Creatine for gut and mental health?

(DougCookRD.com)

Creatine monohydrate is probably best known for it’s use as an ergogenic aid, something that enhances physical performance. Creatine exploded onto the fitness & sport nutrition scene in the 90s; almost everyone I knew at the gym was using it and why not? There’s good science to support its use for exercise and fitness-related activities (1, 2, 3, 4). Creatine is stored as ‘creatine-phosphate’ (CrP), sometimes called ‘phosphocreatine’, which helps to regenerate ATP; a molecule that provides energy including that which is needed for muscle contraction. Having more creatine on board helps to ensure working muscles recover quicker and fully so that more reps can be squeezed out during exercise.

Turns out that muscles are not the only organ or body system that benefits from the extra energy storage that CrP offers. Creatine benefits the gut, the brain and by extension mental health and even the skin. This makes complete sense since creatine is made by every cell in the body. Who knew? Might you benefit from extra creatine in your diet?

Creatine: a quasi amino acid with multiple health benefits

The gut

Creatine, a commonly used dietary supplement, plays an important role in maintaining gut barrier function, i.e. preventing ‘leaky gut‘. Given that dysregulation of the gut barrier (the defense between the intestinal contents and the blood stream) is a hallmark of inflammatory bowel disease, it is plausible that creatine supplementation may reduce intestinal disease severity.

A case study in the American College of Gastroenterology Case Reports Journal found just that (5). A 33-year-old male was seen for evaluation of a 2-year history of hematochezia and anal pain thought secondary to non-healing anal fissures. In addition to rectal bleeding, the patient reported a long history of cramping, abdominal pain and loose stools. Given the patient’s long-standing GI symptoms, anal tag, and hemorrhoids, a colonoscopy was performed to evaluate for IBD. The patient was taking just over 1 g of creatine daily which was stopped and he was then started on mesalamine (an anti-inflammatory).

Over the following 4 months, the patient reported progressively more frequent and severe abdominal pain. A repeat colonoscopy at that time revealed worsening ileitis with more extensive ulceration. Given this progressive ileitis, more intensive therapy was planned. Prior to initiating new agents, however, the patient requested a trial of his previous creatine supplement, as he felt his symptoms were better when taking creatine and worsened once he stopped. Upon stopping mesalamine and reinitiating creatine at 1,034 g/day, the patient reported a significant improvement in his symptoms. A repeat colonoscopy was performed 6 months later to assess endoscopic Crohn’s activity on “creatine monotherapy.” The prior extensive ulceration and inflammation appeared significantly improved, and only one, small ulcer was seen.

Clinical trials are now underway to study the effects of dietary creatine on mucosal inflammation in IBD; this was the first reported case of a patient with IBD who experienced significant clinical improvement with creatine supplementation

Turns out creatine plays an important role in the energy metabolism of intestinal epithelial cells and therefore tissues of the digestive tract. It is needed to maintain gut barrier function (when the digestive tract keeps the ‘bad’ stuff out and lets the good stuff in), support normal digestion and enzyme secretions and gut homeostasis or the ability to self-regulate/balance itself (6, 7, 8)

The brain

Often, what’s good for the gut is good for the brain; a function of the gut-brain axis so gut-loving creatine stands to benefit our noggins as well. You’ll probably be surprised to hear then that it’s actually been over a decade now since scientists demonstrated that supplementing creatine can significantly enhance cognition and delay mental fatigue. Vegetarians will especially benefit from extra creatine since creatine is normally found in animal proteins such as meats, fish and poultry. It’s true that the the body can produce some creatine but we normally rely on dietary sources to provide most of what we need. If we’re not getting enough from our diets, vegetarian or not, supplemental creatine will top up the tank and help us meet and exceed our minimum daily requirements.

The effects of creatine on the brain are so potent that when vegetarians were given 5 g of creatine/day for 6 weeks, a double-blind, placebo-controlled study found that working memory and intelligence (as measured by Raven’s Progressive Matrices) were significantly improved compared to the placebo subjects (9). But creatine supplementation can benefit non-vegetarians too. A 2009 study showed that creatine is capable of increasing I.Q, attention span and working memory in non-vegetarians also (10).

Research is also underway to see how creatine supplementation may work as possible therapy for various neurological degenerative diseases like Huntington’s, ALS and Alzheimer’s diseases (11, 12, 13, 14)

Creatine supplements help to increase CrP levels in the brain cells, or neurons, like it does muscle tissue and the cells of the digestive tract. Cells with more CrP are able to boost energy levels; more energy may lead to better cognitive peformance.

Your Brain on Creatine. Creatine from meat seems to help us think.

Getting the amount of creatine needed for optimal benefits can be challenging even for omnivores making supplementation key to getting the most that creatine has to offer. It’s virtually impossible for vegetarians and vegans to get enough.  Most of the discussion around plant-based nutrition focuses on the usual suspects of protein, zinc, iron, calcium, vitamin B12 and to a lesser extend vitamin D, long-chain fatty acids EPA, DPA and DHA but it’s more nuanced than that. Creatine is never talked about but it’s something that’s touched on in my post Vegan? It’s more than B12 and zinc that’s at risk.

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