Creatine Causes Hair Loss. Truth or Myth?

Bonnke Arunga, MBBS

By    – Updated on October 22, 2020 – Reviewed by dermatologist Dr. Suneil Gandhi, MD

man icon loosing hair and creatine monohydrate bottle

Let’s talk about this widespread rumor that claims creatine is a major cause of hair loss. For years now, male baldness and thinning hair have been cited as possible side effects of creatine use. But is it true? In this article, we’re going to try to find out. First, let us take a look at some clinical facts.

What is creatine?

creatine monohydrate formula

Creatine occurs naturally in the human body. It is typically found in the muscles and the brain. Creatine in powder form is a popular supplement, widely praised for its ability to boost muscle growth in men and women that work out regularly.

An organic nitrogenous acid, Creatine helps to supply our body with energy, in particular, the cells of our muscles. By forming the substance adenosine triphosphate, ADP, it promotes the production of the energy our cells need to perform natural, day-to-day bodily functions.

Possible side effects of using creatine

Creatine works by drawing water from parts of the body to concentrate it in the muscles. This can lead to dehydration, so it’s crucial to make sure you are drinking enough fluids. Besides the claims of Creatine leading to hair loss, other possible side effects may include:

  • muscle cramps
  • nausea
  • diarrhea
  • general stomach discomfort

Concerns have also been raised that creatine use can cause a skin ailment, but a lot more research is needed to substantially prove the irrefutable connection between the condition and the use of supplements such as creatine, in general.

For this reason, anyone considering the use of creatine, or other kinds of supplements, should always consult a medical professional first.

Dihydrotestosterone is a byproduct of testosterone. It is a potent sex hormone that’s responsible for, among other things, forming the male genitalia during pregnancy.  DHT, however, is different from other male hormones such as testosterone in some very interesting ways.

For example, while dihydrotestosterone is widely quoted as being the number one factor in male pattern baldness, it does promote hair growth in other parts of the body, such as the chest, back, armpits, and crotch.

As a natural byproduct of testosterone, DHT can be found in the prostate, liver, skin, and hair follicles, where it binds to receptors in the hair and, over time, causes the follicles to shrivel and die. The result can be a complete halt to hair growth on the head.

Research, research, and more research

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The exact cause of male baldness is, for the most part, still a mystery. Even experts on the subject are reluctant to pin down why some men lose their hair while others don’t. Is Creatine hair loss a myth? We cannot respond to this question with a conclusive answer, yet.

Some studies show that baldness is linked to dihydrotestosterone and it’s a genetic sensitivity to DHT that results in a lack of nutrients becoming absorbed by the hair follicles. Over time, this causes the follicles to shrink.

What is DHT?

dht effect for hair follicle

Dihydrotestosterone is a byproduct of testosterone. It is a potent sex hormone that’s responsible for forming the male genitalia during pregnancy.  DHT, however, is different from other male hormones such as testosterone in some very interesting ways.

For example, while dihydrotestosterone is widely quoted as the most important factor in male pattern baldness, it does promote hair growth in other parts of the body, such as the chest, back, armpits, and groin.

As a natural byproduct of testosterone, DHT can be found in the prostate, liver, skin, and hair follicles. It binds to receptors in the hair and over time, causes the follicles to miniaturize. The result can be a complete halt to hair growth on the head.

Usually, testosterone conversion to DHT is blocked to some extent by using drugs that fall under the class of 5-α reductase inhibitors, a namely oral or topical formulation of finasteride.

Creatine relation to DHT

One such study from PubMed carried out in 2009, set about measuring DHT levels in the blood of rugby players who supplemented Creatine.

One test group was given a daily dosage of 25 grams. This ‘loading phase’ continued for one week and was followed by two weeks with a maintenance dose of 5 grams. A second test group was given pure glucose.

At the end of the study, researchers found that the first group, i.e., the group that supplemented with creatine, showed an increase in DHT levels of 57% in the first week. This level dropped to around 40% during the two-week maintenance phase.

The results of the study are provided in the table below. Note that a lower DHT to testosterone ratio is preferred.

DHT to Testosterone Ratio

creatine vs placebo effect for dht levels chart
Source: Van der Merwe, J., Brooks, N. E., & Myburgh, K. H. (2009)

And here’s the problem: That one study constitutes the main body of evidence on the topic of hair loss and Creatine usage. Or, to put it another way, almost everything you can find on the Internet that is related to the subject comes from this one, single study.

Some points to consider

As the results of that study have never been replicated, there are a few things we should keep in mind here:

  • DHT levels were shown to drop by 16% once the creatine dose was reduced;
  • The study’s duration was only 3 weeks so it’s entirely possible that DHT levels would have continued to drop if the study had lasted longer;
  • Twenty-five grams of creatine is a heck of a lot to take in a single day. And while many experts question the need for a creatine-loading phase, we don’t know what the outcome would have been if the study had continued for a longer period of time, or if a lower dose had been administered right from the start;
  • Hormone levels can fluctuate substantially over any 24 hours, and the study provides no evidence that the DHT measurement was done at the same time every day;
  • The study provides no information regarding nutrition or training or programs. Other research has shown that intense training alone can cause an increase in DHT. So, it is fairly safe to assume that even if the rugby training program wasn’t the only cause for the rise, it could still have been a factor.

What are people saying?

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The internet is full of forums where men report that they have experienced hair loss as a result of using creatine supplements.

But what about the millions of people all around the world who take creatine and are prone to losing their hair anyway? Is it not correct to conclude that there is a connection between athletes and natural baldness?  Maybe it can also be related to testosterone supplements? For this reason alone it’s advisable to take such reports with a healthy grain of salt.

But let’s be honest here, there are no definitive guidelines available.

As always, when it comes to fitness supplements, the answers are never as black and white as we would like them to be. If you currently have a full head of hair with a strong hairline and baldness is not an issue in your family, then you probably should not worry about taking creatine.

Remember, it’s not always an increase in DHT alone that causes hair to thin and fall out. A lot depends on your genetics and how sensitive your body is to DHT.

Even if there is a link between baldness and Creatine, it would only be a cause of concern for men that are genetically prone to it in the first place. Also, if early hair loss does run in your family or you are already experiencing it yourself, then it’s really up to you to take the evidence that’s available here and make your own decision.

factors causing hair loss

The question that remains is can you consider this one study to be a cause for alarm? It is, after all, just one study and it’s up to you to weigh up the pros and cons for yourself.

If you do want to include a Creatine supplement in your training regime, but you would like to minimize any possible risk, stick to a low dose of around three grams per day and try to avoid a strict ketogenic diet at least at the beginning, as it might be a potential cause of hair loss.

Even this small amount will allow most people to enjoy the maximum benefits of creatine usage.

Alternatively, you can take the natural route. Creatine is abundant in a lot of food sources that help in the maintenance of adequate levels, without exposing you to the risk of any potential side effects. Creatine can be found in lean meat, red meat, poultry, and also in seafood like sushi, salmon, tuna, mackerel, and sashimi.

Conclusion

The amount of creatine ingested, along with the length of time it is consumed play major roles in the impact it will have on overall health and well-being.

There is no evidence to suggest significant side effects of creatine usage up to a period of six months. Higher, or more prolonged use, however, could lead to issues such as muscle cramps, strains and tears, and even gastrointestinal problems.

Does Creatine cause hair loss? According to the Mayo Clinic, appropriate creatine doses are safe to use for adults for periods of up to five years, and shouldn’t cause additional problems unless you suffer from kidney and heart diseases.

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