Marshall, Robert Percy, Droste, Jan-Niklas, Giessing, Jürgen et al. · Nutrients · 2022 · DOI
This review examines whether creatine supplements—commonly used by athletes to boost performance—might also help people with diseases involving mitochondrial problems (the energy-producing parts of cells). Creatine appears to have several beneficial effects, including improving energy production, reducing harmful oxidative stress, and protecting nerve cells. While early evidence suggests creatine could be helpful for conditions where mitochondria aren't working well, more rigorous clinical trials are needed before doctors can recommend it as a standard treatment.
ME/CFS is increasingly recognized as involving mitochondrial dysfunction and impaired energy metabolism at the cellular level. If creatine supplementation can improve mitochondrial function and cellular energy availability—mechanisms potentially relevant to ME/CFS—this could represent a relatively safe, accessible therapeutic option worth investigating specifically in ME/CFS populations. This review provides a framework for understanding why creatine warrants clinical investigation in post-exertional malaise and other ME/CFS-related energy metabolism problems.
This narrative review does not provide evidence that creatine supplementation is effective in ME/CFS specifically—the review discusses various mitochondrial dysfunction conditions but does not include ME/CFS-specific clinical trials or data. The authors explicitly state that larger clinical trials are needed before definitive conclusions can be drawn, meaning current evidence is preliminary. Creatine's demonstrated benefits in other conditions (athletic performance, certain neurological diseases) do not automatically translate to efficacy in ME/CFS without dedicated clinical testing.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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