A lot of bodybuilding supplements get a bad rap for causing hair loss. One of them is creatine – a performance-enhancing substance (ergogenic aid) that’s popular with athletes as well. It was a paper published back in 2009 that fueled these rumours.
There are many who complain of creatine hair loss, going completely bald even after taking it. But many are still unsure if there’s any truth to it. That’s because creatine is only an amino acid derivative, after all. And they’re right in questioning the myth’s veracity.
What Is Creatine?
According to the International Society of Sports Nutrition (ISSN), creatine (monohydrate) is “the most effective nutritional supplement.” Athletes can safely use it for improving their exercise capacity and increase lean muscle mass.
However, because it increases muscle mass and strength, it’s also used by many bodybuilders and gym-goers. In the body, creatine is converted into creatine phosphate, which is used to produce energy (ATP) for muscles. It is believed that the way creatine builds up muscle is by retaining water in them, making them look puffier.
However, water retention only occurs in the first few days for which the person is taking creatine. It doesn’t happen long-term. Therefore, the idea that creatine causes a person to gain weight isn’t true. The only way it can make a person gain weight is by making them work out more than before.
Creatine occurs naturally in some of the foods we eat, like red meat and fish. Only 1% of it makes up the human blood. 95% of it is found in the muscle mass, while the remaining 5% is in the brain. Although it is not regulated by the US Food and Drug Administration (FDA), it has a GRAS (General Recognized as Safe) status.
Other than powder and tablet supplements, you can also get creatine energy drinks and bars. Its intake can cause some side effects, such as:
- Muscle cramping
- Upset stomach
- Irregular heartbeat
- Nausea and dizziness
Benefits of Creatine
Creatine can do more than just help build lean muscle mass. It may have other benefits like the following:
- Quicker recovery after an intense training session
- Decreased likelihood of injury to the musculoskeletal system
- Improved capacity to exercise in the heat/better heat tolerance
- Reduced muscle cramping
- Antioxidant effect scavenges free radicals
Other than that, it has also been shown to help with different diseases among young and old. It may:
- Reduce brain damage (neuroprotective)
- Work as an antidepressant
- Help with creatine deficiency syndromes (AGAT, GAMT, CRTR-D)
- Work as a treatment for neurodegenerative diseases like Huntington’s, Parkinson’s and ALS (US National Library of Medicine deems it “possibly ineffective” for ALS and Huntington’s)
- Help with fatigue
- Slow down the loss of muscle mass with age, a condition known as sarcopenia
- Improve cognitive abilities like memory and intelligence
Creatine is contraindicated for use in individuals with kidney disease. Additionally, some say it could cause kidney damage, but more research is needed in this regard. Other than that, people with diabetes and bipolar disorder are cautioned against its use. Drinking coffee with creatine if you have Parkinson’s can worsen it, so you need to avoid that. Lastly, breastfeeding or pregnant women are advised not to take it.
It is considered safe to consume 3-5 grams of creatine (or 0.1/kg of body mass) daily. There are some studies that have shown that it can be safely taken for years. However, it is important that you consult your doctor before you even start taking it.
Does Creatine Cause Hair Loss?
According to only one study published in the Clinical Journal of Sport Medicine, creatine intake can increase the levels of dihydrotestosterone (DHT) in the body. This hormone is directly linked to androgenetic alopecia in males and females. There are many flaws in this study, which have led to much confusion about creatine hair loss.
In the study, college-aged male rugby players took creatine supplements with glucose (which helps increase creatine intake) for 3 weeks. For 7 days, the participants took 25 grams of creatine per day with 25 grams of glucose. The placebo group took 50 grams of glucose per day. After the 1 week “loading period,” there was the “maintenance phase,” which lasted for 14 days. In this, the players took 5 grams of creatine with 25 grams of glucose per day in contrast to the placebo, which had 30 grams of glucose only.
After 3 weeks, it was found that the DHT levels of the rugby players had increased by 56% in the “loading period” and 40% in the “maintenance phase.” Also, this difference was “statistically significant” from the placebo group.
Now the problem with the study was that the increase in DHT that did happen was not above the “clinically normal values.” The players had low levels of DHT (lower than normal) before they took creatine. So, when it increased a little (with a subsequent decrease in the placebo group’s DHT levels), the results were given more credence.
In reality, the authors of the study don’t even report on the rugby players experiencing hair loss during the study. Furthermore, research shows that testosterone levels increase in men when they perform resistance exercises. So, the increase in DHT may not have been a result of creatine at all. In addition, the study has not been replicated, so it’s hard to make any definitive conclusions on creatine hair loss. One clinical trial is still underway to find out the effect of creatine on hair loss and male sex hormones.
Therefore, all the remaining evidence on this is purely anecdotal. It is possible that the time around which you start taking these supplements coincides with the onset of genetic alopecia. This can explain thinning or baldness. However, creatine hair loss isn’t what’s happening to you.
Is Creatine Hair Loss Permanent?
So far, there’s no evidence that creatine hair loss even happens at all. However, those experiencing it have reported that it stopped after they discontinued its use. If the hair loss is a result of androgenetic alopecia, it will be permanent. However, again, there’s no saying that creatine can even cause its onset.
It should be noted that pattern baldness can occur at normal levels of testosterone in the body. The AR gene makes some follicles in the scalp more sensitive to the presence of DHT. An imbalance can exacerbate this kind of hair loss, sure, but it doesn’t mean that it won’t take place at all. That means if you are genetically predisposed to androgenetic alopecia, you will eventually lose your hair anyway, even if you don’t take creatine.
There are some people who confuse it for an anabolic steroid. While those actually do affect the male sex hormones and can cause pattern baldness, creatine is an entirely different substance in its chemical structure. Therefore, creatine hair loss cannot take place for that reason, either.
When Should You See A Doctor?
It’s best to consult a doctor before you start taking creatine for whatever reason. That’s because it may not be safe for use in some individuals. If after you’ve started taking it and you’re experiencing adverse side effects, you should get in touch with your doctor.
About hair loss, if it’s sudden and excessive, you need to go to your doctor for a physical exam and even some tests. You may be suffering from another condition. If it’s pattern baldness, your doctor might recommend the use of minoxidil and finasteride. However, they don’t restore growth permanently. Many people get hair transplants for it.
Creatine hair loss has been much talked about since the study got to social media. It’s well-established that testosterone gets converted into DHT with the help of the enzyme 5-alpha reductase.
This by-product of testosterone then binds with the androgen receptors on hair follicles, shrinking them over time and bringing an end to the growth cycle. It’s only some hair on the head that is sensitive to the presence of these hormones. Therefore, you don’t go completely bald.
The study mentioned above shows that the levels of DHT increase from creatine supplementation, so it can possibly result in hair loss among individuals who are predisposed to pattern baldness.
However, there are many flaws in the study, such as:
- The baseline DHT levels of the rugby players were lower than normal, so even a small increase to normal values with a slight decrease in DHT in the control group made the results “statistically significant.”
- The study doesn’t note any hair loss experienced by the players themselves.
- The participants were taking far, far more creatine than the daily recommended intake.
- Their exercise itself could result in an increase in the androgens.
- The sample size was too small (16 males) to make any generalisations.
Therefore, it can be concluded that there’s no link between creatine and hair loss. There are some studies that have tried to investigate the relationship between testosterone levels and creatine, and so far, nothing’s been found.
Reviewed and Approved by Dr. Hassan Soueid.