By: Raphael Gabiazon
Creatine has become a popular supplement that is primarily used to enhance performance related to general fitness and sport. It is primarily found in red meat, fish, or dietary supplements (1). As it functions in the body, 95% of creatine is stored in muscles and is used for Adenosine Triphosphate - Phosphocreatine (ATP-PCr) - a type of energy system that rapidly produces ATP (the main energy currency of the cell in the human body) for short, powerful movements (2). Creatine maintains the amount of ATP in your muscles stable during intense activities or short bursts of movements and helps prevent the level of ATP from dropping too low in the cells (3). Due to its function within the body, much research supports it as a supplement that has evidence-based benefits. Specifically, with improvements in strength-related movements. However, novel research has started to find that creatine may also be beneficial for brain function. This article will review the evidence regarding the effects of creatine as a supplement.
One main use of creatine as a supplement is to enhance strength performance. Commonly, this may be for improving exercises or sports performances that require strength. Strength with regards to muscle refers to a measure of the greatest force that a muscle or group of muscles can produce in a specific movement speed (4). For example, this can be observed in powerlifters trying to lift the heaviest weight possible with a squat, bench, or deadlift. Creatine is thought to improve strength and the research supports it. One scientific review assessed various studies to see the overall effects of creatine and found that on average, taking creatine while doing resistance training led to greater increases of 8% in muscle strength, 3 to 45% bench press 1RM (the amount of weight a person can lift one time), and 16 to 43% overall weightlifting performance on the bench press (the number of repetitions a person can do at a certain weight) (5). In another study, taking creatine for 5 days along with doing a resistance training program led to significant improvements in the back squat exercise and a test of anaerobic power – which is a measure of a person's ability to perform intense physical work for short periods of time, usually lasting from a few seconds to a minute (6, 7).
Creatine has been shown not to only provide benefits for conventional gym exercises but also for athletic activities, especially sprinting. A study that reviewed 500 studies found that 70% those indicated that short-term creatine supplementation has been shown to improve maximal power/strength (5-15%), work performed during sets of maximal effort muscle contractions (5-15%), single-effort sprint performance (1-5%), and work performed during repetitive sprint performance (5-15%) (8). The increases in sprint performance may be explained by strength given that they are shown to be related (9), and creatine supplementation could facilitate this improvement. It is widely accepted that such improvements with creatine supplementation in strength are due to its effects on the ATP-PCr system which is typically utilized in movements that are highly intensive and short in duration (2, 10). Taken together, the research-based findings support creatine as a supplement for those looking to enhance performance that involves strength whether it is for the gym or sport.
An unconventional use that may be derived from creatine can be as a nootropic - a substance that enhances cognitive-related functions such as thinking, learning, and memory (11). While much of the research remains skeptical of various nootropics, some are shown to have evidence-based benefits, such as creatine. The brain which is responsible for many of the cognitive functions we typically use requires a high amount of energy in the form of ATP (12, 13). Without supplementation, the body naturally creates creatine in the liver, the kidneys, and the brain which play an important role in energy production (14).
Supplementing creatine is reportedly thought to increase the amount of creatine in the brain and lead to a higher ratio of phosphocreatine to ATP (15, 16). This means that there is more creatine available to provide energy in the brain through an increased ability to regenerate ATP which can potentially improve brain-related functions. A systematic review and meta-analysis study – which is a method that analyzes other research and data from similar studies (17) – found that creatine supplementation significantly enhanced performance on measures of memory (18). In one of the studies analyzed, 20g of creatine per day led to improvements in tests of memory in older adults (18, 19) – a population that is known to have reduced cognitive function (20). Younger adult populations were also shown to have benefited from creatine supplementation despite being sleep deprived which is known to significantly reduce cognitive function (18, 21, 22). These findings suggest that creatine can be advantageous for the brain regardless of age and conditions that are known to reduce cognitive function. Although the use of many nootropics to elicit benefits remains highly debated, this may not be the case for creatine.
In conclusion, creatine as a supplement to enhance performance related to strength and brain function is shown to be credible as demonstrated by the research discussed. Creatine in the body is crucial to produce ATP which is necessary for providing energy that we use for physical or mental functions. Supplementing creatine seems to enhance those processes through a greater ability to regenerate ATP for rapidly providing energy. While many supplements make claims that are not supported by scientific evidence, this is not the case for creatine which is supported by numerous studies.
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