Can Creatine Cause Hair Loss? Spoiler: It Doesn’t

Despite the widespread popularity of creatine as a supplement, athletes are uncertain whether or not creatine can lead to hair loss, which can often deter athletes from using it.

Creatine does not lead to hair loss as there is not enough strong evidence linking creatine use to hair loss. The misconception behind this was born from a single study, and the results have not been reproduced in the following studies ^[4].

Why isn’t the science behind creatine supplementation and its potential impact on hair health strong? Where did this myth come from? And what do you need to consider if you are losing hair while using creatine?

Can Creatine Cause Hair Loss?

Every strand of hair consists of a hair shaft (the part that you can see sticking out of the skin) and a hair root (the part of the hair that extends down into deeper layers of skin). The hair follicle (a sheath or “tube-like covering”) surrounds the root ^[1].

A possible role player in hair loss is dihydrotestosterone (DHT), a hormone that interacts with the hair follicles. This leads to shrinkage of hair follicles, and the follicles cease to produce hair over time.

For this reason, DHT has been found to be a contributor in some, but not all, cases of male pattern baldness or female pattern baldness (also called “androgenic alopecia” in research) ^[2].

The confusion behind the relationship between creatine and hair loss stems from a single study done in 2009 by van der Merwe et al ^[3]. In this study, white males between 18-19 years consumed 25 g creatine per day for 7 days (known as a “loading phase,” followed by a maintenance phase of 14 days.

Compared to the placebo group, the group consuming creatine had DHT increases of 56% after the 7-day loading protocol and a 40% increase above their starting levels after the 14-day maintenance period.

Compared to the placebo group, who consumed 50g of glucose per day for 7 days and 30 g of glucose per day for 14 days, these results were considered “statistically significant” (this is when the results from a study or experiment are unlikely to have happened by chance.

It means there’s a good reason to believe that the findings are real, not just a random occurrence and that the results are meaningful and important).

Although this study did not examine hair loss as an outcome, many people concluded that creatine could lead to hair loss due to increased DHT levels.

To put these results into perspective, keep in mind this is only one study, and these results have not been reproduced ^[4]. The increases in DHT that the players experienced in the study remained within normal clinical limits ^[4].

There were more missing pieces to the puzzle: This study did not find increases in total testosterone, and free testosterone (which the body uses to produce DHT) was not measured, adding some layers of contextual nuances and limitations to the results seen in the study.

Twelve other studies have looked at the effects of creatine supplementation on testosterone levels, with dosing protocols ranging from 3 – 25 grams per day for 6 days to 12 weeks. Ten studies found no significant variations in testosterone concentrations ^[4].

Five studies measured free testosterone ^{[5, 6, 7, 8, 9]}, and no increases were found. Only two studies ^{[10, 11]} found small, insignificant increases in testosterone after 6 – 7 days of supplementation.

Does Creatine Cause Hair Thinning?

Hair thinning occurs when an individual hair strand becomes less thick or has a reduced diameter, resulting in diminished hair volume and increased scalp visibility.

Like hair loss, hair thinning is associated with androgenic alopecia ^[12], which is also attributed to the influence of DHT on hair follicles. However, it’s important to note that there is currently no substantial evidence establishing a direct link between creatine consumption and hair thinning.

Why Are You Losing Hair When Taking Creatine?

Other factors beyond creatine intake can lead to hair loss. One (often underestimated) factor is not eating enough food to meet the demands of your exercise routine, a condition known as “Relative Energy Deficiency in Sport” or RED-S ^[13].

The body might not have the resources needed to maintain healthy and thriving hair because of a shortage of energy, protein, and essential nutrients ^[14].

When you start incorporating creatine into your training regimen, you might find yourself capable of training for longer periods and at higher intensities. However, it’s important to ensure that your nutrition plan aligns with this increased level of physical activity.

Other underlying medical conditions that can lead to hair loss include anemia ^[15], diabetes ^[16], lupus ^[17], or thyroid disease ^[18].

Stress and genetics can also play a role in hair loss. If you are getting older and have a family history of hair loss, this might explain why you are also experiencing hair loss ^{[19, 20]}.

Summary

It’s always essential to approach health and fitness rumors, such as whether or not creatine can lead to hair loss, with a critical eye. Remember, when it comes to your health, knowledge is power!

Despite the initial concerns, there is no concrete evidence of hair loss or baldness in humans due to using creatine supplements. Therefore, if you consider incorporating creatine into your fitness regimen, you can do so confidently.

References

1. Institute for Quality and Efficiency in Health Care (IQWiG). (2006-). What is the structure of hair and how does it grow? InformedHealth.org. https://www.ncbi.nlm.nih.gov/books/NBK546248/
2. Ustuner E. T. (2013). Cause of androgenic alopecia: crux of the matter. Plastic and reconstructive surgery. Global open, 1(7), e64. https://doi.org/10.1097/GOX.0000000000000005
3. van der Merwe, J. , Brooks, N. E. & Myburgh, K. H. (2009). Three Weeks of Creatine Monohydrate Supplementation Affects Dihydrotestosterone to Testosterone Ratio in College-Aged Rugby Players. Clinical Journal of Sport Medicine, 19 (5), 399-404. doi: 10.1097/JSM.0b013e3181b8b52f.
4. Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. Journal of the International Society of Sports Nutrition, 18(1), 13. https://doi.org/10.1186/s12970-021-00412-w
5. Cook, C. J., Crewther, B. T., Kilduff, L. P., Drawer, S., & Gaviglio, C. M. (2011). Skill execution and sleep deprivation: effects of acute caffeine or creatine supplementation – a randomized placebo-controlled trial. Journal of the International Society of Sports Nutrition, 8, 2. https://doi.org/10.1186/1550-2783-8-2
6. Cooke, M. B., Brabham, B., Buford, T. W., Shelmadine, B. D., McPheeters, M., Hudson, G. M., Stathis, C., Greenwood, M., Kreider, R., & Willoughby, D. S. (2014). Creatine supplementation post-exercise does not enhance training-induced adaptations in middle to older aged males. European journal of applied physiology, 114(6), 1321–1332. https://doi.org/10.1007/s00421-014-2866-1
7. Hoffman, J., Ratamess, N., Kang, J., Mangine, G., Faigenbaum, A., & Stout, J. (2006). Effect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletes. International journal of sport nutrition and exercise metabolism, 16(4), 430–446. https://doi.org/10.1123/ijsnem.16.4.430
8. Volek, J. S., Ratamess, N. A., Rubin, M. R., Gómez, A. L., French, D. N., McGuigan, M. M., Scheett, T. P., Sharman, M. J., Häkkinen, K., & Kraemer, W. J. (2004). The effects of creatine supplementation on muscular performance and body composition responses to short-term resistance training overreaching. European journal of applied physiology, 91(5-6), 628–637. https://doi.org/10.1007/s00421-003-1031-z
9. Rahimi, M. R., Faraji, H., Sheikholeslami-Vatani, D., & Ghaderi, M. (2010). Creatine supplementation alters the hormonal response to resistance exercise. Kinesiology, 42, 28-35.
10. Sheikholeslami-Vatani, D., Faraji, H., Soori, R., & Mogharnasi, M. (2011). The effects of creatine supplementation on performance and hormonal response in amateur swimmers. Science & Sports, 26, 272-277. DOI: 10.1016/j.scispo.2011.07.003.
11. Arazi, H., Rahmaninia, F., Hosseini, K., & Asadi, A. (2015). Effects of short term creatine supplementation and resistance exercises on resting hormonal and cardiovascular responses. Science & Sports, 30(2), 105-109.
12. Wolff, H., Fischer, T. W., & Blume-Peytavi, U. (2016). The Diagnosis and Treatment of Hair and Scalp Diseases. Deutsches Arzteblatt international, 113(21), 377–386. https://doi.org/10.3238/arztebl.2016.0377
13. Cabre, H. E., Moore, S. R., Smith-Ryan, A. E., & Hackney, A. C. (2022). Relative Energy Deficiency in Sport (RED-S): Scientific, Clinical, and Practical Implications for the Female Athlete. Deutsche Zeitschrift fur Sportmedizin, 73(7), 225–234. https://doi.org/10.5960/dzsm.2022.546
14. Joy, E., Kussman, A., & Nattiv, A. (2016). 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British journal of sports medicine, 50(3), 154-162.
15. Trost, L. B., Bergfeld, W. F., & Calogeras, E. (2006). The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. Journal of the American Academy of Dermatology, 54(5), 824–844. https://doi.org/10.1016/j.jaad.2005.11.1104
16. Zubair, S., & Mujtaba, G. (2009). Hair-A mirror of diabetes. Journal of Pakistan Association of Dermatologists, 19(1), 31-33.
17. Udompanich, S., Chanprapaph, K., & Suchonwanit, P. (2018). Hair and scalp changes in cutaneous and systemic lupus erythematosus. American journal of clinical dermatology, 19, 679-694.
18. Vincent, M., & Yogiraj, K. (2013). A descriptive study of alopecia patterns and their relation to thyroid dysfunction. International journal of trichology, 5(1), 57.
19. Chumlea, W. C., Rhodes, T., Girman, C. J., Johnson-Levonas, A., Lilly, F. R., Wu, R., & Guo, S. S. (2004). Family history and risk of hair loss. Dermatology (Basel, Switzerland), 209(1), 33–39. https://doi.org/10.1159/000078584
20. Davidhizar, R., & Eshleman, J. (2001). Can stress make you lose your hair?. The Journal of practical nursing, 51(4), 18–23.