Creatine May Limit Brain Damage

By Elaine Zablocki
Reviewed By Dr. Jacqueline Brooks


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Nov. 2, 2000 -- The dietary supplement creatine is widely used by athletes to increase muscle mass and performance. Now a new study, conducted in animals, suggests that it may also protect against damage due to brain injury in people.


"Professional quarterbacks in the NFL sustain many concussions, with less damage than we might expect," senior author Stephen W. Scheff, PhD, tells WebMD. "That could be because they're taking creatine." Scheff is professor of anatomy and neurobiology at the University of Kentucky School of Medicine and associate director of basic research at the Sanders-Brown Center on Aging, both in Lexington.


In this study, published in the November issue of The Annals of Neurology, researchers fed rats and mice a diet high in creatine, and then simulated a concussion. They found that rats who ate a creatine diet for four weeks had a 50% reduction in brain damage, compared to rats on a normal diet. Mice who received three days of creatine pretreatment had a 21% decline in damaged cells, while those who received five days of creatine pretreatment had a 36% decline.


This doesn't mean you should eat creatine ahead of time before having a concussion, because concussions obviously aren't planned. But because these animal studies show creatine works by increasing energy production in the part of the brain cells responsible for generating the body's energy, called the mitochondria, it may be possible to find a substance that has a similar effect if taken soon after a concussion or brain injury. Scheff and other researchers have looked at several substances and are now conducting tests on one promising possibility.


Just as important, creatine may be valuable in several diseases where mitochondrial dysfunction plays a role. According to Sinclair Smith, ScD, many previous studies have indicated that creatine has the capacity to protect nerves. These reports have shown that it has good results in Lou Gehrig's disease (also known as amyotrophic lateral sclerosis, or ALS) and multiple sclerosis among others, he tells WebMD. Smith is an assistant professor of physiology in the occupational therapy department at Temple University School of Medicine in Philadelphia.


He believes creatine could potentially assist in treatment of diseases involving nerves and muscle. "I don't expect it will be a cure, but it may slow the disease process. Future research needs to focus on how creatine works in humans, and how it works in conjunction with other treatments. This is a hot area right now."


Head injuries predispose people to early onset of Alzheimer's disease, though no one knows why. This suggests creatine might also possibly slow Alzheimer's progression, Scheff speculates. "We don't know if it will stave off the disease, but it might be worth investigating."


However, since creatine is a nutritional supplement, it isn't regulated by the FDA, and it hasn't been tested for safety in human beings. At the same time, lots of athletes are taking it, and lots of health food stores are selling it.


Last May, the Blue Cross and Blue Shield Association released a statement warning about potential negative consequences of creatine. Although there have been no formal studies, observers say it may be linked to cramps, diarrhea, nausea, dizziness, high blood pressure, and liver and kidney problems.


But Scheff says creatine is an inexpensive substance with no known side effects. "Three grams of creatine per day is a maintenance dose," he says. "I buy it at the local grocery store before I go skiing."


Edward J. Kasarskis, MD, PhD, agrees creatine may play a valuable role in fighting diseases of the nervous system. When mice with ALS are fed creatine, they live longer, he tells WebMD. Now studies are planned to test creatine in humans with ALS. Meanwhile, since creatine is readily available, many of these patients are already taking it on their own.


"When people are faced with a desperate disease that has no effective treatment, they don't worry about side effects. They're eager to try something that may prolong life. We don't encourage them; we don't discourage them. Is creatine safe and effective for this condition? We don't know," says Kasarskis, a professor of neurology at the University of Kentucky's Chandler Medical Center and a member of the Amyotrophic Lateral Sclerosis Association's Subcommittee on Gulf War Veterans and Amyotrophic Lateral Sclerosis.