Creatine and DHT: Current Evidence
Based on the available evidence, creatine supplementation does not reliably increase DHT levels and does not cause hair loss or other androgen-related concerns in most individuals.
Key Research Findings
The Original 2009 Study
The concern about creatine and DHT stems from a single 2009 study in rugby players that reported a 56% increase in DHT after 7 days of creatine loading (25 g/day) and a 40% elevation after 14 days of maintenance dosing (5 g/day), with the DHT:testosterone ratio increasing by 36% initially and remaining 22% elevated 1. However, this study had significant limitations: it involved only 20 participants, used very high loading doses, and has never been successfully replicated 1.
Recent Contradictory Evidence
A 2025 randomized controlled trial directly contradicts the 2009 findings, showing no significant changes in DHT levels, DHT-to-testosterone ratio, or hair follicle health after 12 weeks of creatine supplementation (5 g/day) in 38 resistance-trained males 2. This study was specifically designed to assess hair follicle health using objective measures (Trichogram test and FotoFinder system) and found no evidence that creatine contributes to hair loss 2.
Additional Supporting Evidence
A 2025 study in prostate cancer patients undergoing androgen deprivation therapy found that creatine supplementation (combined with resistance training) produced no additional effects on lean mass, muscle strength, or physical function compared to resistance training alone, suggesting creatine does not meaningfully alter androgen-mediated processes 3. Similarly, a 2019 protocol for a trial in the same population was designed to examine whether creatine augments resistance training adaptations, with no safety concerns raised regarding androgen manipulation 4.
Clinical Implications
For General Population
- Creatine supplementation at standard doses (5 g/day) does not appear to increase DHT levels or cause hair loss 2
- The single positive study from 2009 used supraphysiologic loading doses (25 g/day) that are not typically recommended for long-term use 1
- Direct assessment of hair follicle health showed no deterioration with creatine supplementation over 12 weeks 2
For Individuals with Androgen-Sensitive Conditions
While the evidence suggests creatine is safe regarding DHT levels, individuals with conditions sensitive to androgens (such as male pattern baldness, benign prostatic hyperplasia, or prostate cancer) should be counseled that:
- The theoretical concern about DHT elevation is not supported by recent high-quality evidence 2
- One older study showed DHT increases, but this has not been replicated and may have been due to unusually high dosing 1
- Standard maintenance doses (5 g/day) appear safe with no impact on androgen levels or hair health 2
Common Pitfalls to Avoid
- Do not extrapolate findings from the 2009 study using 25 g/day loading doses to standard 5 g/day maintenance dosing, as the recent trial using standard doses found no DHT elevation 1, 2
- Do not assume creatine causes hair loss based on theoretical DHT concerns, as direct assessment of hair follicle health showed no negative effects 2
- Do not confuse creatine supplementation with testosterone replacement therapy, which does have documented effects on DHT levels through aromatization and 5-alpha reductase conversion 5
Strength of Evidence Assessment
The 2025 randomized controlled trial provides the highest quality evidence on this question, as it was specifically designed to address the DHT/hair loss concern with objective outcome measures and found no effect 2. This directly contradicts the single 2009 study, which had a small sample size and used non-standard dosing 1. The weight of current evidence strongly favors the conclusion that standard-dose creatine supplementation does not increase DHT levels or cause hair loss.