Creatine is a popular supplement used to help people build muscle when they exercise. Creatine is generally safe to take, but it has been suggested that it may be associated with hair loss. For many men, this would be a deal-breaker, so here we explore the evidence to determine whether there is any truth behind this controversy.
Can Creatine Cause Hair Loss?
A study released in 2009 found that rugby players who took creatine had an increased level of a hormone called dihydrotestosterone (DHT). DHT shortens the period of growth in the life cycle of a hair follicle. Over time, a shorter hair growth phase leads to thinning of the hair and ultimately to baldness. This is where the questions around creatine and hair loss first began.
At first glance, the results of the study seem quite clear cut; however, we shouldn’t take it at face value. For one thing, the study only tested DHT levels in 20 men, and only half of them were taking creatine. In science, we call this a small sample size – because there were not very many people in the study, there is a greater risk that abnormal results could occur by chance. This may account for the fact that the results of this study have not yet been replicated.
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Another factor to consider is that the study focused on rugby players. Intense resistance exercise, such as that done by rugby players, can affect hormone levels such as DHT. Therefore, we cannot be sure that the results would be relevant to other men, such as those who are not rugby-players, or are not as physically fit.
The biggest problem with the results comes from the different baseline levels of DHT in each group. The trial divided the rugby players up into two groups. One group took creatine and the other group took a placebo. In this case, a placebo is a dummy pill used in clinical trials to account for the phenomenon of people experiencing changes because they expect to.
Before the study began, the level of DHT was measured in the players who would take the creatine and those who would take the placebo.
The DHT level in the creatine group was found to be 23% lower than that in the placebo group. So, before the players had started taking any treatment at all, the DHT was lower in one group than the other. Due to natural variation in hormone levels, this makes it more likely that the creatine group would have a significant increase in DHT levels compared to the placebo group. This may have skewed the data collected by the study which may explain why no one has replicated its results.
It is also worth noting that, to date, no study has actually identified a clear link between creatine and hair loss. In the 2009 study, the link was hypothetical, as the players taking creatine had higher DHT levels than the others, but the study did not identify any noticeable changes to their hair. Instead, the conclusion that creatine causes hair loss is unproven and theoretical.
A scientific review paper from 2021 explored the other evidence about creatine and hair loss. They reported that a total of 12 studies have been done to explore the effects of creatine supplements. Only two of these studies found any significant increase in testosterone levels in their participants.
This is relevant because DHT is made from a type of testosterone hormone called free testosterone. So, if the DHT levels were high, you would expect that the testosterone levels would have also increased to reflect this. Five of those studies specifically measured free testosterone and not one of them found any increase in those levels for people taking creatine.
Taking all of these factors into account, it is still possible that creatine could contribute to hair loss, but despite a lot of research, science has not yet proven any certain link between them. In fact, more evidence points away from a significant link between creatine and hair loss, than points towards it.
What To Do if You Notice Unexplained Hair Loss
If you are experiencing hair loss and you’re not sure where it’s coming from, there may be several possibilities.
As mentioned above, most male pattern baldness (androgenic alopecia) is caused by high levels of DHT. This is largely genetic and affects many men over the course of their life. For most men, it will not come as a surprise. It’s very likely that other family members would have been similarly affected and the pattern is typically a receding hairline with thinning around the crown.
This is generally nothing to be concerned about, and is a normal part of aging – however, treatments for hair loss such as Propecia or finasteride may be helpful. These medications work by stopping the conversion of testosterone into DHT. This helps to protect the hair follicles and keep them in their growth phase for longer, which can help to prevent hair loss from advancing (particularly in androgenetic alopecia).
Other causes of hair loss include scalp infections, medication side effects and medical conditions affecting your immune system (alopecia areata). Infections such as ringworm can cause patchiness of the hair. They can be treated with antifungals or antibiotics, depending upon the cause, and hair usually grows back after treatment.
Medication side effects are a more common cause of sudden hair loss than gradual hair loss. Chemotherapy is one of the most well-known examples of this, but treatments for arthritis, depression, gout, high blood pressure and heart problems can also lead to hair loss.
In rare cases, your immune system may attack the hair follicles and stop them from growing. This is what happens in alopecia areata. Most people will find their hair grows back over time, but it may take many months to return to normal.
If you are concerned about your hair loss, it’s important to speak to your GP. They may be able to examine your scalp and do further investigations, such as blood tests, to check for the underlying cause of your hair loss. The cause of your hair loss may affect which treatments would be most appropriate, so it’s a good idea to get it checked out if you have any doubts.
