Summary
I took creatine, a safe, cheap and particularly promising nootropic drug and measured its effect on my cognition. The result was neutral or slightly positive.
Nootropics
Nootropics, or cognitive enhancing drugs, like caffeine and theanine have been used for centuries. The search for better nootropics is ongoing. Of the many potential nootropics that have been tested, few have been useful. Even promising substances like modafinil and creatine are supported as intelligence enhancers by only a few high quality trials and reviews of many of low quality ones. As the scientific evidence is often lacklustre and the purported cognitive benefits are qualitative and may vary from person to person, nootropics are also independently investigated and discussed. In Scott Alexander’s survey of r/nootropics, modafinil and caffeine were ranked most useful. Still, it is often hard to tell whether people are on aggregate being helped or harmed by these substances, or whether they are using them more or less than is optimal. These two substances mostly benefit us by making us more alert, motivated and awake. Gwern supposes that they do not improve our peak intelligence or enable us the ability to solve entirely more complex problems, but that they can be used to keep our intelligence nearer to its peak levels more of the time. Their drawbacks include side-effects of anxiety, nausea (especially with modafinil) and dependence (especially with caffeine). So the practical usefulness of nootropics is less than one might hope from the armchair.
Creatine
Creatine (examine.com is a particularly promising nootropic to investigate. It is safe safe, cheap (at about 5c/day), and shows promise as a cognitive enhancer in a few trials. It is in widespread use as a bodybuilding supplement and its main side-effects are mild gain of fluid in muscle tissue and mild nausea if not taken with water. We have some good reasons to think it might improve cognition: First, there is a good mechanism. In the brain, as in muscle tissue, it improves energy availability. It crosses the blood brain barrier and if the proteins that transport creatine through the blood brain barrier are faulty, then retardation syndromes are seen. In Gwern’s meta-analysis of three studies, it showed a gain of 11 IQ points (0.76 SD), and had a middling score in the r/nootropics survey. Furthermore, creatine is known to be in red meat, and its effects have been larger in vegetarians. As a vegetarian, this gives me an additional reason to expect that creatine might give me a large boost.
Experimental Procedure
My plan was to take 5g creatine for two weeks, and to measure my cognition in this period and for at least week before and after. I deviated from this plan in two of ways:
- After taking creatine for 11 days, I increased the dose to 10g for 5 days. i.e. I took creatine for 16 days in total.
- I started the cognitive battery early - about ten days before taking creatine – and started the subjective cognition ratings late – one day before taking creatine.
Metrics
I took three measures of my cognition at roughly noon each day:
1 – I subjectively rated my cognitive ability from 1 to 10.
2 – I completed a twenty-minute battery of tests from Cambridge Brain Sciences: spatial span, double trouble, object reasoning, rotations, hampshire tree task and spatial slider.
3 – I completed ten medical questions.
Results
The number of questions I answered correctly each day varied from 3-8 questions per day. My average score was 5.7 on creatine, the same as my average score off creatine. My subjective cognitive ability was 7.4 on creatine and 6.6 off creatine. These are shown in Figure 1.
Figure 1: Subjective Cognitive Ability, Medical Questions and Creatine. These are plotted on a shared horizontal axis.
My performance of the cognitive battery improved significantly over the first ten days. By the time I took creatine, it was starting to stabilize, but continued to improve slowly throughout my time on creatine and afterwards.
Figure 2: Cognitive Battery. Performance in five cognitive tests performed daily is plotted alongside creatine dosage.
Discussion
There was a hint of an improvement in my subjective cognition with creatine - 0.8 points on a ten-point scale. The creatine didn’t seem to improve my subjective cognition on any objective measures.
It is difficult to make out any trend in the cognitive battery due to random noise and learning effects with the cognitive effects. From this study, my main impression is that if creatine has any effect on me, it is a subtle one.
Will I take creatine despite this negative result? I’m not sure
Should others still take creatine? Probably. They can either try it and then decide whether to continue based on their subjective assessment or just take it indefinitely.
Because the effect – if any – appears subtle, it would be desirable to repeat the experiment with a larger sample size. Ultimately, we could get a really good answer by performing an RCT with 50 participants and using a better test like Raven’s Progresive Matrices before and afterwards. This can be done in a professional academic context. Alternatively, as per Gwern, it could be done in an amateur experiment at a low cost. One would purchase creatine tablets and tablets containing an inert substance like flour, mail these to participants and give a financial incentive to reduce dropout rates.
Conclusion
Creatine has not greatly improved my intelligence. However, given that creatine is safe and cheap, it may be beneficial for many people - especially vegetarians - to take creatine anyway. We can get better answers with a big RCT.
Thanks Katja Grace for feedback on a draft of this article