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In humans, creatine is synthesized in the liver, pancreas, kidney and brain. From arginine and glycine, guanidinoacetate and ornithine are formed. With S-adenosylmethionine and the help of GAMT, guanidinoacetate is converted into creatine. From the liver, pancreas, kidney and brain, creatine is exported to tissues such as skeletal muscle and brain, where it undergoes phosphorylation and serves as a short-term energy store. Creatine is transported to these tissues with the help of SLC6A8 transporter.
Once formed, phosphocreatine and creatine undergo both a slow spontaneous reaction to form creatinine, which is excreted from the body via the urinary system.
This pathway was inspired by Chapter 32 of the book of Blau (ISBN 3642403360 (978-3642403361) ed. 4).
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