The fact that creatine consumption causes alopecia has been spread ad nauseam, due to the fact that, as often happens, data from studies are extrapolated without knowing how to interpret them. As I receive questions on this subject on a daily basis, I have decided to write this post openly. Let’s see then if creatine causes alopecia.
Does creatine consumption cause alopecia?
This argument comes from the study by Van der Merwe et al 2009 (it is the only one in this regard), where it was found that creatine supplementation for 3 weeks in college rugby players, increased Dihydrotestosterone (DHT) by 56% during the loading phase with creatine (25 gr per day of creatine) and 40% during the maintenance phase (5 gr per day of creatine).
2.- The aim of the study was not even to evaluate whether creatine could promote alopecia, so they do not measure this event, but only provide data on this increase in DHT when creatine is consumed.
DHT is produced by the conversion of testosterone by means of 5-alpha-reductase, and in hair follicles it can promote alopecia as it shortens the anagen phase of the hair (growth) and accelerates the telogen phase. Drugs such as finasteride inhibit 5-alpha reductase to limit the conversion of testosterone to DHT.
Therefore, after this study, it was extrapolated and the idea was put forward that creatine increased DHT and this would cause alopecia. But correlation does not mean causation, so it cannot even be said that creatine directly increases DHT. For example, perhaps thanks to the ergogenic effects of creatine, the subjects trained more intensely and this increased intensity may have increased DHT. Not even a mechanistic link is established as to why creatine would increase DHT.
5.- In addition, the size of the effect and relativity must be assessed. When expressing the data in percentages, the 56% increase in DHT and then 40% in the maintenance phase is striking. However, in real data, at the end of the study, the DHT of the placebo group was 106 nmol/L and the concentrations of the group taking creatine was 136 nmol/L (table in the image). This means that although there was an increase in DHT in the subjects taking creatine, this increase is perhaps not substantial enough to cause severe alopecia, since subjects with alopecia usually have almost double the DHT concentrations in blood than the concentrations obtained in the group taking creatine.
To date, there is no evidence to say that creatine causes alopecia.
Thus, to date there is no evidence or data to say that creatine causes alopecia, since the only study that exists (the fact that there is only one is already a limitation) does not even measure this event, does not establish a clear causal relationship between creatine consumption and increased DHT and it cannot even be concluded that this increase in DHT is substantial enough to cause substantial alopecia.
Nor can we say categorically that creatine cannot promote alopecia.
On the other hand, neither can we say categorically that creatine cannot favor alopecia, we can simply say that to date there is no evidence that makes us think that it does, so we must wait for future studies that investigate this fact correctly to draw conclusions. Perhaps people with a tendency to alopecia may be a little apprehensive about this fact, but the data available are not really significant enough to say that creatine consumption can significantly aggravate alopecia.
For the time being, and until there are no more reliable studies on the subject, you can take creatine without fear that you will see the cardboard, your trip to Turkey can wait 😉