Ostojic, Sergej M, Candow, Daren G, Tarnopolsky, Mark A · Journal of the International Society of Sports Nutrition · 2025 · DOI
This review examines how creatine—a natural substance that helps muscles produce energy—might help people with post-viral fatigue syndrome (the prolonged exhaustion that can follow viral infections like COVID-19). The researchers found that people with this condition often have problems with how their body produces and uses energy, particularly in the mitochondria (the cell's power centers). They suggest that taking creatine supplements could help restore energy production and reduce symptoms like fatigue and brain fog.
Understanding the role of creatine and energy metabolism in post-viral fatigue is important because it offers a potential explanation for why patients feel so exhausted and cognitive difficulties occur. If creatine supplementation proves effective, it could provide an accessible, relatively safe treatment option for a condition where therapeutic options are currently limited.
This narrative review does not prove that creatine supplementation is an effective treatment for post-viral fatigue—it summarizes existing research rather than conducting new clinical trials. The review cannot establish causation between creatine metabolism defects and symptoms, only that associations may exist. Individual patient responses to creatine may vary significantly, and more rigorous randomized controlled trials are needed before clinical recommendations can be made.
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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