>> 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.

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.

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/

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.

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...

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.

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?

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

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.

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.

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

that should be perfectly fine

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

Did you dissolve it in hot water before consumption?

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.

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.

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

This is a myth, its not bad for your kidneys. The reason this gets spread is because you will have higher levels of creatine in your urine if your Doctor tests your urine for kidney function, which indicates kidney disease.

However, If you reveal to that doctor that you're supplementing Creatine it will not be concern them.

I'm not aware of any evidence that creatine harms the kidneys if your kidney function is remotely normal. You'd probably want to check with your doctor if your kidney function is already compromised.

Creatine supplementation will freak out a lot of doctors if they're not warned of it ahead of time, though, and sometimes you'll even need to explain to them that they will see elevated levels of creatinine on the tests and it won't be an accurate predictor of kidney function.

If you're supplementing with creatine and need your kidneys tested it's easiest to stop a couple of weeks before, or ask for a Cystatin C test and make sure they use the relevant adjustments for body mass as well if you e.g. lift weights - I've more than once had doctors imply they were worried I had kidney disease because they were entirely unaware of the effects both creatine and large body pass has on the regular tests.

I can second this, do NOT start at 25g of creatine. If you're too lazy to read the literature a friendly AI tool will summarize it.

Yes, the labeling does caution against using it if you have kidney disease. Not sure how much of a risk there is if your kidneys are functioning normally. Maintaining good hydration is always a good idea.

Hei more than that - as an avid weed consumer - drugs are not dangerous by themselves especially when you don't like them - they are dangerous when you create space for them and get along with them. I like to believe weed is my little "cheat" - but i'd argue that any product is an abuse on a daily basis - so taking creatine once in a while might be fun to try out - but i would warn about anything on the spectrum of "regime" that plan for a daily basis etc... especially as you rightfully justified, without a doctor or an expert being able to know what effect this is going to have on a said person.

For lifting you hit a saturation point quickly where your muscles will only hold so much of it. Not sure if there is an equivalent for any brain related effects.

Its changed my life. Im also a long time vegan with MTHFR gene mutations and sleep issues though.

Sometimes when I see muscular guy with a head full of hair, I wonder what is counteracting that increased testosterone.

It’s not increased testosterone in general that causes balding, it’s increased concentrations/sensitivity of testosterone byproducts in the hair follicles. There is no correlation between testosterone itself and baldness.

The effect of creatine is measurable but in no way is related to balding.

Using steroids does have the effect. And a bunch of others, most of them unhealthy.

These things might look correlated as steroid ppl often consume creatine as well as some other things.

I think male baldness is a bit more complex than creatine->DHT->loss of hair.

But if you want to go down that road, there's also indications that the oil in pumpkin seeds reduce the enzymatic process that turns testosterone into DHT - so just eat some pumpkin seeds with your creatine and the problem goes away! It's that simple!!!

This is one study with 20 subjects and has never been replicated. There have since been multiple studies and reviews that have found no effect on hair loss or follicle health

that study is widely regarded as unreliable and outdated.

More water in the muscles is another effect. Also placebo. I do notice I'm a bit heavier when I'm on creatine.

Creatine is known to give you some more energy. Like, 3%-5%. That's just an extra rep, hardly noticeable.

That's a big odd - because creatine seems to be the universally beloved thing and that it's a bit natural and has positive effects with zero negative side effect. Not a criticism but aside fro proten, creatine seems to be 'the natural thing'. Pun intended.

Also a lot of peoples diets have a high amount already. And certain things like energy drinks have a lot if you drink a those.

I think a lot of the minmaxed stuff people do working out is mostly placebo because very few people are actually pushing the limits of natural human physiology and hitting some nutrient bottleneck.

If you dont eat meat nature will not help you here. It will change your life if you're vegan.

That's definitely the good attitude to have for that type of things

Even quite a bit cheaper than that, I buy 1000g of creatine for $30 USD, which is 15 cents per 5g serving. I think it's a no-brainer for most people.

Do you?? Show me an HN thread where half the comments are paid for

> there don’t appear to be downsides for overdoing it

There may or may not be a downside depending on what one considers a downside.

In one of my other comments I just made in this thread, I mentioned my experience taking relatively large doses of 20g a day. While I found it has cognitive benefits, it did interfere with my sleep, though not catastrophically. If a person happens to enjoy sleep, then it's probably best they stick to 5 or 10 grams. On the other hand, if you need to pull an all-nighter, the sleep interference (as well as the better recovery the following day) may not be seen as a downside but beneficial.

But yeah, from a toxicological perspective, creatine does seem very safe even at those doses.

search the micronised version, it is so fine it looks like it disolves completely.

Is this a joke? I hope? A) drinking a glass of water is 'the lowest bar' and 2) using creatine means you have to up your water intake. If you don't drink the water, it won't work.

I do this sometimes with 5g creatine monohydrate and I can definitely tell my coffee is more bitter than usual. Not undrinkable but it does spoil the experience of good coffee somewhat.

My favourite mixer is something slightly acidic or sharp tasting, like kefir which also holds the crystals in suspension and somehow is a little less gritty as a result, and masks the bitterness quite well.