What are the cognitive effects of creatine (creatine monohydrate) supplements?

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Cognitive Effects of Creatine Supplementation

Creatine supplementation may provide modest cognitive benefits, particularly for short-term memory and reasoning tasks, though evidence is mixed and effects appear to be most pronounced in specific populations such as vegetarians, older adults, and those under cognitive stress.

Mechanism of Action

  • Creatine works by increasing phosphocreatine stores in both muscle and brain tissue, enhancing ATP regeneration during high-energy demanding activities 1
  • It can cross the blood-brain barrier, potentially supporting brain energy metabolism and neuroprotection 2
  • Supplementation increases brain creatine levels, which may translate to improved cognitive performance in certain contexts 2, 3

Evidence for Cognitive Benefits

Specific Cognitive Domains

  • Short-term memory and intelligence/reasoning show the most consistent improvements with creatine supplementation 4
  • Effects on other cognitive domains (long-term memory, spatial memory, attention, executive function, word fluency, reaction time) remain inconsistent or conflicting 4
  • Recent research suggests creatine may have small beneficial effects on cognitive performance, though results often border statistical significance 5

Population-Specific Effects

  • Vegetarians may respond better than meat-eaters in memory tasks, likely due to lower baseline creatine levels 4, 6
  • Older adults may experience more pronounced cognitive benefits than younger individuals 6
  • Individuals under cognitive stress (sleep deprivation, hypoxia, aging) appear to benefit more than those in optimal cognitive states 2, 3

Supplementation Protocol

  • For potential cognitive benefits, protocols similar to those used for physical performance can be followed 7:
    • Loading phase: ~20g/day divided into four 5g doses for 5-7 days 7, 1
    • Maintenance phase: 3-5g/day as a single dose 7, 1
  • Lower-dose approaches (2-5g/day for 28+ days) may also be effective 1
  • Taking creatine with protein/carbohydrates (~50g) may enhance uptake through insulin stimulation 7, 1

Safety Considerations

  • Creatine is generally considered safe when used following appropriate protocols 7, 1
  • The primary side effect is a potential 1-2kg increase in body mass, typically due to water retention 7, 1
  • Side effects may be more common with creatine than placebo (relative risk = 4.25) 5
  • In kidney donors or those with kidney concerns, caution is warranted as creatine has been associated with rhabdomyolysis in rare cases 8

Research Limitations

  • Many studies show methodological limitations, including small sample sizes and varying supplementation protocols 3
  • Future research should include measurements of brain creatine content alongside cognitive assessments 3
  • The optimal protocol specifically for increasing brain creatine levels remains undetermined 2

Clinical Implications

  • While creatine is primarily known for enhancing physical performance, its potential cognitive benefits warrant consideration 7
  • The UEFA nutrition guidelines acknowledge that creatine "may also support brain function" beyond its established physical benefits 7
  • Even small cognitive effects could have meaningful benefits when scaled over time and across populations 5
  • The safety profile and accessibility of creatine make it a reasonable consideration for cognitive support, particularly in at-risk populations 6

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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