Doctors in New Zealand who oversaw the care of Jonah Lomu have cast doubt on claims the All Blacks superstar took the supplement creatine.
Former-All Blacks Joeli Vidiri has told the UK Daily Telegraph that both he and Lomu both took creatine while they were playing with the Blues in the 1990s.
Vidiri, 42, believes the muscle-building supplement may have contributed to the kidney disease which ultimately led to Lomu's death late last year and caused his own kidney condition.
Both Vidiri and Lomu were diagnosed with nephrotic syndrome, a rare kidney disease that affects only three in 100,000 of the population.
Vidiri was diagnosed with the disease 15 years ago and finally underwent a transplant last May. Lomu had a transplant in 2004, but it failed seven years later, and he died of a sudden heart attack last November at the age of 40. His death was almost certainly linked to his kidney problems.
Creatine is produced naturally in the body and is not banned, aids muscle growth. The Blues squad began to take it as part of their training regime in the late 1990s. The Telegraph quoted medical experts as saying taking creatine would have impacted on Lomu's disease.
But former All Blacks doctor John Mayhew told the Telegraph that Lomu never took the supplement. The Blues doctor at the time Lomu was playing for the Super Rugby franchise, Graham Paterson, told the New Zealand Herald this morning that no players were encouraged to take creatine during his tenure.
Paterson treated Lomu when he began playing for Counties and organized specialist advice for the wing when his kidneys began to struggle.
"Jonah was absolutely never encouraged to take creatine - not that anyone has shown that it is definitely a bad thing when you have renal impairment," he said today.
"But it seemed like a bad thing and similarly with anti-inflammatory medication. I can't say that he didn't take them but he wasn't supposed to, that's for sure because I knew about it."
Paterson said he was critical about creatine and like most doctors, skeptical about its impact. For normal players on a normal diet the benefits were negligible. That was his stance on most supplements then and remains his stance today.
"Joeli at that stage - we had no knowledge he had any kidney issues and what he might have done, I have no idea about. I know plenty of the players were taking creatine across the rugby landscape including the Blues."
About a month ago, Paterson said he was contacted by a UK news organisation for some comment linking creatine to the health problems of Lomu and Vidiri. "I refused because it was a complete beat-up, some tosser looking for a story. There is not a story and that is my stance to this day."
Lomu was his own man and medical staff did not stand over him, he said. "He knew he had kidney issues, he knew he wasn't to take anti-inflammatories, he knew he wasn't to take creatine and if he was taking it, it was not with my open knowledge that's for sure."
Vidiri told the Telegraph Lomu took the substance even after being diagnosed with nephrotic syndrome in late 1995. "We were in our prime and enjoying ourselves, and you ask, 'why us?'" Vidiri told Telegraph Sport. "It's a question we can't answer for sure. Lots of people have been telling me about creatine and it does make you wonder.
"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. 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."
Vidiri added: "We used to be given a really big container of it [creatine] every few months. Instructions were written on the back and we would take the container away with us.
"We used to mix it with water and it would puff you up. I can't remember how much we would take anymore. We took it before we trained and after too. Jonah would take it too, though maybe not as much, because he was already on the drugs for his kidney condition. We took it from 1997 onwards. We used to have a corner in the dressing room where we'd sit together."
Vidiri said there was huge pressure on the players to perform at the Blues. "The supplements were part of that because you wanted to get stronger. The game was getting tougher and faster. You wanted something to help you improve in your rugby career. I stopped taking creatine when we started to get worried about what it was doing to us. As soon as there were rumours about it, I stopped."
Dr John Mayhew, who was Lomu's personal GP, denies that the legendary wing took creatine. "We knew he had a renal impairment for most of his career, so he definitely wasn't taking it. It is not a banned substance, but as a rule of thumb I advise anyone with kidney problems not to take it."
Professor Phillip Kalra, consultant nephrologist at Salford's Royal Hospital, told Telegraph Sport that significant creatine use would have worsened Lomu's kidney condition.
He said there was evidence that "massive people are more predisposed to nephrotic syndrome" and research has shown that Polynesians have a higher predisposition towards the condition than average.
Creatine: The facts
Creatine IS a legal supplement that has been widely used in professional and amateur rugby circles for more than two decades. It is not on the banned list of supplements issued by the International Olympic Committee and is freely available in retail supplement outlets, gymnasiums and online. It is typically bought in flavored powders and mixed with liquid.
Experts say it increases the body's ability to produce energy rapidly, allowing athletes to train harder and more often, producing faster results. "It's as simple as this: 'If you can lift one or two more reps or 5 more pounds, your muscles will get bigger and stronger'," says Chad Kerksick, Ph.D., assistant professor of exercise physiology at the University of Oklahoma.
It is considered to be a very effective supplement for high-intensity training and explosive activities including weight training and sports that require short bursts of effort, such as sprinting and football.
The supplement is essentially a powerful amino acid that pulls water into your muscle cells, which increases protein synthesis and promotes muscle gain.
While creatine has its critics, it is legal and is widely used around the world by elite and amateur athletes across a variety of sports. Its use gained momentum in rugby circles in New Zealand during the 1990s which is the decade former All Blacks winger Joeli Vidiri says he and Jonah Lomu began using it.
Both Vidiri and Lomu suffered kidney diseases and it has been suggested Pacific Islanders in particular should avoid taking it. But some researchers, trainers and health experts who claim they are constantly studying creatine for effectiveness and safety support the supplement's use.
"Creatine is one of the most-researched sports supplements out there," Kerksick says. "And there's no published literature to suggest it's unsafe."
Paul Greenhaff, Ph.D., professor of muscle metabolism at the University of Nottingham in England, has been studying creatine for almost 20 years and told Men's Health Journal: "If there were any major adverse side effects, we would have seen them by now."
But there have been anecdotal reports of kidney damage, heart problems, muscle cramps and pulls, dehydration, and diarrhea, in addition to other negative side effects, from creatine use.
Experts recommend using creatine only if you are healthy and have no kidney problems. That's because your kidneys excrete creatinine, a breakdown product of creatine. "I feel it would be better for no one to use creatine even though it's shown to increase some strength and muscle mass," says Jim King, M.D., president of the American Academy of Family Physicians.
"I wouldn't recommend doing anything that would show minimal improvement and possible risk. Weigh the negatives and the benefits before you try it."
Kids under age 18 should avoid creatine, King says, because few studies have been done on children using creatine as an exercise enhancement.