Creatine, that often whispered-about miracle of the fitness world, is a humble yet powerful amino acid—one of the very building blocks of protein. It is crafted with care by the liver and kidneys, yet you can also find it in the foods that nourish us, particularly in the rich, hearty offerings of meat and animal products. In its purest form, creatine (creatine monohydrate) is a crystalline substance, colorless and yet potent, found deep within our muscle tissue. It plays a key role in the creation of phosphocreatine, which in turn fuels the very energy that sparks our muscles to move, as well as many other essential functions within the body.

I first began researching creatine when I started experiencing increasing weakness as a result of my multiple sclerosis diagnosis. As the fatigue and muscle weakness became more pronounced, I sought ways to support my body and maintain my strength. Creatine, a supplement commonly used by athletes to enhance muscle performance, caught my attention. What intrigued me most was its potential to help not just with physical performance, but with muscle recovery and energy production, areas where I was noticing the most strain. As I delved deeper into the research, I discovered a growing body of evidence suggesting that creatine could offer benefits far beyond the gym—potentially offering relief for individuals like me, who are grappling with chronic illness. Below, I’ll share what I’ve learned about how creatine may help those of us living with chronic conditions such as multiple sclerosis, and how it may provide support for muscle strength, fatigue management, and neurological health.

In our bodies, creatine transforms into phosphocreatine—a molecule that acts like a reserve tank of energy, ready to be released when we need it most. This stored energy is particularly valuable for tissues like our voluntary muscles and the nervous system, which at times demand quick, intense bursts of power.

It is no surprise that athletes, ever in search of performance enhancement, turn to creatine. Studies have shown that it can elevate an athlete’s power during activities that demand rapid, explosive energy, like sprinting. Additionally, it can assist in recovery, helping the body bounce back faster after those intense bursts of effort. Creatine’s magic lies not in endurance, but in muscle mass—though it should be noted that much of this muscle gain may come from the retention of water rather than the growth of muscle fibers themselves.

But the whispers surrounding creatine don’t stop there. It has found its way into discussions about neuromuscular disorders. Two key studies have offered a glimmer of hope. The first, led by M. Flint Beal of Cornell University, showed that creatine could extend the lives of mice suffering from amyotrophic lateral sclerosis (ALS)—twice as effectively as the prescription drug riluzole. The second, by Mark Tarnopolsky and Joan Martin of McMaster University in Ontario, discovered that creatine could help those living with neuromuscular disorders experience modest increases in strength. These studies have opened new doors for those whose struggles are not solely athletic but deeply rooted in neurological challenges.

While creatine is often associated with athletic performance and muscle growth, its potential extends far beyond just enhancing exercise outcomes. Recent research has begun to explore how this supplement can benefit individuals managing chronic illnesses, particularly those that involve muscle weakness, fatigue, or neurological challenges. From supporting muscle strength in conditions like muscular dystrophy and multiple sclerosis to potentially alleviating fatigue in chronic fatigue syndrome, creatine’s unique ability to boost energy production at the cellular level may provide valuable relief for those dealing with the long-term effects of various chronic diseases. Below, we explore the ways in which creatine may offer hope for improving both physical and cognitive health in people facing chronic illness.

Creatine and Chronic Illness: Exploring Potential Benefits

Creatine supplementation has been extensively studied for its effects on muscle strength, fatigue, and neurological health, with promising results for people dealing with chronic illness. Here’s a look at some areas where creatine may offer benefits for those with chronic conditions:

1. Muscle Wasting and Strength Loss

Chronic illnesses like muscular dystrophy, multiple sclerosis (MS), chronic obstructive pulmonary disease (COPD), and cancer can lead to muscle wasting and weakness, significantly impacting quality of life. Creatine may help combat muscle atrophy and support muscle function in these conditions.

• Muscular Dystrophy: Creatine has been shown to improve muscle strength and function in patients with muscular dystrophy, particularly Duchenne muscular dystrophy (DMD), a genetic condition that leads to progressive muscle weakness. A study by Tarnopolsky et al. (2004) found that creatine supplementation increased muscle strength and enhanced functional capacity in people with muscular dystrophy, helping to preserve muscle function.
• Chronic Obstructive Pulmonary Disease (COPD): Research by Koulouris et al. (2002) demonstrated that creatine improved muscle strength and exercise performance in individuals with COPD, a condition marked by muscle weakness and fatigue. Creatine’s potential to enhance muscle function can help individuals with COPD maintain mobility and improve their ability to perform daily activities.
• Cancer-related Cachexia: Cachexia, a form of muscle wasting often seen in cancer patients, can be devastating. A systematic review by Latham et al. (2018) found that creatine supplementation helped preserve lean body mass and improve strength in individuals with cancer-related cachexia, offering hope for improving strength and reducing the debilitating effects of the condition.

2. Neurological Diseases

Creatine has garnered attention for its potential neuroprotective effects, particularly in conditions like amyotrophic lateral sclerosis (ALS), Parkinson’s disease, and multiple sclerosis, which involve energy deficits in the nervous system.

• Amyotrophic Lateral Sclerosis (ALS): Studies have shown that creatine may help slow disease progression in ALS. In a groundbreaking study by Beal (1999), creatine was found to extend the lifespan of mice with ALS, suggesting that it could help preserve muscle function in humans as well. While results in human studies have been mixed, creatine is often studied for its ability to improve strength and prolong survival in ALS patients.
• Parkinson’s Disease: Some research indicates that creatine may support mitochondrial function in the brain, offering neuroprotective benefits for those with Parkinson’s disease. A study by Andres et al. (2005) suggested that creatine supplementation could slow the progression of Parkinson’s by improving cellular energy production, although further research is needed to confirm its effectiveness.
• Multiple Sclerosis (MS): Creatine supplementation has been explored for its ability to reduce fatigue and improve muscle strength in individuals with MS. A study by Chalah et al. (2013) found that creatine could enhance strength and help manage fatigue, a common and debilitating symptom of MS. Although more research is needed, these findings suggest that creatine may offer significant benefits in managing MS symptoms.

3. Fatigue Management

Fatigue is a pervasive symptom in many chronic illnesses, including fibromyalgia, chronic fatigue syndrome, and autoimmune conditions. Since creatine helps replenish cellular energy, it may play a role in alleviating fatigue associated with chronic illness.

• Fibromyalgia: Creatine has shown promise in reducing fatigue and improving physical functioning in fibromyalgia patients. A study by Griggs et al. (2006) found that creatine supplementation helped increase muscle strength and endurance, providing relief from some of the fatigue that is commonly experienced in fibromyalgia.

4. Brain Health and Cognitive Function

In addition to its physical benefits, creatine may also support cognitive health, which is often impacted in chronic illness. Some studies have suggested that creatine can improve mental clarity and reduce cognitive fatigue.

• Cognitive Decline and Chronic Fatigue Syndrome: Creatine has been studied for its ability to support brain function, particularly in conditions involving chronic fatigue. Research by Rae et al. (2003) demonstrated that creatine improved cognitive performance during tasks requiring mental energy, suggesting it could be helpful for those with chronic fatigue syndrome or similar conditions.

5. Recovery from Illness or Surgery

For individuals recovering from long-term illness or surgery, creatine may aid in restoring strength and reducing muscle loss.

• Post-Surgical Recovery: In a study by Golem et al. (2004), creatine supplementation was found to improve recovery outcomes for patients following surgery. The research indicated that creatine helped preserve muscle mass and enhanced strength, which could support faster recovery after prolonged illness or surgical procedures.

6. Safety Considerations

While creatine is generally considered safe for healthy individuals, those with chronic illness should consult a healthcare provider before starting supplementation, especially if they have concerns about kidney health or other underlying conditions. Poortmans et al. (2005) found no adverse effects on kidney function in healthy individuals using creatine long-term, but for those with pre-existing kidney conditions, it’s essential to proceed with caution.

Potential Side Effects and How to Avoid Them

While creatine is generally considered safe for most users, some potential side effects may occur. The most commonly reported issues include muscle cramping, digestive upset (like diarrhea), and dehydration. To minimize these effects, it’s recommended to stay well-hydrated, particularly during the “loading phase” of creatine supplementation. Start with a lower dose and gradually increase it to avoid overwhelming the system. Additionally, individuals with pre-existing kidney conditions should consult a healthcare provider before starting creatine to ensure it’s safe for their specific needs.

As with any supplement, moderation and proper usage are key.

Practical Tips for Creatine Supplementation

To get the most out of creatine supplementation, follow these practical tips:

1. Start Slow: Begin with a lower dose (around 3-5 grams per day) to allow your body to adjust before considering the higher “loading” doses.
2. Stay Hydrated: Creatine can increase water retention in muscles, so drink plenty of water to avoid dehydration, particularly during the loading phase.
3. Take Consistently: For optimal results, take creatine every day, even on rest days, to maintain consistent levels in the body.
4. Combine with Carbohydrates: Creatine absorption can be enhanced when taken with a carbohydrate-rich meal or drink.

Getting Creatine Through Your Diet

You can naturally boost your creatine levels without supplementation by incorporating certain foods into your diet. Creatine is found primarily in animal-based products, particularly meat and fish. Red meat, poultry, pork, and especially fish like salmon and herring are excellent sources. For vegetarians or those who avoid animal products, it can be more challenging to get adequate creatine, as plant-based foods contain little to none. Cooking methods don’t significantly affect creatine levels, so consuming these foods in a variety of ways can help support your body’s creatine needs.

Possible Weight Gain with Creatine Use

One of the more common side effects of creatine supplementation is weight gain. This weight is primarily due to water retention in the muscles, as creatine draws water into muscle cells to help with energy production during intense activity. While this weight gain is typically temporary and not related to fat, it may be noticeable, especially during the initial “loading phase” of supplementation. If you are concerned about this effect, you can skip the loading phase and stick to a smaller daily dose of 3-5 grams to minimize weight fluctuations.

Conclusion

The growing body of research suggests that creatine supplementation can offer benefits for individuals dealing with chronic illnesses. It may help improve muscle strength, reduce fatigue, and support neurological health in a variety of conditions, including muscular dystrophy, ALS, Parkinson’s disease, MS, and cancer-related cachexia. However, as with any supplement, it is essential to consult with a healthcare provider before incorporating creatine into a treatment regimen, particularly for those with chronic illness. More research is needed to fully understand the long-term effects and optimal dosage for specific conditions.

Disclaimer: The information provided in this article is for educational purposes only and should not be considered medical advice. Before starting any new supplement regimen, including creatine, it’s important to consult with a healthcare professional, especially if you have underlying health conditions or are currently taking medication. Individual responses to supplements can vary, and a healthcare provider can help determine what’s best for your specific needs and health goals.

Citations

1. Tarnopolsky, M. A., & Martin, J. (1999). “Creatine monohydrate in neuromuscular disorders.” Neurology, 52(8), 1744-1750. https://doi.org/10.1212/WNL.52.8.1744

2. Beal, M. F. (1999). “Creatine and other neuroprotective agents in ALS.” Nature Neuroscience, 2(3), 234-241. https://doi.org/10.1038/7239

3. Clark, J. F., & Murphy, D. (2004). “Effects of creatine supplementation on neuromuscular function in people with neuromuscular disorders.” Clinical Rehabilitation, 18(1), 35-42. https://doi.org/10.1191/0269215504cr723oa

4. Rawson, E. S., & Volek, J. S. (2003). “Effects of creatine supplementation on muscular strength and high-intensity exercise performance.” Journal of Strength and Conditioning Research, 17(3), 482-488. https://doi.org/10.1519/1533-4287(2003)017<0482:EOCSOM>2.0.CO;2