Creatine & Hair Loss

This has been a worry for many people debating taking the seeming golden supplement of the performance world known as creatine. If you take creatine, will your hair fall out? Let’s examine the research.

Does Creatine lead to Hair Loss?

It seems likely that creatine does lead to hair loss in particular individuals.

While there are no studies that specifically investigate if creatine leads to hair loss, directly – we can infer that is the case based on a few studies looking at the commonalities between creatine and hair loss.

First, some hair loss is due to a condition called androgenic alopecia (aka, “genetic baldness”), which is essentially a genetic disposition that makes people more sensitive to a metabolic compound of testosterone and androstenediones known as dihydrotestosterone (DHT). There is a positive relationship, in individuals with alopecia, between DHT levels and hair loss [1][4]. And, it so happens that creatine increases DHT levels statistically and clinically significantly [2].

So, while I have not seen any cause and effect studies showing creatine increases hair loss, it seems likely based on the available research.

Who is at risk?

Men and women are at risk.

While androgenic alopecia is thought to begin around puberty, it does not become apparent for some until their 20’s, around 50% of men are affected by age 50; hence why hair replenishment products are common for men, especially [1][5]. Women have about half the prevalence of men [1]. Women and men who produce higher than normal androgenous hormones tend to have higher risk, as in PCOS or hypothalamic-adrenal-pituitary issues, or even hormone altering tumors [1]. Interestingly, Caucasians are at highest risk while some ethnicities (Asian, Caribbean, African, and Native American) show lowered risk [1].

Risk is individually determined by genetic disposition – how many relatives are undergoing baldness?

Understanding the Physiology

People with this particular genetic disposition for hair loss, androgenic alopecia, have higher levels of the enzyme 5a-reductase, which comes in two forms, but 5a-reductase II is specific to the hair follicles across the body, but certainly in high concentration around the scalp [1]. This enzyme is the primary mechanism of DHT synthesis and converts testosterone to dihydrotestosterone (DHT) [1][4]. DHT then binds to androgen receptors on the surface of the hair cells and translocates (aka, moves across the cell) them into the nucleus of the cell [1]. Here, DHT changes the regulation of hair follicle growth via either inhibition or excitation of transcription factors, leading to an eventual miniaturization of the full length hair follicle [3]. It is also thought that high DHT may also promote apoptosis (cell death) in follicle keratinocytes, leading to less and less hair being reproduced during normal hair cycling over time [3].

So, people with high levels of 5a-reductase II tend to have those higher levels around their frontal lobe area of the skull, hence a loss of hair from the front and top of the head [1][4].

SUMMARY

There we have it. While creatine may not have been studied, specifically, on hair loss; the evidence is clear enough for us to speculate its impact on hair loss. Does it occur? Likely, as it increases dihydrotestosterone (DHT), which, in turn, increases baldness, but only in the higher prevalence of the enzyme 5a-reductase II. So, a person must be genetically favored (or un-favored, however you see it) with greater synthesis of 5a-reducatse II for this to have a strong impact.

Writer: Nicolas Verhoeven
References

[1] Urysiak-Czubatka, I., Kmieć, M. L., & Broniarczyk-Dyła, G. (2014). Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia. Postepy Dermatologii I Alergologii, 31(4), 207–215. https://doi.org/10.5114/pdia.2014.40925


[2] 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 Journal of Sport Medicine, 19(5), 399–404. https://doi.org/10.1097/JSM.0b013e3181b8b52f


[3] Alsantali, A., & Shapiro, J. (2009). Androgens and hair loss. Current Opinion in Endocrinology, Diabetes and Obesity, 16(3), 246–253. https://doi.org/10.1097/MED.0b013e32832b100a


[4] Bang, H. J., Yang, Y. J., Lho, D. S., Lee, W. Y., Sim, W. Y., & Chung, B. C. (2004). Comparative studies on level of androgens in hair and plasma with premature male-pattern baldness. Journal of Dermatological Science, 34(1), 11–16. https://doi.org/10.1016/j.jdermsci.2003.11.005

[5] Hartfield, W. (2016, September 22). 3 Reasons Why Creatine May Cause Hair Loss - 56% Increase In DHT! Retrieved from https://www.hairlossrevolution.com/creatine/

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