A term in the gym community has been coined, “creatine headache.” However, is there any truth to the rumor that creatine can cause headaches?
There is no evidence indicating that creatine leads to headaches as a side effect. In fact, certain studies suggest that creatine might have a potential role in alleviating chronic headaches, though further research is required to delve deeper into this aspect.
This article will explore how creatine interacts with the brain, where this myth potentially originates, and what you can do if you are currently getting headaches.
Table of Contents
Does Creatine Cause Headaches?
First of all, what causes headaches?
You get two types of headaches: Acute and chronic.
According to the International Headache Society’s definition, chronic daily headaches refer to experiencing 15 or more headache episodes monthly for a minimum of three consecutive months [19].
The International Headache Society has assigned the term “tension-type headache” to encompass what was formerly known as tension headache, muscle contraction headache, psychomyogenic headache, stress headache, ordinary headache, and psychogenic headache.
With greater precision, the International Headache Society defines tension-type headaches, differentiates between episodic and chronic forms, and categorizes them into two groups: those linked to a pericranial muscle disorder and those not associated with such a disorder [20].
No research shows that headaches are a creatine side effect – on the contrary, some research indicates that creatine may help reduce chronic headaches.
However, more research is needed on the topic.
Researchers have observed a dysregulation in brain creatine levels across various neurological disorders.
This dysregulation impacts cellular energy dynamics and contributes to oxidative stress and neuronal death, particularly in specific brain regions.
The reduction in brain creatine alters cellular energy requirements, affecting adenosine triphosphate (ATP) buffering and cell membrane potentials.
Therapeutic creatine supplementation has demonstrated efficacy in improving clinical outcomes in conditions such as Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, and stroke, attributed to the restoration of cerebral creatine levels.
In the context of mild traumatic brain injury, creatine supplementation has shown promise in modifying biological markers related to neuropathology, potentially alleviating migraine-like symptoms.
Despite encouraging results in secondary headaches, the extension of these findings to chronic migraine necessitates further investigation.
Direct exploration of the relationship between brain creatine levels and clinical outcomes post-intervention is crucial for substantiating the potential benefits of creatine supplementation in addressing neurological challenges.
It’s still uncertain whether taking creatine from outside the body can significantly increase brain creatine levels in specific areas, like the thalamus, for people dealing with chronic migraines.
Also, we’re unsure if the medications taken for chronic headaches can affect how creatine is absorbed through the gut or how it passes through the blood-brain barrier (BBB) [19].
Despite the potential difficulty for creatine to cross the BBB, a few studies have shown that loading up on creatine (like 20 grams per day) can significantly increase brain creatine levels in healthy people.
However, we need more research to confirm if this holds true for those dealing with chronic migraines [19].
Also, the typical creatine protocols used in past trials might not be the best for increasing brain creatine levels, which somewhat limits its therapeutic potential in neurological conditions.
This pushes researchers to explore better alternatives regarding creatine dosages, how it’s administered, and potential analogs [10].
On a positive note, oral creatine enhances cognitive function in healthy individuals, especially when cognitive processes are stressed (like during sleep deprivation or when performing mentally demanding tasks).
Whether this improvement extends to short-term memory, executive function, and other cognitive aspects in people with chronic migraines after taking creatine is still unknown [21].
Creatine And The Brain
The brain is an active and complex organ, using about 20% of the body’s energy at rest, even though it only makes up around 2% of the whole body [1].
Neurons, the cells in the brain, need a continuous supply of a substance called adenosine triphosphate (ATP) for various tasks like maintaining certain balances, releasing neurotransmitters, and keeping communication between nerve cells working [2].
ATP is the cell’s energy currency.
Creatine, which comes from reactions involving specific amino acids, is crucial in making ATP, especially when the brain is under extra pressure, like during sleep deprivation, mental health issues, or neurological diseases [3, 4, 5].
While the primary production of creatine happens in the kidneys and liver, the brain can also make some on its own [6, 7].
Creatine can enter the brain using a transporter called SLC6A8, crossing the blood–brain barrier [6].
However, the amount of creatine that reaches the brain is typically less than what goes to other parts of the body, like muscles.
This might be because the blood–brain barrier doesn’t allow much creatine through or because certain brain cells (astrocytes) lack the necessary transporter [5].
To see significant effects in the brain, you may need to take more creatine or use it longer than its effects on muscles.
Recent research has examined how creatine supplementation could impact various conditions related to how the brain produces energy [8].
The brain might mostly make its creatine unless there’s something that puts a strain on its creatine levels [9].
These challenges could be short-term, like not getting enough sleep or doing intense exercise, or long-term, like aging, experiencing a traumatic brain injury, dealing with depression, or having a condition where the enzymes for creatine production are not working well.
For instance, in children with problems producing creatine, giving them creatine supplements improves their condition and brings their brain and body creatine levels back to normal [8].
Creatine And Brain Function
Clear evidence supporting the importance of creatine for cognitive function comes from people with creatine deficiency syndromes, which lead to low brain creatine levels [10, 11].
These syndromes cause issues like learning delays and seizures, but creatine supplements can partially reverse these symptoms [12, 13].
In studies with humans, there are mixed findings on the cognitive benefits of creatine, with many studies showing positive effects and others finding no impact [8].
The effectiveness of creatine in improving memory is also debated, with some studies in aging adults and vegetarians showing positive results.
In contrast, others found no memory improvement in children and adults [14, 15, 16, 17].
Overall, there is some evidence that creatine might enhance cognitive function, especially when the brain is under stress, like during sleep deprivation [8, 18].
Why Might You Be Experiencing Creatine Headaches?
The research shows that it is most likely not the creatine that causes headaches. Let’s consider that creatine can cause an increase in exercise intensity and duration.
It is possible that you are training harder, which can cause an increased sweat rate and, as a result, dehydration.
It is also possible that you might be experiencing something called an “exercise headache” or “post-exertional headaches”, a headache that is triggered by exercise and strenuous efforts [22].
Creatine enables you to train at a higher intensity and longer, so you might experience a headache for about 5 minutes to 48 hours [23].
There is a lack of high-quality evidence regarding the treatment of post-exertional headaches.
Nevertheless, research suggests that it tends to be self-limiting, with most individuals experiencing resolution within months to years [24].
A last explanation can be caffeine-induced headaches experienced if you are taking creatine in a pre-workout form with other substances, including caffeine, added to it.
How To Avoid Creatine Headaches
It is important you go into training well-hydrated and replace any fluids lost in training. If you have post-exertional headaches, it is a good idea to incorporate sufficient rest days and know that they can also go away on their own.
Summary
No evidence exists that creatine can cause headaches—on the contrary, it may even be protective in some scenarios. However, headaches might occur due to harder training intensities or dehydration when you lose more fluids during training.
References
1. Allen, P.J., Creatine metabolism and psychiatric disorders: Does creatine supplementation have therapeutic value? Neuroscience & Biobehavioral Reviews, 2012. 36(5): p. 1442-1462.
2. Snow, W.M., et al., Chronic dietary creatine enhances hippocampal-dependent spatial memory, bioenergetics, and levels of plasticity-related proteins associated with NF-κB. Learning & Memory, 2018. 25(2): p. 54-66.
3. Forbes, S.C., et al., Effects of creatine supplementation on properties of muscle, bone, and brain function in older adults: a narrative review. Journal of Dietary Supplements, 2022. 19(3): p. 318-335.
4. Ricci, T., S.C. Forbes, and D.G. Candow, Creatine supplementation: practical strategies and considerations for mixed martial arts. Journal of Exercise and Nutrition, 2020. 3(1).
5. Roschel, H., et al., Creatine supplementation and brain health. Nutrients, 2021. 13(2): p. 586.
6. Fernandes-Pires, G. and O. Braissant, Current and potential new treatment strategies for creatine deficiency syndromes. Molecular Genetics and Metabolism, 2022. 135(1): p. 15-26.
7. Harris, R.C., K. Söderlund, and E. Hultman, Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clinical science, 1992. 83(3): p. 367-374.
8. Forbes, S.C., et al., Effects of Creatine Supplementation on Brain Function and Health. Nutrients, 2022. 14(5).
9. Braissant, O., C. Bachmann, and H. Henry, Expression and function of AGAT, GAMT and CT1 in the mammalian brain. Creatine and creatine kinase in health and disease, 2007: p. 67-81.
10. Bender, A. and T. Klopstock, Creatine for neuroprotection in neurodegenerative disease: end of story? Amino Acids, 2016. 48: p. 1929-1940.
11. Mercimek-Andrews, S. and G. Salomons, Creatine deficiency syndromes. 2015.
12. Salomons, G., et al., X‐linked creatine transporter defect: an overview. Journal of inherited metabolic disease, 2003. 26(2-3): p. 309-318.
13. Stöckler, S., et al., Creatine deficiency in the brain: a new, treatable inborn error of metabolism. Pediatric Research, 1994. 36(3): p. 409-413.
14. Pires, L., et al., Creatine supplementation on cognitive performance following Creatine supplementation on cognitive performance following exercise in female Muay Thai athletes exercise in female Muay Thai athletes. J. Soc. NeuroSports, 2020. 1(6).
15. Rae, C., et al., Oral creatine monohydrate supplementation improves brain performance: a double–blind, placebo–controlled, cross–over trial. Proceedings of the Royal Society of London. Series B: Biological Sciences, 2003. 270(1529): p. 2147-2150.
16. Merege-Filho, C.A.A., et al., Does brain creatine content rely on exogenous creatine in healthy youth? A proof-of-principle study. Applied Physiology, Nutrition, and Metabolism, 2017. 42(2): p. 128-134.
17. Turner, C.E., W.D. Byblow, and N. Gant, Creatine supplementation enhances corticomotor excitability and cognitive performance during oxygen deprivation. Journal of Neuroscience, 2015. 35(4): p. 1773-1780.
18. Kaviani, M., K. Shaw, and P.D. Chilibeck, Benefits of Creatine Supplementation for Vegetarians Compared to Omnivorous Athletes: A Systematic Review. Int J Environ Res Public Health, 2020. 17(9).
19. Murphy, C. and S. Hameed, Chronic Headaches, in StatPearls. 2024, StatPearls Publishing Copyright © 2024, StatPearls Publishing LLC.: Treasure Island (FL).
20. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 2013. 33(9): p. 629-808.
21. Avgerinos, K.I., et al., Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Experimental gerontology, 2018. 108: p. 166-173.
22. Sandoe, C.H. and W. Kingston, Exercise Headache: a Review. Curr Neurol Neurosci Rep, 2018. 18(6): p. 28.
23. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 2018. 38(1): p. 1-211.
24. Rooke, E.D., Benign exertional headache. Med Clin North Am, 1968. 52(4): p. 801-8.