If you are an athlete, bodybuilder, or simply someone who’s looking to improve their strength and exercise performance, then you’ve probably heard of creatine supplements. By providing short bursts of energy, creatine helps build muscle mass, which leads to increased strength and enables faster movement. 

However, as creatine has increased in popularity, concerns have arisen regarding the impact that the supplement could have on your hair. Some studies have suggested that creatine could accelerate the rate at which male pattern baldness takes hold in men. And if larger muscles come at the price of early hair loss, is taking creatine really worth it? 

Before you dismiss creatine supplements for good, it’s worth looking into what the research has to say. In this article, we discuss everything that is currently known about the relationship between creatine and hair loss to help you determine whether this sports supplement is right for you. 

What is creatine? 

The body produces approximately half of its creatine supply in the liver, pancreas and kidneys using amino acids. The other half is derived from the food that you eat. However, creatine only occurs naturally in animal tissue, which means that it can only be obtained by eating red meat and seafood. Consequently, vegans and vegetarians will have to take supplements to incorporate creatine into their diet. 

When you engage in heavy lifting or other kinds of physical activity, your body breaks down and releases the creatine that is stored in your muscles to give them the energy that they need to move. For this reason, many people, such as athletes or bodybuilders, take creatine supplements, which increase the quantity of creatine that is stored in the body. This provides the muscles with more energy, which can lead to increased muscle mass, enhanced strength and an improved athletic performance. 

Creatine supplements are taken orally, and can be consumed in the form of a tablet, powder or liquid. Patients are advised to take the supplement with a meal – especially one which contains starches and fruit – because the body absorbs creatine best when it is taken alongside carbohydrates. 

Who takes creatine supplements, and why do they do so? 

Creatine supplements are often taken by vegetarians and vegans, since they cannot obtain creatine through eating seafood or red meat. They are also taken by athletes, who want to build their strength and improve their exercise performance. Creatine supplements are particularly effective for athletes who engage in short-duration but high-intensity exercise, such as sprinters or weight lifters.

There is also some evidence to suggest that creatine supplements may help to reduce the frequency and severity of muscle cramps and straining, whilst also protecting the body against injuries to the tendons, bones, nerves and muscles – which is another reason why athletes involved in high-intensity strength training may take these supplements. 

What are the side effects of taking creatine supplements? 

When creatine supplements are taken under the supervision of a healthcare provider, and in the doses that are outlined by the manufacturer, they are relatively safe. However, there are some potential side effects:

1. Weight Gain

Creatine supplements direct water into the cells of your muscles. This can lead to ‘water weight’, or fluid retention, which may cause bloating around your stomach, arms and legs. This can sometimes cause problems for athletes who are competing in a specific weight category. 

Importantly, this extra weight is not fat: the body only gains additional fat when you consume more calories than you burn, and creatine does not contain any calories. 

Moreover, fluid retention is usually temporary, and it can be reduced by drinking lots of water (so as to stimulate urination) and engaging in exercise. 

2. Gastrointestinal Distress and Diarrhoea

Many supplements cause stomach pain and digestive problems when they are consumed in high doses, and creatine is no different. 

A 2008 study found that a 10g dose of creatine, taken once a day, increased the risk of diarrhoea by 56%. For this reason, patients should stick to the recommended daily dosage of 3-5g per day, and the risk of stomach discomfort and diarrhoea will be minimal. 

3. Nausea

As with stomach pain, the risk of nausea is dosage-dependent, and so you may feel sick if you take too much of the supplement at once. 

You are also more likely to feel nauseous if you consume creatine on an empty stomach, and so patients are advised to take the supplement alongside a meal (ideally one which is rich in carbohydrates).

Who should avoid taking creatine supplements? 

Although creatine is safe to use when it is consumed in the correct doses, there are some people who should exercise caution before they begin to take the supplement. 

For example, patients with kidney problems should consult their doctor before they begin to take creatine supplements. This is because some case studies have found that – though creatine has no effect on kidney function in healthy patients – it may cause damage to the kidneys in those who already suffer from underlying kidney problems. 

Similarly, those who suffer from high blood pressure or liver disease should avoid taking creatine supplements, unless they are advised otherwise by their doctor.

Teenagers should also consult a medical professional before they begin to take creatine supplements since research on the effect of creatine on adolescents is relatively limited. As a result, children under 18 are advised to boost their athletic performance by making changes to their diet (such as incorporating more protein into their meals) rather than taking creatine supplements. 

Finally, pregnant or nursing women must not take creatine, as it is not safe for babies to consume the supplement. 

What causes hair loss? 

There are several potential reasons for hair loss, such as: 

1. Hereditary Causes

The most common cause of baldness is a genetic predisposition for a hair loss condition, such as male pattern baldness. If there is a history of hair loss in your family, then it is likely that you have inherited a gene that will make you lose your hair as you age, too. 

As we discuss below, some studies have found that creatine supplements could trigger male pattern baldness in men who are already genetically predisposed to the condition. 

2. Hormonal Changes

Our hormones have a huge impact on the strength and health of our hair. If you have a medical condition that alters the resting hormone levels in your body, such as a thyroid problem, or you are experiencing pregnancy or the menopause, then hair loss may be an unfortunate side effect of hormonal fluctuations. 

3. Medication

Hair loss can be a side effect of some medicines, such as those used to treat depression, high blood pressure, heart problems, cancer, or arthritis. If you are prescribed a medicine for a particular condition, it is always best to discuss the side effects with your doctor. 

4. Intensive Hair Treatments

Styling your hair in such a way that requires it to be strained excessively or exposed to lots of heat may eventually lead to hair loss. 

5. Stress

An extremely stressful event – or the maintenance of high stress levels over a long period of time – can force the hair follicles on the scalp into a resting phase, which halts hair growth. Over time, the scalp will begin to shed hair, leading to thinning or baldness. 

Does creatine cause hair loss? 

There are lots of anecdotal reports of creatine supplements causing hair loss in men, but the scientific evidence to support these testimonies is slim and somewhat contradictory. 

A study which supports the notion that creatine supplements cause hair loss in men was undertaken in South Africa in 2009. 20 university-aged rugby players participated in this experiment: some of the participants were given a daily dose of 25g of creatine, whilst the remainder were given a placebo (50g of glucose a day). 

After one week, the study found that the participants who were taking the creatine supplements experienced a 56% in the concentration of dihydrotestosterone (DHT) in their bodies. After a further two weeks (during which time the participants were maintaining the creatine dose), the level of DHT in the body remained 40% above average.

DHT is a hormone which can cause male pattern baldness in men who are genetically predisposed to the condition, which suggests that creatine supplements increase the risk of hair loss. 

However, it should be noted that the rugby players in the study who were taking the creatine supplements were found to have lower than average baseline levels of DHT before the experiment began (23% lower than the placebo group, in fact). Moreover, although DHT levels increased in the participants who were taking creatine supplements, they did not experience any hair loss during the experiment. Nevertheless, increased concentrations of DHT in the body could cause hair loss later on, after the study was finished. 

Ultimately, these findings are a little unclear: if creatine supplements do increase DHT levels in the body, then there is certainly a risk that they could trigger hair loss in the men who take them. However, the experiment’s sample group was small (since only 20 men participated) and more data is required to confirm whether or not creatine truly does promote baldness. 

Nevertheless, one thing that is clear is that creatine supplements do not cause hair loss directly. Instead, if they do cause baldness, they do so by increasing

DHT levels in the body, and it is this hormone which is ultimately responsible for the hair loss that results. To understand this better, it is useful to examine the relationship between creatine, DHT and hair loss more closely. 

What is the Relationship Between Creatine, DHT, and Hair Loss?

DHT and Hair Loss

Dihydrotestoreone, or DHT, is an androgen – which is the scientific name for a sex hormone. The body creates DHT from another androgen, called testosterone. In men, sex hormones are responsible for the emergence of ‘male’ characteristics (such as chest hair, increased muscle mass and a deepened voice) during puberty. 

DHT and testosterone work together to trigger the development of these ‘male’ features. However, DHT is very powerful (it is approximately 3 to 6 times more potent than testosterone, in fact), and so, when the body produces too much of this sex hormone, it can cause quick and early hair loss.

DHT causes hair loss by binding to the hair follicles on your scalp. This forces the follicles to shrink and, in some cases, seal shut entirely. When the diameter of a hair follicle is slimmed, the hair that grows out of it becomes narrower and weaker than it was before, which leads to thinning and patchiness on the scalp. When the follicle closes up completely, hair will cease to grow from it altogether, causing baldness. 

The hairs that grow on the top of your head (in the crown area and along the hairline) are most sensitive to DHT. By contrast, the hair that grows along the lower half of the scalp is resistant to the sex hormone. This is why patients who suffer from male pattern baldness typically have a horseshoe-shaped pattern of hair running along the lower half of their head. 

Creatine and DHT

As we discussed above, a study in 2009 found that taking creatine supplements increased levels of DHT in the body. At a first glance, this suggests that creatine causes hair loss, since DHT can trigger baldness. 

However, it should be noted that DHT does not cause hair loss in everyone. Instead, the sex hormone only triggers baldness in men who have a genetic predisposition for androgenetic alopecia (which is the medical term for male pattern baldness). If you have not inherited the gene which predisposes you to this condition, therefore, then high DHT levels will have no effect on your hair growth. 

Of course, no one can know for sure whether they have a genetic predisposition for androgenetic alopecia. If you have a history of male pattern baldness in your family, then your chances of having the condition yourself is much higher – in which case, there is a greater risk that creatine supplements will trigger hair loss for you. 

Nevertheless, the participants in the 2009 study consumed 25g of creatine a day, which is significantly higher than the recommended daily dosage of 3-5g per day. Therefore, taking creatine supplements in the quantities that are outlined by the manufacturer may not have an impact on your DHT levels. Unfortunately, there is simply not enough data available to know for sure. 

So, is it a myth that creatine causes hair loss? 

Frustratingly, the answer to this question is both yes and no. There is evidence to suggest that creatine supplements increase the concentration of DHT in the body, which does suggest that creatine loading could trigger hair loss in some men. But the key word here is ‘some’: if you do not have a genetic predisposition for male pattern baldness, then creatine supplements may increase your DHT levels, but this will not have any impact on your hair. 

Moreover, the 2009 study is simply not conclusive enough to determine whether creatine supplements cause hair loss for sure. The experiment only tested 20 men, and those that took the creatine supplements already had unusually low levels of DHT. The dose that they were given was also extremely high, which makes it unclear whether the recommended daily dosage of 3-5g has an impact on the concentration of DHT in the body or not. 

So, is it a myth? Ultimately, there is enough evidence available to prevent us from dismissing the idea that creatine supplements cause hair loss, but this evidence is not conclusive or strong enough for us to know for sure. 

FAQs

Does creatine affect testosterone levels? 

No, creatine supplements do not affect the level of testosterone in the body. Although the supplements will provide you with energy, increase your muscle mass and boost your body’s recovery process, your resting hormonal level will remain the same. 

Is creatine good for your hair?

The impact that creatine supplements have on the condition of your hair depends on the genes that you have inherited from your parents. If you have a genetic predisposition for male pattern baldness, then taking creatine supplements could cause you to lose hair quicker and sooner than you would if you were not consuming creatine. However, if you are not genetically predisposed for male pattern baldness, then creatine supplements will have no effect on the growth or strength of your hair. 

How much does creatine increase DHT levels? 

Research into the impact of creatine supplements on DHT levels in the body is relatively limited, so it is difficult to provide a definitive answer regarding how much DHT levels increase in response to taking these supplements. An experiment undertaken in 2009 found that DHT levels increased by 56% in men who consumed 25g of creatine every day for one week. However, taking a smaller dose of creatine (such as the recommended daily dosage of 3-5g) will not necessarily increase DHT levels at all. At this time, the research is simply too limited to say for sure. 

Which type of creatine supplement does not cause hair loss?

Unfortunately, all types of creatine supplement come with the risk of quickening the rate at which you lose your hair. It is not the type of supplement that determines whether hair loss occurs, but the genes of the person who takes the supplement: if you have a genetic predisposition for male pattern baldness, then creatine may increase the onset of this condition. 

Conversely, those who have not inherited the gene for male pattern baldness will not experience any hair loss after taking creatine supplements. Reflecting on whether there is a history of baldness in your family will help you to determine whether you are genetically predisposed for this condition.

References:

1. Antonio, Jose, et al., ‘Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?’, Journal of the International Society of Sports Nutrition, 18 (2021).
2. Boskey, Elizabeth, ‘What is dihydrogesterone (DHT)?,’ Very Well Health (April 2022). 
3. Ostojic, Sergej, and Zlatko Ahmetovic, ‘Gastrointestinal Distress after Creatine Supplementation in Athletes: Are Side Effects Dose Dependent?’, Research in Sports Medicine (2008), 15-22. 
4. Van der Merwe, J., et. al, ‘Three Weeks of Creatine Monohydrate Supplementation affects Dihydrotestosterone to Testosterone Ratio in College-aged Rugby Players’, Clin J. Sport Med, 19 (2009), 399-404.

About the Author

Dr Suhail Alam

Dr Alam is devoted to providing high quality, holistic, patient centred care designed to make patients look and feel their best. He has a specialist interest in Hair Restoration Surgery and Regenerative Medicine.

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