May 22, 2024 7 min read

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    Written by Chris Bellanger, BHSc in Nutritional Medicine

    Creatine, derived from the Greek word “kreas,” meaning “meat” because it only naturally occurs in animal foods, is one of the most popular and widely researched supplements used by athletes. Due to its ability to regenerate ATP levels rapidly, it’s best known as a way to enhance power and strength. 

    However, many people don’t realize that creatine also has some amazing benefits for cognitive and mental health. In this detailed guide, we will unveil the surprising, often neglected roles of creatine in brain health, cardiovascular health, and sleep.

    Not Just for Athletes: Looking Closer at Creatine’s Health Benefits 

    Creatine supplements are primarily known for their performance-enhancing effects in athletes and fitness enthusiasts, which include improvements in power output, strength training adaptations, and enhanced exercise capacity, both in the general population as well as older adults.[1] [2]

    However, research has more recently also uncovered numerous potential health benefits associated with creatine supplementation

    These briefly include: [2] [3] 

    • Helping to lower cholesterol and triglycerides, as well as help manage blood lipids and reduce fat accumulation in the liver 
    • Decreasing homocysteine levels, thus potentially reducing cardiovascular health risks 
    • Providing antioxidant benefits
    • Enhancing glucose management and glycemic control 
    • Minimizing bone loss 
    • Improving function capacity in patients with osteoarthritis and fibromyalgia 
    • Enhancing cognitive function, especially in older populations 
    • Supporting fat loss while maintaining muscle on a calorie-restricted diet 

    Creatine’s Cognitive & Neuroprotective Benefits

    Creatine for Cognitive Health

    Emerging research indicates that creatine may have neuroprotective properties, potentially benefiting brain health and cognitive function, particularly in populations with below-average creatinine levels, such as vegans, older populations, or people with mild cognitive impairments. [2] [4] [5] [6]

    Studies have shown that creatine supplementation can increase brain phosphocreatine levels, which may help to buffer energy deficits by enhancing brain bioenergetics. It may also protect against neurodegenerative conditions such as Parkinson's and Alzheimer's diseases, conditions with a progressive and irreversible loss of neuronal function that hamper the performance of cognitive and motor tasks.[3]

    Creatine has also been investigated for its potential to improve cognitive performance and memory in both healthy individuals and those with neurological disorders.

    It also increases oxygen utilization in the brain, helping reduce cognitive fatigue while improving working memory and processing speed.[5] [7]

    Creatine’s Exciting Benefits for the Sleep Deprived 

    There's some great news for those who are burning the candle at both ends with excessive work and social commitments. 

    Recent research found that just one large dose of creatine could improve cognitive performance in people experiencing the negative effects of acute sleep deprivation. [8] [9] [10

    Creatine and Healthy Sleep

    Supporting Healthy Blood Sugar 

    Creatine has the ability to enhance GLUT4, a vesicle transporter for glucose into the cell, thereby helping to reduce high blood sugar, particularly in combination with exercise.[11] [12]

    Creatine & Bone & Muscle Health

    Creatine supplementation has shown promise in the treatment of certain medical conditions characterized by muscle weakness or wasting and subsequent loss of strength and bone mass, such as sarcopenia and muscular dystrophy, or simply due to aging. 

    Some research suggests that creatine supplementation may help to preserve bone density and muscle mass, thus maintaining muscle function and enhancing quality of life in individuals with muscular dystrophy and related conditions. [3] [13] [14]

    Creatine & Cardiovascular Health

    There is growing evidence to suggest that creatine supplementation may have positive effects on cardiovascular health. 

    Creatine shows great promise in this area by improving blood pressure, lipid profiles, and cardiac function in people with heart failure.

    Creatine also helps maintain optimal heart function by supporting bioenergetics, particularly during ischemic events such as heart failure.[15]

    Creatine and Cardiovascular Health

    Antioxidant Properties

    Creatine has antioxidant properties that may help to combat oxidative stress and protect against cellular damage. By scavenging free radicals and reducing oxidative stress, creatine may support overall health and reduce the risk of chronic diseases such as diabetes and cardiovascular disease.

    Oxidative stress and mitochondrial damage are also common features in neurodegenerative diseases.[3]

    Which Form of Creatine Is Best & How Much Should You Take?

    Two common forms of creatine found in supplements are creatine monohydrate (CM) and creatine hydrochloride (HCl). While both forms help increase creatine stores in the muscles, there are a few key differences. 

    Creatine monohydrate is the most researched and commonly used form of creatine. It consists of creatine molecules bonded with a water molecule, resulting in a highly soluble powder. Creatine hydrochloride is bonded with a hydrochloride molecule, making it much more bioavailable; as a result, smaller dosages seem to be sufficient to achieve the same effects. 

    Creatine HCl is typically marketed as causing less gastrointestinal discomfort than creatine monohydrate. This is because the monohydrate form is often taken in loading doses of up to 20 grams at the commencement of supplementation. The larger required dosages cause gastrointestinal issues, which the HCL form negates. This explains why it’s quickly becoming more popular, especially in the antiaging and biohacking spaces. 

    Research on creatine monohydrate is far more extensive, and the hydrochloride form has not been commercially available for nearly as long. Therefore, while HCl seems highly promising, the research is still in its early stages. 

    It appears that the two have comparable outcomes for athletes. However, since creatine HCL is more easily absorbed by the body, a lower dosage is required for the same outcomes without causing the gastrointestinal issues associated with the monohydrate form. 

    Additionally, two studies showed superior benefits for body composition in those taking the HCl form.[16] [17] [18]

    Creatine and Muscle Uptake and Performance

    Muscle Uptake and Performance

    Both creatine monohydrate and creatine HCl are ultimately converted into phosphocreatine within the body, which plays a key role in the regeneration of adenosine triphosphate (ATP), the primary energy source for muscle contractions during high-intensity exercise.

    Numerous studies have demonstrated the performance-enhancing effects of creatine supplementation, including improvements in strength, power, and muscle mass, by increasing phosphocreatine levels in muscle tissue.

    While fewer studies have directly compared the effects of creatine monohydrate and creatine HCl supplementation, research so far suggests that creatine HCl is similarly effective in increasing muscle creatine levels and improving performance, but at a lower dosage. 

    In Summary

    Creatine's shiny reputation as the bodybuilding holy grail is well-deserved and scientifically proven. However, what many people don't know about creatine is that it is much more than just a go-to supplement for muscle building, performance enhancement, and fat loss. Its part in cardiovascular health, glucose management, bone health, and cognitive functions is equally as significant. Remember that, to get the most out of your creatine supplement, the form you choose matters, especially if you suffer from gastrointestinal discomfort.

    Article References:

    1. Kreider, Richard B., et al. “International Society of Sports Nutrition Position Stand: Safety and Efficacy of Creatine Supplementation in Exercise, Sport, and Medicine.” Journal of the International Society of Sports Nutrition, vol. 14, no. 1, 13 June 2017, https://doi.org/10.1186/s12970-017-0173-z.
    2. Gualano, Bruno, et al. “Creatine Supplementation in the Aging Population: Effects on Skeletal Muscle, Bone and Brain.” Amino Acids, vol. 48, no. 8, 23 Apr. 2016, pp. 1793–1805, https://doi.org/10.1007/s00726-016-2239-7.
    3. Kreider, Richard B., and Jeffery R. Stout. “Creatine in Health and Disease.” Nutrients, vol. 13, no. 2, 29 Jan. 2021, p. 447, www.ncbi.nlm.nih.gov/pmc/articles/PMC7910963/, https://doi.org/10.3390/nu13020447.
    4. Forbes, Scott C., et al. “Effects of Creatine Supplementation on Brain Function and Health.” Nutrients, vol. 14, no. 5, 22 Feb. 2022, p. 921, www.mdpi.com/2072-6643/14/5/921, https://doi.org/10.3390/nu14050921.
    5. Rae, Caroline, et al. “Oral Creatine Monohydrate Supplementation Improves Brain Performance: A Double–Blind, Placebo–Controlled, Cross–over Trial.” Proceedings of the Royal Society of London. Series B: Biological Sciences, vol. 270, no. 1529, 22 Oct. 2003, pp. 2147–2150, https://doi.org/10.1098/rspb.2003.2492.
    6. Balestrino, Maurizio, and Enrico Adriano. “Beyond Sports: Efficacy and Safety of Creatine Supplementation in Pathological or Paraphysiological Conditions of Brain and Muscle.” Medicinal Research Reviews, vol. 39, no. 6, 23 Apr. 2019, pp. 2427–2459, https://doi.org/10.1002/med.21590.
    7. Watanabe, Airi, et al. “Effects of Creatine on Mental Fatigue and Cerebral Hemoglobin Oxygenation.” Neuroscience Research, vol. 42, no. 4, Apr. 2002, pp. 279–285, www.sciencedirect.com/science/article/pii/S016801020200007X, https://doi.org/10.1016/s0168-0102(02)00007-x.
    8. Gordji-Nejad, Ali, et al. “Single Dose Creatine Improves Cognitive Performance and Induces Changes in Cerebral High Energy Phosphates during Sleep Deprivation.” Scientific Reports, vol. 14, no. 1, 28 Feb. 2024, p. 4937, www.nature.com/articles/s41598-024-54249-9, https://doi.org/10.1038/s41598-024-54249-9.
    9. ---. “Single Dose Creatine Improves Cognitive Performance and Induces Changes in Cerebral High Energy Phosphates during Sleep Deprivation.” Scientific Reports, vol. 14, no. 1, 28 Feb. 2024, p. 4937, www.nature.com/articles/s41598-024-54249-9, https://doi.org/10.1038/s41598-024-54249-9. Accessed 5 Mar. 2024.
    10. McMorris, T., et al. “Effect of Creatine Supplementation and Sleep Deprivation, with Mild Exercise, on Cognitive and Psychomotor Performance, Mood State, and Plasma Concentrations of Catecholamines and Cortisol.” Psychopharmacology, vol. 185, no. 1, 17 Jan. 2006, pp. 93–103, https://doi.org/10.1007/s00213-005-0269-z.
    11. N. NEWMAN, JACKIE E., et al. “Effect of Creatine Ingestion on Glucose Tolerance and Insulin Sensitivity in Men.” Medicine & Science in Sports & Exercise, vol. 35, no. 1, Jan. 2003, pp. 69–74, https://doi.org/10.1097/00005768-200301000-00012.
    12. Pinto, Camila Lemos, et al. “Creatine Supplementation and Glycemic Control: A Systematic Review.” Amino Acids, vol. 48, no. 9, 15 June 2016, pp. 2103–2129, https://doi.org/10.1007/s00726-016-2277-1. Accessed 2 Jan. 2020.
    13. Candow, Darren G., et al. “Variables Influencing the Effectiveness of Creatine Supplementation as a Therapeutic Intervention for Sarcopenia.” Frontiers in Nutrition, vol. 6, 9 Aug. 2019, https://doi.org/10.3389/fnut.2019.00124.
    14. Candow, Darren G., et al. “Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation.” Journal of Clinical Medicine, vol. 8, no. 4, 11 Apr. 2019, p. 488, https://doi.org/10.3390/jcm8040488.
    15. Sihem Boudina, et al. “Alteration of Mitochondrial Function in a Model of Chronic Ischemia in Vivo in Rat Heart.” American Journal of Physiology. Heart and Circulatory Physiology, vol. 282, no. 3, 1 Mar. 2002, pp. H821–H831, https://doi.org/10.1152/ajpheart.00471.2001. Accessed 18 Apr. 2024.
    16. Tayebi, M., and H. Arazi. “Is Creatine Hydrochloride Better than Creatine Monohydrate for the Improvement of Physical Performance and Hormonal Changes in Young Trained Men?” Science & Sports, Dec. 2019, https://doi.org/10.1016/j.scispo.2019.07.013.
    17. Tayebi, Mohammad Milad, et al. “Effects of Creatine Hydrochloride Supplementation on Physical Performance and Hormonal Changes in Soldiers.” Physical Activity Review, vol. 9, no. 1, 2021, pp. 93–99, https://doi.org/10.16926/par.2021.09.11. Accessed 6 Apr. 2021.
    18. França, Elias de, et al. “Creatine HCl and Creatine Monohydrate Improve Strength but Only Creatine HCl Induced Changes on Body Composition in Recreational Weightlifters.” Food and Nutrition Sciences, vol. 06, 2015, p. 1624, www.scirp.org/html/5-2701782_62283.htm#txtF9, https://doi.org/10.4236/fns.2015.617167



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