Creatine - What It’s Doing To Your Brain
Issue 2 — Deep Dive
What It's
Doing To
Your Brain
I'll be honest with you, like many people, I haven't always thought of creatine as a brain health tool. For a while, creatine has held a reputation for being a gym supplement: something that athletes use to push harder in training, recover faster and build lean mass. While the benefits for this are well established, the science is revealing something more compelling.
About two years ago, I began taking creatine myself - not just for the gym, but for my brain. As someone who spends his days thinking about how we preserve cognitive function across the lifespan, I couldn't ignore a growing body of research suggesting that one of the most well-studied, safe, and affordable compounds in sports science might also be one of the most underutilised tools in cognitive longevity.
In this edition, I want to walk you through the science of what we know, what's promising, and what still needs more research, so you can decide whether creatine deserves a place in your own routine.
Let's get into it...
Here is where it gets clinically interesting. As we age, the muscle and brain's capacity for energy metabolism begins to quietly decline. Mitochondrial efficiency drops. Phosphocreatine stores deplete. ATP regeneration slows. These changes can begin years, sometimes decades, before any noticeable cognitive symptoms emerge.
Layered on top of this is chronic neuroinflammation, now increasingly recognised as one of the primary drivers of accelerated brain ageing. It compounds the energy deficit, degrades neural communication, and creates the conditions in which cognitive decline takes hold.
Declining creatine is not the only factor, but it is a meaningful one. And unlike many aspects of biological ageing, it is something we may genuinely be able to influence.
The research here has matured considerably over the past few years, and the picture emerging is more compelling than most people realise.
The most consistent finding is in memory, particularly in older adults. This makes biological sense as older adults have the most depleted brain creatine stores, so the potential for restoration is greatest. A 2023 meta-analysis confirmed this, finding significant memory improvements specifically in adults aged 66 to 76, with no meaningful effect in younger populations. That contrast is telling. It points to restoration rather than enhancement.
There is also solid evidence for cognitive performance under conditions of stress and fatigue which may be the finding most relevant to modern life. When the brain is under pressure, whether from sleep deprivation, high cognitive load, or sustained mental effort, creatine appears to offer a measurable buffer. A 2024 randomised trial found that a single dose of creatine partially reversed both the metabolic changes and the cognitive deterioration associated with sleep deprivation, with participants sustaining working memory and processing speed that the placebo group could not. The mechanism is consistent, a depleted or stressed brain needs more energy, and creatine is there to supply it.
At the frontier sits Alzheimer's disease. The CABA trial, published in 2025 and the first human study of its kind, gave 19 patients with Alzheimer's 20 grams of creatine daily for eight weeks. Brain creatine levels rose by 11%, and participants showed improvements in global and fluid cognition. Notably, this was the first study to demonstrate that supplemental creatine can actually raise brain creatine levels in people with Alzheimer's - a question that had remained open until now.
But it's important to be straight: this research is early and larger trials are needed. But the direction of the evidence is coherent, the mechanism is sound, and creatine's risk profile is about as well established as it gets. That combination deserves serious attention.
Let's be abundantly clear: this is early-stage research and larger trials are needed. But the direction of the evidence is coherent, the mechanism is sound, and creatine's risk profile is about as well established as it gets. That combination deserves serious clinical and research attention.
If you're considering creatine as part of your routine, the real question is how it fits within your broader physiology and long-term goals.
Learn more about how I approach longevity medicine →What makes creatine particularly interesting from a longevity perspective is that its relevance extends well beyond cognition. At the cellular level, creatine plays a direct role in mitochondrial function, supporting the energy infrastructure that underpins almost every system in the body. It helps stabilise cell membranes, reduce oxidative stress, and improve energy transport across tissues. Supporting phosphocreatine availability may therefore influence more than performance. It may influence resilience - the capacity of cells and systems to absorb stress and continue functioning well.
A 2025 study of nearly 5,000 adults over 50 found that higher dietary creatine intake was associated with slower biological age acceleration, as measured by DNA methylation clocks, one tool for assessing the rate of cellular ageing. The effect was independent of other lifestyle factors.
There is also emerging research around bone health, mood resilience, and women's health across different hormonal life stages, areas I expect to see considerably more data on over the next five years. Creatine is not a single-target compound. It is increasingly looking like one that engages the very infrastructure of how we age.
Emerging evidence suggests relevance in:
- Cognitive performance under fatigue
- Neurological resilience
- Mild cognitive impairment
- Depression
- Brain injury recovery
- Age-related decline in energy metabolism
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The evidence is not equally distributed across all populations. Some groups have more reason to act on this than others.
- Adults over 55The most studied group, and the data is the most robust here. Brain and muscle creatine stores decline with age, and if you are not supplementing, you are likely operating with a depleted baseline you may not even be aware of.
- High cognitive workloads, chronic fatigue or disrupted sleepThe data suggests creatine's ability to support brain energy under stress is most pronounced when the system is already under strain - which, in my experience, describes a large number of the people I work with.
- Vegetarians and vegansGet little to no dietary creatine from food, making this one of the more underappreciated nutritional gaps in plant-based diets - and one of the more straightforward ones to address.
- Women in perimenopause and menopauseAn area I find fascinating, and one that has been underserved by the research for too long. Estrogen appears to play a regulatory role in the creatine system, which may partly explain why cognitive symptoms - brain fog, memory lapses and low mood - are so commonly reported during this transition. The research is still developing, but the biological rationale is sound and I expect the evidence to strengthen.
- Family history of neurodegenerative diseaseAnyone with known elevated risk has reason to engage with this data thoughtfully - even if the clinical picture isn't yet complete enough to make firm recommendations.
Personally, I take 5g of creatine monohydrate daily. No loading phase, no cycling, just a consistent habit I've maintained for the past two years. It sits alongside a small number of other evidence supporting additions to my longevity stack.
For those considering it, a daily dose of 5 to 10 grams is where the brain health research sits. Pure creatine monohydrate is the most researched form and the one I recommend. Also consistency matters - this is a long-term intervention, and the benefits accumulate over time.
That said, supplementation should never be generic. Before starting, it is worth considering your renal function, dietary intake, training load, neurological goals, and overall metabolic context - all of these influence how your body responds and what dose makes sense for you.
Creatine will not replace sleep, exercise, or a well-structured diet. But as part of a broader, integrated approach to longevity, one built on consistent habits and genuine optimisation, the risk-benefit calculation here is about as favourable as it gets.
Before we close, it's worth addressing three myths that still circulate widely - and that continue to put people off a compound with a genuinely strong safety record.
This one has some historical basis but is largely overstated. Older loading protocols - using 20–25g per day in the first week - could draw water into muscle cells rapidly, creating a transient feeling of fullness. At a standard maintenance dose of 3–5g daily, this is rarely reported. If you're sensitive, starting low and building gradually addresses it entirely.
Creatine can increase intramuscular water retention, which may show as a small increase on the scale - typically 0.5 to 1kg in the first few weeks. This is not fat gain. For most people, particularly those using creatine for cognitive or longevity purposes rather than performance, this effect is minimal and clinically irrelevant. The scale is not the right metric here.
This is perhaps the most persistent myth, and the evidence simply does not support it in healthy individuals. Creatine supplementation does raise creatinine levels in the blood - a metabolic byproduct - which can superficially resemble a marker of kidney stress on standard panels. However, this is a direct chemical consequence of creatine metabolism, not a sign of kidney dysfunction. Long-term studies in healthy adults show no adverse renal effects. That said, if you have pre-existing kidney disease or reduced renal function, this is worth discussing with your clinician before starting.
If you're thinking about optimising cognitive performance long-term, it's worth understanding how this fits into your overall strategy.
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