Does creatine cause hair loss?

The claim that creatine causes hair loss is based on a single unreplicated study (van der Merwe et al., 2009) in South African rugby players that showed elevated DHT (not hair loss as a clinical outcome) after a loading dose of 25 g/day for 7 days, this study has not been replicated in over 15 years, and no clinical trial has documented creatine-induced hair loss as a measurable outcome (van der Merwe et al., Clin J Sport Med, 2009).

DHT (dihydrotestosterone) is converted from testosterone by 5-alpha reductase and does play a role in androgenic alopecia (male pattern baldness) in genetically predisposed men. However, the pathway from creatine → elevated DHT → accelerated hair loss requires: (a) the DHT elevation to be real and sustained at standard doses (not established), (b) the man to be genetically predisposed to androgenic alopecia (only in SOME men), and (c) the DHT elevation to be sufficient to accelerate this process beyond what testosterone alone produces. None of these steps is supported by the current evidence base beyond one short-duration loading protocol study.

Honesty Scale: Unsupported (5) for creatine causing hair loss at standard (3–5 g/day) doses as a clinical outcome.

What to do: Take creatine without concern about hair loss unless your physician has specifically identified elevated DHT as a contributing factor to diagnosed androgenic alopecia and you are concurrently using a loading dose. At 3–5 g/day, the hair loss concern has no evidential foundation.

For the full picture, read The Supplementation Deep Dive