Creatine is a substance that occurs naturally in the body. It can also be consumed, typically in meat and fish. Creatine can be purchased as a supplement, as well. Athletes most commonly use it because of the popular belief that it can help increase strength or improve athletic performance. However, evidence to support this claim is inconclusive and sometimes contradictory.
One study found that creatine supplementation was linked to hair loss, but none of the studies that examined creatine and hair loss found that taking creatine supplements leads to hair loss. The body of evidence suggests the link does not exist.
This article will discuss if creatine can cause hair loss, the side effects of creatine supplements, causes of hair loss, and precautions to consider with creatine supplements.
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Creatine and Hair Loss: What’s the Link?
A 2009 study of college-aged male rugby players who supplemented with creatine found that the players experienced increased blood levels of dihydrotestosterone (DHT) over time. DHT is a metabolite of testosterone and can bind to androgen receptors in susceptible hair follicles in males. This can cause the follicles to shrink, leading to hair loss.
Because of the link of DHT to hair loss, this study led to a theory that creatine supplementation could cause hair loss.
However, this study had a number of flaws, such as:
- The sample size was small (20 participants).
- The study did not measure free testosterone (which the body uses to produce DHT), and the 16 participants who completed the study showed no increase in total testosterone.
- The increase found in DHT, and the DHT to testosterone ratio stayed within normal clinical limits.
- Intense resistance exercise on its own can also cause an increase in androgenic hormones.
By early 2021, 12 other studies examining the effects of creatine supplementation on testosterone had not replicated the results of the 2009 study. Two studies found small increases in total testosterone after six and seven days of supplementing with creatine, but the increases were physiologically insignificant. No change in testosterone concentrations were reported in the other 10 studies. No increases in free testosterone were reported in five of the studies.
No study has reported hair loss in humans with creatine supplementation, and the current body of evidence does not support a link between creatine supplementation and hair loss or balding.
Side Effects of Supplementing With Creatine
Creatine supplements may cause muscle water retention, leading to weight gain for some people.
Most research shows significant side effects are uncommon at the doses used for up to six months, but some side effects, particularly with long-term use, may include:
- Muscle strains and pulls
- Muscle cramps
- Gastrointestinal problems, such as nausea or diarrhea
- Dizziness
- Dehydration
- High blood pressure
- Kidney damage
- Liver dysfunction
- Seizures
Average Creatine Dosage
Supplements are typically sold as powders but may come in forms such as:
- Tablets
- Capsules
- Liquids
- Drink mixes
- Flavored chews
- Energy bars
- Other products
To find the dosage that is right for you, it's important to talk to your healthcare provider. How much to take and when depends on your goals and personal characteristics.
Sometimes, a loading stage, followed by a maintenance stage, is suggested when taking creatine for exercise performance. An example of a loading dose for adult athletes age 19 and older may be 5 grams (g) of creatine monohydrate taken four times daily (20 g total for the day) for a maximum of two to five days.
A maintenance dose for an adult athlete 19 years old and up may be 2 g daily.
Some research suggests the loading stage is not necessary.
Creatine may be better absorbed when taken with carbohydrates such as fruit (including juices) and starches.
What Does Cause Hair Loss?
Hair loss, also called alopecia, can be categorized as either scarring or nonscarring.
Scarring alopecia causes permanent destruction of hair follicles. Nonscarring alopecia is more common and causes hair loss classified as patterned, diffuse, or focal.
Patterned Hair Loss
- Involves progressive thinning of the hair, particularly at the top, front, and sides of the scalp
- Is symmetrical
- Most commonly caused by androgenic alopecia, which is hereditary, linked to DHT, and more common in men
Diffuse Hair Loss
- Hair loss that is even across the scalp
- Most commonly caused by telogen effluvium, which causes hair to shed faster than it is replaced
- Often follows a medical event such as surgery, illness, pregnancy, certain health conditions, rapid weight loss, or vitamin/mineral deficiencies
- Can also be caused by certain medications
- Typically resolves within six to nine months
Focal Hair Loss
- Loss of hair in patches on the scalp and/or body
- Most commonly caused by alopecia areata, an autoimmune disorder
- Spontaneous hair regrowth occurring in about 30% of people with milder forms of alopecia areata
Hair loss may also be caused by factors such as:
- Hormonal imbalances
- Infection on the scalp
- Scalp psoriasis and other scalp conditions
- Tight hairstyles that regularly pull on the scalp
- Thyroid disease
- Deficiencies in iron, biotin, protein, or zinc
Precautions to Know About When Taking Creatine
Creatine supplements are popular among athletes who believe it will help with strength-building and performance in sports. There is no conclusive evidence that supplementing with creatine will accomplish this goal.
Often it is friends or other people without medical credentials that athletes turn to for advice on creatine rather than qualified healthcare providers. This can lead to taking creatine supplements when it would be advised against or taking more than a healthcare provider would recommend.
Creatine can affect people differently, depending on their body makeup. What may be safe and effective in one person may have little effect or be unsafe in another.
Use in Children, Adolescents, and Pregnant/Nursing people
Adolescent and child athletes sometimes take creatine. There isn't enough research to know if creatine supplements are safe for children and adolescents or for people who are pregnant or nursing. Unless advised by a healthcare provider, children, adolescents, pregnant people, and people who are breastfeeding should not take creatine supplements.
Unregulated Supplements
Nutritional supplements such as creatine are not regulated by the Food and Drug Administration (FDA). There is no guarantee that the quality or quantity of the supplement agrees with what's printed on the label.
Several independent organizations offer companies the opportunity for quality testing. If the product is found to contain the ingredients on the label, not contain harmful contaminants, and be manufactured properly, the organization gives it its seal. These organizations include:
- ConsumerLab.com
- NSF.org
- U.S. Pharmacopeia (USP)
It's important to note that a seal from these organizations does not guarantee the product is safe or effective.
Side Effects and Interactions
Creatine may be unsafe to take in situations where you are undergoing dehydration (such as to make a weight class for a wrestling competition) or trying to lose weight.
There are a lot of unknowns when it comes to the effects of creatine supplementation. The medical community doesn't know the effects creatine supplements may have on organs such as the brain, heart, liver, kidneys, and reproductive organs.
It's also unknown if or how creatine supplements interact with prescription and over-the-counter medications, other supplements (including vitamins), caffeine, or products such as energy drinks.
Talk to your healthcare provider about any medications or supplements you are taking, particularly if you take:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Motrin/Advil (ibuprofen) and Aleve (naproxen)
- Diuretics (water pills)
- Tagamet (cimetidine), which reduces stomach acid
- Probenecid, which treats gout
- Drugs that affect the kidneys
Taking high doses of creatine may affect your body's ability to make its own creatine.
People with kidney problems, high blood pressure, or liver disease should not take creatine supplements unless advised by their healthcare provider.
Summary
Although a 2009 study found that creatine supplementation caused an increase in DHT, leading to a theory that creatine supplements could cause hair loss, the study was flawed, and the results have not been replicated. Current research does not support a link between creatine supplementation and hair loss.
Hair loss can be caused by factors such as hormone changes, genetics, autoimmune conditions, illness, life events such as pregnancy, nutritional deficiencies, scalp conditions, and other considerations.
Side effects of creatine supplements may include weight gain due to water retention, gastrointestinal symptoms, and muscle cramps.
The effects of creatine supplementation and how it may interact with medical conditions, medications, and other areas are not well-known. Always talk to your healthcare provider before taking creatine supplements.
Creatine is a substance that occurs naturally in the body and can also be consumed through meat, fish, and supplements. It is commonly used by athletes due to the belief that it can increase strength and improve athletic performance. However, the evidence supporting these claims is inconclusive and sometimes contradictory [[1]].
One study suggested a potential link between creatine supplementation and hair loss. The study found that college-aged male rugby players who supplemented with creatine experienced increased blood levels of dihydrotestosterone (DHT) over time. DHT is a metabolite of testosterone that can bind to androgen receptors in susceptible hair follicles, leading to hair loss. However, this study had several flaws, such as a small sample size and the absence of an increase in total testosterone among the participants [[2]].
By early 2021, 12 other studies examining the effects of creatine supplementation on testosterone had not replicated the results of the 2009 study. Some studies found small increases in total testosterone after a few days of creatine supplementation, but these increases were physiologically insignificant. No study has reported hair loss in humans as a result of creatine supplementation, and the current body of evidence does not support a link between creatine supplementation and hair loss or balding [[2]].
Hair loss can be caused by various factors, including hormonal imbalances, infections on the scalp, scalp conditions, tight hairstyles, thyroid disease, and deficiencies in iron, biotin, protein, or zinc [[3]].
When it comes to the side effects of creatine supplementation, it may cause muscle water retention, leading to weight gain for some individuals. Other potential side effects, particularly with long-term use, may include muscle strains, muscle cramps, gastrointestinal problems (such as nausea or diarrhea), dizziness, dehydration, high blood pressure, kidney damage, liver dysfunction, and seizures [[1]].
It's important to note that creatine supplements are not regulated by the Food and Drug Administration (FDA). Therefore, the quality and quantity of the supplement may not always match what is printed on the label. It is advisable to consult with a healthcare provider before taking creatine supplements, especially if you have any medical conditions or are taking medications [[1]].
In summary, while a 2009 study suggested a potential link between creatine supplementation and hair loss, subsequent studies have not replicated these findings. The current body of evidence does not support a connection between creatine supplementation and hair loss. Hair loss can be caused by various factors unrelated to creatine supplementation. Creatine supplements may have side effects, and it is important to consult with a healthcare provider before taking them, especially if you have any medical conditions or are taking medications [[1]][[2]][[3]].
