Creatine Shows Potential in Treating Brain Disorders

Creatine is a chemical your body synthesizes from amino acids that supply energy mainly to your muscles. You have probably heard or read about athletes taking supplemental creatine to increase their power and performance. However, new uses for this compound have emerged as researchers learn more about its potential in treating age-related disorders, including loss of healthy muscle. Muscle atrophy associated with aging may contribute to overall body weakness and loss of physical independence.

Prior thinking was that creatine was mainly found in skeletal muscle. However, we now know that at least 5 percent of the body's creatine can be found in other organs, such as the liver, kidneys, testes (if you are male), and brain. More recent research has focused on different uses of supplemental creatine in preventing or treating congestive heart disease, insulin resistance, and high cholesterol.

Because I am a psychiatrist, my interest in creatine focuses more on its potential brain effects, including its possible role in treating mood disorders.

How Does Creatine Work in Your Brain?

• Cognitive Functions: Your skeletal muscles use great energy, especially if you are an athlete. In the same way, your brain is a highly active organ that uses almost 20 percent of your body’s energy consumption. Children born with hereditary or acquired impairments in creatine metabolism are at risk for delayed brain development and cognitive function. To maintain a steady supply of creatine, your brain relies on a healthy consumption of creatine-containing nutrients and consistent production from your liver. Your brain plays a significant role in cognitive domains such as attention, decision-making, memory, reasoning, and language. Research has shown that supplemental creatine can improve cognitive function in laboratory animals, particularly females. However, the results of research studies in humans are mixed. One study reported improved memory following creatine supplementation in healthy elderly patients, but the opposite was found with the same supplementation in younger adults. Sleep deprivation affects all aspects of cognitive function and performance. In a different study of male rugby players who were intentionally sleep-deprived, those who received creatine after 24 hours without sleep performed better than those who did not receive the dose. There is some evidence that creatine supplementation can enhance cognitive function when activities that challenge the brain's energy are present. Examples of such activities include sleep deprivation, mental fatigue, or prolonged stress.
• Traumatic Brain Injuries: Several patients in my practice have experienced TBI as the result of concussions, whether from athletic activities or as the result of motor vehicle accidents. Researchers are looking at creatine as part of the overall therapy for people recovering from TBIs. Trauma to the brain reduces creatine. Increasing the brain’s reserve through supplementation has been proposed to enhance recovery after brain trauma. It has been hypothesized that creatine’s neuroprotective effects following TBI may involve creatine-induced maintenance of mitochondria, the components of your cells responsible for energy production used by your major organs, including your brain.
• Mood Disorders: Major depressive disorder (MDD), bipolar disorder, anxiety disorders, and post-traumatic stress disorder are leading contributors to disability worldwide, with recent estimates suggesting that roughly 5-6 percent of the world’s population experience symptoms of such disorders at any one time. Although medication and various forms of talk therapy are helpful in treating these disorders, some studies document that complete remission of symptoms is achieved only 50-60 percent of the time. One of the reasons for this shortfall is the side effects experienced by some patients, causing them to discontinue their medications prematurely. Some research reports that concentrations of creatine in the frontal lobe of your brain may be related to symptoms of mood disorders. For example, a study in 2012 reported that a small sample of nine medication-free patients with social anxiety had lower concentrations of creatine in a portion of their prefrontal cortex than a control group. In 1999, one researcher reported that a four-week daily dose of 20mg of creatine monohydrate increased total brain creatine levels in a small group of non-depressed individuals. Additionally, one research group looking at patients with depression reported that adding a creatine supplement to their antidepressant improved their mood within four weeks.

What are the takeaways from this? Creatine supplementation can increase brain creatine content, improving brain health in several crucial areas. This includes recovery from traumatic brain injury, treatment for severe neurodegenerative disorders such as Parkinson’s and Alzheimer’s diseases, and adjunct treatment for mood and anxiety disorders. One of the difficulties in using creatine as an alternative treatment is that it does not easily pass the blood-brain barrier. This is a layer of tightly locked cells that protects your brain from harmful substances entering the brain. The challenge for researchers will be to create a creatine-containing compound that more easily passes into the brain to have an effect.

In the meantime, how can you raise your level of creatine?

• Diet: Red meat is a sure way to increase your creatine level. However, eating red meat in excess can cause other health issues, such as high cholesterol, and is a risk factor for certain gastrointestinal cancers. Chicken and even fish will raise your level, but less so, though it is a healthier choice for some. If you do not eat meat, high-protein foods like lentils, nuts, eggs, beans, and Greek yogurt are other excellent sources.
• Exercise: Creatine is mainly found in skeletal muscle, so increase your exercise and incorporate weight training to build muscle mass.
• Supplements: Many forms of supplemental creatine are available. Research studies have generally used between 10 and 20g per day. Doses higher than that can put significant strain on your kidneys, and if you suffer from kidney disease, be mindful that high levels of creatine can be toxic to those organs.