Investigating the use of oral creatine supplementation as a means of treatment for the symptoms of fibromyalgia syndrome

Valerie Marie Andrus, The College of Wooster

Abstract

Fibromyalgia Syndrome (FM) is a chronic musculoskeletal pain syndrome of unknown etiology that affects approximately 4-5% of the general population. The symptoms of fibromyalgia are poorly defined and variable; currently, there is no definitive diagnostic test for FM. The aim of this study was to investigate the effectiveness of creatine supplementation in treating the pain symptoms of FM, as well as to investigate the mechanism through which this treatment acts. Clinical observations suggest that creatine is effective in reducing the symptoms of pain in some FM patients, and the literature provides evidence for metabolic abnormalities in the muscle tissues of those who suffer from FM. We hypothesized that metabolic abnormalities may be significant contributing factors in FM pathogenesis. Creatine is a necessary component of proper metabolic function, and creatine supplementation is an untested intervention for FM. Our approach to investigating the role of metabolic alterations in FM pathogenesis was to conduct a clinical trial during which we investigated respiratory exchange ratio, lactate, pyruvate, creatine, and creatinine concentrations, and assessed overall presentation of FM symptoms. Clinical responsiveness to creatine supplementation was correlated with measures of muscle creatine and with other metabolite levels. Data from this intervention suggest that those FM patients who are creatine responsive have lower baseline creatine levels than those who are non-responsive. No relationship was found between symptom assessment and metabolite concentrations, and in the future a different approach to symptom quantification should be used. Based on these results, serum creatine concentrations can be useful in determining treatment options for those already diagnosed with FM, and oral creatine supplementation may be a successful treatment option for those FM patients with low serum creatine concentrations. Additionally, if results from this study are reproducible, then creatine may play a significant role in a pathogenic mechanism for select FM patients.