Recently, much has been questioned about the use of creatine supplementation and hair loss.
Creatine supplementation is very popular among athletes and sportsmen for performance improvement, muscle mass gain, performance and recovery (recovery). Evidence from literature reviews has also found that creatine supplementation can produce a variety of beneficial effects in older and patient populations.
New studies show that creatine supplementation is relatively well tolerated, especially when used at recommended dosages (ie, 3-5 g/day or 0.1 g/kg of body mass/day).
In this article, we will discuss the possible link between creatine, hair loss and the underlying factors of hair loss in men.
Summary: Creatine does not cause hair loss
Creatine supplements, as well as protein powders (whey protein), do not directly cause hair loss.
However, there may be a possible indirect link between the use of these supplements and hair loss in certain people who already have a genetic predisposition to develop androgenic alopecia.
Understanding male pattern hair loss
Male pattern baldness, also known as androgenic alopecia, is a genetic condition caused by the interaction between genes and hormones.
Testosterone, a hormone present in the body, is converted to dihydrotestosterone (DHT) by the enzyme 5-alpha reductase.
In people with a genetic predisposition to hair loss, high levels of DHT can cause hair to thin and fall out.
The role of creatine in this process
When people exercise and consume supplements like creatine or protein powder, they provide their muscles with the nutrients they need to build more muscle mass.
As muscle mass increases, testosterone levels in the body also increase. This increase in testosterone can lead to greater conversion of testosterone to DHT, potentially exacerbating hair loss in people with a genetic predisposition.
It is important to stress that not everyone who trains and has increased testosterone levels will suffer from hair loss. The key factor in determining whether hair loss occurs is the individual’s genetic makeup.
Summary of studies: creatine supplementation and hair loss/baldness
Concern about the relationship between creatine supplementation and hair loss/baldness stems primarily from a single study by van der Merwe et al. In this study, male rugby players who supplemented with creatine showed an increase in serum dihydrotestosterone (DHT) concentrations. As changes in DHT levels have been linked to some cases of hair loss/baldness, the theory that creatine supplementation leads to hair loss has gained traction. However, it is essential to note that the results of this study have not been replicated, and intense resistance exercise itself can cause increases in androgenic hormones.
DHT is a testosterone metabolite produced when the enzyme 5-alpha-reductase converts free testosterone to DHT. In men, DHT can bind to androgen receptors on susceptible hair follicles, causing them to shrink and leading to hair loss. However, in the study by van der Merwe et al., no increase in total testosterone was found and free testosterone was not measured. Furthermore, the increase in DHT and the DHT:testosterone ratio remained within normal clinical limits.
Twelve other studies investigated the effects of creatine supplementation on testosterone, with only two reporting small, physiologically insignificant increases in total testosterone. The remaining ten studies reported no change in testosterone concentrations. In five of these studies, free testosterone was also measured and no increase was found.
To date, we have no studies showing hair loss or worsening baldness in creatine users. What we do have is evidence of increased DHT in a small group of young athletes. Therefore, the relationship between creatine and hair loss is not yet well established in medicine.
In conclusion, according to the authors, the current body of evidence does not support the notion that creatine supplementation increases total testosterone, free testosterone, DHT or causes hair loss/baldness.
While there is a possible indirect link between creatine consumption, increased testosterone levels and hair loss, it is not the creatine or protein powder itself that causes hair loss.
Rather, the crucial determinant is the individual’s genetic predisposition to androgenic alopecia. In the absence of the hair loss gene, the increase in testosterone and DHT levels due to exercise and taking supplements will not result in hair loss.
Patients who do not suffer from hair loss and do not have a genetic predisposition to baldness do not need to worry about using creatine. Likewise, patients with baldness undergoing treatment and medical follow-up, in principle, also have no contraindications to the use of creatine.
We hope this article dispels the myth surrounding creatine and hair loss and provides a clear understanding of the factors at play. Ultimately, the key factor in hair loss is genetics, which remain beyond our control.