Is Creatine safe?
Amid allegations that the powder may have played a role in Jonah Lomu's illness, our reporter asks if we should be concerned about its popularity among our young atheletes
It's hailed as the wonder powder to boost performance on the pitch. But this week saw Creatine in the spotlight after it was alleged by a former team-mate the supplement may have played a part in Jonah Lomu's death.
According to the All Black legend's former teammate, Joeli Vidiri, both he and Lomu routinely took the muscle-bulking product as part of their training regime in the late 1990s.
Both players were later diagnosed with the rare kidney disease, nephrotic syndrome, with Lomu's death last November at the age of 40, almost certainly linked to kidney disease.
Dad-of-two Vidiri (42) says he now wonders what role Creatine may have played in their condition. "I would be happy if somebody came through with a study to help with that - and to help the young people who are taking it now," he says in an interview with the Telegraph.
"We need to know what are the side effects of taking it. I would love to know that because we can advise the young people about the right way to go."
It's a troubling development for the product that is routinely sold over the counter at health stores across Ireland. Particularly given the number of young players who may be following their sporting idols' example in a bid to bulk up.
Former Ireland and British Lions player David Irwin is now a practising GP. He believes there's increasing pressure on younger players to match the physicality of older players.
"I'm sure most of the professionals use or have used Creatine in the past and I'm aware that at schools level they are probably using it too. Players at school tend to copy other players further up," he says.
"There's a big debate as to whether schools teams should be bulking up, but the professional game is creeping further down the age groups. Players get talent-spotted at an early age, they're trying to stay a step ahead so they can potentially get into an academy - they want to do whatever they can to stand out."
And that means doing whatever it takes to be the most physically assertive person on the pitch. Several years ago Dr Suzanne Guerin, from the department of psychology at UCD, conducted research that revealed 12pc of those involved in schools sports had at one time taken Creatine. Given the increased demands made of players on the rugby pitch, it seems likely this figure will only have risen.
Creatine is made from the body's own amino acid and used to build muscle mass and improve performance. It's not banned, but there's clearly a degree of uncertainty around it. In 2013 the Irish Sports Council recorded 56 separate requests online to check if Creatine was on its prohibited substances list. The IRFU states on its website that it "strongly advises against the use of nutritional ergogenic aids, in particular Creatine, in young players under 18 years of age".
Professor Brendan Buckley, chairman of the Irish Sports Council's anti-doping committee, says school rugby players are making themselves "more susceptible to injury" by taking Creatine before their bones are hardened and fused.
A few years ago a report from the French Agency of Medical Security for Food reported a "potential carcinogenic risk" associated with the product. Welsh runner, Iwan Thomas has been vocal in blaming it for leg cramps that negatively impacted his performance.
"Taking Creatine may cause stomach cramps, diarrhoea and renal issues," says Tom Coleman, a health scientist and consultant specialising in performance and recovery and founder of My Nutrition.
"Creatine will not build muscle. It's involved in the energy system and not muscle repair. Although muscles appear bigger, this is due to creating binding molecules of water within the muscle."
While he's keen to point out that credible sporting bodies have recorded Creatine as safe, legal and effective when taken under correct supervision, he agrees there's cause for concern around young athletes taking it without direction.
"Young men are still developing in a physiological sense and there are a huge amount of changes occurring due to their own natural hormones," he explains.
"Taking excessive doses of Creatine may be dangerous and have an effect on kidney function. The best advice would certainly be to wait until they have reached physical maturity."
Dr Declan de Freitas, consultant in Renal Medicine at Beaumont Hospital Kidney Centre, disputes the notion that Creatine can cause kidney failure, but says that taking it on top of an existing kidney problem could exacerbate it.
A pertinent point, given that Vidiri asserts that Lomu continued taking the muscle-bulking supplement after his diagnosis in 1995.
"There has been a number of studies examining the use of Creatine supplements for a variety of indications, with no evidence that Creatine causes kidney disease," he explains. "Creatine supplementation could artificially make kidney blood tests look worse."
But ultimately perhaps what's needed is a total overhaul in rugby. "The game has changed a lot since I was playing and in my opinion it's changed for the worse," says Irwin.
"Even in the pro game a lot of the players are almost too big now. It's very physical, there's no room to do anything other than run into each other. It nearly comes down to who's biggest and heaviest is going to win."
He adds: "It's why we're seeing so many injuries, the muscles are so strong that they are pulling the bone off the skeleton."
The fact that the pro game is rife with tacticians and nutritional trainers has "stopped players being able to think for themselves" and there's a need to turn the clock back on how rugby is played.
"Otherwise we're going to see more and more young players get put off entering the game," he warns.