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Creatine Supplementation and the Brain: Have We Put the Cart Before the Horse?

Darren G Candow, Jedd Pratt, Nicholas Fabiano, Ali Gordji-Nejad, Aaron Smith, Eric S Rawson, Terence Moriarty, Scott C Forbes, Chad M Kerksick
J Diet Suppl 2026 23(2):175-204

Bibliography

PubMed
PMID 41556609
DOI
10.1080/19390211.2026.2616440
Funding
The authors reported no funding associated with the work.
Competing interests
Darren G. Candow disclosed creatine-industry sponsored research, supplement donations, travel support, advisory-board roles with Alzchem, Create and Iovate, and expert-witness/consulting work. Scott C. Forbes disclosed prior creatine-company advisory work, creatine donations, educational-product sales, ISSN advisory work and Bear Balanced advisory work. Eric S. Rawson disclosed industry-sponsored creatine research, supplement donations, travel support, Alzchem advisory-board service and expert-witness/consulting work. Chad M. Kerksick disclosed grants, honoraria, consulting fees, multiple industry advisory roles and Scientific Affiliate status with Alzchem. Other authors reported no conflicts.

Study snapshot

DesignInvited expert narrative review
ModelHuman-focused review
SampleNarrative synthesis; no single pooled participant count
InterventionCreatine supplementation across human brain, cognition, sleep-deprivation and clinical studies
DurationVaried across reviewed studies
EndpointsBrain creatine measured by magnetic resonance spectroscopy; Cognition; Sleep deprivation; Mental fatigue; Hypoxia; Alzheimer's disease; Major depressive disorder; Mild traumatic brain injury; Sleep quality

What the study showed, in plain terms

2026 expert review examining why creatine's brain effects are harder to establish than its muscle effects, including measurement limitations, dose and duration questions, stressed-state cognition and preliminary clinical applications.

Key findings

Creatine supplementation can increase brain creatine, but the response appears more variable and may depend on dose and duration. Benefits are most consistently suggested during acute metabolic stress such as sleep deprivation, mental fatigue and hypoxia, while disease-specific clinical findings remain preliminary and inconsistent.

What this study can and cannot tell us

Narrative rather than systematic quantitative synthesis. Brain magnetic-resonance spectroscopy is sensitive to voxel placement, signal quality, analysis pipelines and reporting conventions, making across-study comparisons difficult. Several authors disclosed creatine-industry relationships.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction