Creatine: Does It Worsen Hair Loss? It Depends On The Hair Loss Type.

Article Summary

Creatine, a substance that supports energy production in the muscles and brain, is commonly used as a supplement to boost athletic performance. However, its potential link to hair loss has raised concerns, particularly due to its effect on dihydrotestosterone (DHT), a hormone associated with androgenic alopecia. While studies suggest creatine may increase DHT levels, the evidence remains inconclusive, and no direct link to hair loss has been confirmed. Some research even indicates creatine may support hair growth in cases of telogen effluvium. When fighting hair loss, mitigating the risk of hair loss acceleration is key – as it’s much easier to stop hair loss than it is to regrow significant amounts of lost hair. So, unless you’re an elite athlete, is creatine worth the unknown risk on hair health? This article explores the science.

Full Article

Creatine is a naturally occurring compound found in muscles and the brain. It is commonly used as a dietary supplement to enhance athletic performance and muscle strength. But could it be contributing to your hair loss?

This article will explore whether creatine is connected to hair loss, who might benefit from its use, potential health risks, and whether taking it is truly worth it if you have hair loss.

What Is Creatine?

Creatine is a substance found naturally in muscle cells. However, it is made primarily in the liver and kidneys. This process begins with converting the amino acids (building blocks of proteins), glycine, and arginine into guanidinoacetate. This intermediate is then methylated to form creatine.^[1]Rosko, L.M., Gentile, T., Smith, V.N., Manavi, Z., Melchor, G.S., Hu, J., Shults, N.V., Albanese, C., Lee, Y., Rodriguez, O., Huang, J.K. (2023). Cerebral creatine deficiency affects the timing of … Continue reading

Creatine can also be found in red meat and seafood. For example, a pound of uncooked beef and salmon provides about 1-2 grams of creatine.^[2]Kreider, R.B., Kalman, D.S., Antonio, J., Ziegenfuss, T.N., Wildman, R., Collins, R., Candow, R.G., Kleiner, S.M., Almada, A.L., Lopez, H.L.International society of sports nutrition position stand: … Continue reading About half of our daily creatine comes from the diet, and half is produced by the body.

Another way that creatine can be gained is through supplementation, with creatine monohydrate being the most common form. It is often used in this form by athletes, bodybuilders, and avid gymgoers.

Types of Creatine

There are several types of creatine supplements available, each with unique characteristics and potential benefits. Some of them include: 

Creatine Monohydrate

This is the most common and well-researched form of creatine, consisting of a creatine molecule bonded with a water molecule. This type increases phosphocreatine stores in the muscles, enhancing energy production during high-intensity exercise.^[3]Preen, D., Dawson, B., Goodman, C., Lawrence, S., Beilby, J., Ching, S. (2001). Effect of creatine loading on long-term sprint exercise performance and metabolism. Medicine and Science in Sports and … Continue reading 

Micronized Creatine

Micronized creatine has smaller particles for better solubility and absorption. It is similar to creatine monohydrate but might reduce digestive discomfort for some users.^[4]de Moraes, R., Diogo, V.B., de Moraes, B.S., Tuiibirica, E. (2014). Effects of dietary creatine supplementation on systemic microvascular density and reactivity in healthy young adults. Nutrition … Continue reading

Creatine Ethyl Ester

This is creatine with an added ethyl ester group, which is thought to improve absorption. It has been developed to enhance absorption compared to creatine monohydrate, though studies suggest it might not be as effective in increasing muscle creatine levels.^[5]Spillane, M., Schoch, R., Cooke, M., Harvey, T., Greenwood, M., Kreider, R., Willoughby, D.S. (2009). The effects of creatine ethyl ester supplementation combined with heavy resistance training on … Continue reading

Buffered Creatine

Buffered creatine is creatine monohydrate mixed with alkaline compounds like sodium bicarbonate. It is intended to be more stable in the stomach and potentially reduce conversion to creatinine. While it is claimed that buffered creatine is more effective at lower doses, evidence is limited.^[6]Jagim A.R., Oliver, J.M., Sanchez, A., Galvan, E., Fluckey, J., Riechman, S., Greenwood, M., Kelly, K., Meininger, C., Rasmussen, C., Kreider, R.B. (2012). A buffered form of creatine does not … Continue reading

How Does Creatine Work?

1. Creatine helps muscles produce energy, especially during high-intensity exercise or heavy lifting.^[7]Cooper, R., Naclerio, F., Allgrove, J., Jiminez A. (2012). Creatine supplementation with specific view to exercise/sports performance: an update. Journal of the International Society of Sports … Continue reading  It does this by: 
   • Increasing stores of phosphocreatine in muscles helping rapidly produce more ATP (the body’s energy currency).
   • Allowing faster regeneration of adenosine triphosphate (ATP) from adenosine diphosphate (ADP) by donating its phosphate group.
2. It increases the water content in muscle cells (cell volumization), which may contribute to muscle growth.
3. It boosts workload capacity, allowing for more total work in a training session.
4. It may enhance muscle growth through mechanisms like improved cell signaling and reduced protein breakdown.
5. In the body, creatine is converted to creatine phosphate and stored in muscles to be used for energy.
6. During intense exercise, creatine phosphate donates its phosphate to ADP to regenerate ATP, providing a rapid energy source.

Supplementing with creatine increases the available creatine phosphate stores, allowing for sustained energy production during high-intensity activities.

What Is The Effect of Creatine On Hormone Levels?

Creatine has an indirect but notable effect on hormone levels in the body, particularly testosterone and dihydrotestosterone (DHT). 

While creatine does not directly increase testosterone levels in the body, it can influence the hormone through several mechanisms. 

• Enhanced exercise performance: Creatine improves workout intensity and muscle strength, which can lead to increased testosterone production as a response to exercise.
• Improved muscle mass: As creatine helps to build muscle mass, it might contribute to higher overall testosterone levels, as muscle tissue is associated with testosterone production.
• Reduced cortisol: Some studies suggest that creatine may help reduce cortisol levels, which can indirectly support testosterone production.

Creatine may have a more direct and significant effect on DHT levels: 

One study involving college-aged rugby players found that after 7 days of creatine loading (25 g/day plus 25 g/day of glucose), DHT levels increased by 56% and remained 40% above baseline after 14 days of maintenance. The DHT: testosterone ratio also increased by 36% after 7 days and remained elevated by 22% after the maintenance dose.^[8]van der Merwe, J., Brooks, N.E., Myburgh, K.H. (2009). Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clinical … Continue reading

However, upon closer examination of the data, these changes are still within normal clinical limits. Subsequent reviews ultimately attributed the increase in DHT to a small baseline difference between the creatine and placebo groups.^[10]Antonio, J., Candow, D.G., Forbes, S.C., Gualano, B., Jagim, A.R., Kreider, R.B., Rawson, E.S., Smith-Ryan, A.E., van Dusseldorp, T.A., Willoughby, D.S., Ziegenfuss, T.N. (2021). Common questions and … Continue reading

Does Creatine Contribute to Hair Loss?

As mentioned above, there is one study showing that creatine can increase DHT levels. As DHT is implicated in hair follicle miniaturization and the pathogenesis of androgenic alopecia, it should be considered for people with DHT sensitivity or diagnosed with AGA. However, the study was not conducted on people with AGA or any type of hair loss, so we can’t know for sure what effect it might have.

One study conducted in 2021 suggested that creatine might actually be beneficial for hair growth for women with telogen effluvium.^[11]Turlier, V., Darde, M.S., Loustau, J., Mengeaud, V. (2021). Assessment of the effects of a hair lotion in women with acute telogen effluvium: a randomized controlled study. JEADV. 35(2). 12-20. … Continue reading 100 adult women aged between 19 and 50 took part in a randomized controlled trial, using either a lotion called Creastim (containing creatine, acetyl tetrapeptide-2, and B vitamins) or a control lotion three times weekly for 16 weeks.

Significant improvements in the growing/non-growing hair follicle ratio (anagen: telogen ratio) were observed at week 4 in the treatment group, indicating accelerated improvement in hair regrowth (Figure 3). However, by week 16, both the treatment and control showed significant improvements from the baseline, with no significant difference between groups.

Telogen hair density was also measured (Figure 4). Significant reductions in non-growing hairs were observed in the treated group, with a 19.9% reduction by Week 16 compared to 23.7% in the control group. However, once again, there was no significant difference between the groups by Week 16.

One outcome that showed significant improvement compared to the control at Week 16 was hair shedding (Figure 5). The participants conducted a 60-second hair count, in which they combed their hair and then counted the number of hairs in 60 seconds. At Week 16, the treated group showed a 43.6% reduction in hair shedding, whereas the control group showed a 33.1% reduction. 

So, a creatine-containing lotion led to some improvements, but of course, there are a few issues. The first is that the lotion contains other ingredients, which may have had individual effects on hair regrowth. The second is that the participants had telogen effluvium. Any positive effects could be due to the spontaneous resolution of hair loss rather than the treatment itself (which may also be why the control group also had significant improvement by Week 16 in a few parameters). The third is that even though they showed before and after photos (of only one participant in the treatment group), it is unclear if there are any visible effects on hair regrowth (Figure 6).

Ultimately, more research is needed to determine what (if any) effects creatine might have on hair loss or hair regrowth.

Who Might Benefit From Creatine

Based on the current evidence, it is possible that those with telogen effluvium might benefit from topical creatine. However, there have been no studies determining whether topical creatine affects scalp DHT levels and whether it might lead to hair loss in those predisposed to AGA. 

While creatine has benefits for those engaged in high-intensity or resistance training, if you are not taking part in these kinds of exercises and you are suffering from hair loss, then it might not be for you. 

Is Creatine Worth Taking For Hair Health?

As can be seen above, there is a lack of direct evidence supporting creatine’s role in improving hair growth outcomes or worsening hair loss outcomes. For this reason, unless you are taking creatine for sports activities, we don’t believe that it is worth the risk to take it.

Final Thoughts

While creatine is widely recognized for its benefits in enhancing exercise performance and muscle strength, its impact on hair loss remains uncertain. Some studies suggest that creatine may raise DHT levels, but the evidence is limited and ultimately inconclusive. There is no direct proof that creatine worsens conditions like androgenic alopecia, although if you have diagnosed AGA, you may want to be cautious in using it. On the other hand, creatine-containing lotions have shown the potential to promote hair growth in cases of telogen effluvium, though these results need further validation. Ultimately, unless you’re using creatine for fitness purposes, it may not be worth the risk to hair health.