COMMENTARY

Creatine Supplements to Improve Strength in Fibromyalgia

Kevin Deane, MD

Disclosures

October 16, 2013

Creatine Supplementation in Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Trial

Alves CR, Santiago BM, Lima FR, et al
Arthritis Care Res (Hoboken). 2013;65:1449-1459

Study Summary

Some data suggest that abnormal muscle function is part of the pathophysiology of fibromyalgia. In particular, magnetic resonance (MR) spectroscopy studies have shown reduced phosphorylcreatine (PC) content in patients with fibromyalgia.[1]

With this as background, Alves and colleagues conducted a 16-week randomized, double-blind, placebo-controlled trial of creatine monohydrate (CM) oral supplementation in patients with fibromyalgia as defined by the American College of Rheumatology preliminary criteria.

Fifteen patients were randomly assigned to receive CM 20 g daily for 5 days (divided into 4 equal doses), then 5 g daily (as a single dose) for the study duration, and 13 patients received placebo. All patients were on other therapies for fibromyalgia, although there were reportedly no significant differences between groups. Outcomes assessed were muscle strength, PC levels by MR spectroscopy, aerobic fitness, pain, cognition, sleep, and quality of life.

They found that the patients who were treated with CM had increased strength as measured by chest and leg presses and increased levels of muscle PC as measured by MR spectroscopy. However, there were no differences between groups in measures of aerobic fitness, pain, cognition, sleep, and quality of life. Furthermore, there were no differences between groups in adverse reactions or renal function as measured by creatinine level. They concluded that creatine supplementation may be useful to improve muscle function in patients with fibromyalgia.

Viewpoint

This interesting yet small study suggests that creatine supplementation may be helpful in improving some aspects of muscle function in fibromyalgia, although it is disappointing that other perhaps more clinically relevant measures for fibromyalgia, such as pain and overall quality of life, were not improved. However, as the investigators commented, perhaps ultimately creatine supplementation could be part of a multifaceted treatment approach for patients with fibromyalgia. This will need to be explored in future trials.

Abstract

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