The usefulness of creatine for strength athletes has been sufficiently scientifically proven. Moreover, creatine has no significant side effects. Well, except for that one rumor: creatine use could lead to hair loss. But how true is that actually?
Where does that rumor about hair loss with creatine use come from? Well, there is exactly one study, by Van der Merwe et al., that suggests that creatine increases dihydrotestosterone (DHT) and DHT causes hair loss. In the participants, 20 healthy, young, male rugby players, a small but statistically significant increase in DHT was noted after creatine use for 21 days.
However, there are some caveats to this study, as coach and author Greg Nuckols does extensively in this article.
His main points:
- It is only one study and a relatively small one at that;
- This study did not assess actual hair loss;
- The observed changes in DHT levels were all relatively small fluctuations within the normal range;
- It is not entirely clear whether creatine supplementation actually increased serum DHT levels;
- Only serum DHT levels were measured. And serum DHT levels are probably not relevant to hair loss. From a 2018 review we can deduce that serum DHT levels – the DHT levels in your blood – are not predictive or important for hair loss. Rather, the DHT that causes hair loss is the DHT produced in your hair follicles themselves.
Even if we were to uncritically accept the findings of Van der Merwe’s study, and confidently claim that creatine increases serum DHT levels, that would still not mean that creatine increases the risk of hair loss.
CREATINE AND TESTOSTERONE
The Van der Merwe study is the only randomized controlled trial (RCT) to date to test the effects of creatine on DHT. A number of RCTs have examined the effects of creatine on testosterone, as listed by Examine.com. Of the twelve RCTs, two saw a significant increase in testosterone, but 10 saw no effect. Of those twelve RCTs, five also tested the effects of creatine on free testosterone, the form that converts to DHT, and all saw no significant increase.
Theoretically, creatine could significantly increase DHT without increasing free testosterone. So while it is technically possible that creatine has some effect on hair loss, current evidence and mechanistic data indicate that this is quite unlikely, according to Examine.com.
According to Nuckols, there is currently no good reason to expect that creatine use would increase your risk of hair loss. Or that creatine affects testosterone in some other way. This is also the conclusion of a 2021 scientific review:
The current body of evidence does not indicate that creatine supplementation increases total testosterone, free testosterone, or DHT or causes hair loss/baldness.
Nuckols tells the skeptics that he does not claim with certainty that creatine does not increase the risk of hair loss. He just points out that there is currently no good reason to expect that this would increase your risk of hair loss. In other words, there is as much evidence for and against the idea that creatine causes hair loss as there is for the idea that eating apples causes hair loss.
Want to know more about the myths surrounding creatine? Listen to the podcast below from Stronger by Science with Greg Nuckols.