Creatine Supplements and Hair Loss
Creatine monohydrate supplementation does not cause hair loss, based on the most recent and highest quality direct evidence from a 12-week randomized controlled trial that specifically measured hair follicle health and found no adverse effects on hair density, follicular unit count, or cumulative hair thickness. 1
Direct Evidence on Creatine and Hair Loss
The concern about creatine causing hair loss stems from a single 2009 study suggesting increased dihydrotestosterone (DHT) levels, but this has never been directly validated with actual hair follicle measurements until recently. 2
The 2025 randomized controlled trial provides definitive evidence:
- 45 resistance-trained males (ages 18-40) received either 5g/day creatine monohydrate or placebo for 12 weeks 1
- Hair follicle health was directly assessed using the Trichogram test and FotoFinder system measuring hair density, follicular unit count, and cumulative hair thickness 1
- No significant differences were found in DHT levels, DHT-to-testosterone ratio, or any hair growth parameters between creatine and placebo groups 1
- This was the first study to directly assess hair follicle health following creatine supplementation, providing strong evidence against the claim that creatine contributes to hair loss 1
Guideline Perspective on Creatine Safety
The British Journal of Sports Medicine recommends creatine monohydrate as an effective ergogenic aid with minimal concerns, noting that the main documented concern is potential for 1-2 kg body mass increase, not hair loss. 3 The guideline explicitly states no negative health effects follow appropriate supplementation protocols. 3
Common Causes of Hair Loss to Consider Instead
If you're experiencing hair loss while taking creatine, investigate these evidence-based causes:
Nutritional deficiencies:
- Iron deficiency (ferritin ≤15 μg/L) is the most common nutritional cause of hair loss worldwide 4
- Vitamin D deficiency (<20 ng/mL) shows 70% prevalence in alopecia areata patients versus 25% in controls 5
- Zinc deficiency impairs hair follicle function 5
Hormonal and autoimmune conditions:
- Thyroid dysfunction (check TSH and free T4) 5
- Androgenetic alopecia related to DHT sensitivity 5
- Alopecia areata (autoimmune T-lymphocyte attack on hair follicles) 5
Other triggers:
- Telogen effluvium from physiologic stress, illness, surgery, rapid weight loss 5
- Medications (chemotherapy, anticoagulants, beta-blockers) 5
Recommended Diagnostic Workup for Hair Loss
The American Academy of Dermatology recommends baseline testing for any woman presenting with hair loss: 4
- Complete blood count (CBC)
- Serum ferritin (most important test for iron stores)
- TSH
- Transferrin saturation
Additional testing based on clinical presentation: 5
- Vitamin D levels
- Zinc levels
- Total testosterone or free testosterone with SHBG if signs of androgen excess present
- Dermoscopy to differentiate alopecia areata from telogen effluvium and androgenetic alopecia
Clinical Bottom Line
Creatine supplementation at recommended dosages (3-5 g/day) is safe and well-tolerated with no evidence of causing hair loss. 2, 1, 6 Studies consistently show creatine is safe even with long-term use in healthy individuals. 6 The 2025 direct measurement study definitively refutes the hair loss concern. 1
If experiencing hair loss, pursue proper diagnostic evaluation for the actual common causes listed above rather than discontinuing creatine supplementation. 4, 5