The COVID-19 pandemic has left a lasting impact on countless individuals, with many experiencing long-term symptoms that persist even after recovery. One of the most prevalent and frustrating symptoms is fatigue, which can significantly impact daily life and overall well-being.
Understanding the Link Between Fatigue and Creatine
Research suggests that fatigue in long COVID patients is primarily caused by muscle weakness, which is linked to a decrease in muscle energy production. Here, creatine, a well-known supplement among fitness enthusiasts, emerges as a potential solution.
Creatine is a naturally occurring substance found in the muscles, brain, and heart. It serves as a rapid energy source for cells, providing a quick boost of ATP (adenosine triphosphate) to fuel muscle contractions, especially during high-intensity exercise.
Surprisingly, studies have shown that long COVID patients often have lower levels of creatine in their skeletal muscles and brain. This deficiency in this crucial energy source can contribute to the persistent muscle weakness and fatigue experienced by many long COVID patients.
The Benefits of Creatine Supplementation
Incorporating creatine supplementation into the treatment plan for long COVID fatigue may offer several potential benefits:
- Energy Boost: Creatine provides a direct energy source for muscles and the brain, helping to alleviate fatigue and improve overall energy levels.
- Antioxidant Protection: Creatine has antioxidant properties, protecting the DNA in mitochondria (the energy-producing organelles in cells) from damage caused by free radicals.
- Anti-inflammatory Effects: Creatine can help reduce inflammation by modulating the activity of immune cells, potentially alleviating some of the inflammatory processes associated with long COVID.
- Neuroprotective Properties: Creatine can protect the brain by maintaining the integrity of the mitochondrial membrane and stabilizing ATP levels in neurons, which is crucial for brain function.
- Improvement of Glutamate Regulation: Creatine can help regulate the levels of glutamate, a neurotransmitter that can become dysregulated in long COVID patients, leading to brain fog and other cognitive difficulties.
Research Support and Recommendations
Numerous studies have supported the use of creatine supplementation for long COVID fatigue. One study found that long COVID patients who took 4 grams of creatine daily for three months experienced a significant reduction in overall fatigue and improved physical function compared to those who took a placebo.
Based on this evidence, it is recommended that individuals experiencing long COVID fatigue consider supplementing with creatine. The recommended dosage is typically 5 grams per day, which can be easily incorporated into a balanced diet or through supplements.
Incorporating Creatine into Your Diet
Creatine is naturally found in animal-based foods, such as red meat, poultry, and fish. Incorporating these foods into your diet can help ensure an adequate intake of creatine. However, for individuals experiencing long COVID fatigue, additional supplementation may be necessary to achieve the desired therapeutic effect.
In conclusion, creatine supplementation may offer a promising approach for managing fatigue in long COVID patients. By providing an energy boost, protecting against oxidative stress, and supporting brain health, creatine can help improve quality of life and restore energy levels.
Many people experience prolonged fatigue after COVID-19 infection, to the extent that it affects their daily lives.
Various research studies have also shown that fatigue is the most predominant symptom in long COVID.
Fatigue primarily manifests as a sense of muscular weakness, which is related to reduced energy production in muscles. In this regard, one nutrient deserves our attention—creatine, long familiar to fitness enthusiasts.
The majority of creatine in the human body is stored in muscle tissue, with small amounts found mainly in the brain and heart. Creatine is the fastest energy source in cells, capable of rapidly generating ATP to power cells. During high-intensity exercise, muscle cells rely on this type of energy.
Even before COVID-19, numerous studies on chronic fatigue syndrome had identified lower creatine levels in patients’ muscles and brains—the lack of this rapid energy source in muscles is clearly a key factor contributing to physical weakness.
Studies on patients with post-COVID fatigue syndrome also found that their creatine levels in skeletal muscles and the brain were significantly lower, which partly explains why they experience muscle weakness (and cognitive impairment).
Directly supplementing creatine at this stage is equivalent to providing the most immediate energy source to muscles and the brain, theoretically helping restore the function of various cells and alleviate fatigue symptoms.
Additionally, beyond supplying cells with direct energy, creatine can also:
〇 Antioxidant – Creatine has direct antioxidant capabilities, protecting mitochondrial DNA from damage by reactive oxygen species.
〇 Anti-inflammatory – By downregulating related membrane proteins such as “Toll-like receptors” on various innate immune cells, it suppresses excessive inflammatory responses.
〇 Neuroprotective – By inhibiting the “mitochondrial permeability transition pore,” it maintains mitochondrial membrane integrity, stabilizes mitochondrial function, and sustains ATP levels in nerve cells. Mitochondrial dysfunction is a key factor in many brain injuries and neurodegenerative diseases.
〇 Improves glutamate regulation in the brain – Creatine activates central GABAA receptors and modulates NMDA receptors, ultimately aiding in glutamate regulation—a function often impaired in chronic fatigue patients. This impairment leads to excessive glutamate accumulation in the brain, which interferes with neural signaling and causes mental fatigue, corresponding to the cognitive exhaustion experienced by many fatigue sufferers.
A study conducted on patients who had been infected with COVID-19 within the past three months and experienced moderate to severe persistent fatigue found that, compared to those who supplemented with 4 grams of inulin (placebo) daily, patients who took 4 grams of “creatine monohydrate” daily showed a significant reduction in overall fatigue levels after 3 months. After 6 months, they could engage in activities for significantly longer durations before experiencing exhaustion, and various symptoms associated with chronic fatigue (such as fibromyalgia, poor memory, poor concentration, difficulty breathing, and headaches) also improved (except for loss of smell and chest pain).
Based on current knowledge, it is recommended that individuals experiencing long-term fatigue after COVID-19 infection supplement with creatine (“creatine monohydrate” is sufficient), at least 5 grams daily.
During the pandemic, even if not infected with COVID-19, maintaining adequate creatine intake through daily diet is advisable to support good physical condition and immunity.
Naturally, animal muscle tissues—commonly known as “meat”—are rich in creatine. For example, every 100 grams of beef or lamb contains 4–5 grams of creatine, chicken has over 2 grams, and various types of fish generally contain creatine levels between 2–5 grams.
A previous survey of female patients with chronic fatigue syndrome showed that although they did not have a unified dietary pattern, they seemed to frequently avoid eating meat.
Eating half a kilogram of meat per day can provide approximately 10 to 30 grams of creatine, which is significantly higher than the dosage used in related studies. However, considering the uncertain and unstable absorption rate, it is still recommended to use specialized supplements if experiencing long COVID fatigue symptoms.
