Creatine.... the professors response

I just found this. It's a few months old but still good - originally posted on UK-Muscle:

Today I had the long-awaited call with Paul Greenhaff. He was very relaxed about the call, not at all concerned about the readership and happy to answer any questions. Please appreciate the answers are based on Paul's research, that of his peers, the knowledge he has gained through his work and his own opinions. You may not agree with the answers, but hey that's life.
I won't write one word answers to the questions, as it wouldn't give the general feeling for the conversation, I'll try to summarize as best I can....

Types
On the subject of the various different types, this is all hype/gimics (bull**** to use Paul's real term). Most of these products boast an improved absorption rate into the cells, when actually all of them are broken down to basic creatine phosphate in the gut and so its the same compound by the time it reaches the cell wall, irrespective of its nature when its started the journey (if you get what I mean). The limiting factor for creatine uptake is at the cell wall, as creatine phosphate, and not as CEE, Kre- etc etc. Absorption in the gut is rapid, and is not a problem at all. 30 mins after ingestion, the blood plasma levels rise to about 20x resting levels, which is far more than sufficient for the rate it can enter the cell at. ie you don't particularly need high blood plasma levels.

Loading / Entry to Cell
Most efficient and effective method remains 20g per day for 5 days, split into 4x5g, each one with 80-100g of simple sugars (thats about 500ml of Lucozade). The one thing that can significantly improve the movement across the cell wall, is the ingestion of the simple carbs, this stimulates the sodium potassium pumps and improves the uptake across the cell wall. Adding an esther, or buffering the creatine has no effect at all. As he put it, its the quickest way to link your bank balance with the sea!

Cycling/Toxicity
No evidence whatsoever that cycling is necessary either from a point of continued effectiveness of the supplement, or for renal health. Despite the sheer volume of creatine sold worldwide, there remains no evidence of renal damage unless a pre-existing renal condition was present. And there is no evidence that the effectiveness reduces over time, ie no resistance builds up. So no need to cycle.

Dependence
Not really studied. Any supplement can illicit training adaptations that if beneficial, will probably stop when the supplement is withdrawn. Doesn't necessarily indicate any dependence.

Water Retention
This is real, but is not extra-cellular in Pauls view. In exercising people, creatine facilitates glycogen storage and this directly causes water retention within the muscle cells. So the water retention that occurs is positive in his opinion.

Combining with other Products
There is no evidence as far as he knows that other products improve the effects of creatine, just the benefits of taking with simple carbs.

Asked him about Nitric Oxide pre-cursors or L-Arginine and he said that product in itself really is unproven, the only evidence proving L-Arginine's effects was done on dogs and in huge concentrations (I told him I think it works!)

Breakdown
Talked about creatinine and he says its not a good marker for the breakdown of supplemental creatine, but could indicate that some of the creatine itself has degraded to creatinine prior to ingestion, or as an indicator of renal damage per se. ie creatinine is a marker for creatinine presence, not for creatine breakdown.

Muscletech
No relationship with them, they funded some research into insulin and muscle protein metabolism in the past, its normal for manufacturers to do this. Paul doesn't endorse any product, and when questioned on difference between brands, answered he hasn't come across any brand that is better than others (simple pure creatine monohydrate varies little).

Other
There is some new research into L-Carnitine and ingestion with sugars to give an insulin response. I'll try and locate Paul's study and post it. Its supposed to be interesting. And then current research in general is focused on understanding less about the effects of products, and more about what is happening at a molecular level and then working back from there.

In general, not an awful lot has changed with creatine in 10 years and the research done in the '90s pretty much established the facts. His advice for using creatine for bodybuilding, go back to basics, stop ****ing your money into the sea and use creatine monohydrate in the way that has been proven countless times. Also, for us as individuals, be as critical as possible about the products you are using and don't get sucked in by any hype.