Creatine – Helpful in Alzheimer’s Disease

As many of my followers know, I have been emphasizing the importance of improving brain energetics in the context of Alzheimer’s disease for many years. And of course, any conversation dealing with brain energetics is ultimately going to focus on the mitochondria. In the brain, supporting mitochondrial function is especially critical because of the high energy demands of neurons and other brain cells. A new pilot study published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions explores the potential of the increasingly popular dietary supplement, creatine monohydrate, to do just that—enhance mitochondrial function and support cognitive health in individuals with Alzheimer’s disease. This study offers encouraging preliminary results that highlight the potential of creatine to improve brain energetics and cognitive performance in this population.

Conducted at the University of Kansas Medical Center, the study enrolled 20 individuals diagnosed with Alzheimer’s disease who were given 20 grams of creatine monohydrate per day for 8 weeks (10 grams twice a day). And as the researchers described, the primary goals of this intervention was to determine if giving creatine at this level was feasible and safe and further, to examine its effects on brain creatine levels as well as, importantly, cognitive performance.

Nearly all participants (19 out of 20) adhered to the protocol, reporting over 80% compliance with no serious adverse events. Mild side effects such as muscle cramps and digestive discomfort were noted but generally subsided after the initial weeks. Importantly, serum creatine levels increased significantly, confirming that the participants were absorbing the supplement as intended. And while this finding wasn’t really emphasized in the study, it’s important nonetheless since we know that creatine plays an important role in other areas of the body, perhaps most significantly in muscle cells are able to work.

The researchers used magnetic resonance spectroscopy to measure changes in the levels of creatine in the brain and found that these levels increased by 11% over the 8-week period. In that creatine levels are generally pretty tightly held, this 11% increase is quite remarkable. And, it is important because creatine plays a direct role in the function of mitochondria. in addition to providing a better environment for energy production in brain, neurons, it’s important to keep in mind that the brains immune cells, the microglia, are also highly energy dependent and would benefit from increased levels.These cells can either support brain health or contribute to neuroinflammation depending on their energy state and metabolic environment. By improving mitochondrial efficiency and supporting energy metabolism, creatine may help microglia remain in a supportive, non-inflammatory state, reducing the likelihood of them producing damaging inflammatory molecules that are commonly found in the Alzheimer’s brain as we will explore in my next book, Brain Defenders.

Cognitive testing in the study revealed statistically significant improvements in several areas, including working memory, attention, and language processing. Notably, performance on the oral reading recognition test, which measures the ability to correctly pronounce visually presented words, improved meaningfully. These improvements were positively correlated with increases in brain creatine, indicating a potential direct link between improved brain energy stores and better cognitive function. While this was not a placebo-controlled study and thus cannot prove causality, the data suggest that creatine supplementation may offer real cognitive benefits by boosting brain bioenergetics.

This is a very important piece of the puzzle as it relates to what makes a good brain go bad in the context of Alzheimer’s disease. Yes, it is a small study and yes, it was not placebo controlled. Nonetheless, this is not the first time we have seen evidence that creatine supplementation is worthwhile in the Alzheimer’s patient, and this adds more to the story that targeting brain energetics is potentially a major advance in the treatment of this disease. Beyond actually treating disease, in recognizing how important maintaining brain energetics is in terms of keeping the brain, healthy and disease resistant, creatine supplementation, to me, is something we should all consider, although perhaps not at this dosage. My recommendation has been to consider creatine monohydrate, at a dosage of 5g per day as a way of maintaining good brain health.