If you’re a serious athlete, weekend warrior, or want to stay healthy, you’ve probably heard of the supplement creatine. It’s a fast-acting energy source that allows you to push your body harder, work out longer, and recover faster. That all sounds great, but there are whispers that the benefits come at a price: hair.
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Registered dietitian Kate Patton, MD, RD, CSSD, LD, discusses the positive and negative effects of creatine. She reveals the truth about creatine and hair loss and shares what you need to know about creatine’s other possible side effects.
What is creatine?
Creatine helps produce adenosine triphosphate (ATP), the energy that keeps your muscles active. Creatine is obtained from the diet and produced by the liver, kidneys, and pancreas.
“We get very little creatine from our food, and our bodies only produce a few grams each day,” Patton says. “When you supplement with creatine, your body stores it in your muscles before converting it into the energy needed for acute exercise.” The recommended daily intake of creatine is 3 to 5 grams.
However, creatine should not be confused with anabolic steroids or proteins. Creatine improves ATP production, but steroids affect muscle growth.
Creatine and steroids: Creatine is an amino acid. Its chemical structure is completely different from steroids, and its effects on the body are also different. Creatine improves ATP production, but steroids affect muscle growth. Creatine and protein: Creatine and protein both support healthy muscles, but they have different roles. “Creatine provides fast-acting energy and improves the ATP system,” says Patton. “Protein is not as efficient an energy source as creatine. It helps build and repair new muscle fibers.”
Can creatine cause hair loss?
Concerns about creatine and hair loss stem from creatine’s effects on the hormone dihydrotestosterone (DHT). DHT is a byproduct of testosterone. It can attach to hair follicles and eventually cause hair loss. Some experts suggest that creatine may increase DHT.
A 2009 study of collegiate rugby players reported a 56% increase in DHT after taking the supplement (and higher doses of creatine) for seven days. However, no study has been able to reproduce that result. An additional 12 studies have examined the effects of creatine on testosterone. No one reported significant hormonal increases.
“If you’re concerned about your testosterone, talk to your GP or endocrinologist before using creatine,” Patton advises. “However, there is no conclusive evidence to suggest that creatine increases testosterone or causes hair loss.”
Other possible side effects of creatine
Research on creatine is limited and there is no clinical evidence of negative side effects. However, the effects of creatine vary from person to person, and participants in some small studies have reported some side effects.
Some of the suspected and reported side effects of creatine include:
1. Water retention
The most commonly reported side effect of creatine is water retention, especially during the first few days after use. Creatine is transported to the muscles along with sodium (salt), which binds water.
However, experts have not proven that creatine increases total water content (compared to muscle mass) in the body over the long term. They believe that as muscle mass increases, the total amount of water in the body also increases. However, the ratio of muscle mass to total body water remains unchanged.
“Water retention is more likely to occur during a creatine ‘loading phase’. Athletes may take higher doses of creatine for several days to optimize performance,” Patton says. explains. “However, if you take the recommended daily dose of creatine, you won’t notice any water retention.”
2. Kidney damage
In 1998, a case study of people who took creatine supplements reported that creatine worsened kidney health. Since then, researchers have studied the effects of creatine supplements on kidney function. They found no adverse effects associated with the recommended creatine dose.
“There is no conclusive evidence of kidney damage, but if you have chronic kidney disease or renal insufficiency, it’s a good idea to avoid creatine,” says Patton.
3. Dehydration and muscle cramps
Typically, people use creatine when they are doing high-intensity exercise, which means they are sweating. There are concerns that the combination of sweat and possible water retention in the muscles can cause dehydration and muscle spasms.
Some people report cramping and dehydration when using creatine, but there is no research-based evidence to prove this. On the contrary, previous studies in athletes found that creatine supplementation reduced cramps, sometimes by as much as 60%.
Use creatine safely
Consult your healthcare provider before adding any supplements to your diet. Take only the recommended daily amount unless directed by your health care provider.
As a supplement, creatine is not approved by the U.S. Food and Drug Administration (FDA). This means that safety and effectiveness are not regulated.
To ensure you’re using the best possible product on the market, Patton recommends using brands certified as safe. Independent third-party testing companies, such as the National Safety Foundation and Informed Choice, evaluate products. They test supplements for banned substances and check ingredients.
“If creatine has been tested by a third party, there will be a certification label on the product packaging,” says Patton. “Safety certification provides some reassurance for products that are not regulated by the FDA.”
