Can creatine improve women’s brain health?

Bottle of creatine supplement on table with measuring spoon

As a supplement researcher, I’m often asked about creatine, which is typically taken for muscle building and body composition, but recently it’s become a popular supplement for overall physical and brain health, particularly in women. While I’ve never personally tried creatine, it is one of the most widely studied, safe and effective supplements on the market. 

The recent data on creatine’s effects on women, particularly aging women, and brain health does have me intrigued. For women, specifically, the aging process introduces a spectrum of cognitive challenges manifesting as brain fog, fatigue, and memory deficits that often occur during perimenopause and menopause.

To address these symptoms, creatine supplementation is emerging as an interesting bioactive supplement with some pretty compelling evidence in women (Forbes et al., 2022; Smith-Ryan et al., 2021). 

Creatine and the brain.

Creatine is a naturally occurring compound found in small quantities in certain foods, with its highest concentrations residing in meat and fish. The human body also has the capability to synthesize creatine from amino acids (i.e. protein). Traditionally lauded for its role in energy metabolism and muscular performance, creatine has recently taken center stage in the realm of cognitive function research.

To truly understand how creatine works on the brain, we need to dive deep into energy production in the cell. ATP (adenosine triphosphate) is the primary energy currency of cells, including those in the brain. The brain is a massive consumer of energy, demanding a constant and reliable source to fuel its myriad functions. When a task requires a burst of energy, such as a cognitive challenge, ATP gets rapidly consumed. This is where creatine flexes its molecular muscles. 

Creatine’s major role is to regenerate ATP from ADP (adenosine diphosphate), ensuring a steady supply of energy to power the intricate processes that govern cognition. By acting as a reservoir of readily available energy, creatine becomes a valuable ally in the battle against cognitive decline.

Creatine and cognitive empowerment.

As we age, cognitive decline becomes a looming concern, particularly for many women in perimenopause and menopause. The gradual ebbing of memory, attention, and overall cognitive function can be perplexing and frustrating – especially at a time when social, professional and personal pressures are the most demanding.

Several early studies shed light on the potential benefits of creatine for cognitive function, particularly in the context of aging. A study published in the journal “Psychopharmacology” in 2003 found that supplementing with creatine led to significant improvements in cognitive performance among young adults. While these findings were initially intriguing, subsequent research expanded the scope to include older populations, uncovering promising results for women in their 40s and 50s.

In another study conducted by Rae et al. and published in the “Journal of Clinical Psychopharmacology” in 2003, participants aged 45-65 were subjected to a battery of cognitive tests after creatine supplementation. The results were compelling, showcasing enhancements in tasks related to short-term memory and overall cognitive performance. The study hinted at creatine's potential to act as a cognitive enhancer, offering a glimmer of hope for those seeking to fortify their mental acuity in the face of aging.

The gender factor: creatine and women's brain health.

But does this mean every woman in her 40s and 50s should rush to stock up on creatine supplements? Not necessarily. The landscape of nutritional supplementation is nuanced, and individual considerations play a pivotal role. (Note: Always consult with a healthcare professional before embarking on any supplementation journey!!)

As the scientific community digs deeper into creatine supplementation, questions arise about whether its effects on cognitive function differ at all between men and women. This is a critical distinction as females exhibit 70-80% lower endogenous creatine stores compared to males, and understanding creatine metabolism pre- and post-menopause could have crucial implications for performance and health.

Traditionally, studies on women’s health and performance have been scarce. With regard to creatine, that early study published in the “Journal of Clinical Psychopharmacology” in 2003 got scientists thinking by using both male and female participants. Both genders experienced cognitive benefits after supplementation. Since then, literature is slowly emerging that examines supplementation for women, specifically, across the lifespan.

A comprehensive review in 2021, by Dr Abby Smith-Ryan and colleagues, suggested that pre-menopausal females can enhance strength and exercise performance through creatine supplementation, while peri- and postmenopausal females may see benefits in muscle size, function, and bone health.  

They go on to state that hormone-related changes suggest that creatine supplementation may be particularly beneficial during menses, pregnancy, post-partum, and post-menopause. Additionally, both preclinical (cell & animals) and clinical evidence (humans) indicate positive effects on mood and cognition, making creatine supplementation a potential option for women to consider.

I was able to attend a recent online webinar sponsored by Asker Jeukendrup of MySportScience led by Dr Smith-Ryan and her colleagues Dr Daron Candow and Dr Scott Forbes - all of whom have published extensively on creatine. It struck me that we have a pretty solid grasp on how creatine works for athletic and sports performance, but how little is actually known about more health and cognitive related markers, particularly in women. Also, as a female scientist in my 40’s, I was also pretty bummed to hear why and how it’s working uniquely in women is not quite clear. Dosage, long term protocols, and outcomes were honestly all over the map.

Hopefully, in the coming years, as researchers focus more explicitly on gender-specific responses to creatine supplementation, a clearer picture may emerge. Women, especially those in their 40s and 50s, stand to gain invaluable insights into how creatine can be harnessed as a tool for preserving and enhancing cognitive function.

Navigating the terrain: dosage and safety considerations.

While the promising landscape of creatine for brain health unfolds, it's essential to approach supplementation with caution and informed decision-making. Dosage is a critical factor, and recommendations vary. Studies have explored a range of dosages, from a few grams to more substantial amounts. However, starting with a lower dose and gradually increasing, while monitoring for any adverse effects, is a prudent approach. Typically, the recommended dose for women is 3-5g per day, with most outcomes seen in muscle increase and body composition.

Moreover, as with any supplement, individual responses may differ. Women considering creatine supplementation should consult with their healthcare providers to assess potential interactions with existing medications or underlying health conditions. Safety remains a paramount concern, and anyone considering supplements to improve cognition and brain health outcomes should prioritize well-informed and personalized decisions.

References

Cooper, R., Naclerio, F., Allgrove, J., & Jimenez, A. (2012). Creatine supplementation with specific view to exercise/sports performance: an update. Journal of the International Society of Sports Nutrition, 9(1), 33.

Forbes, S. C., Cordingley, D. M., Cornish, S. M., Gualano, B., Roschel, H., Ostojic, S. M., Rawson, E. S., Roy, B. D., Prokopidis, K., Giannos, P., & Candow, D. G. (2022). Effects of Creatine Supplementation on Brain Function and Health. Nutrients, 14(5), 921.

Rae, C., Digney, A. L., McEwan, S. R., & Bates, T. C. (2003). Oral creatine monohydrate supplementation improves brain performance: a double––blind, placebo––controlled, cross––over trial. Psychopharmacology, 167(3), 324–327.

Rae, C., Lee, M., Dixon, R. M., Blamire, A. M., Thompson, C. H., Styles, P., & Radda, G. K. (2003). Brain bioenergetics and cognitive ability. Developmental Neuroscience, 25(5), 324–331.

Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients, 13(3), 877. https://doi.org/10.3390/nu13030877

Van Wijngaarden, J. P., Doets, E. L., Szczecińska, A., Souverein, O. W., Duffy, M. E., Dullemeijer, C., ... & de Groot, L. C. (2014). Vitamin B12, folate, homocysteine, and bone health in adults and elderly people: a systematic review with meta-analyses. Journal of Nutrition and Metabolism, 2013, 486186.

 

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