Palm Beach Gardens Fire Rescue Health & Wellness

Creatine for the Brain: Can Higher Doses Boost Mental Performance?

Creatine is best known as the supplement that helps firefighters crush workouts and occupational tasks, a.k.a. strength and power. But recent research now suggests that higher doses (10–20 g per day) may also support brain performance. From memory and focus to resilience under sleep deprivation, creatine has potential benefits far beyond the gym.

Updated Dosing from 2024 Review

According to a review by Candow et. al, in Advanced Exercise and Health Science, creatine dosage depends on a person’s individual response and the tissue targeted (e.g., muscle, bone, or brain)1. To summarize, the paper recommended the following:

  • Muscle: 
    • Loading: ~20 g/day (or 0.3 g/kg/day) for ≤7 days 
    • Maintenance: 3–5 g/day (or 0.10–0.14 g/kg/day)
  • Bone: 0.10–0.14 g/kg/day + resistance training
  • Brain: ≥20 g/day (≤7 days) or ≥4 g/day long term
  • 30% of people are “non-responders” (small or no increase in muscle creatine).

Note that the dose for brain benefits is much higher than muscle requirements. The authors also noted that brain creatine levels may require higher or longer dosing to increase meaningfully compared to muscle tissue. They emphasized that the brain’s limited capacity to import creatine from circulation means longer or higher dosing periods may be needed to impact cognition1.

They also noted that factors such as baseline creatine levels, sex hormones, diet, and age can influence the amount of creatine that enters the brain. Individuals with lower initial brain creatine (such as vegetarians or those with chronic fatigue) appear to respond best. However, the relationship between dose and brain response is not linear, a.k.a., more is not always better, but higher doses can accelerate saturation.

How Creatine Fuels the Brain

The brain uses roughly 20% of the body’s daily energy. Creatine helps recycle adenosine triphosphate (ATP), the body’s main energy currency, in both muscle and brain tissue2. More available ATP allows neurons to fire efficiently and sustain focus under stress. This is critical for first responders who face long hours, unpredictable calls, and disrupted sleep. When brain energy dips, focus, decision-making, and reaction time decline. Supplementing with creatine may buffer those dips2.

What the Research Says

Recent research has expanded our understanding of creatine’s impact on brain health and cognition, particularly at higher doses.

  • Rae et al., 2003: 5 g/day for six weeks improved working memory and intelligence in young adult vegetarians3.
  • McMorris et al., 2007: 20 g/day (split over 4 doses of 5g) for seven days enhanced reaction time and mental performance during sleep deprivation4.
  • Avgerinos et al., 2018: A meta-analysis found that creatine improved reasoning and short-term memory, especially in vegetarians and older adults5.
  • Gordji-Nejad et al., 2024: A single high dose of 0.35 g/kg (~25 g) improved reaction time, logic, and memory after 21 hours of sleep deprivation and prevented brain ATP and pH decline6.

When Higher Doses Make Sense

A short loading phase of 20 g/day for 5–7 days saturates muscle and brain stores for those new to creatine monohydrate, followed by 3–5 g/day for maintenance. For those who are easily bloated or have GI issues with higher creatine doses, stick to the maintenance dose for 3-4 weeks to start. For firefighters or tactical athletes facing extended shifts, sleep loss, or cognitive strain, 10 g/day for short periods may help maintain focus and mental clarity.

Candow et al. (2024) also support relative dosing strategies, such as 0.1–0.14 g/kg/day, especially for older adults (65 or older), which may support both muscle and brain energy systems simultaneously. This is 9-13 g for a 200 lb firefighter.

Who Might Benefit Most

  • First responders working long shifts or under chronic fatigue
  • Older firefighters & retirees (>65 years old) with slower cognitive recovery
  • Vegetarians or low-meat eaters with lower baseline creatine stores

Recruits and officers preparing for high-pressure training or exams

Potential Side Effects of Higher Doses

While creatine is generally safe, higher doses (above 10 g/day) can cause mild gastrointestinal discomfort in some users2. Symptoms may include bloating, nausea, or cramping, especially if large single doses are taken at once2. To minimize these effects, divide doses into smaller servings throughout the day, mix thoroughly in warm water, and stay hydrated.

Blood Creatinine Levels

Ever have a doc get worried about your blood creatinine levels after starting creatinine? No need to worry! Williamson and New (2014) noted an increase in blood creatinine can occur with creatine supplementation, even when kidney function is normal. This is because creatine naturally breaks down into creatinine during normal energy metabolism. When more creatine is consumed, the total creatinine pool in the body rises, which can falsely appear as impaired kidney function on lab results. Williamson and New described a case of elevated serum creatinine after creatine ethyl ester use, which normalized once supplementation stopped, confirming no true kidney damage. This “pseudo-elevation” is due to the additional conversion of supplemental creatine to creatinine, not reduced clearance by the kidneys. When in doubt, clinicians can measure cystatin C or perform a creatinine clearance test to confirm true renal function.

Bottom Line

Creatine is no longer just for muscles; it’s emerging as a cognitive enhancer. Studies show higher absolute doses (10–20 g/day) or relative dosing strategies (0.1–0.3 g/kg/day) may improve brain energy, focus, and reaction time during fatigue or sleep deprivation. For first responders, consistent use or short high-dose phases may help sustain both mental and physical performance.

References

  1. Candow, D.G., Ostojic, S.M., Forbes, S.C., & Antonio, J. (2024). Does one dose of creatine supplementation fit all? Adv Exerc Health Sci, 1, 99–107. https://doi.org/10.1016/j.aehs.2024.05.002
  2. Antonio, J., Candow, D.G., Forbes, S.C. et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr 18, 13 (2021). https://doi.org/10.1186/s12970-021-00412-w
  3. Rae, C., Digney, A.L., McEwan, S.R., & Bates, T.C. (2003). Oral creatine monohydrate supplementation improves brain performance: a double blind, placebo controlled, cross over trial. Proc Biol Sci, 270(1529), 2147–2150. https://pubmed.ncbi.nlm.nih.gov/14561278/
  4. McMorris T, Harris RC, Swain J, Corbett J, Collard K, Dyson RJ, Dye L, Hodgson C, Draper N. Effect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisol. Psychopharmacology (Berl). 2006 Mar;185(1):93-103. doi: 10.1007/s00213-005-0269-z. Epub 2006 Jan 17. PMID: 16416332. 
  5. Avgerinos KI, Spyrou N, Bougioukas KI, Kapogiannis D. Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Exp Gerontol. 2018 Jul 15;108:166-173. doi: 10.1016/j.exger.2018.04.013. Epub 2018 Apr 25. PMID: 29704637; PMCID: PMC6093191.
  6. Gordji-Nejad, A., et al. (2024). Single-dose creatine improves cognitive performance and induces changes in cerebral high-energy phosphates during sleep deprivation. Sci Rep, 14, 4937. https://doi.org/10.1038/s41598-024-54249-9
  7. Williamson L, New D. How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology. BMJ Case Rep. 2014 Sep 19;2014:bcr2014204754. doi: 10.1136/bcr-2014-204754. PMID: 25239988; PMCID: PMC4170516.

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