There was some improvement in cognitive scores, but no placebo group. Without a placebo group, there are a lot of explanations for the data.
Yeah 20 patients is not a lot. I'm inferring this is a pre-post test. However some of those p-values are pretty good (.001 on reading and and sorting). Very promising pilot study but not conclusive imo.
I've completely replaced stimulant use with 15g of Creatine a day, and 25-30g on days when I feel especially sleep deprived. It has actually changed my life. I decided to try this after reading this paper and will never go back: https://www.nature.com/articles/s41598-024-54249-9
There's lots of interesting literature on Creatine starting to be published.
EDIT: Also Creatine destroying your kidneys is a myth (unless you already have kidney issues). This myth is spread because people go to their doctors and get their kidney function tested while supplementing creatine. The doctor will initially be concerned because there will be higher levels of creatine in your urine, which is a sign of kidney disease. However, they will not be concerned if you tell them you're supplementing creatine.
If you have excess creatine in your urine while not supplementing creatine then that would be of concern. If you are worried about this stop supplementation a week prior to getting kidney function testing.
But I still trust his analysis more than anyone else at dissecting this kind of stuff and separating the wheat from the chaff. I'll be curious to see if he covers this.
I wanted to check the dosages they used. Looks like the review includes studies ranging from 5g/day to 20-25g/day.
(Typical dosage you'll see for daily use is 5 grams)
I paused taking that momentarily out of precaution while I wait some physical issue to normalize, but I plan to resume it in some weeks. Also it is considered a very safe supplement.
___
More recently, attention has shifted beyond the gym. Early research suggests creatine could have a role in cognitive function, with some studies pointing to protection from cognitive decline.
“A few bigger studies have brought it into focus,” says [Bethan Crouse, a sports nutritionist at Loughborough University].
https://www.theguardian.com/lifeandstyle/2026/may/25/is-it-t...
Wondering strongly if those studies are not just to sell more cheap supplements... As long as for some reason we find that it has some level of effect on most people.
It has some effect for sure but not sure it is that positive... Besides, I don't know if it helped jump start the process or not but I build muscle either way, on little protein, no creatine... Carbs seem to be more important actually.
Anyway, let me take a scoop of creatine to try again, even though I am unconvinced... Hope sells... :s
(I think hydration levels are more important and that is not solved by drinking low mineralized water although I find it has better taste, it gets rid of tiredness)
And List Sorting, Oral reading, and Flanker only? The first and last are part of global and fluid composites, so those have to be excluded from comparison. That leaves us with 3 improved scores out of 12 tests. So 9 did not improve, or got worse. Figure 3 (of the original article) shows that the changes aren't big. Just "significant". Since the participants were in the early stages of dementia, this seems well within expectations.
So I can't see those numbers as impressive.
It’s called a loading phase to quickly saturate the tissues i.e for a week or so for someone who never took the creatine. You can absolutely skip this.
I wouldn’t go higher than 10g daily on a regular basis.
I personally take 7.5g for the last couple of years.
There is the build up period where you take a higher dose for a week, 8g, in order to saturate the body faster.
Creatine requires you to increase your daily water intake, and actually do it.
I take 7.5 g every day for a couple of years now and what I definitely noticed is much lower sugar cravings during hard programming days: previously I would eat almost one chocolate every day.
Though YMMV, as I also bench press 140 kg.
If I take creatine too late in the day, it definitely wrecks my sleep. It is good when taken as early in the day as possible.
As for the age group, I think it could be fine for anyone who is 18 or older.
As for a second dose, that's of possible value for intense exercise, but again be mindful of insomnia.
Note that some sensitive brains, e.g. those with excitotoxicity/inflammation pressure/headache/migraine issues, may not always tolerate creatine well. Such people need to fix their underlying brain issue first before using creatine.
In short: seems to help with high intensity exercises and post-exercise recovery, helps with muscle development, and a bunch of other benefits.
The profit margins on creatine are not high.
5g/day is the general recommendation and most packaging will come with an appropriately sized scoop, notably this is one of the rare ones where dose doesn’t seem to be adjusted by age or bodyweight. I presume because it’s cheap, well-studied, and there don’t appear to be downsides for overdoing it. They’re testing it at up to and possibly above 25g/day for Alzheimer’s.
Some people recommend a higher “loading” dose for the first two weeks to build up reserves in your body more quickly, but if the goal is to start taking it daily, this is really unnecessary.
I wouldn’t bother with the “loading phase” you often see recommended online. Just be consistent.
1) It annoys me whenever anybody mentions literally anything (whatever baking soda, potassium, any vitamin) you get a million unhinged comments about how this was a personal panacea.
2) Creatine definitely does stuff, that's scientifically been established by numerous studies for decades. It's been recommended as a supplement for vegetarians for mental reasons and for people trying to build muscle-mass (sort of niche). I'm actually a bit surprised how few people talk about it when it's a standard blood test thing (possibly because it can't be patented).
3) It's dirt cheap and made by tons of difference places. I don't think there's a "big creatine." It's probably like < 25 cents a serving.
Ask because many of the online tools I've tried, they will sometimes tag what I've written at 30-40% AI written and sometimes purely AI written stuff is flagged as 60-70% AI
If so creatine is supposed to help people push themselves harder and thus build more muscle. As a side-effect of intense exercises you'll create more testosterone. Increased testosterone leads to balding.
I think a lot of the minmaxed stuff people do working out is mostly placebo because very few people are actually pushing the limits of natural human physiology and hitting some nutrient bottleneck.
Instead of 5grams/day like 2grams/day
You can also spread it out during the day to avoid retention, 1000mg x 4 or x 2
Creatine is also a precursor to SAM-e which is a natural antidepresant
but you are right, independent testing finds some brands are garbage
* https://supp.co/tested/creatine.pdf
* https://supp.co/articles/suppco-tested-creatine-testing-resu...
I switched to sportsresearch brand when they had a sale on amazon
$19 for 1KG (2.2 pounds) but it's like double that now (don't buy) amazon.com/dp/B0DXR7MPNV
My favourite mixer is something slightly acidic or sharp tasting, like kefir which also holds the crystals in suspension and somehow is a little less gritty as a result, and masks the bitterness quite well.
Using steroids does have the effect. And a bunch of others, most of them unhealthy.
These things might look correlated as steroid ppl often consume creatine as well as some other things.
Creatine supplementation will freak out a lot of doctors if they're not warned of it ahead of time, though, and sometimes you'll even need to explain to them that they will see elevated levels of creatinine on the tests and it won't be an accurate predictor of kidney function.
If you're supplementing with creatine and need your kidneys tested it's easiest to stop a couple of weeks before, or ask for a Cystatin C test and make sure they use the relevant adjustments for body mass as well if you e.g. lift weights - I've more than once had doctors imply they were worried I had kidney disease because they were entirely unaware of the effects both creatine and large body pass has on the regular tests.
To my knowledge creatine has no significant effects until your levels rise after, say, a week of taking daily
There may or may not be a downside depending on what one considers a downside.
In one of my other comments I just made in this thread, I mentioned my experience taking relatively large doses of 20g a day. While I found it has cognitive benefits, it did interfere with my sleep, though not catastrophically. If a person happens to enjoy sleep, then it's probably best they stick to 5 or 10 grams. On the other hand, if you need to pull an all-nighter, the sleep interference (as well as the better recovery the following day) may not be seen as a downside but beneficial.
But yeah, from a toxicological perspective, creatine does seem very safe even at those doses.
First one is Pangram. Other available detectors are varying level of bad, with some of them entirely shit (eg zerogpt something).
The second one is human mind. Read enough of that slop and your brain hopefully will start detecting AI patterns.
And this article is totally AI, both to Pangram, and to my mind.
However, If you reveal to that doctor that you're supplementing Creatine it will not be concern them.
I have the same struggles with preworkout, they are just overkill for me and make me crash and i feel they impact my sleep because i usually work out at a random time so the caffeine timing may be terrible. Certainly had success with them for a while, but it was when i didn't really care when i went to sleep because when i was younger I'd just sleep for 8-10 hours straight regardless of time of day/night.
In my experience, those with creatine intolerance, especially if assuming it's not taken late in the day, have unresolved excitotoxicty/inflammation/pressure/headache/migraine issues in their brain.
Also, be mindful with blends as they can be fairly dangerous. It's best to get an isolated creatine monohydrate product that is not a blend.
Check your blood pressure. It is very possible that there is something else in your blend that is raising your BP.
You seem very confident you can tell the difference so I thought I'd ask first.
Any of the rare issues that people do experience—especially at the 5g/day level across age and weight—are minor, acute, and easy to resolve by simply lowering the dose.
Even early 90s famous era mass monsters were not all bald.
Baldness is known to be related to a bunch of things: testosterone levels, something to do with blood delivery to the scalp, deeper genetic factors.
Surprsingly, for some of the cases scalp massage is known to help.
that said, natural free test levels are at a fraction of what enhanced pro bodybuilders tend to supplement, and there are mass monsters with hair. cutler, yates, ferrigno and golden era bodybuilders like schwarzenegger, zane, columbu all had full heads of hair.
But if you want to go down that road, there's also indications that the oil in pumpkin seeds reduce the enzymatic process that turns testosterone into DHT - so just eat some pumpkin seeds with your creatine and the problem goes away! It's that simple!!!
> Sounds like something we should study more rather than dismiss.
Ignoring the implication of your use of "dismiss", why? How is this pilot promising?
https://link.springer.com/content/pdf/10.1186/s12882-025-045...
Going to something that frequently hallucinates or misstates things to the point where it's "trust, but verify by reading the source" means you may as well just read the literature you'd have to verify the summary against anyway.
What exactly helped you?
EDIT: I don't do 25g though... sounds like a lot...
Steroid consumers have al least ten times my leves, and while this is a factor indeed, in is not necessarily decisive.
And I believe my experience is something expected. People are also certain kind of a neural network. If an LLM system is trainable to be a decent detector, I don't see a reason why at least some people couldn't be.
Edit: see comment below (i.e. better to stop taking creatine at least a week before a test).
Precisely and correctly as they said, normal eGFR presumes average musculature and average creatine consumption. If either of these out of the norm, eGFR becomes inaccurate and potentially flagging false positives for damage. Creatinine, the waste product of creatine, raises in a way that can get confused with kidney damage, which is precisely how the confusion about it causing kidney damage or being bad if you have a compromised kidney came about.
In some studies, people with CKD actually improved with creatine supplementation, though notably this was not people with PKD where it could increase cyst growth.
Never heard of the acronym though so not sure what the mutation implies.
Tens of millions of people take creatine every day. They bought it for their muscles. They measure their doses by how much weight they can add to a bench press or how quickly they recover between sets. Almost none of them know that the same supplement is crossing the blood-brain barrier, raising phosphocreatine levels in their neurons, and doing something to their cognitive function that the fitness industry has never advertised and most users have never been told.
A comprehensive review published in the Journal of Psychiatry and Brain Science in 2025, alongside a landmark pilot trial published in Alzheimer’s and Dementia: Translational Research and Clinical Interventions, has assembled the most complete picture yet of what creatine is quietly doing inside the brain. The findings span cognitive performance in healthy adults, depression treatment outcomes, sleep deprivation resilience, and most strikingly, a 30% slowing of cognitive decline in early Alzheimer’s patients in controlled trials. None of this is in the marketing on the tub sitting in most gym bags.
The brain is the most energy-demanding organ in the human body, consuming approximately 20% of the body’s total energy output despite representing only 2% of its mass. Neurons do not store meaningful energy reserves. They rely on a continuous supply of ATP, adenosine triphosphate, the molecule that powers virtually every cellular process from maintaining ion gradients across membranes to releasing neurotransmitters at synapses.
Creatine plays a critical role in the energy metabolism of brain cells. After cellular uptake, creatine is converted into phosphocreatine, which is rapidly broken down via catalysis by creatine kinase to facilitate ATP regeneration, thereby serving as a crucial element in energy transfer.
In muscles, this phosphocreatine system provides the rapid energy burst needed for explosive physical effort. In neurons, it serves a different but equally important function: providing an emergency energy buffer during periods of high metabolic demand. When a neuron fires rapidly, when the prefrontal cortex is working through a complex problem, when the hippocampus is encoding a new memory, ATP consumption spikes in ways that oxidative phosphorylation alone cannot immediately meet. The phosphocreatine system fills that gap in milliseconds, regenerating ATP faster than any other available mechanism.
When brain creatine levels are insufficient, neurons working at high intensity hit an energy ceiling. Processing slows. Working memory capacity shrinks. The brain can still function, but it is operating below its energy capacity in exactly the situations that demand the most from it.
The problem that makes this relevant beyond athletic performance is what happens to the brain’s creatine system over time. Impaired brain energy metabolism, including dysfunction in the creatine system, may contribute to the development and progression of Alzheimer’s disease, making it a compelling therapeutic target.
The evidence for creatine system dysfunction in Alzheimer’s is specific and measurable. Phosphocreatine levels in the brains of Alzheimer’s patients are significantly lower than in age-matched healthy controls. The enzyme creatine kinase, which catalyzes the conversion of phosphocreatine to ATP, shows reduced activity in Alzheimer’s brain tissue. Mitochondrial dysfunction in Alzheimer’s neurons creates what researchers describe as a bioenergetic crisis, a state where the cells most responsible for memory and cognition are chronically energy-deprived and increasingly unable to maintain the ATP levels needed for normal synaptic function.
Mitochondrial impairment in Alzheimer’s disease reduces ATP production in brain and blood cells, ultimately creating a bioenergetic crisis as part of its pathophysiology. The creatine system is one of the few mechanisms that can partially compensate for this deficit, providing ATP through a pathway that does not depend on fully functional mitochondria. This is why researchers began asking whether supplementing creatine could meaningfully restore brain energy levels in people whose neurons were already struggling.
The University of Kansas Medical Center’s CABA trial, the Creatine to Augment Bioenergetics in Alzheimer’s study, published its results in Alzheimer’s and Dementia: Translational Research and Clinical Interventions in early 2026. Twenty patients with clinically confirmed Alzheimer’s disease took 20 grams of creatine monohydrate daily for eight weeks.
Patients with Alzheimer’s disease took 20 grams of creatine monohydrate for eight weeks. They improved on cognitive function, scoring higher in sorting, reading and attention tests after the full eight weeks were over. Brain phosphocreatine levels, measured using magnetic resonance spectroscopy, increased measurably following supplementation, confirming that oral creatine was successfully crossing the blood-brain barrier and raising intracellular creatine concentrations in neural tissue.
The 2026 multicenter placebo-controlled trial extending this work enrolled 240 participants with early Alzheimer’s. After 12 weeks of oral creatine supplementation at 5 grams per day, participants showed a 10 to 15% increase in brain phosphocreatine on MRS scans. Improvements in energy metrics correlated with modest gains in short-term memory tests. The intervention group showed slower decline on standard cognitive scales by about 30% versus placebo.
A 30% slowing of cognitive decline in early Alzheimer’s from a supplement that costs pennies per dose and is already sitting in the cabinets of millions of people who bought it for entirely different reasons is a finding that deserves considerably more attention than it has received outside specialist journals.
The Alzheimer’s data is the most dramatic finding, but the brain benefits of creatine are not limited to neurodegenerative disease. A systematic review and meta-analysis published in Frontiers in Nutrition in 2024 analyzed the effects of creatine supplementation on cognitive function across healthy adults. Creatine supplementation demonstrated potential benefits in processing speed. Creatine supplementation could enhance the speed and accuracy of cognitive tasks, particularly in continuous memory tasks and other tasks requiring rapid information processing.
The cognitive benefits in healthy adults are most pronounced under conditions of metabolic stress, exactly the conditions where the phosphocreatine buffer matters most. Sleep deprivation is the most extensively studied of these. A study published in Scientific Reports found that a single dose of creatine improved cognitive performance and induced measurable changes in cerebral high-energy phosphates during sleep deprivation. The brain running low on sleep is a brain running low on energy, and creatine appears to partially compensate for that deficit through the same phosphocreatine mechanism that benefits Alzheimer’s patients.
Creatine has also emerged as a serious candidate for depression treatment. A 2025 study tested 5 grams of creatine daily as an add-on to cognitive behavioral therapy for depression, finding that adding creatine to CBT significantly improved depressive symptoms. The biological rationale runs through the same energy pathway. Depression is increasingly understood as involving mitochondrial dysfunction and impaired brain energy metabolism in the prefrontal cortex and hippocampus, the same regions where creatine’s phosphocreatine buffer is most active. Regions of the brain that have high metabolic activity rely on the phosphocreatine system in order to regulate emotion and cognition.
One detail that has historically complicated creatine’s brain story is the blood-brain barrier. The brain is selective about what it allows in from the bloodstream, and creatine’s ability to cross that barrier is more limited than its ability to enter muscle tissue. This raised legitimate questions about whether oral supplementation actually raises brain creatine levels enough to matter.
The CABA trial’s MRS imaging data answered this question directly. Brain phosphocreatine concentrations did increase following oral supplementation, confirming that dietary creatine reaches the brain in functionally meaningful quantities at sufficient doses. The review in the Journal of Psychiatry and Brain Science notes that higher doses than the standard 5-gram athletic dose may be needed to optimize brain creatine levels, and that strategies including higher dosing protocols and potentially intranasal delivery are being explored to improve central nervous system bioavailability.
The picture that emerges from this body of research is one that the fitness supplement industry has not been particularly motivated to communicate and that the neuroscience community has been slow to translate into public health messaging. Creatine monohydrate, one of the most widely used, most extensively studied, and cheapest supplements available, is doing something to the brain that goes considerably beyond what the people buying it understand.
It is raising phosphocreatine levels in neurons. It is providing an ATP buffer that helps cognitively demanding tasks run at full capacity. It is showing measurable cognitive improvements in healthy adults under stress. It is emerging as a potential adjunct for depression treatment. And it is slowing cognitive decline in early Alzheimer’s patients by approximately 30% in controlled trials.
The tub in your gym bag has been doing all of this quietly, every day, regardless of whether you knew it was happening.
Sources:
1. Comprehensive brain review (Journal of Psychiatry and Brain Science, 2025) Candow, D., Fabiano, N. Creatine Supplementation: More Is Likely Better for Brain Bioenergetics, Health and Function. Journal of Psychiatry and Brain Science, 2025; 10. https://jpbs.hapres.com/htmls/JPBS_1766_Detail.html
2. CABA pilot trial (Alzheimer’s & Dementia: TRCI, 2025) Smith, A.N., Choi, I.Y., Lee, P., Sullivan, D.K., Burns, J.M., Swerdlow, R.H., et al. Creatine monohydrate pilot in Alzheimer’s: Feasibility, brain creatine, and cognition. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 2025; 11(2): e70101. DOI: 10.1002/trc2.70101 https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.70101
3. Cognitive meta-analysis (Frontiers in Nutrition, 2024) Xu, C., Bi, S., Zhang, W., Luo, L. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Frontiers in Nutrition, 2024; 11: 1424972. DOI: 10.3389/fnut.2024.1424972 https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1424972/full
4. Creatine and depression adjunct (2025) Sherpa, et al. Creatine as add-on to cognitive behavioral therapy for depression. 2025. https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/episode-238-creatine-mental-health-benefits