Hair loss can be a frustrating and stressful experience for both men and women, and billions are spent on treating and preventing it each year. But what if a popular fitness supplement, creatine, is one of the culprits leading to hair loss in the first place?
Many factors, including age, genetic predisposition, and lifestyle choices can all contribute significantly to whether or not a person will experience hair loss. If you spend time scrolling through fitness forums you might come across the claim that creatine supplements are another contributing factor to hair loss. While much of the evidence for this side effect is inconclusive and anecdotal, we'll explore how creatine supplements may be connected to hair loss for some people and what you can do if you think you might be experiencing hair loss from taking creatine.
Before getting into how creatine supplements might impact hair loss as a side effect, it's helpful to understand what creatine is exactly, and how it is processed by the body.
Creatine is an amino acid — a building block of protein — that’s produced naturally in the body, can be added to your diet by including meat and fish, and can also be taken orally as a supplement. It's a popular performance enhancer among athletes and more casual fitness enthusiasts who are trying to increase their strength and lean muscle mass.
In a 2003 review of over 300 studies evaluating creatine's effectiveness, roughly 70% of the studies found a statistically significant improvement in performance. These studies show that creatine supplements improve sprint performance, power and strength during workouts, gains in strength from workouts, fat-free mass, and performance of high-intensity tasks. It's easy to understand why creatine supplementation is as popular as it is.
Bear with us while we get a bit technical about how this all works. Creatine supplements achieve these results by helping your body produce adenosine triphosphate, or ATP, more quickly than it otherwise would be able to. ATP provides the energy necessary to drive many processes, such as muscle contraction, in cells.
When cells use ATP to complete a process, such as contracting a muscle, the ATP is converted to adenosine diphosphate or ADP. The body uses phosphocreatine stored in the muscles to convert that ADP back to ATP and generate the energy required by cells to start the process over again. When you supplement with creatine, muscles store it as phosphocreatine, and these extra stores make the process of converting ADP to ATP much faster.
Despite the widely held misconception that creatine hair loss is a known side effect of taking this supplement, there actually isn't any conclusive evidence that this is the case. Existing "evidence" comes primarily in the form of anecdotal accounts on fitness message boards, which aren't a particularly reliable place to get medically reviewed information. There isn't conclusive evidence that creatine doesn't contribute to hair loss either, but hair loss is not typically listed among potential side effects for creatine supplements.
There is one small study from 2009 that is frequently cited as evidence that creatine causes hair loss, but it did not produce conclusive results. The study only involved 20 college-aged male rugby players as subjects over a period of three weeks. The study found significantly higher levels of a hormone called dihydrotestosterone, or DHT, in the group that took creatine compared to the control group.
DHT is indeed sometimes responsible for hair loss, but the small sample size and short duration of the study limit the significance of the results. The study also didn't measure any hair loss in the test subjects, just their serum levels of DHT.
DHT is a natural byproduct of testosterone production, so everyone has some level of it naturally present in the body. A higher than normal level of DHT can contribute to hair loss, but only if you already have a genetic predisposition to it. When DHT binds to the hormone receptors on hair follicles, it can shorten the growth cycle of that hair and make it thinner and shorter. When hair's growth cycle shortens, hairs fall out sooner, resulting in hair loss.
If someone isn't genetically predisposed to this type of hair loss, an increase in DHT won't have this effect. The most common side effect you are likely to experience from taking creatine is water retention leading to weight gain.
Since men have naturally higher levels of testosterone than women, they also naturally have higher levels of DHT. In fact, DHT plays a role in the normal development of male attributes such as a deeper voice and stronger bones.
If a man happens to have a genetic predisposition towards baldness, i’s possible that an increase in DHT levels binding to the hormone receptors of their hair follicles may have some impact on hair loss. However, this is likely a minor contributing factor and there isn't enough conclusive evidence that creatine can have a significant impact on hair loss in men.
The small study we mentioned earlier only involved male test subjects, so women may be wondering if they should also have some concerns about creatine hair loss.
While testosterone and DHT are also present in women, they circulate at much lower levels than in men. Creatine increases DHT levels by converting more testosterone to DHT, so given the already low levels of testosterone in women it is unlikely that an increase in conversion to DHT from creatine supplementation would be sufficient to cause hair loss.
There is no one-size-fits all recommended dose for supplementing with creatine because we all have unique creatine requirements. For example, someone who is going through intense training for a weight lifting competition will benefit from more creatine than someone who lives a relatively sedentary lifestyle.
Since diet can also contribute naturally to creatine levels in the body, someone who eats a diet rich in fish and red meat may not need to take as much creatine to see results as someone who eats a vegan diet and doesn't get much creatine from diet alone.
Given that phosphocreatine is stored in the muscles, someone with high muscle mass can store more than someone with low muscle mass. What is an appropriate dose of creatine supplements for one person may be too much for another person. A professional will be able to provide you with a better idea of how much is safe for you to take based on your activity level, muscle mass, weight, and other factors.
When people begin creatine supplementation, they often begin with what is called a loading protocol. This means you take more for the first week to load the levels of phosphocreatine in your muscles, and then reduce your dosage to a maintenance level.
For example, in the small study examining increased DHT levels resulting from taking creatine supplements, the subjects took 25 grams per day for a seven day loading period, followed by five grams a day for the remaining 14 days of the study. DHT spiked up during the loading period, and remained above normal levels but below loading period levels for the remainder of the study period.
Remember, there is no conclusive link between creatine supplements and hair loss, and one small study indicating an increase in DHT after a period of creatine consumption is not sufficient to draw conclusions from. However, if you're experiencing hair loss, there are effective hair loss medications out there that might be right for your situation.
Drugs like Propecia, also known by the generic name finasteride, work by blocking the process of converting testosterone to DHT. If your hair loss is related to high levels of DHT, this type of medication may work for you. Another well known medication used to treat thinning hair in both males and females is minoxidil, more commonly known by the brand name Rogaine.
For patients seeking more permanent treatment options, laser treatments and hair transplants are also possible options for stopping hair loss or restoring hair that has been lost.
Finally, there are cosmetic options that don't actually regrow hair or stop hair loss but mask the appearance of lost hair. For example, scalp micropigmentation, in which pigments are deposited on the scalp in a process similar to tattooing, can create the appearance of a buzzcut.
To talk to a healthcare practitioner about hair loss, start an online assessment with Felix.
While it can be tempting to accept anecdotal stories about how taking creatine supplements causes male pattern baldness, the fact remains that there isn't enough research to support this claim. On the other hand, there is scientific evidence supporting the claim that taking creatine supplements can improve athletic performance.
If you want to continue this popular fitness supplement and are worried about the potential creatine side effects of hair loss, medications exist that can help counter an increase in DHT levels that may be linked to hair loss in some genetically predisposed individuals.
The views expressed here are those of the author and, as with the rest of the content on Health Guide, are not a substitute for professional medical advice, diagnosis, or treatment. If you have any medical questions or concerns, please talk to your healthcare practitioner.