This post started listing to a Pod Cast from The Economist. I am not sure if the pod cast and article is available to non-subscribers so I will do a few quotes from it:

Creatine works mainly by increasing the amount of energy that muscles can produce. Cells use a molecule called adenosine triphosphate (ATP) as a carrier of chemical energy. Aerobic respiration, which uses oxygen to break down fats or sugar, is by far the most efficient way of making ATP. But it is relatively slow. When muscles need a lot of ATP in a hurry most of it is supplied instead by the phosphocreatine system which, as its name suggests, relies on creatine to work.

As summarised in a review published in 2021 in Nutrients, some studies have suggested that creatine might sharpen things like short-term memory or reaction times. Others have reported it may lessen the symptoms of mental-health problems such as depression, and tentative evidence suggests it improves cognition in those with Alzheimer’s disease. Both may be associated with a misallocation of energy within the brain.

More Literature

Creatine (C₄H₉N₃O₂) is a ubiquitous molecule synthesized predominantly in the liver, kidneys, and pancreas at a rate of ~1 g/day via an interorgan process. [2024]. It is often low in people with ME/CFS; see MEPedia for more information.

• Diagnostic and Pharmacological Potency of Creatine in Post-Viral Fatigue Syndrome [2021] 
  “supplemental creatine and related guanidino compounds appear to impact both patient- and clinician-reported outcomes in syndromes and maladies with chronic fatigue.”
• Creatine and post-viral fatigue syndrome: an update [2025]
  “Emerging evidence highlights the role of mitochondrial dysfunction and creatine metabolism in PVFS, positioning creatine as a promising therapeutic candidate. While initial studies suggest its efficacy in alleviating fatigue and improving bioenergetics, further large-scale, rigorous trials are essential.”
• Six-Week Supplementation with Creatine in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Magnetic Resonance Spectroscopy Feasibility Study at 3 Tesla [2024]
  “Conclusion: Creatine supplementation over six weeks in ME/CFS patients increased brain creatine and improved fatigue and some aspects of cognition. “
• Creatine Supplementation Beyond Athletics: Benefits of Different Types of Creatine for Women, Vegans, and Clinical Populations—A Narrative Review [2024]
  ” It may mitigate muscle wasting in conditions such as sarcopenia and cachexia, support neuroprotection in neurodegenerative diseases such as Parkinson’s and Huntington’s, improve exercise capacity in cardiovascular diseases, and enhance energy metabolism in chronic fatigue syndrome. Creatine may also aid recovery from traumatic brain injury by promoting brain energy metabolism and reducing neuronal damage.”
• Creatine monohydrate supplementation for older adults and clinical populations [2025]
  “when combined with exercise training, is safe and has beneficial effects on measures of whole-body lean body mass, regional muscle size, muscle strength, bone area and thickness, functional ability, glucose kinetics, cognition and memory.”
  “have application for treating age-related sarcopenia, osteoporosis, frailty, and those with metabolic and neuromuscular disorders.”

For findings of a well known ME/CFS specialist, Sarah Myhill (UK) see Chronic fatigue syndrome and mitochondrial dysfunction [2009]

It’s a Cheap Supplement

Going to iherb.com, we see one kilo is $21 on subscription. This is 200 dosages of 5mg (i.e. 10 cents a day). Some sources suggests 4 5mg dosages per day — so we have 2 months for $21.00. You can spend a lot more buying from fancy sources in capsules. I am a frugal person….

By some on a 6 month subscription. Cancel if it has no positive impact.

Gut Impact

For those interested, you can see what it changes on Microbiome Prescription. Of note is that it increases:

• Lactobacillus
• Blautia
• Faecalibaculum
• (healthy) Escherichia coli

Autism

• Children with autism reliably show lower ATP levels compared to neurotypical controls. [2011]
• Impaired energy metabolism—including reduced ATP and other high-energy metabolites—correlates with features like poor methylation, low sulfate recycling, and high oxidative stress in autism.[2016]
• Several studies report mitochondrial dysfunction in ASD, with deficits identified in electron transport chain activity and energy production, leading to abnormal ATP levels in brain and peripheral samples.[2011]
• Some preliminary research and clinical trials are investigating creatine supplementation for ASD, focusing on cases with low brain creatine or known metabolic defects. [2025]

Bottom Line

It is cheap, safe and has significant potential benefits for many.