One study, published in 2009, found that creatine monohydrate supplementation raised dihydrotestosterone (DHT) levels by 56% after a seven-day loading phase and kept them about 40% above baseline during a two-week maintenance phase. That single trial, conducted in college-aged rugby players in South Africa, is the only published human study to report a meaningful creatine-driven spike in DHT. A 12-week randomized controlled trial published in 2025 specifically set out to replicate this finding and found no significant change in DHT at all. The real picture, then, is more complicated than either “creatine raises DHT” or “it doesn’t,” and the nuance matters if you’re deciding whether creatine might affect your hair.
The Study That Started the Conversation
The trial that fuels nearly every creatine-and-DHT discussion was led by Johan van der Merwe and published in the Clinical Journal of Sports Medicine. Twenty college-aged male rugby players were split into creatine and placebo groups. During the first seven days, the creatine group loaded at 25 grams per day, then dropped to a 5-gram maintenance dose for 14 more days. Blood draws showed that testosterone itself didn’t change in either group. But DHT rose 56% above baseline after the loading week, then settled to about 40% above baseline by the end of the maintenance period. The ratio of DHT to testosterone climbed 36% after loading and stayed 22% elevated during maintenance.
1PubMed. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby playersThose numbers sound dramatic, but context matters. The study had only 20 participants total, the intervention lasted just three weeks, and no follow-up research from the same group ever appeared. The authors themselves noted that the clinical significance of the shift was unclear, and they called for replication. For over 15 years, that call went unanswered, which means the entire creatine-DHT narrative in fitness circles rested on a single small trial.
What Happened When Researchers Tried to Replicate It
In 2025, a research team published the study the field had been waiting for: a 12-week randomized, placebo-controlled trial designed specifically to test whether creatine raises DHT and whether it affects hair. Participants took creatine at standard doses over a period four times longer than the original trial. The results were unambiguous. There were no significant differences in DHT levels, the DHT-to-testosterone ratio, or any hair growth parameter between the creatine group and the placebo group.
2PubMed Central. Does creatine cause hair loss? A 12-week randomized controlled trialThe study did observe changes in testosterone and free testosterone over time in both groups, but raw DHT concentrations didn’t budge. Across every hair-related measurement, there were no statistically significant effects from creatine. No side effects were reported in either group over the full 12 weeks.
2PubMed Central. Does creatine cause hair loss? A 12-week randomized controlled trialSo we have one small, short study saying yes and one longer, purpose-built trial saying no. Researchers who review the full evidence base tend to lean toward the 2025 finding, partly because its design was stronger and partly because nothing else in the published literature supports a reliable creatine-to-DHT connection. That said, two studies still isn’t many. The honest summary: creatine probably doesn’t raise DHT in most people under normal dosing, but the evidence base remains thinner than you’d expect for one of the most popular supplements on the planet.
Why Exercise Itself Muddies the Picture
One reason it’s hard to isolate creatine’s effect on DHT is that the people taking creatine are almost always training hard, and resistance training itself appears to raise DHT, at least locally in muscle tissue. Animal research has shown dramatic increases in muscular DHT after resistance training. In young rats, muscle DHT was roughly 35-fold higher in trained animals compared to sedentary ones.
3PubMed Central. Resistance training-induced dihydrotestosterone is blunted in aging rat skeletal muscleFurther rat studies confirmed the pattern: resistance training increased both circulating and muscular DHT, and the effect was blocked when researchers administered a 5-alpha-reductase inhibitor, the same class of drug (finasteride) used to treat hair loss. The training itself was upregulating the enzyme that converts testosterone to DHT inside muscle.
4PubMed Central. Increased Muscular 5α-Dihydrotestosterone in Response to Resistance Training Relates to Skeletal Muscle Mass and Glucose Metabolism in Type 2 Diabetic RatsThe same phenomenon shows up in humans. A study of older men found that 12 weeks of progressive resistance training significantly restored muscle DHT levels that had declined with age, pushing them from about 6.2 to 9.8 pg/μg protein. The enzymes responsible for converting testosterone into DHT in muscle tissue were also upregulated by the training itself.
5PubMed. Resistance training restores muscle sex steroid hormone steroidogenesis in older menThis matters because in the original 2009 trial, the rugby players were training during the study. If exercise alone raises DHT and creatine helps you train harder or longer, there’s a plausible indirect pathway where creatine could contribute to a DHT increase without directly raising it through any hormonal mechanism. But separating those effects requires carefully controlled studies, which we still don’t have many of.
DHT and Hair Loss Are Not a Simple Equation
Even if creatine did raise DHT, that wouldn’t automatically mean hair loss. DHT is the main androgen involved in androgenetic alopecia, the pattern hair loss that affects a majority of men at some point in their lives. It works by binding to androgen receptors in hair follicles on the scalp, gradually miniaturizing those follicles until they stop producing visible hair.
6PubMed Central. Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopeciaBut the key factor isn’t your DHT level in the blood. It’s the genetically determined sensitivity of your follicles to DHT. Two people with identical circulating DHT can have wildly different amounts of hair because their follicles respond differently. Research on androgenetic alopecia consistently points to the androgen receptor gene, located on the X chromosome, as one of the first genes linked to pattern hair loss.
7PubMed Central. Androgenetic Alopecia in Men: An Update On GeneticsWhat this means in practice: if you don’t carry the genetic variants that make your follicles sensitive to DHT, even substantial increases in DHT won’t cause hair loss. And if you do carry those variants, your hair was likely thinning long before you opened a tub of creatine. The conversation around creatine and hair loss has been framed as if DHT increase equals hair loss, but the biology is more like DHT increase plus genetic susceptibility equals hair loss. Without the genetic piece, the DHT piece is largely irrelevant to your scalp.
A Measurement Problem Nobody Talks About
There’s a technical wrinkle that rarely comes up in fitness forums but matters to the science. DHT is notoriously hard to measure accurately in blood. The method used in the 2009 study was radioimmunoassay, which was standard at the time but has known problems with DHT specifically. Validation studies comparing immunoassays to more precise methods (liquid chromatography-tandem mass spectrometry, or LC-MS/MS) have found that immunoassays consistently report higher DHT values. The difference is concentration-dependent, meaning it gets worse when DHT levels are low, and the variability between the two methods can be large.
8PubMed Central. Validation of a testosterone and dihydrotestosterone liquid chromatography tandem mass spectrometry assay: Interference and comparison with established methodsThe inflated readings from immunoassays appear to be caused by interfering substances in the blood that cross-react with the antibody used in the assay. When researchers added a purification step before running the immunoassay, the difference between methods shrank, confirming that the higher readings were partly artifacts.
9PubMed. Simultaneous measurement of serum testosterone and dihydrotestosterone by liquid chromatography-tandem mass spectrometryThis doesn’t invalidate the 2009 study outright, since both the creatine and placebo groups would have been measured the same way and within-group changes should still be meaningful. But it does inject extra uncertainty into the exact magnitude of the reported DHT increase. A 56% jump measured by immunoassay might represent a smaller real change, or might partly reflect random noise amplified by the assay’s imprecision. Without replication using modern measurement techniques showing the same result, the specific numbers from 2009 should be treated as provisional rather than definitive.
Should You Worry About Hair If You Take Creatine?
If you’re genetically predisposed to pattern hair loss, the honest answer is that we can’t completely rule out some interaction, but the available evidence doesn’t support creatine as a meaningful contributor. The 2025 trial found zero measurable effect on hair growth parameters over three months, which is roughly the length of time where you’d expect to see early signs of acceleration if creatine were actually speeding up follicle miniaturization.
2PubMed Central. Does creatine cause hair loss? A 12-week randomized controlled trialIf you’re already using hair loss treatments like finasteride or minoxidil, current evidence doesn’t suggest that creatine interferes with those treatments. Finasteride works by blocking the enzyme that converts testosterone to DHT, and since creatine doesn’t appear to meaningfully alter that pathway, the two shouldn’t conflict. There’s no published evidence showing that creatine reduces the effectiveness of standard hair loss therapies.
The more realistic concern for someone noticing thinning while taking creatine is timing coincidence. Men typically start supplementing creatine in their twenties and thirties, which is exactly when androgenetic alopecia commonly becomes visible. It’s tempting to blame the new thing in your routine, but the base rate of hair loss in young adult men is high enough that the overlap is expected even without any causal relationship.
Creatine’s Established Effects Are Well Documented
Part of the reason the DHT question matters is that creatine is one of the most researched and effective sports supplements available. Systematic reviews consistently show that long-term creatine monohydrate supplementation improves muscle strength, increases muscle mass, and enhances high-intensity training performance and recovery.
10Quality in Sport. Additional Benefits of Creatine Monohydrate Supplementation on Muscle Strength, Muscle Mass Gain and Training Performance – A Systematic ReviewBeyond physical performance, research also supports creatine’s role in brain energy metabolism, with evidence that it can improve cognitive performance, particularly under conditions of sleep deprivation or mental fatigue.
11Strength & Conditioning Journal. Creatine Monohydrate Supplementation: Considerations for Cognitive Performance in AthletesIf creatine did reliably raise DHT by 56%, it would be a legitimate factor to weigh against these benefits, especially for people already losing hair. But with only one small positive study and a longer, better-designed study showing no effect, the risk-benefit calculation for most people strongly favors continued use if creatine is helping your training.
What About Other Safety Concerns?
While we’re clearing the air on creatine myths, the other persistent worry is kidney damage. This concern has followed creatine since early case reports, and it’s understandable because creatine supplementation raises serum creatinine, a common marker doctors use to estimate kidney function. The problem is that the creatinine increase from creatine supplementation is a measurement artifact: you’re consuming more creatine, so your body produces more creatinine as a byproduct, which makes your estimated kidney filtration rate look worse even though your actual kidney function hasn’t changed.
A systematic review and meta-analysis of creatine’s effect on kidney function found that more precise kidney markers, such as measured glomerular filtration rate, cystatin C, and urine protein levels, generally don’t change with creatine use. The concern appears to stem primarily from early case reports, animal studies, and the overreliance on serum creatinine as a proxy for kidney health.
12PubMed Central. Effect of creatine supplementation on kidney function: a systematic review and meta-analysisThat said, there is at least one published case of a healthy individual developing kidney problems while taking recommended creatine doses, and the authors noted that even standard doses could potentially cause issues in rare cases. The patient recovered fully after stopping creatine, and the condition hadn’t been linked to creatine supplementation before.
13PubMed Central. The effects of the recommended dose of creatine monohydrate on kidney functionNarrative reviews of the broader safety data conclude that long-term creatine use is well tolerated and safe in people with healthy kidneys, while acknowledging that more long-term studies across diverse populations would strengthen that conclusion.
14Journal of Education, Health and Sport. Creatine supplementation and renal function – myths and evidence – a narrative reviewSex Differences in Creatine Metabolism
Most creatine research, including both DHT studies discussed here, has been conducted in men. Women have meaningfully different creatine physiology: they tend to carry substantially lower endogenous creatine stores compared to men, and hormonal fluctuations across the menstrual cycle, pregnancy, and menopause alter creatine kinetics in ways that haven’t been fully mapped yet. Research suggests these differences may actually make creatine supplementation particularly beneficial for women at certain life stages.
On the DHT question specifically, there’s essentially no data on whether creatine affects DHT in women. Since women have much lower baseline testosterone and DHT levels than men, and since the single positive study was conducted exclusively in young male athletes, extending its findings to women would be a stretch even if the study had been replicated. Women concerned about androgenetic alopecia, which does occur in a different pattern than in men, would need female-specific data that simply doesn’t exist yet.
The Loading Phase Question
One detail worth noting is that the 2009 study’s largest DHT spike (56%) occurred during the loading phase, when participants were taking 25 grams per day. The number dropped to 40% above baseline during the maintenance phase at a much lower dose. Many creatine users today skip the loading phase entirely and start at 3 to 5 grams per day, which is the standard maintenance dose. If there were a real dose-dependent effect on DHT, the loading protocol would presumably carry more risk than steady low-dose supplementation.
But again, the 2025 trial, which did not use a loading protocol, found no DHT changes at all over 12 weeks. This could mean the loading phase was responsible for the 2009 result, or it could mean the 2009 result was a fluke. We don’t have enough data to distinguish between those explanations. If you’re cautious and the loading phase concerns you, skipping it in favor of starting directly at 3 to 5 grams per day is a perfectly reasonable approach that most sports nutrition researchers now consider equally effective over time for building up muscle creatine stores, if slightly slower.
How Age Might Change the Equation
The interaction between age, exercise, and DHT adds another layer to consider. As noted earlier, resistance training in older men restores age-related declines in muscle DHT and the enzymes that produce it.
5PubMed. Resistance training restores muscle sex steroid hormone steroidogenesis in older menIn animal research, this training-induced DHT response appears to decline with age. Old rats showed no significant increase in muscle DHT from resistance training, while young rats showed the dramatic 35-fold increase mentioned earlier.
3PubMed Central. Resistance training-induced dihydrotestosterone is blunted in aging rat skeletal muscleHow this applies to creatine is entirely speculative at this point, but it suggests that the hormonal response to training and supplementation is not uniform across the lifespan. A 22-year-old rugby player’s endocrine system is going to respond differently than a 55-year-old recreational lifter’s. The fact that both existing DHT studies were conducted in young men means we have virtually no information about how creatine interacts with DHT in older adults, who are both more likely to be losing hair and increasingly likely to be using creatine for its muscle-preserving and cognitive benefits.
For now, the most responsible interpretation is that creatine probably doesn’t raise DHT meaningfully, that exercise almost certainly affects local DHT more than any supplement, and that hair loss depends far more on your genetics than on your creatine intake. But anyone telling you the question is settled is overstating what two studies can prove.