Ostojic, Sergej M · Nutrients · 2021 · DOI
This review examines how creatine—a natural substance in the body that helps muscles produce energy—may be abnormal in people with post-viral fatigue syndrome (PVFS, which includes ME/CFS and long COVID). The authors looked at whether creatine supplements or related compounds might help reduce fatigue and improve function in these conditions. While some studies suggest creatine could be helpful, the review shows we still need more research to know if it actually works.
ME/CFS and post-COVID fatigue currently lack diagnostic biomarkers and approved treatments. If creatine metabolism abnormalities are confirmed to play a role in these conditions, supplementation could represent a low-cost, accessible therapeutic avenue worth investigating further in rigorous clinical trials.
This review does not prove that creatine supplementation is an effective treatment for ME/CFS or PVFS—it identifies metabolic abnormalities and summarizes preliminary evidence. The review does not establish causation between creatine metabolism disturbances and fatigue symptoms, nor does it provide definitive dosing or safety recommendations. Results from preliminary studies do not yet demonstrate efficacy in large, well-controlled patient populations.
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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Primary citation
Ostojic, Sergej M (2021). Diagnostic and Pharmacological Potency of Creatine in Post-Viral Fatigue Syndrome.. Nutrients. https://doi.org/10.3390/nu13020503
BibTeX
@article{mecfsatlas-ostojic-2021-diagnostic-pharmacological,
author = {Ostojic, Sergej M},
title = {Diagnostic and Pharmacological Potency of Creatine in Post-Viral Fatigue Syndrome.},
journal = {Nutrients},
year = {2021},
doi = {10.3390/nu13020503},
note = {PubMed: 33557013},
url = {https://www.mecfsatlas.com/evidence/ostojic-2021-diagnostic-pharmacological},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/ostojic-2021-diagnostic-pharmacological
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