Does Creatine Cause Hair Loss? What the Evidence Actually Shows

Where does the creatine-hair loss concern come from?

The concern traces almost entirely to one study published in 2009 in the *Clinical Journal of Sport Medicine* 1Ref 1van der Merwe J, Brooks NE, Myburgh KH (2009).Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players.DHT rose 56% after creatine loading and remained 40% above baseline at maintenance; testosterone levels unchanged; no hair outcomes measured. Researchers gave 20 college-aged male rugby players either creatine monohydrate or a placebo for three weeks. They found that DHT — dihydrotestosterone, the androgen most responsible for follicle miniaturization in genetically susceptible people — rose by 56% after the loading week and remained about 40% above baseline during the maintenance phase. Testosterone levels themselves did not change.

DHT is the hormone that, in people who are genetically predisposed, gradually shrinks hair follicles through a process called miniaturization, producing progressively thinner and shorter hairs over time — a condition known as androgenetic alopecia, or pattern hair loss 2Ref 2Dhurat R, Sharma A, Rudnicka L, et al. (2020).5-Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety.DHT mechanism in androgenetic alopecia: 5-alpha reductase converts testosterone to DHT; androgen receptors and 5-alpha reductase more abundant in balding scalp follicles; follicle miniaturization mechanism3Ref 3Adil A, Godwin M (2017).The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis.Androgenetic alopecia mechanism and genetic predisposition basis for follicular DHT sensitivity. The inference drawn from the 2009 finding is straightforward: if creatine raises DHT, and DHT accelerates pattern hair loss, creatine might be bad for people prone to hair thinning.

That logic is biologically plausible. What the study did not do — and what no study has done until recently — is measure whether creatine supplementation actually leads to hair loss.

What does more recent research show?

Two pieces of evidence substantially temper the 2009 finding.

First, the van der Merwe study has not been convincingly replicated. A 2021 review by Antonio and colleagues, published in the *Journal of the International Society of Sports Nutrition*, concluded that "the current body of evidence does not indicate that creatine supplementation increases total testosterone, free testosterone, DHT, or causes hair loss/baldness" 4Ref 4Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN (2021).Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?.Current evidence does not indicate creatine raises free testosterone, total testosterone, or DHT or causes hair loss; 2009 DHT elevation remained within normal clinical limits; finding not replicated. The reviewers noted that the 2009 DHT elevation, while notable, remained within normal clinical limits, and that no documented reports of hair loss appear in the broader creatine literature, which spans hundreds of trials over decades.

Second — and more directly — a 2025 randomized controlled trial is the first study to directly measure hair follicle health in creatine users 5Ref 5Lak M, Forbes SC, Ashtary-Larky D, et al. (2025).Does creatine cause hair loss? A 12-week randomized controlled trial.First RCT to directly measure hair follicle health in creatine users; no significant differences in DHT, hair density, follicular unit count, or cumulative hair thickness between creatine and placebo groups over 12 weeks. Forty-five resistance-trained men were assigned to either 5 g/day creatine monohydrate or placebo for 12 weeks. At the end of the trial, there were no significant differences between groups in DHT levels, the DHT-to-testosterone ratio, hair density, follicular unit count, or cumulative hair thickness. The authors concluded the data provide "strong evidence against the claim that creatine contributes to hair loss."

The International Society of Sports Nutrition's position stand on creatine, updated in 2017, identifies weight gain as the only consistently documented side effect, with no mention of androgenic effects 6Ref 6Kreider RB, Kalman DS, Antonio J, et al. (2017).International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.Short- and long-term creatine supplementation safe and well-tolerated; weight gain the only consistently documented side effect.

Why does the genetic factor still matter?

Even with the newer evidence, it is worth understanding why the theoretical concern is not entirely dismissible for a specific group of people.

Androgenetic alopecia works through follicular sensitivity to androgens, particularly DHT, which is shaped by genetic variation in androgen receptor expression and local 5-alpha reductase activity in scalp tissue 2Ref 2Dhurat R, Sharma A, Rudnicka L, et al. (2020).5-Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety.DHT mechanism in androgenetic alopecia: 5-alpha reductase converts testosterone to DHT; androgen receptors and 5-alpha reductase more abundant in balding scalp follicles; follicle miniaturization mechanism3Ref 3Adil A, Godwin M (2017).The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis.Androgenetic alopecia mechanism and genetic predisposition basis for follicular DHT sensitivity. People who are genetically predisposed to pattern hair loss — those with a family history on either side, particularly early-onset loss — have follicles that are more reactive to the same circulating DHT level that would have little effect in a person without that predisposition.

If creatine does raise DHT meaningfully in some individuals (a finding that is inconsistent across studies), the practical significance of that rise would depend heavily on whether a person's follicles are sensitive to it in the first place. Someone with no family history of pattern hair loss and no current thinning has little biological reason to be concerned. Someone already experiencing early androgenetic alopecia, or with a strong family history of it, has more reason to note the timing of any new shedding relative to starting creatine.

What the evidence does not support is the conclusion that creatine causes or accelerates hair loss in the general population.

What other causes of shedding are common in people who train hard?

Many people who supplement with creatine do so in the context of regular resistance training, which creates several concurrent factors that can drive hair shedding — and these are frequently overlooked when creatine gets the blame.

Iron deficiency is common in people who exercise heavily, especially women. A systematic review and meta-analysis found that women with hair loss have measurably lower ferritin levels than controls — and that using a higher ferritin threshold (30–40 ng/mL rather than the anemia cutoff) revealed iron deficiency in the majority of affected women 7Ref 7Treister-Goltzman Y, Yarza S, Peleg R (2021).Iron Deficiency and Nonscarring Alopecia in Women: Systematic Review and Meta-Analysis.Women with hair loss have significantly lower ferritin than controls; iron deficiency a common reversible contributor to hair shedding. Iron plays a direct role in follicular proliferation, and low iron stores can cause diffuse shedding independently of any hormonal factor.

Telogen effluvium — the diffuse shedding that follows physiological stress — can be triggered by inadequate caloric intake, aggressive cutting phases, rapid weight loss, illness, or very high training volumes 8Ref 8Rebora A (2019).Telogen effluvium: a comprehensive review.Telogen effluvium — diffuse shedding triggered by physiological stress, nutritional deficit, or illness — is a common and reversible cause of hair shedding in physically active people. This type of shedding typically begins two to four months after the triggering event, which can make it appear to coincide with starting a new supplement.

Nutritional gaps — including low protein intake relative to training demand, or inadequate zinc — can independently affect hair cycling.

Other supplements and hormonal products in pre-workout formulas or performance stacks may have androgenic or metabolic effects that creatine itself does not have.

A clinician can help sort out which factor is driving shedding in any individual case.

What does this mean practically?

For most people, the current body of evidence does not support stopping creatine out of concern for hair loss. Creatine monohydrate is one of the most studied sports supplements in existence; its safety profile over decades of research is well established 6Ref 6Kreider RB, Kalman DS, Antonio J, et al. (2017).International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.Short- and long-term creatine supplementation safe and well-tolerated; weight gain the only consistently documented side effect.

For people with a personal or family history of androgenetic alopecia who notice new or accelerating shedding after starting creatine, a brief trial off the supplement — paired with a clinician evaluation — is a reasonable conversation to have. Scalp dermoscopy can help distinguish pattern hair loss from diffuse shedding, and blood work can rule out iron deficiency, thyroid dysfunction, or other reversible contributors 9Ref 9Mella JM, Perret MC, Manzotti M, Catalano HN, Guyatt G (2010).Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review.Evidence base for 5-alpha reductase inhibitors as established treatment for confirmed androgenetic alopecia when pattern hair loss is clinically diagnosed.

If pattern hair loss is confirmed, treatments with the strongest evidence — topical minoxidil and, for eligible individuals, finasteride or other 5-alpha reductase inhibitors — address the underlying DHT pathway directly and can be discussed with a dermatologist 9Ref 9Mella JM, Perret MC, Manzotti M, Catalano HN, Guyatt G (2010).Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review.Evidence base for 5-alpha reductase inhibitors as established treatment for confirmed androgenetic alopecia when pattern hair loss is clinically diagnosed.