Does Creatine Cause Hair Loss? What the Viral Study Gets Right — and What It Leaves Out

Widely cited as conclusive proof, this new study has design flaws, conflicts of interest, and leaves key questions unanswered.

In late April 2024, a newly published study went viral across fitness forums and social media, with celebratory posts claiming it proved that creatine supplementation does not cause hair loss. The paper, titled "Does Creatine Cause Hair Loss? A 12-Week Randomized Controlled Trial," was quickly embraced as definitive evidence that creatine is completely safe for your hair — but a closer look tells a more complicated story.

The study was conducted by researchers affiliated with the International Society of Sports Nutrition (ISSN), a trade organization closely tied to the sports supplement industry. It was also published in the Journal of the International Society of Sports Nutrition (JISSN) — the official journal of the ISSN itself. While the study meets technical peer-review standards, the close relationship between the researchers, the organization, and the publishing body is important context when evaluating the findings, especially as they are amplified across social media.

Before diving into the study’s limitations, it’s important to first acknowledge its strengths. This was a well-organized, randomized, double-blind, placebo-controlled trial — the gold standard for clinical research. The authors made a sincere attempt to bring scientific structure to a conversation that has historically been dominated by anecdote. Measuring key hormonal markers (DHT, testosterone, free testosterone) alongside hair density and thickness reflects a thoughtful design intended to explore a biologic basis for these concerns.

That said, while the study's structure is commendable, structure alone does not guarantee that a study is definitive — particularly when dealing with a complex, gradual process like androgenetic hair loss.

The goal of this article is not to discredit the researchers, nor to spark unnecessary fear. Rather, it is to provide readers with the tools to critically evaluate scientific findings — particularly when those findings are rapidly amplified and simplified across social media by influencers, marketers, and even physicians eager to build online visibility.

Understanding what a study does and does not tell us is essential to making informed decisions about your health.

The truth is, we still don't know for certain whether creatine supplementation can exacerbate hair loss, particularly in those genetically predisposed to androgenetic alopecia. However, there are countless anecdotal reports from individuals across forums, social media, clinical observations — and even dating back to my nationally syndicated radio program between 1998 and 2009 — years before significant online concern about the phenomenon emerged. Back then, while few outside niche circles were aware of this potential connection, reports of hair shedding associated with creatine supplementation were still surprisingly prevalent.

Although no causal relationship was ever formally studied or proven, the consistency of these independent observations across decades should not be casually dismissed. It was not until 2009, after I retired from radio, that a small but notable study involving South African rugby players (van der Merwe et al., Clinical Journal of Sport Medicine) drew wider attention to the potential link between creatine supplementation and elevated DHT levels. This study found a statistically significant rise in DHT following creatine loading; however, it was extremely limited — involving only 20 participants, short-term hormone measurements, and no assessment of hair loss outcomes or genetic predisposition. Despite its flaws, the study amplified growing online concerns and helped push this conversation into broader public awareness.

It is important to clarify: creatine supplementation is not believed to directly cause hair loss. Rather, based on anecdotal reports and limited early observations, it may accelerate the underlying genetic process of androgenetic alopecia in those who are already predisposed. In other words, creatine supplementation may hasten the timeline for those who are destined to experience hair thinning, rather than trigger hair loss in someone who would not have otherwise been affected.

Let's walk through the facts:

1. Short Study Duration
The study lasted only 12 weeks. While this is not an unusually short timeframe for supplementation studies, it is critically short when attempting to assess complex biological processes like hair follicle miniaturization associated with androgenetic alopecia. Hair loss progression typically unfolds slowly over months or years, meaning a three-month study is unlikely to capture the real impact of subtle shifts in hormonal or follicular environments over time.

2. Participant Enrollment, Attrition, and Small Sample Size
Originally, 45 participants were enrolled in the study, but only 38 completed the full 12-week protocol. The publication does not specify the reasons why participants withdrew or were disqualified. While some level of attrition is expected in clinical research, the absence of detail makes it difficult to assess whether side effects, compliance issues, or other factors may have influenced the final results.

While the study used standard statistical tools such as repeated measures ANOVA and sensitivity analyses to check for outliers, these techniques cannot compensate for the limited power of the study due to its short duration and lack of participant stratification based on hair loss risk.

3. Lack of Creatine Loading Phase and Implications
An important methodological note is that this study did not include a typical creatine loading phase. In standard supplementation protocols, individuals take a higher daily dose (often around 20 grams per day) for about 5–7 days to quickly saturate muscle creatine stores, followed by a maintenance dose. Without loading, it typically takes about 28–30 days of consistent daily dosing to achieve comparable tissue saturation levels.

Because this study omitted a loading phase and relied only on maintenance dosing, it is possible that participants' muscles and systemic creatine stores were not fully saturated during much of the 12-week trial. This raises questions about whether any observed lack of change in DHT levels truly reflects a long-term steady-state effect of creatine supplementation. It is plausible that systemic DHT levels — and any potential downstream impact on hair follicles — would require more time or higher saturation levels to become meaningfully detectable.

4. No Genetic Screening for Hair Loss Risk
The study did not attempt to screen participants for a family history of androgenetic alopecia or determine whether they were genetically predisposed to hair loss. This is a major flaw. Hair loss from androgenic pathways typically only affects those who are genetically susceptible, and not accounting for this variable makes it impossible to truly assess risk.

Another important limitation is the exclusion of participants with a history of hair transplant surgery. Men who have undergone a hair transplant are, by definition, individuals with clinically significant androgenetic alopecia. They represent a population highly sensitive to even minor hormonal fluctuations at the scalp level. Even subtle shifts in scalp DHT — or other factors triggered by supplementation — could potentially accelerate miniaturization or induce telogen effluvium in this group. By excluding these individuals, the study removed those most likely to exhibit early or subtle signs of hair loss progression, further narrowing its ability to assess whether creatine supplementation poses a risk for those predisposed to or already managing androgenetic alopecia.

5. No Reports on Actual Hair Loss Experience
The primary outcomes measured were hormonal levels (DHT, testosterone, free testosterone) and hair parameters such as density and thickness. Participants were not surveyed or clinically assessed for noticeable hair shedding or loss — meaning we don't know if anyone actually experienced hair loss symptoms during the study.

6. No Assessment of Scalp DHT
While the study measured serum DHT levels, it did not measure DHT directly within the scalp — the site where androgenetic alopecia occurs. This is an important limitation. Scalp hair follicle miniaturization is driven primarily by local DHT activity at the tissue level, and serum levels may not accurately reflect what’s happening at the follicle. Tissue-specific activity of the enzyme 5α-reductase — which converts testosterone to DHT — varies significantly between individuals and is often elevated locally in the scalp of those genetically predisposed to hair loss. In fact, many men with “normal” or only slightly elevated serum DHT levels still experience progressive androgenetic alopecia due to high scalp DHT and local receptor sensitivity. This is precisely why treatments like topical finasteride, which reduce scalp DHT without dramatically affecting serum levels, can be effective. By relying solely on blood-based hormone measurements, the study may have missed the very mechanism most relevant to hair loss.

7. Conflict of Interest Concerns
Several of the study's authors have disclosed financial ties to supplement companies, including relationships with brands that sell creatine products. The research was conducted by individuals closely affiliated with the International Society of Sports Nutrition (ISSN), the same organization that publishes the Journal of the International Society of Sports Nutrition (JISSN), and which maintains close ties to the supplement industry.
While disclosure is important (and they did disclose), it doesn't erase the fact that industry funding and advisory roles present significant potential for bias. Research consistently shows that studies funded by industry are more likely to produce favorable outcomes for the funder.

8. Journal and Publishing Environment Concerns
The study was published in the Journal of the International Society of Sports Nutrition (JISSN), the official publication of the ISSN. While peer-reviewed and boasting a moderate impact factor, JISSN is a niche journal heavily focused on sports nutrition and supplementation, and is largely funded by supplement company sponsorships. Several of the study's authors are closely affiliated with the supplement industry through leadership roles and advisory connections.

While peer-review standards are technically met, studies published in highly specialized, industry-adjacent journals must be interpreted cautiously. Supplement-friendly narratives may be unintentionally incentivized within such ecosystems.

9. Hair Measurement Limitations
While the study utilized a Trichogram and digital imaging (FotoFinder) to assess hair density and cumulative shaft thickness, these methods are considered outdated by today's research standards. The Trichogram, first described in the scientific literature in 1964, involves manually plucking hairs for microscopic analysis. It offers only basic insights and samples an extremely limited scalp area.

Similarly, digital imaging systems like FotoFinder are heavily influenced by external factors such as lighting and scalp tension, which can easily skew results. Critically, the study did not employ advanced diagnostic tools now standard in professional hair research — including Cross-Section Trichometry (CST), regrown hair weight assays, or advanced trichoscopic imaging to track early miniaturization patterns and subtle hair shaft diameter changes.

Using a Trichogram in 2025 is akin to evaluating heart health with a stethoscope alone when high-resolution cardiac imaging is readily available — it provides a very limited picture and risks missing early, critical changes.

What the Study Actually Concluded The study authors ultimately concluded that 12 weeks of creatine monohydrate supplementation did not lead to increases in serum DHT, nor did it adversely affect hair density or cumulative hair shaft thickness in young, resistance-trained males. This conclusion, while accurate within the study’s limited framework, does not address broader or long-term implications — nor does it account for scalp-specific DHT activity, individual susceptibility, or the limitations of the measurement tools used. It is a narrow conclusion that has been widely interpreted as far more definitive than the study's design or data can reasonably support.

The Bottom Line

The new study adds some valuable information to the discussion but certainly doesn't "debunk" concerns about creatine supplementation and hair loss. At best, it suggests that short-term creatine supplementation does not significantly alter androgenic hormone levels or visible hair density in a small group of young, resistance-trained men without confirmed genetic risk factors.

Given the conflicts of interest, outdated measurement methods, absence of scalp-specific DHT assessment, and the study’s short timeline, these results should be viewed as just one small piece of a much larger, still-unfinished puzzle — not a definitive answer.

If you are genetically prone to male pattern baldness and are concerned about your hair, approaching creatine supplementation with informed caution remains a reasonable choice until larger, longer-term, and truly independent studies are conducted.

At the end of the day, navigating personal health decisions often means looking beyond the headlines — especially when the story is still being written.

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