuring decision-making, following sleep deprivation ( less then 24h) and some exercise.
- Better scores on working memory and executive memory tests after real sleep deprivation (36h).
- Partial reduction of age-related cognitive decline in people older than 76 years – better scores on verbal and spatial short-term memory tests, as well as long-term memory tests after only a week of supplementation.
- Better scores on abstract reasoning and short-term memory tests.
This is important because of two reasons.
Vegetarians and vegans show greater benefits in cognitive processing because their dietary restriction is more likely to lead to lower creatine levels in their brain. Here, lower creatine levels due to dietary restriction are considered to be a source of stress, but not in the conventional sense.
In one study, creatine did not improve the performance of rested non-vegetarians on a battery of neurocognitive tests . While it did improve it when people were sleep-deprived, as mentioned before. This shows that if people have ideal phosphocreatine levels, it doesn’t necessarily improve their cognitive functioning. But then again, more studies should focus on people who aren’t under a source of stress and have an ideal diet.
As we can see, creatine is one interesting substance. It may improve cognitive functioning on a variety of tasks. However, whether there would be any measurable improvements depends on a number of factors, including age, diet type, and stress levels. Future studies should focus on varying the dosage levels together with young healthy people who aren’t as susceptible to low levels of creatine.
Do you take creatine? Has it helped you in any way? Share your thoughts!