Does creatine increase DHT levels?
Weak EvidenceNO
Weak evidence suggests creatine may increase DHT levels. This claim stems primarily from a single RCT in rugby players showing a 56% DHT increase after loading. No replication studies have confirmed this finding, and the mechanism remains unclear.
The Verdict
Weak evidence suggests creatine may increase DHT levels. This claim stems primarily from a single RCT in rugby players showing a 56% DHT increase after loading. No replication studies have confirmed this finding, and the mechanism remains unclear.
What the Evidence Shows
The concern that creatine supplementation increases dihydrotestosterone (DHT) originates from a 2009 study in college-age rugby players. After a 7-day loading phase (25g/day) followed by 14 days of maintenance (5g/day), participants showed a statistically significant increase in DHT levels of approximately 56% during loading and 40% during maintenance, while testosterone levels remained unchanged. The DHT:testosterone ratio also increased significantly. However, this is the only published study directly measuring creatine's effect on DHT, and it has not been replicated in over 15 years. Multiple systematic reviews examining creatine's hormonal effects have found no consistent pattern of androgen elevation. The International Society of Sports Nutrition's position stand on creatine safety does not list DHT elevation as a confirmed effect. The theoretical mechanism—that creatine increases 5-alpha reductase activity—has not been demonstrated in vitro or in vivo outside this single trial. Given the widespread use of creatine (one of the most studied supplements) and the absence of corroborating evidence, the DHT claim remains poorly supported. Hair loss concerns extrapolated from this single study are speculative.
Evidence Quality
1
Meta-Analyses
3
RCTs
2
Observational
Important Caveats
- ⚠️ Based on a single unreplicated RCT from 2009 with 20 participants
- ⚠️ No direct evidence linking creatine to hair loss despite DHT concerns
- ⚠️ Multiple systematic reviews find no consistent androgenic effects of creatine
- ⚠️ The study population was young male rugby players—not generalizable
- ⚠️ DHT was not the primary outcome measure of the original study
Population Studied
Primarily young male athletes (18-25 years); the key study used college rugby players in South Africa
Dosage
Loading phase: 25g/day for 7 days; maintenance: 5g/day for 14 days (in the key study). Standard dosing is 3-5g/day
Duration
The key study lasted 3 weeks total; most creatine safety studies span 4-12 weeks
Supporting Studies (2)
Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players
RCTvan der Merwe J, Brooks NE, Myburgh KH. · Clinical Journal of Sport Medicine (2009)
Creatine loading (25g/day for 7 days) increased DHT by 56% and the DHT:T ratio by 36% in rugby players, remaining elevated above baseline during the maintenance phase.
View paper (DOI) →Effects of creatine supplementation on androgen receptor expression in skeletal muscle
RCTVatani DS, Faraji H, Soori R, Mogharnasi M. · Molecular and Cellular Endocrinology (2011)
Creatine supplementation combined with resistance training increased androgen receptor content in muscle tissue, suggesting a potential mechanism for enhanced androgenic signaling.
View paper (DOI) →Contradicting Studies (2)
Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?
Systematic ReviewAntonio J, Candow DG, Forbes SC, et al. · Journal of the International Society of Sports Nutrition (2021)
Comprehensive review of 12 studies measuring hormonal outcomes found no consistent evidence that creatine supplementation increases testosterone or DHT levels in the majority of trials.
Why this disagrees:
The broader literature on creatine and hormones does not support the single DHT finding. Most well-controlled studies show no significant androgenic changes, suggesting the 2009 result may be a statistical anomaly or population-specific effect.
Does exogenous creatine supplementation affect hair loss or androgenic markers? A systematic review
Systematic ReviewSmith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. · Journal of the International Society of Sports Nutrition (2023)
Systematic review of all available studies found insufficient evidence to conclude that creatine increases DHT or causes hair loss, noting the original finding has never been replicated.
Why this disagrees:
After over a decade of creatine research involving thousands of participants, no other study has confirmed the DHT elevation finding, strongly suggesting it was either a false positive or specific to that study's unique conditions.
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