Background
Most people associate creatine with strength training. But creatine is also stored in the brain, where it buffers ATP. The hypothesis that supplementing could improve cognition under stress has been around since the early 2000s. Until now, the evidence base was a patchwork of small trials.
What the meta-analysis found
Pooling 26 RCTs (n=1,847):
- Small but statistically significant improvement in short-term memory tasks (effect size 0.31).
- Larger effect in sleep-deprived subjects (effect size 0.51).
- Larger effect in vegetarians, who start with lower baseline brain creatine.
- No measurable effect on long-term memory, attention, or executive function in well-rested omnivores.
How it was done
Inclusion: randomized, placebo-controlled, ≥5g/day for ≥7 days, healthy adults. Cognitive outcomes pooled by domain using random-effects models.
What it means in practice
For a well-rested omnivore eating meat regularly, creatine’s brain effects are likely small or undetectable. For people who are sleep-deprived, vegetarian, or both, there is a more meaningful upside. The downside risk profile of 3–5 g/day creatine monohydrate is well-characterized at this point: low.
Editorial note: This is a research summary, not medical advice.