The Origin of the Creatine and DHT Myth: The 2009 Rugby Study
The widespread concern linking creatine to elevated dihydrotestosterone (DHT) and subsequent hair loss stems almost entirely from one specific study. Published in 2009, this double-blind, placebo-controlled crossover study on male rugby players is the foundation of the controversy.
- The Study Protocol: Participants received a creatine loading dose of 25g per day for seven days, followed by a maintenance dose of 5g per day for 14 days.
- The Findings: After the loading phase, researchers observed a 56% increase in DHT levels, which remained 40% above baseline during the maintenance phase. The ratio of DHT to testosterone also increased. Importantly, the study did not measure or report any actual hair loss.
- The Interpretation: While the observed DHT increase was statistically significant, the study's conclusions are often misinterpreted. The DHT levels remained within normal physiological ranges for healthy males. Furthermore, the study's limitations—including a small sample size and a high initial loading dose—have been widely criticized. Intense resistance exercise itself can also cause an increase in androgenic hormones, complicating the interpretation of these findings.
Subsequent Research Fails to Confirm a Significant DHT Link
Since the 2009 study, numerous researchers have attempted to replicate its results or investigate the creatine-DHT link further. The overwhelming consensus from these subsequent studies and reviews is that the initial findings were an outlier, and there is no strong evidence that creatine supplementation significantly increases DHT or causes hair loss.
- Majority of Studies Show No Effect: Over a dozen studies have examined the effect of creatine on testosterone, and the majority have found no significant change in total or free testosterone, which is required for DHT production.
- A 2025 Randomized Controlled Trial: A recent 12-week randomized controlled trial, specifically designed to address this controversy, found no significant differences in DHT levels, the DHT:testosterone ratio, or any hair-related outcomes (density, thickness, follicular count) between the creatine and placebo groups. This robust study provides strong evidence that creatine does not cause hair loss in healthy, young, resistance-trained males at standard doses.
- Anecdotal Evidence is Unreliable: While some individuals report hair thinning while using creatine, this is often subjective and not backed by controlled scientific observation. Many factors, including stress, diet, and genetics, could be responsible.
Deciphering the Creatine-DHT Relationship
To understand why creatine is unlikely to cause baldness, it is crucial to examine the pharmacological mechanisms of both creatine and DHT.
- Creatine's Mechanism of Action: Creatine is an amino acid derivative, not a hormone. Its primary role is to help muscles produce energy during high-intensity exercise by aiding in the regeneration of adenosine triphosphate (ATP). It does this by increasing phosphocreatine stores in muscle cells, not by mimicking or significantly altering hormonal pathways.
- DHT's Role in Hair Loss: Dihydrotestosterone (DHT) is a potent androgen hormone produced from testosterone by the enzyme 5-alpha-reductase. In individuals with a genetic predisposition to androgenetic alopecia (male pattern baldness), DHT binds to receptors on hair follicles, causing them to shrink (miniaturize) and eventually cease production.
- The Conversion Connection: The proposed link relies on creatine upregulating the 5-alpha-reductase enzyme, increasing the conversion of testosterone to DHT. However, the latest research, particularly the 2025 study, suggests this effect does not happen with standard creatine supplementation.
Comparison of Creatine and Anabolic Steroids
Comparing the effects of creatine to anabolic steroids highlights the vast differences in their mechanisms and hormonal impacts. This distinction helps to clarify why the two substances are not comparable in their potential to cause hair loss.
| Feature | Creatine | Anabolic Steroids |
|---|---|---|
| Mechanism of Action | Increases phosphocreatine stores to help regenerate ATP for muscle energy. | Synthetic variants of testosterone that bind to androgen receptors, promoting protein synthesis. |
| Hormonal Impact | Minimal to no significant, sustained impact on testosterone or DHT levels. | Directly increase testosterone and, consequently, can significantly elevate DHT levels. |
| Effect on Hair Loss | Not shown to cause or accelerate hair loss in individuals without a predisposition, based on current evidence. | Strong, well-documented link to accelerating hair loss in genetically predisposed individuals. |
| Legality and Regulation | A legal dietary supplement, widely available without prescription. | Classified as controlled substances in many countries; their use is highly regulated and often illegal without a prescription. |
| Health Risks | Generally considered safe for healthy individuals at recommended doses; potential side effects are typically minor (e.g., water retention). | Associated with a wide range of severe health risks, including liver damage, cardiovascular issues, and hormonal imbalance. |
The Primary Driver of Hair Loss: Genetics
While the creatine-DHT debate captures attention, the truth is that genetics are the most significant determinant of male and female pattern hair loss (androgenetic alopecia).
- Inherited Sensitivity: The key factor isn't just the amount of DHT, but the sensitivity of your hair follicles to it. This sensitivity is inherited from your family. If you have a genetic predisposition, your follicles are more susceptible to miniaturization from normal or even slightly elevated DHT levels.
- Other Factors: Stress, diet, age, and underlying health conditions can also contribute to hair loss. It's easy to mistakenly attribute hair thinning to a new supplement like creatine when another factor is the true cause.
Conclusion: Making an Informed Choice
For most healthy adults, especially those without a strong genetic predisposition to hair loss, the evidence does not support the claim that creatine causes or significantly accelerates hair loss. The concern, primarily stemming from a single, high-dose study from 2009, has been largely debunked by subsequent research showing no effect on DHT levels with standard creatine supplementation. Creatine is a well-researched, safe, and effective supplement for improving athletic performance and increasing muscle mass through its action on the body's energy systems.
If you have a strong family history of androgenetic alopecia and are still concerned, it is always wise to consult a healthcare professional. For those who choose to supplement, sticking to the standard recommended maintenance dose (3-5 grams per day) is considered safe and effective. Ultimately, genetics, not creatine, plays the dominant role in pattern baldness. You can confidently reap the benefits of creatine supplementation without fear of going bald, knowing the scientific consensus is on your side.
For more in-depth information on creatine safety and usage, you can refer to the International Society of Sports Nutrition (ISSN) guidelines on creatine supplementation, which provide comprehensive, evidence-based recommendations.
