Six-Week Supplementation with Creatine in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Magnetic Resonance Spectroscopy Feasibility Study at 3 Tesla

• Published in: Nutrients Vol. 16; no. 19; p. 3308
• Main Authors: Godlewska, Beata R, Sylvester, Amy L, Emir, Uzay E, Sharpley, Ann L, Clarke, William T, Martens, Marieke A G, Cowen, Philip J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.09.2024; MDPI
• Subjects: Adenosine triphosphate; Adult; Brain research; Chronic fatigue syndrome; Cognition - drug effects; Creatine - administration & dosage; Dietary Supplements; Dorsolateral Prefrontal Cortex; Encephalomyelitis; Energy; Fatigue Syndrome, Chronic - drug therapy; Feasibility Studies; Female; Gyrus Cinguli - diagnostic imaging; Gyrus Cinguli - drug effects; Gyrus Cinguli - metabolism; Hand Strength; Humans; Intervention; Magnetic Resonance Spectroscopy - methods; Male; Middle Aged; Reaction Time - drug effects; Spectrum analysis; Treatment Outcome; supplementation; creatine monohydrate; myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); cognition; hand grip strength; MRS
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16193308

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic medical condition with no specific pharmacological treatment. Creatine, a nutrient essential for maintaining energy homeostasis in the cells, is a candidate for interventions in ME/CFS. Fourteen participants with ME/CFS received supplementation with 16 g creatine monohydrate for 6 weeks. Before starting creatine and on the last day of treatment, participants underwent brain magnetic resonance spectroscopy (MRS) scanning of the pregenual anterior cingulate cortex (pgACC) and dorsolateral prefrontal cortex (DLPFC), followed by symptom, cognition, and hand-grip strength assessments. Eleven participants completed the study. Creatine treatment increased creatine concentration in both the pgACC and DLPFC ( = 0.004 and 0.012, respectively), decreased fatigue and reaction time (RT) on congruent and incongruent trials of the Stroop test ( = 0.036 and 0.014, respectively), and increased hand-grip strength ( = 0.0004). There was a positive correlation between increases in pgACC creatine and changes in RT on Stroop congruent and incongruent trials ( = 0.048 and = 0.022, respectively). Creatine was well tolerated, and none of the participants stopped treatment. Creatine supplementation over six weeks in ME/CFS patients increased brain creatine and improved fatigue and some aspects of cognition. Despite its methodological limitations, this study encourages placebo-controlled investigations of creatine treatment in ME/CFS.