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Review
. 2023 Dec;53(Suppl 1):49-65.
doi: 10.1007/s40279-023-01870-9. Epub 2023 Jun 27.

"Heads Up" for Creatine Supplementation and its Potential Applications for Brain Health and Function

Darren G Candow  1 , Scott C Forbes  2 , Sergej M Ostojic  3 , Konstantinos Prokopidis  4 , Matt S Stock  5 , Kylie K Harmon  6 , Paul Faulkner  7
Affiliations
Review

"Heads Up" for Creatine Supplementation and its Potential Applications for Brain Health and Function

Darren G Candow et al. Sports Med. 2023 Dec.

Erratum in

Abstract

There is emerging interest regarding the potential beneficial effects of creatine supplementation on indices of brain health and function. Creatine supplementation can increase brain creatine stores, which may help explain some of the positive effects on measures of cognition and memory, especially in aging adults or during times of metabolic stress (i.e., sleep deprivation). Furthermore, creatine has shown promise for improving health outcome measures associated with muscular dystrophy, traumatic brain injury (including concussions in children), depression, and anxiety. However, whether any sex- or age-related differences exist in regard to creatine and indices of brain health and function is relatively unknown. The purpose of this narrative review is to: (1) provide an up-to-date summary and discussion of the current body of research focusing on creatine and indices of brain health and function and (2) discuss possible sex- and age-related differences in response to creatine supplementation on brain bioenergetics, measures of brain health and function, and neurological diseases.

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Conflict of interest statement

DGC has conducted industry-sponsored research involving creatine supplementation and received creatine donations for scientific studies and travel support for presentations involving creatine supplementation at scientific conferences. In addition, DGC serves on the Scientific Advisory Board for Alzchem (a company that manufactures creatine) and as an expert witness/consultant in legal cases involving creatine supplementation. SCF has previously served as a scientific advisor for a company that sold creatine monohydrate and has received industry-sponsored research involving creatine supplementation and received creatine donations for scientific studies. SMO serves on the Scientific Advisory Board for Alzchem (a company that manufactures creatine). SMO owns patent “Sports Supplements Based on Liquid Creatine” at European Patent Office (WO2019150323 A1), and active patent application “Synergistic Creatine” at UK Intellectual Property Office (GB2012773.4). SMO has served as a speaker at Abbott Nutrition, a consultant of Allied Beverages Adriatic and IMLEK, and has received research funding related to creatine from the Serbian Ministry of Education, Science, and Technological Development, Provincial Secretariat for Higher Education and Scientific Research, AlzChem GmbH, KW Pfannenschmidt GmbH, ThermoLife International LLC, and Hueston Hennigan LLP. SMO does not own stocks and shares in any organization. All other authors have no conflicts of interest that are directly relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Potential effects of creatine monohydrate on measures of brain function. Creatine reaches the cytosol via CRT’s at the blood–brain barrier, neurons, and oligodendrocytes cells and contributes to the maintenance of glycolytic ATP levels. Creatine enters the mitochondria via MtCKs and converts ATP to PCr through oxidative phosphorylation. ATP and PCr are able to circulate from the mitochondria back into the cytosol, regulating energy requirements which in turn may enhance brain energy metabolism. ADP, adenosine diphosphate; ATP, adenosine triphosphate; CRT, creatine transporter; MtCK, mitochondrial creatine kinase; NMR, nuclear magnetic resonance; PCr, phosphocreatine
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