Does Creatine Affect Brain Fog?

Creatine is a well-known supplement that is used in the bodybuilding world. It is normally used to improve short-term energy generation when lifting weights. Dietary sources include red meat, seafood, and poultry. The amino acid sources are arginine, glycine, and methionine. Dietary shortfalls can be made up by production in the kidney and liver.

Many supplement it before workouts. But creatine is likely also useful in brain fog and other cognitive symptoms.

The majority is stored in skeletal muscle totaling around 95%, while the brain may have up to 5%.

Interestingly, there seems to be a beneficial effect on aging muscle even if someone is not resistance training although there are studies going both ways.

Anti-inflammatory effects

While my patient population is not largely athletic performance focused, there is a lot of utility of creatine in chronic illness as well.

A rat model of "oxidative stress" (ischemia/reperfusion injury) found that creatine reduced lung injury by reducing NF kappa B activation. This model of inflammation is quite useful in many conditions that I treat, including chronic infections, postinfectious conditions with immune system abnormalities persisting, and toxicities.

Going back to the performance world, creatine may benefit not only weight training but also aerobic performance.A study in marathon runners found certain inflammatory markers being reduced including the cytokine tumor necrosis factor alpha as well as prostaglandin E2. There was also a reduction in creatine kinase in the blood, which is a marker for muscle cell breakdown. There is some theoretical data that there may be anti-inflammatory effects in aerobic exercise but not resistance exercise.

Other conditions that have low-grade inflammation showed some benefit as well. A [knee osteoarthritis study]https://pubmed.ncbi.nlm.nih.gov/29673544) didn't show any benefit, but a heart failure study did find some benefits with the combination of exercise and creatine again reducing the cytokines IL-6, CRP, and found better endothelial (blood vessel wall) function.

This hints that creatine may be useful in many conditions outside of the performance world.

Cognitive improvements and neurological effects

The study titled Use of creatine in the elderly and evidence for effects on cognitive function in young and old found benefit in cognition when deficits were produced either with sleep deprivation, or if there were deficits due to aging.

There was a double-blind trial that used 8 g of creatine for five days showing reduction in mental fatigue with mathematical processing. Imaging done in the studies suggested that there was better oxygen uptake and utilization in the brain. It found that the effect was greater when external stressors were present.

A study in depression also found benefit with creatine supplementation that was both dose and absorption dependent. Part of the mechanism was thought to be related to creatine supporting BDNF (brain derived neurotrophic factor), as compounds that inhibited this block be effective creatine.

Some of the improvements in cognition with the use of creatine might also be attributed to improvements in mitochondrial function.

Mitochondrial dysfunction is common to many chronic illnesses, and accordingly not unique. However, it does give rise to useful supportive treatments. Often these mitochondrial agents, such as riboflavin, CoQ10, and magnesium are useful in headache prevention as well.

In the past, I frequently used creatine in treating and supporting traumatic brain injury study. This linked study showed there was improved self-care, cognition, and communication when creatine was used for six months after brain injury.

However, even in nontraumatic conditions where mitochondrial dysfunction is still present, such as in diabetes there were improved markers such as sugar levels and metabolic syndrome markers.

In many cases, creatine might be considered as a supportive treatment for cognitive function, mitochondrial support, and overall physical and muscular fatigue support.