Author: Ing. Esteban Fuquene
Editorial staff: Prof. Jorge L. Petro, CSCS, ND. Mayra Márquez, & Prof. Jana Kočí, PhD
The ergogenic effects of creatine supplementation (SCr) are widely documented, with strong evidence of its properties in increasing lean mass, strength and improving physical/muscular performance. These effects have been demonstrated, particularly when combined with exercise, in different population groups; their benefits have been reported with supplementation protocols using creatine alone or in conjunction with other compounds or nutrients1-4. In addition to being effective, SCr is safe and well-tolerated in the short and long term (e.g., up to 30 g/day for 5 years) in healthy people, with certain pathologies and at different stages of the life cycle5; Based on the U.S. Food and Drug Administration’s (FDA) Adverse Event Reporting System (CAERS), Jagim & Kerksick6 note that only 22 of the 15274 (i.e0.144%) reports of adverse events were related to creatine during the period 2018-2020, therefore there is a very low incidence of adverse effects of SCr6.
The best-known role of creatine is the rapid supply of energy by delivering the creatine phosphate (PCr) group to adenosine diphosphate (ADP), resulting in the synthesis of adenosine triphosphate (ATP); in this way, it contributes to the maintenance of the cellular energy state. However, since the largest amount of creatine in the body is found at the muscular level, the brain – which is a metabolically active organ – adds up to ~20% of total energy consumption. Brain tissue mainly expresses the creatine kinase type B (B-CK) isoform, indispensable in the ATP/CK/PCr system, suggesting that creatine may also be relevant for energy in the nervous system1.
Creatine deficiency syndromes, which involve creatine depletion at the brain level, have been reported to be characterized by mental and developmental disorders (e.g., learning delays, mental retardation, seizures, and autism), which can be partially reversed with SCr 1,7. On the other hand, it has been proposed that creatine can decrease the concentrations of reactive oxygen species (ROS), which can cause significant negative effects on cell structure; therefore, it is attributed to antioxidant properties or effects that, to some extent, can have great benefits in patients with neurodegenerative diseases.
The use of SCr protocols can be beneficial in neurodegenerative diseases, cognitive function (CF), brain injuries, contusions, and some states in which the oxygen supply is altered (i.e. hypoxia), mainly because these conditions present a decrease in PCr concentrations and alterations in the demand for ATP. Whereas, when presented, it imparts a negative effect directly on neurocognitive, communication, personality, and behavioral abilities; likewise, a reduction in headaches, dizziness, and fatigue presented in patients with brain injuries has been evidenced 1,8.
In regards to CF, which refers to multiple mental skills, including learning, thinking, reasoning, remembering, solving problems, making decisions, and paying attention 9, poor lifestyles (e.g., physical inactivity or sedentary lifestyle), aging, and neurodegenerative diseases are associated with its decline and which ultimately affects quality of life10,11. In this scenario, la SCr has shown benefits in HR in different population groups as evidenced in Table 1, which summarizes the findings of SCr in HR from recently reviewed studies by Roschel et al.1.

Finally, it is possible to conclude that the use of CRS can improve CF, present great benefits in brain health care and that, due to its highly safe profile, it is a very good option to reduce damage and improve recovery in patients with brain injuries.
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References
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