The Creatine Connection: New Hope for Post-Viral Fatigue and Long Covid.
Creatine and Long Covid: exciting new research
As we continue to manage the lasting impact of the COVID-19 pandemic, one major challenge is the growing number of people experiencing ongoing symptoms long after the initial infection has resolved. In clinical practice, I am seeing a substantial increase in individuals presenting with Long COVID, or post-viral fatigue syndrome (PVFS). These patients often report a wide range of difficult symptoms: deep, unrelenting fatigue, cognitive dysfunction (often described as "brain fog"), breathlessness, muscle weakness, nerve-related discomfort, and occasionally even irregular heart rhythms. Increasingly, researchers are turning their attention to creatine supplementation as a potential tool to support recovery (1).
Understanding Long COVID and Post-Viral Fatigue
Long COVID describes a set of symptoms that persist well beyond the acute stage of COVID-19 infection, often lasting for weeks or months and now years. Common symptoms include:
Persistent fatigue
Brain fog and difficulty concentrating
Muscle and joint pain or weakness
Disrupted sleep
Shortness of breath
Loss of taste or smell
Headaches (2)
The precise biological causes are still being unravelled, but experts believe immune system disruption, ongoing inflammation, and impaired cellular energy production (particularly within the mitochondria) all contribute.
What is Creatine?
Creatine is a naturally occurring compound produced by the liver, kidneys, and pancreas from amino acids such as arginine, glycine, and methionine. It is stored mainly in skeletal muscles and in the brain. Its primary function is to help produce adenosine triphosphate (ATP), the molecule that powers virtually all cellular activity (3).
Although the body makes creatine, we also get it through food, particularly from animal-based sources like meat and fish. But for many people, especially those under physiological stress or with low dietary intake, this may not be enough to fully support energy needs in both muscle and brain.
Creatine's Role in Brain and Body Energy
Creatine is best known for supporting energy bursts during high-intensity physical activity, but its influence goes far beyond the gym. In the brain, creatine helps maintain stable energy levels, supporting cognitive processes such as memory, focus, and attention.
It also appears to have neuroprotective effects, meaning it may help safeguard brain cells from damage. Additionally, it may influence neurotransmitters (chemical messengers in the brain) and reduce oxidative stress, which can otherwise impair mental clarity and increase fatigue (4).
What the Research Says About Creatine and Long COVID
Recent clinical studies have begun to examine the possible benefits of creatine in people recovering from Long COVID or experiencing post-viral fatigue:
1. Six-Month Creatine Supplementation Study
In a randomized, placebo-controlled trial, individuals with post-COVID fatigue took 4 g of creatine monohydrate daily over six months. Those in the creatine group experienced notable improvements in:
Energy levels
Physical strength
Cognitive function
Overall quality of life (5)
Follow-up scans showed higher creatine concentrations in the brain, suggesting better energy support for cognitive function (6).
2. Eight-Week Creatine + Glucose Study
In another study, participants with Long COVID took a combination of creatine and glucose over eight weeks. They saw improvements in:
Exercise tolerance
Muscle creatine levels
Cognitive performance (7)
3. Brain Energy Studies
Magnetic resonance spectroscopy (MRS) has shown that creatine supplementation can increase creatine levels in the brain, which may help reduce mental fatigue and improve brain function (2).
Additional studies on chronic fatigue syndrome (8) and fibromyalgia (9) have echoed these findings, showing that creatine may enhance strength, thinking ability, and overall well-being, particularly in those with depleted brain creatine levels.
How Might Creatine Work in Long COVID?
The positive effects of creatine in Long COVID likely stem from its actions on several key biological systems:
1. Energy Regeneration
Creatine helps the body quickly restore ATP, which is essential when energy production is impaired, as it often is in post-viral fatigue (10).
2. Protecting Brain Cells
Research suggests creatine acts as an antioxidant and can protect neurons from stress and inflammation (11).
3. Supporting Mitochondrial Health
Mitochondria are the cell’s energy generators, and creatine helps them function more efficiently (12).
4. Anti-Inflammatory Properties
Some studies indicate that creatine may reduce systemic inflammation, which is often elevated in Long COVID cases (13).
Safety and Considerations
Creatine has a strong safety profile and is widely regarded as safe for most healthy adults when taken at recommended doses. Mild side effects can include:
Stomach upset or bloating
Water retention
Occasional muscle cramping (14)
However, individuals with kidney issues or other medical conditions should consult a qualified health practitioner before starting creatine supplementation. Long-term use should always be guided by a healthcare provider.
In Summary
Creatine is not just a sports supplement; it’s a compound with wide-reaching effects on physical and mental energy, and growing evidence supports its potential role in managing symptoms of Long COVID. Early research suggests it may improve fatigue, mental clarity, and muscular function by supporting brain energy, reducing inflammation, and enhancing mitochondrial performance.
While more research is needed, creatine is shaping up to be a safe and cost-effective strategy worth exploring under professional guidance. I have been using creatine with my clients with good effect and I do advise anyone considering adding it in to their current supplementation protocol should do so only under practitioner guidance.
References
1. Can creatine supplements help people with long covid?
3. Health benefits of creatine monohydrate
5. Could creatine supplementation be the answer to post-COVID-19 fatigue?
6. Creatine: A Promising Therapeutic Approach for Long COVID Symptoms
7. Eight-Week Creatine-Glucose Supplementation Alleviates Clinical Features of Long COVID
8. Postviral fatigue syndrome and creatine: a piece of the puzzle?
9. Creatine supplementation in fibromyalgia: a randomized, double-blind, placebo-controlled trial
10. Creatine
12. Creatine metabolism and the consequences of creatine depletion in muscle
14. Studies on the safety of creatine supplementation