Does Creatine Cause Hair Loss

Creatine monohydrate is one of the most studied sports supplements, yet a persistent myth still surrounds it: that it supposedly causes baldness. On forums, stories like “I started taking creatine and my hair began falling out” appear regularly. The editorial team looked into where this fear comes from, how solid the data is, and what actually determines hair loss in men.

Where the myth came from

Unlike many sports myths, this one has a concrete source — a single small 2009 study conducted in South Africa on college-age rugby players. In it, after several weeks of creatine intake, the ratio of dihydrotestosterone (DHT) to testosterone increased. Since DHT is a key hormone in the development of androgenetic baldness, the conclusion “creatine = baldness” seemed to follow on its own.

It is worth emphasizing: that study did not measure hair condition at all. The authors assessed neither the number of hairs, nor density, nor signs of shedding. The link to baldness is an extrapolation made by readers, journalists, and forum posters.

The second factor is a coincidence in timing. Creatine is most often started by men aged 18 to 30 — precisely the period when androgenetic alopecia begins in genetically predisposed people. Noticing the first signs, a person looks for a cause in whatever changed recently, and the supplement becomes a convenient “suspect”.

The third is confusion between creatine and anabolic steroids. Some gym-goers do not distinguish these substances, and steroids are known to have DHT derivatives capable of accelerating baldness. Creatine, however, is not a hormone and does not act on androgen receptors.

The rugby players study: what was actually found

The study by van der Merwe and colleagues (2009) included 20 rugby players who received either creatine or placebo for three weeks. The creatine group had a loading phase (25 g per day for 7 days) followed by a maintenance dose of 5 g per day. The control group received placebo.

DHT levels in the creatine group rose by roughly 56% after the loading phase and remained elevated (about 40% above baseline) after the maintenance phase. The ratio of DHT to testosterone also increased. Total testosterone, meanwhile, did not change significantly.

Although the rise in DHT looks substantial, its absolute values remained within the normal physiological range. For context: the DHT level in the blood is not a direct indicator of what is happening in the hair follicles, where the hormone is produced locally.

The main limitations of the work are a very small sample, short duration, absence of data on hair, and the failure to reproduce this result in independent studies over many years. A single non-replicated result in 20 participants is grounds for further research, not proof of harm.

How androgenetic alopecia actually develops

Androgenetic alopecia is the most common cause of baldness in men. It has a pronounced hereditary component: the sensitivity of hair follicles to androgens is determined by gene variants, in particular the androgen receptor gene, and a number of other loci. It is genetics that determines whether a person will begin to go bald and at what age.

A key role is played by DHT, which is formed from testosterone under the action of the enzyme 5-alpha-reductase directly in the tissues, including the scalp. In genetically sensitive follicles, DHT gradually shortens the hair growth phase (anagen) and causes miniaturization: hairs become thinner, shorter, and lighter, until the follicle stops producing visible hair.

Importantly, the development of alopecia does not require “high” DHT levels. In predisposed men, baldness progresses at entirely normal hormone levels. So even if creatine slightly raised blood DHT, the deciding factor would remain follicle sensitivity, not the absolute hormone concentration.

Besides androgenetic alopecia, there are other causes of hair loss: telogen effluvium after stress, illness, or sharp weight loss, iron deficiency, thyroid dysfunction, and the use of certain medications. For a person on a strict diet who simultaneously started taking creatine, stress and a calorie deficit are far more likely culprits.

What reviews and expert positions say

The International Society of Sports Nutrition (ISSN), in its position stand on creatine (Kreider et al., 2017), recognizes it as one of the safest and most effective supplements, and does not link long-term use at recommended doses with clinically significant side effects.

The review by Antonio and colleagues (2021), devoted to common questions and misconceptions about creatine, separately addresses the issue of baldness. The authors conclude that the available data do not support a link between creatine and hair loss, and the only study showing a rise in DHT did not assess hair and was not reproduced.

Other studies that measured testosterone during creatine intake mostly did not record significant changes in androgens. There is no systematic evidence in the scientific literature that creatine increases the risk of baldness.

At the same time, we honestly acknowledge: there are few dedicated long-term studies aimed specifically at hair condition. So the correct formulation sounds like this: there is no evidence of harm, and the theoretical concern rests on one small study with an indirect marker.

• Creatine is not a hormone and does not bind to androgen receptors.
• The rise in DHT was recorded in only one study of 20 people.
• Hair condition in that study was not measured.
• Reviews by the ISSN and independent authors do not confirm a link with baldness.

What to do if your hair is falling out

If you have noticed increased hair loss, you should not immediately blame supplements. The first step is to assess whether it is androgenetic alopecia (receding at the temples, thinning at the crown, family history) or diffuse shedding over the whole head, characteristic of telogen effluvium.

The second step is a consultation with a dermatologist or trichologist. Trichoscopy allows follicle miniaturization to be seen, and tests can rule out iron deficiency, thyroid problems, and other causes. Androgenetic alopecia responds better to treatment in the early stages.

The third is to assess the context: a strict diet, lack of sleep, stress, recent infections, use of anabolic steroids or prohormones. It is precisely the DHT derivatives among anabolic steroids that have a proven effect on the progression of baldness in predisposed men.

If, however, the very possibility worries you and you have a strong family predisposition, you can discuss with a doctor monitoring your hair condition while taking creatine. But refusing a supplement of proven benefit over a single non-reproduced study is a decision worth weighing, not making on emotion.

Editorial conclusions

The myth that creatine causes baldness comes from a single small study in which a rise in DHT was recorded but hair was not assessed.

Androgenetic alopecia is determined above all by the genetic sensitivity of the follicles, and there is no direct evidence that creatine accelerates it.

In case of hair loss, it is worth looking for the real cause together with a doctor, rather than drawing conclusions based solely on a coincidence in timing.

We also recommend reading our materials on how to properly take creatine monohydrate, on the effect of anabolic steroids on hair, and on whether breaks in creatine intake are necessary.

References

1. van der Merwe J, Brooks NE, Myburgh KH. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clin J Sport Med. 2009;19(5):399–404.
2. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18.
3. Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021;18(1):13.
4. Lolli F, Pallotti F, Rossi A, et al. Androgenetic alopecia: a review. Endocrine. 2017;57(1):9–17.
5. Pope HG Jr, Wood RI, Rogol A, et al. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev. 2014;35(3):341–375.