Does creatine cause hair loss?
Current research shows that creatine does not raise DHT and has no effect on hair follicle health. There is no need to avoid creatine out of fear of hair loss.
No, creatine does not cause hair loss. That idea originates from one small, old study that observed elevated levels of the hormone DHT (dihydrotestosterone). DHT plays a role in hereditary baldness, so the reasoning seemed logical. But that study never directly measured whether people actually lost any hair.
The only study that directly investigated hair loss showed that this fear has no basis. Men who took 5 grams of creatine monohydrate daily for twelve weeks had exactly the same DHT levels at the end as the group that received a placebo. The ratio of DHT to testosterone did not differ either. The researchers also measured hair follicles directly: hair density, the number of follicular units, and total hair thickness. After twelve weeks, there was not a single difference to be seen between the two groups. Two international expert panels reached the same conclusion after reviewing all available evidence: there is no scientific basis for the claim that creatine causes hair loss.
Creatine has not been studied enough as a treatment for hair loss to recommend it for that purpose. If you want to use creatine for muscle strength or lean body mass, choose creatine monohydrate in powder or capsule form. The label will read 'Creatine monohydrate'. More expensive variants such as HCl, citrate or malate offer no proven advantage and are not worth considering. Take 3 to 5 grams per day and do so for at least 8 to 12 weeks. Hair loss is not a known side effect of creatine monohydrate, and there is therefore no reason to avoid it out of fear of that. The findings described apply to periods of up to twelve weeks in young men; one caveat is that several authors have ties to Alzchem, the manufacturer of creatine.
This answer is based on one randomised study involving 38 trained men and two international expert reviews. The randomised study is relatively small, but it measures both hormone levels and hair follicle health directly. The review publications support the conclusion on a broader literature base. The evidence regarding hair loss in women or with long-term use (longer than twelve weeks) has not been specifically examined in these sources.
Do you need to do a loading phase with creatine?
A loading phase is not necessary, but it does speed up the build-up of creatine in your muscles. Choose a loading phase if you want fast results, or simply take 3 to 5 grams daily if you have more patience.
Why don't doctors always recommend creatine?
Creatine is well supported for building muscle during strength training and is safe for healthy people. For other goals, such as mental health complaints or fat loss, the evidence is too mixed to base a recommendation on.
Does creatine put a strain on your kidneys?
For healthy people without kidney disease, creatine monohydrate at normal doses is not harmful to the kidneys, although it can raise a blood marker that resembles signs of kidney problems. If you have diabetes, high blood pressure, already reduced kidney function, or are taking medications that are hard on the kidneys, discuss it with your doctor first.
What is best not to combine with creatine?
Combining creatine with caffeine powder adds nothing to your performance and increases the risk of gastrointestinal complaints; ready-made pre-workout blends with many ingredients carry additional risks due to possible contamination and unknown long-term effects.
Does creatine help with weight loss?
Creatine is not a slimming aid and is not recommended for fat loss as a primary goal. If you combine it with strength training, your body composition improves modestly: slightly less fat, more muscle mass.
Does creatine do anything to your immune system?
Creatine influences immune cells via a specific switch, but whether the outcome is favourable or unfavourable depends strongly on the situation. For boosting immunity or preventing infections, there is too little evidence in humans to recommend it.