Effects of Creatine Supplementation on Central Fatigue, Cognitive Function and Recovery in Physically Active Individuals: A Narrative Review

Abstract

Background. Creatine monohydrate is widely used to support high-intensity exercise, strength, power and repeated-effort performance. Recent evidence suggests that its role may also extend to brain bioenergetics, mental fatigue, cognition and recovery. Aim. This review summarizes evidence from 2018-2025 on creatine supplementation in relation to central fatigue, cognition, fatigue resilience and recovery in active individuals. Methods. A narrative search was conducted mainly in PubMed, with additional searches in Quality in Sport, Journal of Education, Health and Sport and Pedagogy and Psychology of Sport. Priority was given to reviews, meta-analyses, trials and mechanistic studies on creatine, fatigue, cognition, sleep, recovery and sports performance. Results. Creatine may support selected cognitive outcomes, especially under increased energetic demand such as sleep deprivation, mental fatigue or high training load. Potential mechanisms include ATP buffering, the creatine-phosphocreatine system, brain high-energy phosphate metabolism and recovery support. Evidence also suggests possible benefits for muscle function, soreness and exercise-induced muscle damage, although findings vary by protocol and outcome measure. Conclusions. Creatine monohydrate may be useful not only for high-intensity performance but also for selected cognitive and recovery-related outcomes. Direct evidence for reducing central fatigue remains limited, and further sport-specific trials are needed.