Creatine is a widely used dietary supplement, particularly among athletes and those engaging in resistance training, known for its ability to improve strength and muscle mass. A common concern among users is whether creatine supplementation increases levels of dihydrotestosterone (DHT), a potent androgen hormone. Increased DHT levels are linked to androgenic alopecia, commonly known as male pattern hair loss. This concern stems from a single study, which will be examined alongside the broader scientific consensus.
The Role of DHT in the Body
Dihydrotestosterone (DHT) is a biologically active hormone derived from testosterone via the enzyme 5-alpha reductase. Although testosterone is the primary male sex hormone, DHT is significantly more potent and has a stronger affinity for androgen receptors. DHT is crucial for developing male characteristics during puberty, including the growth of the prostate, facial hair, and body hair.
In genetically predisposed individuals, high DHT activity in the scalp causes hair follicle miniaturization. This process shrinks the hair follicle, shortening the hair growth cycle and leading to the production of thinner, shorter hairs, which results in pattern baldness. Elevated DHT levels also contribute to the enlargement of the prostate, known as benign prostatic hyperplasia.
Analyzing the Initial Creatine Study
The controversy linking creatine to hair loss originated with a single, small study published in the Clinical Journal of Sport Medicine in 2009. Conducted by Van der Merwe and colleagues, the investigation examined the effects of creatine monohydrate supplementation on the hormonal profiles of twenty college-aged male rugby players. The methodology used a double-blind, placebo-controlled crossover design.
Participants followed a protocol that included a seven-day “loading phase” of 25 grams of creatine daily, followed by a fourteen-day “maintenance phase” of 5 grams per day. The study’s primary finding was a significant increase in serum DHT concentrations following supplementation. Researchers reported that DHT levels increased by 56% after the initial seven-day loading phase.
These levels remained elevated, measuring 40% above the baseline concentration throughout the maintenance period. The study found no significant change in total testosterone levels. This suggested that creatine may have increased the activity of the 5-alpha reductase enzyme, which converts testosterone to DHT, sparking speculation about creatine’s role in accelerating hair loss.
Broader Scientific Findings on Creatine and Hormone Levels
The findings of the 2009 study have not been replicated in subsequent, more extensive research. A significant body of evidence has since examined creatine’s impact on various hormones, including total testosterone, free testosterone, and DHT, across diverse populations and dosing regimens. The consensus from later studies and systematic reviews is that creatine supplementation does not consistently elevate androgen hormones to a clinically concerning degree.
Multiple randomized controlled trials investigating creatine’s effect on hormone levels have found no statistically significant changes in DHT concentrations. Five separate studies that looked at free testosterone, the precursor to DHT, also reported no meaningful increase following creatine use. The minor DHT elevation observed in the initial study, despite being a large percentage increase, kept the hormone concentration well within the normal clinical range for healthy adult males.
A more recent 12-week randomized controlled trial directly addressed the hair loss concern by measuring androgen levels and hair growth parameters. This study involved subjects taking 5 grams of creatine monohydrate daily. It found no significant differences between the creatine and placebo groups in total testosterone, free testosterone, DHT, or measures of hair density or thickness, demonstrating no negative effect on hair follicle health.
Practical Considerations for Creatine Users
Based on the current scientific literature, the fear that creatine supplementation causes or accelerates hair loss appears unfounded for the average user. The isolated finding of a DHT increase in one study has been overshadowed by numerous other trials and meta-analyses showing no consistent hormonal effect. Creatine monohydrate remains one of the most studied supplements available for enhancing athletic performance.
Individuals using the supplement should follow standard recommended dosages, typically involving a maintenance phase of 3 to 5 grams daily. Monitoring hormone levels is generally unnecessary for healthy individuals. However, those with a strong genetic predisposition to pattern baldness or existing prostate concerns may consider consulting a healthcare professional.