Variable particle masses have sometimes been invoked to explain observed anomalies in low energy nuclear reactions (LENR). Such behavior has never been observed directly, and is not considered possible in theoretical nuclear physics. Nevertheless, there are covariant off-mass-shell theories of relativistic particle dynamics, based on works by Fock, Stueckelberg, Feynman, Greenberger, Horwitz, and others. We review some of these and we also consider virtual particles that arise in conventional Feynman diagrams in relativistic field theories. Effective Lagrangian models incorporating variable mass particle theories might be useful in describing anomalous nuclear reactions by combining mass shifts together with resonant tunneling and other effects. A detailed model for resonant fusion in a deuterium molecule with off-shell deuterons and electrons is presented as an example. Experimental means of observing such off-shell behavior directly, if it exists, is proposed and described. Brief explanations for elemental transmutation and formation of micro-craters are also given, and an alternative mechanism for the mass shift in the Widom–Larsen theory is presented. If variable mass theories were to find experimental support from LENR, then they would undoubtedly have important implications for the foundations of quantum mechanics, and practical applications may arise.