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Creatine and Concussions

In recent years, creatine has gained attention not just among athletes but also in the medical and research communities for its potential benefits in treating and preventing concussions. While it's best known for enhancing athletic performance, emerging research suggests that creatine could be a game-changer for brain health, particularly in managing mild traumatic brain injuries (mTBI). 


First, let's talk about how creatine works. The brain, like any high-performance engine, requires a constant supply of energy to function properly. ATP (adenosine triphosphate) is the primary energy currency in the brain. During periods of high energy demand, such as intense cognitive tasks or after sustaining a concussion, creatine helps by rapidly resynthesizing ATP from ADP (adenosine diphosphate). This ensures a steady supply of ATP, supporting brain function and potentially mitigating the effects of energy deficits following a concussion.


One of the critical consequences of mTBI is an alteration in ATP demand due to reduced blood flow and hypoxia (lack of adequate oxygen). It has also been demonstrated that brain creatine levels are often significantly decreased following mTBI. This resultant "cellular energy crisis" can lead to cognitive impairments, prolonged recovery times, and numerous other symptoms. Studies have shown that creatine supplementation can help address these energy deficits, potentially reducing the severity of concussion symptoms and enhancing recovery. This point is further illustrated by a study involving children and adolescents with TBI where creatine supplementation was associated with significant improvements in cognition, communication, self-care, personality, and behavior. It also helped reduce common post-concussion symptoms such as headaches, dizziness, and fatigue. 


Creatine's benefits extend beyond energy metabolism. Though the mechanism is still not fully understood, it also may possess antioxidant properties, reducing the formation of reactive oxygen species (ROS) and scavenging radical species in the brain. These antioxidant effects can offer neuroprotection, reducing cellular damage and inflammation that often follow a concussion, and may even have a therapeutic effect on some neurodegenerative diseases as well.


Animal studies provide additional support for creatine's neuroprotective effects. In one such study, creatine supplementation before a traumatic brain injury reduced brain damage in rats by up to 50%. Similar studies in humans are currently lacking, but this indicates that creatine could serve as a preventative measure for those at high risk of sustaining a concussion, such as athletes.


But… is it safe? The safety of creatine supplementation in healthy individuals has been well-documented in recent years. Extensive research indicates that both short- and long-term creatine use is safe and well-tolerated, even at high doses of up to 30 grams per day for five years. However, like any supplement we always recommend speaking with a healthcare provider to establish an appropriate dose and make sure that creatine is an appropriate supplement for you. 


If you are interested in learning more about CFNC’s approach to treating TBI, concussion, or post-concussion syndrome, please check out our other blog postsor contact us to schedule a consultation with one of our doctors. 


References

  • Roschel H, Gualano B, Ostojic SM, Rawson ES. Creatine Supplementation and Brain Health. Nutrients. 2021 Feb 10;13(2):586. doi: 10.3390/nu13020586.

  • Hall M, Manetta E, Tupper K. Creatine Supplementation: An Update. Current Sports Medicine Reports 20(7):338-344, July 2021. DOI: 10.1249/JSR.0000000000000863.

  • Candow DG, Forbes SC, Ostojic SM, Prokopidis K, Stock MS, Harmon KK, Faulkner P. "Heads Up" for Creatine Supplementation and its Potential Applications for Brain Health and Function. Sports Med. 2023 Dec;53(Suppl 1):49-65. doi: 10.1007/s40279-023-01870-9.

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