>> Recently, a pilot study (single-arm) by Smith et al., recruited 20 patients (73 years of age) with AD and provided them with 20 grams/day of CrM for 8 weeks [20]. Serum creatine levels were increased at weeks 4 and 8 (p < 0.001), and total brain creatine levels (as measured by H-MRS) increased by 11% (p < 0.001). Clinically, there were demonstrated improvements in cognition on global (p = 0.02) and fluid composites (p = 0.004), as well as List Sorting (p = 0.001), Oral Reading (p < 0.001) and Flanker tests (p = 0.05).

Yeah 20 patients is not a lot. I'm inferring this is a pre-post test. However some of those p-values are pretty good (.001 on reading and and sorting). Very promising pilot study but not conclusive imo.

FWIW creatine is "one of the most studied supplements for muscle and strength".

But at the same time "creatine’s brain benefits aren’t as exciting as social media makes them out to be. The research at this point just doesn’t support the hype".

Source: https://physiqonomics.com/creatine-cognitive-performance/

Yes, I can't find a 30%-slowdown number either.

I'll add to this: the referenced trial occurred over 8 weeks, so even if we stipulate that the improvements in cognition (which are dubious, as tgv points out in this comment: https://news.ycombinator.com/item?id=48347906) are due to treatment rather than some other effect, we don't know that the effect is disease-modifying as opposed to symptomatic. As with acetylcholinesterase inhibitors, it may just be having a cognition-enhancing effect which, nevertheless, does not alter the underlying disease trajectory (i.e. just shifting the declining trajectory up vertically by a constant amount), and might revert shortly after discontinuing use of the drug.

A controlled trial, over a much longer duration, and ideally with a wash-out period, would be necessary to identify a disease-modifying effect.

> Without a placebo group...

You just needed to read the next paragraph:

"The 2026 multicenter placebo-controlled trial extending this work..."

I think you're right.

Confusingly they reference a 2026 article (which isn't included in their citation list) that allegedly includes "placebo-controlled trial", but I think it might just be [0], which is based on the same single-arm trial. If they do have a paper using a placebo-controlled trial, they should definitely include that citation.

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC12927926/

Normally I wouldn't ask this, but having seen the effects of Alzheimer's I must ask: is there any evidence that taking creatine will harm my brain?

Let's be real: I take a lot of edibles. I smoke sometimes on a hike. Every once in a while I get a Guiness and a gyro. My health is by no means perfect, and if I'm willing to take in literal poison (yes, alchohol is that dangerous that I say such things even about my precious Guiness).

Anyways, for years I've been mostly skeptical of vitamins. I've heard a megadose of Vitamin C can shorten the symptoms of a cold, but a "megadose" is relatively small enough that just some OJ can do that, no need for pills.

But if I'm not giving up my Guiness and gyros, I probably should be willing to be more flexible about my "no vitamins or weird supplements rule".

So TL;DR: Let's flip this around: What are the risks of creatine, presuming a safe supply chain? (It's legal where I am as far as I know, which I'm a fan of for most things since then you can get a receipt and there will be some authority that investigates if you're unlucky to get a "bad batch".)

They also quote a follow up study that sounds more compelling:

> The 2026 multicenter placebo-controlled trial extending this work enrolled 240 participants with early Alzheimer’s... The intervention group showed slower decline on standard cognitive scales by about 30% versus placebo.

But there's no such study in the references section. Not sure what's going on there but I want to see the data before I believe this.

Lots of creatine gummy dropshippers trying to gain ground.

I can't speak for the Alzheimer piece, but there are other studies about supporting the brain.

Worth looking at the range of studies as well.

Wow I have been mixing 5g of creatine in my morning for the past several months, this is terrifying.

Just in case anyone is thinking about trying it: 25g seems pretty high. It’s worth it to review what that means for the rest of your body before starting this regime. Kidneys are really useful organs to have working.

>CONFLICTS OF INTEREST

DC has conducted industry-sponsored research involving creatine supplementation and received creatine donations for scientific studies and travel support and speaking honoraria for presentations involving creatine supplementation at scientific conferences and on social media. In addition, DC serves on the Scientific Advisory Board for Alzchem and Create (companies that manufacture creatine products) and as an expert witness/consultant in legal cases involving creatine supplementation. NF declares no conflicts of interest

A nice unbiased study, I may as well ask Exon Mobil for their opinion on climate change at this point

I use it as a supplement because I do weightlifting. 5g/day. I did 20g/day for a week once, and didn't notice it made any difference, so I'm back to 5g now. In terms of stuff like memory, mood, etc. I can't say it's made any improvement but the idea that it might be helping prevent decline is nice.

High dosage is not for your daily intake

It’s called a loading phase to quickly saturate the tissues i.e for a week or so for someone who never took the creatine. You can absolutely skip this.

I wouldn’t go higher than 10g daily on a regular basis.

I personally take 7.5g for the last couple of years.

What did you use to determine this?

Ask because many of the online tools I've tried, they will sometimes tag what I've written at 30-40% AI written and sometimes purely AI written stuff is flagged as 60-70% AI

To be clear you're not alleging the journal article published in Journal and Brain Psychiatry is ai-generated right.

My personal experience has been dramatic:

5/6g a day.

Very demanding job with lots of ‘thinking’

3 times a week gym

Pre creatine I would struggle to maintain ability to do the hard thinking around 3pm. Just like, fog or I could feel my brain didn’t have capacity.

Now, I am capable till the end of the day. Feels like a well trained athlete at the end of a game being able to deliver rather than just holding on.

Do you work out?

If so creatine is supposed to help people push themselves harder and thus build more muscle. As a side-effect of intense exercises you'll create more testosterone. Increased testosterone leads to balding.

There's evidence creatine may raise DHT levels, and DHT causes hair thinning: https://pubmed.ncbi.nlm.nih.gov/19741313/

I bumped mine from 5g daily to 15 and noticed way less anxiety. It's a must have for me now. Besides that is the regular benefit of being able to squeeze out a few more reps during my kettlebell workouts

I tried getting on it several times, I would feel energized at first but after a two or three days it would do the opposite and I would get very lethargic.

My body has a strange reaction to comonly used substances, though. For instance, even a single soda's worth of caffeine causes me to have an extreme 18-24 hour mania phase and then a two day crash afterwards. So, your mileage will definitely vary.

n=1 here, I noticed considerable shedding and thinning when taking creatine. I've taken it alone for 3 months and noticed thinning and shedding. I took it with Minoxidil and Finasteride for six months and noticed reduced shedding. At one point I stopped Mino and Fin, but kept the creatine and the shedding increased rapidly.

I am now on Minoxidil and Finasteride, with no creatine, and no longer have shedding.

I take 10g a day, have for a couple years now. Started mostly because of training but it does wonders in sleep deprived states.

5g would probably be fine without a lot of training ( I train about 10hrs a week). Seems like I need 10g to both get the physical and mental benefits, especially during peak training blocks (running 50-60 mpw with strength training).

No but every time I try to take creatine supplements I get heart palpitations. Everyone says I am crazy and that it’s impossible but I have proof from my Apple Watch, one time it was so bad it said I had atrial fibrillation. I went to a cardiologist and he acknowledged it is a possibility but he hasn’t seen it before.

I take 10 g a day and have maybe noticed muscles seem to bulk more after a hard strength workout. But other than that I feel about the same.

Interesting, I also noticed thinning

There was one study that has never been replicated that showed it increased DHT levels in Rugby players. Higher DHT levels are associate with hair loss and enlarged prostate. Creatine has always come with too many side effects for me as well, I don't get how people take that stuff every day.

The plausible mechanism is for male pattern baldness, but increased shedding is not MPB. MPB shrinks the size of the hairs on the top of your head over time. It isn't really affected by shedding which is normal and happens to everyone.

Same. Not clumps, but a definite uptick in hair shed. Stopped taking it.

> Creatine mono-hydrate which mostly comes from China and "creapure", which is a patented formula known for its purity.

Creapure sells Creatine Monohydrate not a proprietary form of creatine [1]. The higher end in creatine is Creatine HCL which is more expensive but more water soliable, easier on the stomach, and requires a smaller dose.

In terms of creatine manufactured in the Western World:

* CON-CRĒT manufactures creatine in the US, they produce Creatine HCL.

* Creapure manufactures creatine in Germany. They produce Creatine Monohydrate.

There are also a variety of brands that import creatine and run various tests to ensure quality.

[1] https://www.creapure.com/en/creapure/what-is-creapure/

On the sleep deprivation topic, adenosine buildup in the brain is, along with melatonin, one of the brain's core sleep mechanisms. As you expend energy during the day, adenosine builds up, so your brain has an idea of how long you've been awake.

Creatine recycles adenosine back into ATP, so less adenosine builds up. The amount of creatine you find in foods naturally is way less than the amount people are supplementing with.

So it makes sense physiologically why mega doses of creatine might negatively affect sleep.

Some people simply don’t digest the monohydrate form well. I get all of the symptoms you list.

The HCL form is more expensive, but does wonders for me. None of the negative side effects.

> "creapure", which is a patented formula known for its purity

You mean known for its branding. Most people have never heard of creapure and those who do haven't tested it for purity.

Creatine is $10 at Walmart, I don't think they are paying for astroturfing. It's a chemical like salt.

Creatine doesn't need astroturfing.. It's not <frontier AI lab>'s newest model turbo boost max pro extreme rocket 5.9. It's just a supplement that some people take.

I work out but I've never taken it. I feel like not everything has to be minmaxed, sometimes some things are better left to nature. Easy come easy go as they say

Creatine is very uncontroversial and the scientific consensus is that it's an all around good thing, so I wouldn't be surprised

A few thoughts

1) It annoys me whenever anybody mentions literally anything (whatever baking soda, potassium, any vitamin) you get a million unhinged comments about how this was a personal panacea.

2) Creatine definitely does stuff, that's scientifically been established by numerous studies for decades. It's been recommended as a supplement for vegetarians for mental reasons and for people trying to build muscle-mass (sort of niche). I'm actually a bit surprised how few people talk about it when it's a standard blood test thing (possibly because it can't be patented).

3) It's dirt cheap and made by tons of difference places. I don't think there's a "big creatine." It's probably like < 25 cents a serving.

That strikes me as a really poorly calibrated expectation. Who benefits? Who's paying? How could I get this job?

There isn't much money to make from creatine recommendation, it's a well known nutritional supplement that can be found for pretty cheap. You can read more about it here if you want: https://www.researchgate.net/publication/317612254_Internati...

You tend to see that more for the more high margin and branded supplements.

The profit margins on creatine are not high.

I’m still in the 30s but have found it to lower how much energy it takes to start something, rather than helping me stay focused. Same sort of idea, being in a higher-energy state, just pointing out that age doesn’t seem to be a requirement to get any benefit. I do also respond well the low-carb diets and heat that a lot from pro-creatine people so maybe there’s a connection to diet.

Funny because I'm not sure I quite notice it immediately when I stop taking it, presumably since the body retains a certain amount of it. But I definitely notice a difference when taking it the first day after not having had it a little while, especially when taking 20+ grams a day. It gives me so much mental energy and alertness that I won't get a whole lot of sleep, but the next day I end up feeling just fine. If I remember correctly, there have been at least 2 studies that suggested high doses of creatine reduce the side effects of suboptimal sleep, and that definitely seems to be the case in my experience.

The only thing I notice is the impact to my weight. I think it makes me marginally stronger but not a huge effect. I take it because research seems to indicate it's a net positive with a small effect and it seems very safe...

What sort of differences beyond gym related?

I feel like it makes me feel like crap and my brain weird every time I try it and searching my spreadsheet shows this effect many times when I forget and read something like the above article and try it again. Anyone else feel like this?

N=1 P=0.5

I get mine from bulksupplements. Gummies and many gym focused powders are extremely overpriced. Buying in bulk you should be able to get it for ~$.15 a day at 5g.

Powder, from any company that you find reputable. I like the micronized form. I would avoid any of the gummies, as a huge percentage of them have nowhere near the amount of creatine they claim (I believe the cooking process denatures it or something but this is just conjecture).

I run and do strength training. I think the consensus is that it's not that beneficial for running. You're going to gain a bit of weight which presumably is going to make you slower.

If you were a competitive runner then you'd probably want to cycle it so that you get the strength training benefit but also optimize for your races.

I take it. I did a 10k race and stopped for two weeks. I'm also not super consistent but I try to take about 5-10g a day.

In terms of optimizing overall health I would say take it + running + strength training is a good combination. The effects are not huge and vary person to person.

I’m an ultra runner, I’ll do 50-60 mpw weeks during peak weeks with strength training.

I take 10g creatine, it did wonders for me. More energy and mental sharpness.

Strength training is essential for runners to avoid injury at high mileage. Sleep, strength, and nutrition. It can’t be ignored or you will get injured.

Some folks mention cutting it out to lose weight but at higher mileage I find it hard to keep on weight anyway.

Used to do something similar.

If you intend to have any benefits of going to the gym then protein (and overall calorie consumption) would have to be monitored.

Running sort of conflicts with working out: it wants you to be light and burns plenty of energy.

Gym wants you to gain mass. No mass gains -> gym us useless.

Creatine is kind of an afterthought in this bigger picture. Might give you an extra rep or two but that's it.

Check this video, that gives you a good overview and the description has a good amount of references you can look at: https://www.youtube.com/watch?v=XxZB3Q6EFJU

In short: seems to help with high intensity exercises and post-exercise recovery, helps with muscle development, and a bunch of other benefits.

In a similar situation, I do take creatine. However vo2max will reduce simply due to the waterweight gains.

I counteract it with Magnesium Glycinate. Works well for me.

I discover the sleep issues were related to my inability to digest the monohydrate form. I’d get sweats, chills, all of the nasty side effects.

I switched to HCL and tolerate it massively better.

I don't take it. But to the best of my knowledge there are basically only three things with any body of evidence that they work with few/any downsides: protein supplements, fish/algae oil, and creatine. That's it. It's kind of weird that people get so hyped up about it, but at least they're not getting hyped up about some random wellness influencer supplement.

How can you be sure you weren't placebo'ing yourself into feeling it?

To my knowledge creatine has no significant effects until your levels rise after, say, a week of taking daily

Did you inject or smoke it in order to feel "the mental effect just 2 minutes later"? Taken orally it can only be placebo effect.

Creatine has been tested over long time spans already so this comment is not applicable here.

The better rebuttal is that the paper didn’t follow RCT protocols.

Creatine is one of the most studied substances that humans consume.

Try the micronized (even finer powder) version — never had an issue with 7.5g daily

Did you dissolve it in hot water before consumption?

While this is true, but to my understanding this applies to women as well. Even one of these things has lots of benefits, but both are even better.

“potentially deleterious interaction between caffeine and creatine” in https://doi.org/10.1097/WNF.0000000000000102 mentioned later/elsewhere in today’s thread: https://news.ycombinator.com/item?id=48348670

that should be perfectly fine

It’s a flavorless powder you mix into a drink. It unfortunately doesn’t really dissolve, so it can be a little grainy if taken with water but it’s mostly flavorless so outside of that you wouldn’t notice it.

5g/day is the general recommendation and most packaging will come with an appropriately sized scoop, notably this is one of the rare ones where dose doesn’t seem to be adjusted by age or bodyweight. I presume because it’s cheap, well-studied, and there don’t appear to be downsides for overdoing it. They’re testing it at up to and possibly above 25g/day for Alzheimer’s.

Some people recommend a higher “loading” dose for the first two weeks to build up reserves in your body more quickly, but if the goal is to start taking it daily, this is really unnecessary.

It's often a powder you can mix in to a drink. 5g a day for an adult is pretty normal.

Im 34, 72kg, I take 5g a day. White powder I mix in water, tastes like nothing and has a sandy texture I dislike a bit, but you get used to it.

There is the build up period where you take a higher dose for a week, 8g, in order to saturate the body faster.

Others mentioned dissolving it. I find just getting it over with is easier for me. I dump the whole scoop into my mouth and wash it down with a mouthful of water or two. It is flavorless, after all.

I dissolve it in my coffee every morning, it’s flavorless. I believe 5 grams is the standard dose, it’s about a teaspoon.

I wouldn’t bother with the “loading phase” you often see recommended online. Just be consistent.

I just add to whatever food I'm cooking, I don't notice it

In water, with a bit of regular or pink salt added for general absorption.

Creatine requires you to increase your daily water intake, and actually do it.

I take 3-5g of creatine monohydrate in a glass of water. People usually take it with their protein shake, which for me contains a 30g serving of Organic low-sodium pea protein powder.

If I take creatine too late in the day, it definitely wrecks my sleep. It is good when taken as early in the day as possible.

As for the age group, I think it could be fine for anyone who is 18 or older.

As for a second dose, that's of possible value for intense exercise, but again be mindful of insomnia.

Note that some sensitive brains, e.g. those with excitotoxicity/inflammation pressure/headache/migraine issues, may not always tolerate creatine well. Such people need to fix their underlying brain issue first before using creatine.

His website https://peterattiamd.com returns several direct creatine articles, podcasts, and AMAs with him and others.

Isn't that, like, the most common side effect of it? I was just googling for side effects, and different sources vary a bit, but almost all list digestive discomfort

I haven't heard of that but I know creatine causes loads of water absorption. I wonder if you're borderline dehydrated and creatine pushes you over the limit.

I have the same response. I had it with lots of water but had to stop taking it after a couple of days every time I tried because it made me feel completely zoned-out. Maybe I should try again with a different brand.

Be sure it’s pure creatine, they often mix in all kinds of shit. I take creapure just to be sure.

Try micronised (even finer powder, maxxwell has them) or even in jelly gummy form.

I take 7.5 g every day for a couple of years now and what I definitely noticed is much lower sugar cravings during hard programming days: previously I would eat almost one chocolate every day.

Though YMMV, as I also bench press 140 kg.

I had a lot of issues with stomach when taking creatine until I tried the micronised version. Bucked up makes a good product you can find at Walmart.

What precisely does it mean to "feel crap"? Is that how you would describe it to a doctor? You seem to also be making broad generalizations. Overall your comment is providing zero insight whatsoever wrt creatine.

In my experience, those with creatine intolerance, especially if assuming it's not taken late in the day, have unresolved excitotoxicty/inflammation/pressure/headache/migraine issues in their brain.

Also, be mindful with blends as they can be fairly dangerous. It's best to get an isolated creatine monohydrate product that is not a blend.

Check your blood pressure. It is very possible that there is something else in your blend that is raising your BP.

Creatine is great regardless, just dont get sold by whatever the nonsense article is pushing if anything. Generic creatine the cheapest you can find is likely your best bet.

I have the same struggles with preworkout, they are just overkill for me and make me crash and i feel they impact my sleep because i usually work out at a random time so the caffeine timing may be terrible. Certainly had success with them for a while, but it was when i didn't really care when i went to sleep because when i was younger I'd just sleep for 8-10 hours straight regardless of time of day/night.