5 ms·

The article made up the claim it’s not from the paper itself. There was some improvement in cognitive scores, but no placebo group. Without a placebo group, th

The article made up the claim it’s not from the paper itself. There was some improvement in cognitive scores, but no placebo group. Without a placebo group, there are a lot of explanations for the data.

zug_zug 4mo ago
>> 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.
- tgv 4mo ago
  19 patients completed, according to the article. And List Sorting, Oral reading, and Flanker only? The first and last are part of global and fluid composites, so those have to be excluded from comparison. That leaves us with 3 improved scores out of 12 tests. So 9 did not improve, or got worse. Figure 3 (of the original article) shows that the changes aren't big. Just "significant". Since the participants were in the early stages of dementia, this seems well within expectations. So I can't see those numbers as impressive.
  - rzz3 4mo ago
    Sounds like something we should study more rather than dismiss.
    - tgv 4mo ago
      This study holds little promise at first sight. Remember that there is a lot to study, and only limited research capability. > Sounds like something we should study more rather than dismiss. Ignoring the implication of your use of "dismiss", why? How is this pilot promising?
    - jstummbillig 4mo ago
      Sounds like something that should fly under a different headline until then.
    - ChuckMcM 4mo ago
      Interesting that you are hearing "dismissal" in the antecedent response. I read it as the poster "studying more" the data, and finding a lot of flaws in both the experimental design and the data analysis.Typically things a reviewer would do when a publication was submitted (or in our case posted here). The author, then goes back and answers the questions raised to show that the effect they are suggesting is durable in face of the flaws. Or perhaps they run an additional experiment and augment their data. After a bunch of back and forths either the effect is sufficiently well expressed in the data or the paper is withdrawn for more work. When I go through the process of reading the entire paper, analyzing the data myself, and the experimental design. That is the opposite of dismissing the claim. That is me, positing that the claim as stated is 'true,' and then asking the questions if the claim is supported by the provided evidence. If it isn't, then doing the work to express what evidence would be needed to support the claim is the feedback needed to help prove the science.
      - spiralcoaster 4mo ago
        Don't waste your time responding to people like this. Their post is not much more than a passing thought where they take the headline fully at face value, and therefore are convinced it must be worth something and we should continue to study it. They will never read the paper or have a critical thought of their own.
      - salad-tycoon 4mo ago
        I don’t really leave thank you notes as they don’t add anything but just to balance out the opinions here: Thank you for taking the time for that wonderful explanation, may it teach some of us/me to think before we shoot. I found it very enlightening and am sure many other drive by casuals do as well.
    - econ 4mo ago
      Creatine effects vary a lot from person to person. It isn't all that harmful and easy to notice. Best test it yourself. I apparently produce much less than I can use. Effect is in the, how is this even legal? range.
  - joenot443 4mo ago
    I can’t help but feel that the participants being in the early stage of dementia is a lede being buried. Perhaps I’m misunderstanding.
- fer 4mo ago
  .001 for creatine levels isn't surprising; that's a lot of creatine. I'd explain the cognitive tests with the practice effect, because it is unlikely that creatine had such a massive effect and we only discover it now.
  - pitched 4mo ago
    I hear about tech bros taking creatine these days with the tone of voice that they use to talk about microdosing. So I can’t imagine it having zero effect. What I worry about more is that it has more to do with fixing a deficiency. That being deficient in creatine causes a cognitive loss more than supplementing causes a boost.
    - fer 4mo ago
      As someone who's microdosed (though mostly normal-dosed and occasionally megadosed) in the distant past, the whole microdosing fad was equal parts entertaining and baffling. Anecdotal, but from all people I know that has taken psychedelics, only one doesn't find it to be a waste.
      - pitched 4mo ago
        Maybe a better analogy would have been the Balmer curve. I wasn’t trying to imply psychedelics are unhelpful, just that we should be careful of suggesting coding productivity gains while on them. Also IMO, the Balmer peak is a stronger effect than creatine.
    - deleted 4mo ago
      [deleted]
- trehalose 4mo ago
  I wouldn't even call it "promising but inconclusive" so much as "not conclusively a dead-end for further research". In a single-arm open-label study, with no blinding, both the participants and the researchers know who's getting what. You need a placebo and double-blinding for comparison against the active group and to adjust for any ways in which the researchers may have unwittingly influenced the results. (Or perhaps even wittingly, when there are conflicts of interest. I spent half a minute looking up this study and didn't see any statement attesting that there were none.)
  - amluto 4mo ago
    Worse: go look at the MMSE. I bet that, at least for patients with reasonably functional memory, taking the MMSE and then taking it again a few weeks later from the same examiner will tend to improve the score the second time.
  - j45 4mo ago
    One study rarely makes or breaks anything. Creatine has lots of studies going back 10-20 years.
- anigbrowl 4mo ago
  [dead]
baxtr 4mo ago
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/ https://physiqonomics.com/creatine-cognitive-performance/
- tensor 4mo ago
  I think people often overestimate the effects of these things. It absolutely works for muscle growth but it's not like a steroid or something. Similarly there is enough evidence to suggest that it actually does have some small effect on cognition; I remember a study 10 years ago showing that in people who are creatine deficient (vegans) it improved cognition scores. But it's not going to be a huge effect for someone whose not deficient in some way. It would actually make sense that as you age and eat less you might get creatine deficient so sure. I don't think it's bullshit, but it's not going to be a huge noticeable effect either. All of this reminds me of people who don't weight lift "because they don't want to get built." They somehow think you lift some weights and boom you're looking like Arnold. No, it doesn't work that way.
DavidSJ 4mo ago
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 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.
qnleigh 4mo ago
They also quote a follow up study that sounds more compelling: > The 2026 multicenter placebo-controlled trial extending this work enrolled 240 participants with early Alzheimer’s... The intervention group showed slower decline on standard cognitive scales by about 30% versus placebo. But there's no such study in the references section. Not sure what's going on there but I want to see the data before I believe this.
- kleinishere 4mo ago
  [flagged]
- mkl 4mo ago
  The only other pages I can find talking about this supposed follow-up study seem to be AI slop and similarly fail to include it in their references.
firefax 4mo ago
Normally I wouldn't ask this, but having seen the effects of Alzheimer's I must ask: is there any evidence that taking creatine will harm my brain? Let's be real: I take a lot of edibles. I smoke sometimes on a hike. Every once in a while I get a Guiness and a gyro. My health is by no means perfect, and if I'm willing to take in literal poison (yes, alchohol is that dangerous that I say such things even about my precious Guiness). Anyways, for years I've been mostly skeptical of vitamins. I've heard a megadose of Vitamin C can shorten the symptoms of a cold, but a "megadose" is relatively small enough that just some OJ can do that, no need for pills. But if I'm not giving up my Guiness and gyros, I probably should be willing to be more flexible about my "no vitamins or weird supplements rule". So TL;DR: Let's flip this around: What are the risks of creatine, presuming a safe supply chain? (It's legal where I am as far as I know, which I'm a fan of for most things since then you can get a receipt and there will be some authority that investigates if you're unlucky to get a "bad batch".)
- omnimus 4mo ago
  Creatine is one of the most studied supplements in fitness and i don't think there ever was evidence it was harmful. Then again supplements mostly create expensive pee.
  - dahart 4mo ago
    > supplements mostly create expensive pee Haha, that’s a great quote. Definitely going to borrow that one. Thanks!
    - mmh0000 4mo ago
      https://m.youtube.com/watch?v=O27Tn06bEXU&pp=0gcJCTkCo7VqN5tD&ra=m https://m.youtube.com/watch?v=O27Tn06bEXU&pp=0gcJCTkCo7VqN5t... The joke has been around forever. Big bang probably did the best “popular” showing off it.
    - firefax 4mo ago
      concern is less "expensive pee" more "it'll act as a diuretic" (which might have long term kidney effects)
j45 4mo ago
I can't speak for the Alzheimer piece, but there are other studies about supporting the brain. Worth looking at the range of studies as well.
lkbm 4mo ago
I think you're right. Confusingly they reference a 2026 article (which isn't included in their citation list) that allegedly includes "placebo-controlled trial", but I think it might just be [0], which is based on the same single-arm trial. If they do have a paper using a placebo-controlled trial, they should definitely include that citation. [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC12927926/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12927926/
YeahThisIsMe 4mo ago
Lots of creatine gummy dropshippers trying to gain ground.
- Schiendelman 4mo ago
  Those gummies also usually have a fraction of the creatine they claim they do.
GeorgeKangas 4mo ago
> Without a placebo group... You just needed to read the next paragraph: "The 2026 multicenter placebo-controlled trial extending this work..."
aussieguy1234 4mo ago
I also noted the lack of a placebo group. Give them sugar pills and call them smart pills and their test scores will also improve. That said, I work out daily and only just discovered the well researched and proven benefits of creatine on that front, so now I'm going to try it.
senderista 4mo ago
The article appears to be LLM-written.

zug_zug 4mo ago

>> 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.

tgv 4mo ago
19 patients completed, according to the article. And List Sorting, Oral reading, and Flanker only? The first and last are part of global and fluid composites, so those have to be excluded from comparison. That leaves us with 3 improved scores out of 12 tests. So 9 did not improve, or got worse. Figure 3 (of the original article) shows that the changes aren't big. Just "significant". Since the participants were in the early stages of dementia, this seems well within expectations. So I can't see those numbers as impressive.
- rzz3 4mo ago
  Sounds like something we should study more rather than dismiss.
  - tgv 4mo ago
    This study holds little promise at first sight. Remember that there is a lot to study, and only limited research capability. > Sounds like something we should study more rather than dismiss. Ignoring the implication of your use of "dismiss", why? How is this pilot promising?
  - jstummbillig 4mo ago
    Sounds like something that should fly under a different headline until then.
  - ChuckMcM 4mo ago
    Interesting that you are hearing "dismissal" in the antecedent response. I read it as the poster "studying more" the data, and finding a lot of flaws in both the experimental design and the data analysis.Typically things a reviewer would do when a publication was submitted (or in our case posted here). The author, then goes back and answers the questions raised to show that the effect they are suggesting is durable in face of the flaws. Or perhaps they run an additional experiment and augment their data. After a bunch of back and forths either the effect is sufficiently well expressed in the data or the paper is withdrawn for more work. When I go through the process of reading the entire paper, analyzing the data myself, and the experimental design. That is the opposite of dismissing the claim. That is me, positing that the claim as stated is 'true,' and then asking the questions if the claim is supported by the provided evidence. If it isn't, then doing the work to express what evidence would be needed to support the claim is the feedback needed to help prove the science.
    - spiralcoaster 4mo ago
      Don't waste your time responding to people like this. Their post is not much more than a passing thought where they take the headline fully at face value, and therefore are convinced it must be worth something and we should continue to study it. They will never read the paper or have a critical thought of their own.
    - salad-tycoon 4mo ago
      I don’t really leave thank you notes as they don’t add anything but just to balance out the opinions here: Thank you for taking the time for that wonderful explanation, may it teach some of us/me to think before we shoot. I found it very enlightening and am sure many other drive by casuals do as well.
  - econ 4mo ago
    Creatine effects vary a lot from person to person. It isn't all that harmful and easy to notice. Best test it yourself. I apparently produce much less than I can use. Effect is in the, how is this even legal? range.
- joenot443 4mo ago
  I can’t help but feel that the participants being in the early stage of dementia is a lede being buried. Perhaps I’m misunderstanding.
fer 4mo ago
.001 for creatine levels isn't surprising; that's a lot of creatine. I'd explain the cognitive tests with the practice effect, because it is unlikely that creatine had such a massive effect and we only discover it now.
- pitched 4mo ago
  I hear about tech bros taking creatine these days with the tone of voice that they use to talk about microdosing. So I can’t imagine it having zero effect. What I worry about more is that it has more to do with fixing a deficiency. That being deficient in creatine causes a cognitive loss more than supplementing causes a boost.
  - fer 4mo ago
    As someone who's microdosed (though mostly normal-dosed and occasionally megadosed) in the distant past, the whole microdosing fad was equal parts entertaining and baffling. Anecdotal, but from all people I know that has taken psychedelics, only one doesn't find it to be a waste.
    - pitched 4mo ago
      Maybe a better analogy would have been the Balmer curve. I wasn’t trying to imply psychedelics are unhelpful, just that we should be careful of suggesting coding productivity gains while on them. Also IMO, the Balmer peak is a stronger effect than creatine.
  - deleted 4mo ago
    [deleted]
trehalose 4mo ago
I wouldn't even call it "promising but inconclusive" so much as "not conclusively a dead-end for further research". In a single-arm open-label study, with no blinding, both the participants and the researchers know who's getting what. You need a placebo and double-blinding for comparison against the active group and to adjust for any ways in which the researchers may have unwittingly influenced the results. (Or perhaps even wittingly, when there are conflicts of interest. I spent half a minute looking up this study and didn't see any statement attesting that there were none.)
- amluto 4mo ago
  Worse: go look at the MMSE. I bet that, at least for patients with reasonably functional memory, taking the MMSE and then taking it again a few weeks later from the same examiner will tend to improve the score the second time.
- j45 4mo ago
  One study rarely makes or breaks anything. Creatine has lots of studies going back 10-20 years.
anigbrowl 4mo ago
[dead]

baxtr 4mo ago

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/ https://physiqonomics.com/creatine-cognitive-performance/

tensor 4mo ago
I think people often overestimate the effects of these things. It absolutely works for muscle growth but it's not like a steroid or something. Similarly there is enough evidence to suggest that it actually does have some small effect on cognition; I remember a study 10 years ago showing that in people who are creatine deficient (vegans) it improved cognition scores. But it's not going to be a huge effect for someone whose not deficient in some way. It would actually make sense that as you age and eat less you might get creatine deficient so sure. I don't think it's bullshit, but it's not going to be a huge noticeable effect either. All of this reminds me of people who don't weight lift "because they don't want to get built." They somehow think you lift some weights and boom you're looking like Arnold. No, it doesn't work that way.

DavidSJ 4mo ago

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 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.

qnleigh 4mo ago

They also quote a follow up study that sounds more compelling: > The 2026 multicenter placebo-controlled trial extending this work enrolled 240 participants with early Alzheimer’s... The intervention group showed slower decline on standard cognitive scales by about 30% versus placebo. But there's no such study in the references section. Not sure what's going on there but I want to see the data before I believe this.

kleinishere 4mo ago
[flagged]
mkl 4mo ago
The only other pages I can find talking about this supposed follow-up study seem to be AI slop and similarly fail to include it in their references.

firefax 4mo ago

Normally I wouldn't ask this, but having seen the effects of Alzheimer's I must ask: is there any evidence that taking creatine will harm my brain? Let's be real: I take a lot of edibles. I smoke sometimes on a hike. Every once in a while I get a Guiness and a gyro. My health is by no means perfect, and if I'm willing to take in literal poison (yes, alchohol is that dangerous that I say such things even about my precious Guiness). Anyways, for years I've been mostly skeptical of vitamins. I've heard a megadose of Vitamin C can shorten the symptoms of a cold, but a "megadose" is relatively small enough that just some OJ can do that, no need for pills. But if I'm not giving up my Guiness and gyros, I probably should be willing to be more flexible about my "no vitamins or weird supplements rule". So TL;DR: Let's flip this around: What are the risks of creatine, presuming a safe supply chain? (It's legal where I am as far as I know, which I'm a fan of for most things since then you can get a receipt and there will be some authority that investigates if you're unlucky to get a "bad batch".)

omnimus 4mo ago
Creatine is one of the most studied supplements in fitness and i don't think there ever was evidence it was harmful. Then again supplements mostly create expensive pee.
- dahart 4mo ago
  > supplements mostly create expensive pee Haha, that’s a great quote. Definitely going to borrow that one. Thanks!
  - mmh0000 4mo ago
    https://m.youtube.com/watch?v=O27Tn06bEXU&pp=0gcJCTkCo7VqN5tD&ra=m https://m.youtube.com/watch?v=O27Tn06bEXU&pp=0gcJCTkCo7VqN5t... The joke has been around forever. Big bang probably did the best “popular” showing off it.
  - firefax 4mo ago
    concern is less "expensive pee" more "it'll act as a diuretic" (which might have long term kidney effects)

j45 4mo ago

I can't speak for the Alzheimer piece, but there are other studies about supporting the brain. Worth looking at the range of studies as well.

lkbm 4mo ago

I think you're right. Confusingly they reference a 2026 article (which isn't included in their citation list) that allegedly includes "placebo-controlled trial", but I think it might just be [0], which is based on the same single-arm trial. If they do have a paper using a placebo-controlled trial, they should definitely include that citation. [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC12927926/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12927926/

YeahThisIsMe 4mo ago

Lots of creatine gummy dropshippers trying to gain ground.

Schiendelman 4mo ago
Those gummies also usually have a fraction of the creatine they claim they do.

GeorgeKangas 4mo ago

> Without a placebo group... You just needed to read the next paragraph: "The 2026 multicenter placebo-controlled trial extending this work..."

aussieguy1234 4mo ago

I also noted the lack of a placebo group. Give them sugar pills and call them smart pills and their test scores will also improve. That said, I work out daily and only just discovered the well researched and proven benefits of creatine on that front, so now I'm going to try it.

senderista 4mo ago

The article appears to be LLM-written.