Creatine is a dietary supplement recognized for its effectiveness in improving the physical performance of athletes. Used in conjunction with an appropriatetraining program, it is without risk to health.
Yet false beliefs about its effects persist, including a risk to hair. Does creatine accelerate hair loss? If the idea persists, it's because of the supposedly increased levels of DHT in the body, indirectly linked to taking a creatine supplement. Let's take a look at how science came up with this myth, and the role of different substances in hair loss.
Contents
Understanding creatine: definition and function
What is creatine?
Creatine (or N-(aminoiminomethyl)-N-methyl glycine in scientific language) is a natural, non-essential nitrogen compound, derived from 2 distinct sources.
Firstly, it is endogenous, i.e. it is synthesized by the body, in the liver and kidneys via amino acids, to the tune of around 1 g/day.
Secondly, it is ingested through thediet in similar quantities (1g/d), notably through meat and fish, as creatine is concentrated in animal muscles. This explains why creatine levels in people on a vegetarian diet are low.
It's also a very popular dietary supplement, used in sports to improve physical performance.
Not to be confused with creatinine! Creatinine is a metabolic waste product resulting from the breakdown of creatine. It is released into the bloodstream and eliminated by the kidneys. Thus, creatine is a molecule useful for performance, while creatinine is a medical indicator, notably for assessing renal function via blood or urine tests.
What is creatine used for?
It is used to increase thebody's energy for short, intense efforts.
Most creatine is stored in the muscles, in the form of creatine or phosphorylcreatine. It plays a role in the resynthesis of ATP, a muscle cell's energy source. Although it rapidly produces energy, it has a low storage capacity, sufficient for 8 to 10 seconds of maximum effort.
Studies¹ show thatsupplementing with creatine monohydrate:
- increases muscle creatine and phosphocreatine concentrations by 15 to 40%;
- improves anaerobic exercise capacity (short, intense effort);
- increases training volume.
In short, it has an effect on strength and power gains. It also indirectly promotes muscle mass growth, by increasing training capacity.
The aim of supplementation is therefore to increase muscle reserves of creatine and phosphorylcreatine to optimize performance during intense exercise.
A small amount of creatine is also found in the brain, where it produces energy. Supplementation can increase brain creatine levels, but the phenomenon is less marked than in muscles. In terms of benefits, creatine intake has a positive influence on cognitive processing and potential damage reduction. As a result, recovery from mild traumatic brain injury is enhanced.
The different forms of creatine
Creatine monohydrate is the most common form, and the only one scientifically recognized as safe and effective. It is a white powder incorporated into a liquid or food, such as yoghurt.
Creatine should be ingested immediately after mixing, as it degrades rapidly.
Other forms were then developed: anhydrous creatine, nitrate, ethyl ester and others. Manufacturers claim better physical and chemical properties, greater bioavailability, etc.
Yet the absorption rate of creatine monohydrate is over 99%, and no other form of creatine can scientifically claim better bioavailability. What's more, the 2011 study, confirmed in 2022², states that there is no scientific reason to take any form of creatine other than creatine monohydrate. Its safety and efficacy are the only ones clearly recognized by the scientific community and authorities worldwide.
In Europe, creatine monohydrate is the only product to have received a positive opinion from the European Food Safety Authority (EFSA).
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Does creatine accelerate hair loss? What science says
Does creatine influence DHT production?
A 2009 study by Van der Merwe et al. on rugby players is at the heart of the debate.
In particular, it concluded that there was a 56%increase in dihydrotestosterone (DHT) concentration after creatine supplementation. Since DHT has been recognized as a contributory factor in the pathogenesis of baldness³, the shortcut to the association between creatine and hair loss was made.
Yet a 2021⁴ study on beliefs around creatine reminds us that:
- The results of this study have never been reproduced.
- An increase in overall testosterone levels was not observed in Van der Merwe's study.
- Pre-supplement DHT levels were 23% lower in the creatine group than in the control group, partly explaining the observed increase.
- Resistance exercise can induce an increase in androgenic hormones such as DHT.
- 12 other studies on the effects of creatine on testosterone showed no significant change in levels.
No study today therefore proves that taking creatine increases total testosterone, DHT and causes hair loss ⁴
Is DHT responsible for alopecia?
Baldness, most commonly found in men, is known as androgen-dependent alopecia.
The problem lies in the life cycle of the hair, known as the terminal hair follicle (THF). In the latter, it's the link between DHT and androgen receptors (AR) that causes the problem.
Under normal circumstances, each follicle undergoes 10 to 30 regeneration cycles consisting of three phases:
- a growth phase (anagen) ;
- an involution phase (catagen);
- a resting phase (telogen).
This cyclical system is located within the follicle itself, where the dermal papilla (DP) is considered a command center. This is where the signals to alternate the three phases of the life cycle and regulate hair formation originate.
In baldness, hair miniaturization is linked in part to the excessive density of androgen receptors (AR) in the cells of the command center (DP), which alters the famous signals.
Individual variability in the face of alopecia
Genetic factors involved
Unfortunately, the heredity rate for this condition in men is 80%.
Individuals with a genetic predisposition to alopecia actually have PDs with a higher density of androgen receptors (ARs) and increased 5α-reductase type 2 activity.
DHT binds to ARs and changes under the action of 5α-reductase type 2, disrupting the signaling triggered in the hair cycle.
It should also be noted that, whilealtered signaling has been highlighted as the main cause of this disease:
1. Their mechanisms have not been clearly elucidated to date, and remain researchers' greatest concern when it comes to treating the disease.
2. DHT, through its relationship with AR receptors, is recognized as the culprit, but is only one piece of the whole systemic organization responsible for this disease.
3. There are many factors involved in alopecia, including a high degree of genetic heredity.
Other causes of hair loss
In addition to predisposition, other factors play a role in alopecia:
- severe stress;
- taking certain substances such as dexamethasone;
- environmental factors such as pollution or UV exposure;
- lifestyle habits (smoking, sport and nutrition) ;
- aging.
These different origins influence gene transcription, leading to protein imbalances such as in androgens.
Conclusion
False beliefs about the effects of creatine supplementation persist, including an adverse effect on hair loss. Does creatine accelerate hair loss? It's tempting to believe that creatine helps you build muscle and testosterone. This could increase DHT levels and promote hair loss, but to date there are no studies to prove this.
Alopecia is a pathology linked to a number of interdependent, synergistic causes. Its mechanism lies in the signals sent by the control center inside the hair follicle itself, and to this day remains mysterious. Dihydrotestosterone is just one part of the much more complex baldness system. This is why creatine cannot be said to accelerate hair loss.
Further information
- To get to the bottom of preconceived ideas, find out whether creatine has an impact on libido or sexual performance.
- Find out whether eggs naturally contain creatine, an often overlooked aspect of sports nutrition. You can also find out more about the potential link between creatine and tendonitis.
- If you're wondering whether creatine can be used in pre-workout, we explain when and how to take it to get the most out of it.
- Wondering which drink to take creatine with: water, milk or the creatine + coffee combination? We've got the answer.
- Finally, does taking creatine before bed affect sleep? Find out in our dedicated analysis.
