Creatine supplementation and Hair Loss: Myth or Molecular Reality? A recent 12-Week Randomized double-blind Clinical Trial Unveils the Truth

For decades, creatine monohydrate has held the throne as one of the safest, most effective, and most affordable dietary supplements for athletes, bodybuilders, and fitness enthusiasts. With its well-documented ability to enhance physical performance, stimulate muscle hypertrophy, and aid recovery, it is little surprise that creatine remains a cornerstone of many strength and conditioning regimens (Antonio et al., 2021). However, one rumor has continued to overshadow its otherwise sterling reputation: Does creatine cause hair loss? 

This concern first gained traction after a 2009 study suggested that creatine supplementation might elevate levels of dihydrotestosterone (DHT). The DHT is an androgen closely associated with male pattern baldness and the rumor has persisted for over a decade (van der Merwe et al., 2009). Despite numerous rebuttals and the absence of direct evidence linking creatine to hair loss, anxiety around this topic remained unresolved. That is, until now.

In 2025, a team of researchers led by Dr. Mohammadyasin Lak and colleagues conducted a first-of-its-kind randomized, double-blind, placebo-controlled clinical trial designed to directly answer this longstanding question. Published in the Journal of the International Society of Sports Nutrition, this 12-week investigation stands as the most comprehensive assessment yet of creatine's effect on hormonal markers and hair follicle health (Lak et al., 2025). The results? Creatine supplementation does not cause hair loss.

The hair loss claims trace back to a 2009 study by van der Merwe et al. in which college rugby players were given a high-dose creatine regimen (25 g/day for 7 days followed by 5 g/day for 14 days) alongside glucose. The study noted a 56% increase in DHT levels after the loading phase, although no actual changes in hair growth or loss were measured. Key limitations of that study included a small sample size of 20 participants, lack of direct hair assessments, the use of glucose –which can, itself, affect hormone responses– and a short duration of only three weeks. Despite these shortcomings, the study received disproportionate media coverage, embedding itself in fitness culture as the spark for the creatine–hair loss rumor.

The 2025 clinical study set out to answer three key questions: whether creatine monohydrate increases DHT or alters testosterone ratios; whether it affects objective measures of hair health such as density and follicular structure; and whether creatine supplementation has any adverse physiological effects over a 12-week period. The trial enrolled 45 resistance-trained men aged 18 to 40 and randomly assigned them to one of two groups: a creatine group receiving 5 g per day of creatine monohydrate and a placebo group receiving 5 g per day of maltodextrin. Supplements were identical in taste and appearance to ensure participant and researcher blinding. Allocation was concealed using numbered envelopes, and weekly check-ins and the collection of empty sachets ensured adherence.

Participants were excluded from the study if they had used creatine or hair-related medications within the previous three months; if they had undergone hair transplants; if they had endocrine or dermatological disorders; or if they had taken anabolic steroids in the past six months. All participants agreed to maintain their regular diets and resistance training routines throughout the study.

Blood samples were drawn before and after the 12-week supplementation period to analyze total testosterone, free testosterone, DHT, creatinine, and estimated glomerular filtration rate (eGFR). Hair assessments were conducted using the Trichogram test and the FotoFinder system, both administered by board-certified dermatologists. The Trichogram test determines the percentage of hair in different growth phases, while the FotoFinder system uses polarized dermoscopic imaging to measure hair density, follicular unit count, and shaft thickness. To ensure reliability, participants followed strict protocols such as avoiding shampoo, styling products, haircuts, and caffeine before each assessment.

Of the original 45 participants, 38 completed the study. Hormonal results showed a slight increase in total testosterone in both the creatine and placebo groups and a modest decrease in free testosterone. Crucially, there were no significant changes in DHT levels or in the DHT-to-testosterone ratios. Kidney function markers, including creatinine and eGFR, also remained stable. Researchers attributed minor hormonal fluctuations to seasonal variation, as the study was conducted between late summer and early autumn.

This is a period associated with natural hormonal shifts (Zornitzki et al., 2022).

To understand the biochemical concern, it is important to clarify the role of DHT. DHT is synthesized from testosterone through the enzymatic action of 5-alpha reductase. It has a significantly higher binding affinity to androgen receptors than testosterone, particularly in tissues such as the prostate and scalp hair follicles. In genetically susceptible individuals, DHT binds to androgen receptors in the scalp, causing hair follicle miniaturization, which leads to thinner hair shafts and, eventually, to follicular dormancy. The mechanism described in the prior sentence is a hallmark of androgenetic alopecia. However, the enzymatic conversion from testosterone to DHT is tightly regulated, and there is no evidence that creatine supplementation disrupts this balance under normal physiological conditions. A 2025 clinical study offered a novel opportunity to evaluate the effects of creatine supplementation on DHT conversion and hair follicle miniaturization. In this study, the researchers employed both hormonal assays and direct imaging techniques to assess hair growth. 

Hair assessments revealed no significant differences between the creatine and placebo groups in terms of hair count, density, growth phase distribution, follicular unit count, or cumulative shaft thickness. Even after analyzing the data with rank-based statistical models to account for outliers, the results remained consistent: Creatine supplementation had no measurable impact on hair follicle health. Additionally, there were no changes observed in the levels of serum creatinine, a waste product generated from the breakdown of creatine phosphate in muscle tissue. There were also no changes observed in the estimated glomerular filtration rate (eGFR). This further dispels the persistent myth regarding creatine's alleged effects on kidney function. 

This groundbreaking recent study delivers the clearest message yet: Creatine monohydrate (5 g/day) does not cause hair loss. The study’s strengths include a larger sample size compared to earlier studies, a double-blind placebo-controlled design, and the integration of direct follicular imaging. This is a first in creatine research. It decisively rebuts the 2009 study, provides context for anecdotal reports, and affirms creatine's well-established safety profile.

Understanding why the myth persisted for so long requires an examination of broader social and scientific dynamics. The 2009 study was widely cited and often misrepresented by media outlets. Fitness forums and anecdotal user experiences amplified the narrative, and without rigorous counter-evidence, the speculation remained. Additionally, users with a genetic predisposition to hair loss may have experienced natural progression during creatine use, mistakenly attributing causality to the supplement.

While the recent clinical study provides compelling evidence, it also points toward areas for further research. These include evaluating longer-term supplementation beyond 12 weeks, assessing effects on women, exploring the impact of genetic predispositions, and measuring DHT levels directly from scalp tissue. Such studies could build on the current findings to offer even more granular insight into creatine's biological impacts.

In summary, this landmark trial provides the strongest evidence to date refuting the claim that creatine causes hair loss. Creatine did not increase DHT levels, did not alter androgen ratios, did not impact hair count or follicular health, and did not affect kidney function over the 12-week period. If you're a lifter, athlete, or health enthusiast hesitant about creatine due to hair loss fears, this research offers solid reassurance. Creatine remains one of the safest, most researched, and most effective supplements available.

If you are ready to incorporate creatine into your routine with full confidence in its safety and efficacy, we recommend Pristine’s Creatine Monohydrate supplement. Pristine’s offers high-quality 100% pure micronized creatine for superior absorption and performance. Free from unnecessary additives or flavor and backed by third-party testing, it's the ideal choice for athletes and health-conscious users who want results without compromise. Backed by the most current scientific evidence, Pristine’s ensures that you can supplement with confidence, knowing your health and hair are both protected. 

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ABOUT THE AUTHOR

Dr. Subrata Sabui, PhD in LifeScience and Biotechnology

 

 

 

 

References

1. Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18(1), 13.

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: official journal of the Canadian Academy of Sport Medicine, 19(5), 399–404

3. Lak, M., Forbes, S. C., Ashtary-Larky, D., Dadkhahfar, S., Robati, R. M., Nezakati, F., Khajevandi, M., Naseri, S., Gerafiani, A., Haghighat, N., Antonio, J., & Tinsley, G. M. (2025). Does creatine cause hair loss? A 12-week randomized controlled trial. Journal of the International Society of Sports Nutrition, 22(sup1), 2495229.

4. Zornitzki, T., Tshori, S., Shefer, G., Mingelgrin, S., Levy, C., & Knobler, H. (2022). Seasonal Variation of Testosterone Levels in a Large Cohort of Men. International journal of endocrinology, 2022, 6093092.