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Creatine Increases Dihydrotestosterone (DHT): Is Creatine Bad For Your Health?

December 18 2009

Is creatine bad for your health? The recent study shows an increase in DHT (dihydrotestosterone) as one of the side effects of creatine and raises some interesting questions about the safety of long-term creatine use.

creatine monohydrate & DHT

What is DHT & is it Harmful?

DHT (dihydrotestosterone) is male hormone formed in the hair follicles, testes, prostate and adrenal glands.

Apart from the benefits, DHT is a contributing factor for male pattern baldness and plays a key role in Benign prostate hypertrophy.

Prostate cancer is strongly linked to male hormones, and recently DHT has been associated (not causative) with prostate cancer.

What was the creatine & DHT study design?

The study was well designed to minimize biases and errors.

creatine DHT study design

Double Blinded:
The study was double blinded and hence the researchers and the subjects did not know if they were getting creatine or placebo.

Cross over design: As shown in the pic, the study used a cross over design so that every subject receives both creatine and placebo, thereby minimizing the errors and the need for a large group of subjects.

Groups: Subjects loaded with creatine (25 g/day creatine with 25 g/day glucose) or placebo (50 g/day glucose) for 7 days followed by 14 days of maintenance (5 g/day creatine)

What were the results of the creatine & DHT study?

The major findings of the study were:

DHT: The levels of DHT increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (significant)

Ratio of DHT to T:  The ratio of DHT:T also increased by 36% after 7 days creatine supplementation and remained elevated by 22% after the maintenance dose.

The ratio tells us that the increased DHT levels are not because of a higher testosterone levels but a greater conversion of T to DHT.

So is creatine bad for your health?

  • Bad News: For the first time, the study shows a significant increase in DHT levels (at loading & maintanance phase), and as mentioned above DHT is contributing factor for male pattern baldness and is associated with prostrate cancer.
  • Almost all the studies done on the safety of creatine were short term. Only a handful of long-term studies exist and they only lasted for a year.  So the long-term safety of consuming creatine for 5-10 years is still not conclusive.
  • Good News: There has been a number of studies in humans showing creatine has no adverse effects, barring the gastric upset in a few folks.
  •                
  • People have been using creatine for years and we haven’t heard much about people losing hair and getting prostate cancer.
  • A high DHT to testosterone ratio do not always mean that you will get prostate cancer. Like all cancers, the cause of prostate cancer is multi factorial and cannot be pinned down to one factor.
  • In research, controversial findings like these need to be replicated in other labs before it can be taken seriously.

Reference 1
Prostate cancer prevention trial

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Jim@TBF | Sun December 20, 2009  

Interesting as I am a big CM user and promoter. I was actually part of an EAS beta for their product “Phosphagen” over 10 yrs. ago. The only side I have felt is muscle gain and thankfully at 37 I still have a full head of hair after many yrs. of use.

I will wait and see however.

Jim

Aaron | Thu December 31, 2009  

One thing that I’m curious about is whether exercise, which has so many proven health benefits, will have enough of a counter-effect on the DHT. Since just about the only people using creatine supplements are working out (hopefully hard), is this taken into consideration as far as the possibility of an increased occurrence of getting prostrate cancer? Does this increase in DHT mean the same to a regular exerciser as it does to someone that does not exercise in regards to prostrate cancer?
I’m already a chrome-dome so as far as male pattern baldness goes that’s no big deal to me.

Anoop | Thu December 31, 2009  

Hi Aaron,

That’s a good question.

From what little I have read about exercise & prostrate cancer, exercise seems to reduce the risk of prostrate cancer. But there was a recent study which showed no effect of exercise on prostrate cancer risk. If you think about it, exercise seems to have a favorable effect of anything these days.

And just reminding, I didn’t mean to say that people who take creatine will end up with prostrate cancer. I think the study raises an interesting question which needs further investigation.

robert salyer | Mon March 08, 2010  

i developed prostate cancer at the young age of 44..i was a creatine user for 12 years and had always suspected it as it always caused some urinary issues with me from the moment i took it [probably due to creatine inflamation]
  This artice of creatine causing increases in dihydrotestosterone reinforces my concern that the creatine contributed to my condition…by the way, i was incurable and stage 4 upon diagnosis..I am so far doing alright at 47..

Anoop | Wed March 10, 2010  

Hi Robert

I am sorry to hear about the cancer, but glad that you are doing alright.

I think it is too early to say anything about the creatine and DHT link. There are too many factors that prevent us from pinning your cancer to creatine.

BR | Sat March 20, 2010  

Prostrate?  Seriously?

BR | Sat March 20, 2010  

Hi BR,

Thanks for the correction. Changed it.

Personal Training Melbourne | Fri June 18, 2010  

Good post and interesting facts, as a creatine user myself will be keeping a close watch!

Sirdon | Fri June 18, 2010  

Iam really worry,i do take creatine with dextrose and vitamin c and antoxyforte cap,should i discontinue?

Sirdon | Mon June 28, 2010  

Iam taking creatine for the last 10 mths,but mine hair is intact…

Diggler | Wed July 07, 2010  

I’ll contribute my $.02.
I started taking creatine in the spring of 2006.
By next summer, my wife noticed my hair was thinning at the crown of my head.
By 2009 my hairline had moved back about 1/2 inch.
I had googled Creatine-and-hairloss several times during the course of these 3 years and despite hearing from many ‘experts’ that creatine has no effect on hair loss, I read dozens upon dozens of personal stories who contradicted this.
In fact, one hair-doctor posted a number of emails from people asking if creatine killed hair. This doctor remarked that he got these letters all the time.

Since quitting in 2009 my hairline and thinning on the crown have appeared to stop. In fact, my hair is thicker now than it was a year ago. My barber even started using thinning shears again.

But just to make sure my imagination wasn’t playing a trick on me I went through many photo’s and videos of myself from 2000 until 2006 to see if my hairline was naturally receding.
I showed pictures of myself during that time frame and tried to have my wife guess what year it was from. She never got it right. In fact, in photo’s where I was 33 (before Creatine) she routinely guessed thought I was in my 20’s. My hairline was the exact same for over half-a-decade.
But when I showed her photo’s of my hair from 2007 and 2008 (after a year or more of Creatine) it was night-and-day. She hadn’t realized it because she lived with me. And my friends noticed it too.
And the kicker? Not one male on either side of my family has any hair loss. Both my grandfathers, well into their 80’s, have hair John Stamos would be jealous of.
The same goes for my father, my brothers and uncles and cousins on both sides of the family. We look like a large group of Baldwin’s for crying out loud.
So that’s why I knew genetics weren’t playing a mean trick on me.

I’ve started taking Saw Palmeto and a multi-vitamins (Vitamin B and E) to help lessen the affects that creatine ravaged on my hair but it’s disappointing that I sacrificed a great hairline for more muscle. So while I was making one part of me look better, I hampered my appearance from the neck up.

I’m just happy I caught it before I did major damage. The thinning in my crown isn’t noticeable unless I’m under intense light and my hair is wet. But my hairline took a beating and can’t be ignored by most. It just sucks that I’ll have to live with that the rest of my life.
I hope others read this and don’t fall into the same mistake I did.
Stay away from creatine. It’s not worth it.
It’s a quick fix for extra muscle. But if you do it right (like I am now) by eating healthier and consuming more natural foods filled with protein, not only will you look great, but you’ll be naturally bigger too. Win-win.

Sirdon | Wed July 07, 2010  

Buddy iam taking creatine for the last 1 year but mine hair is still intact,no side effects of hair loss.

Sirdon | Thu July 08, 2010  

http://www.creatinemonohydrate.net/long-term-creatine-use

Steve | Sun July 11, 2010  

So,

1. Creatine is not for everyone.

2. Some people are negatively affected by DHT; some people are not.

Anoop | Thu July 15, 2010  

Hi Sirdon,

It is still inconclusive about creatine and DHT. We need more studies and I am sure we will see one soon.

Hi Steve,

Creatine and weight training seems to significantly increase DHT in short term. We do not know this will happen in long term. We do not know if this short term increase in DHT can cause hair loss or prostate cancer. 

Thanks for the comments guys.

sasoconga | Wed November 24, 2010  

i am truly sorry to hear about your prostate cancer, however why would anyon want to take creatine for more than a year straight.any supplement no matter how safe, always has damaging long term effects. ex… vitamins are supposed to supplement our diet, but when taken over a long period of time they will store excess of any natural substance in your body and cause negative effects in your body. everything should be taken in intervals or cycles so that your body has an opportunity to refresh or clean itself.

Kurtis | Tue December 07, 2010  

The people that go bald have a less chance of getting prostate cancer, and the people that don’t go bald have a higher chance of prostate cancer. It was on the news about 3 months ago on a find about balding and prostate cancer.. Im 20 and have a receding hairline. My dad is balding and my grandpa was fully top head bald at 21.. So of course im gunna be bald.. hahaha

JJ | Sat January 15, 2011  

I have heard about all this DHT stuff lately because I am losing some hair all of a sudden.  I am thinking of eating much more healthy organic food instead of any shakes.  Also, have you heard about DHT production with frequency of ejaculation?  I was wondering if any good clinical studies have been done for that.
It seems more speculation at this point that sex=DHT…It’s very weird if nobody has performed a proper clinical study to test the link between the two.

Anoop | Mon January 17, 2011  

Hi JJ,

I am aware of no studies which looked at this issue. I don’t think there is a link considering there is no biological link between ejaculation/sperm and DHT.

Louis | Fri February 25, 2011  

Just make sure you guys don’t try to reduce your dht levels too much, trust me DHT is a very useful and misunderstood hormone. DHT is absolutely essential for libido, erection quality and being able to blow more than one load a day. DHT blockers have messed with my sex life so bad, I think i’m gona try creatine and a heavy workout routine and see if this will raise my DHT levels so I can function again.

Anoop | Sun February 27, 2011  

Hi Louis,

Thanks for the comment.

I think what you need is an endocrinoligist instead of creatine.

louis | Sun February 27, 2011  

Hey anoop, can endocrinologists do anything to treat low dht levels?

Anoop | Sun February 27, 2011  

Hi Louis

There are are pharmacological agents that can raise DHT levels. But, more importantly, they need to make sure you indeed have low levels and why you have those levels.

I would be very wary messing with all these hormones. It is better to leave those to people who know about it.

louis | Sun February 27, 2011  

I agree however doctors in canada seem to tell me I have nothing more than psychological problems. Its very fristrating. That’s why I’m going to the mayo clinic in phoenix in a couple weeks. Hopefullu they can undoe this mess accutane got me into

Juarez | Fri March 25, 2011  

Have there been any new studies on this tie between creatine and dht?

Anoop | Sun March 27, 2011  

Hi Juarez,

I haven’t seen any and I just checked. Why? Are you losing hair (:-

Pauly | Mon March 28, 2011  

So I started working out hard and taking supplements about a 2 years ago. I’ve began to notice my hair thinin quite a lot. My question is If I top taking supplements will my DHT levels go back to how they were before? Or after they are raised they remain high? Any suggestions?

Greg | Sun April 10, 2011  

I, like Jim@TBF took EAS Phosphagen at a young age, however I lost a lot of hair while taking it (in my early/mid 20’s).  Subsequently after discontinuing use, my hair loss stopped.  I loved the results that I got from CM, but I could tell something was making my hair fall out excessively at an early age.  Now, at the age of 38, I have decent hair but maintain the same hairline.  I believe this study whole-heartedly.  I haven’t touched Creatine since, and I feel like that has saved my remaining hair.

TJ | Wed September 07, 2011  

I took CM for about a year.  Some hairline issues that my wife noticed over time, and I thought was just aging, but no baldness in my family either.  The bigger issue was that I ended up in the hospital for six days with what seemed like heart issues/palpitations.  Turned out my magnesium level had dropped severely due to renal issues.  Now I have to take magnesium supplements every day, as my kidneys do not maintain proper levels.  A contributing factor may have been regular use of whey protein powder, which is also hard on the kidneys.  Regardless, I’m off CM and will never go there again.  My advice: Stay away from it.  Short-term “benefits” are not worth the long-term risks.  Eat healthy and work hard, and let your body develop to the levels it is designed to.

John | Thu September 22, 2011  

This article makes a poor assumption that dht is bad.
Dht is a critical hormone in masculinity and what makes you a man.
It is the sole hormone in what gives you chest hair penis growth and general masculinization.

Just check out what happens to baby boys that are missing 5alpha reductace, which is what converts test to Dht.

Dht is a very good thing.

I would say to the guys trying to lower Dht be careful. Ful head of half but no sex drive, I wouldnt find pleasent.

NikiaSophia | Sat October 08, 2011  

The emphasis of this post so far has centered around the potential negative effects of DHT. Whether elevated DHT levels are associated with various risks and side effects is an ongoing question. Even among serious bodybuilders, DHT is often tagged as an undesirable metabolite of testosterone; hence the use of 5-alpha reductase inhibitors, such as finasteride, by those who inject testosterone in supraphysiologic quantities for the augmentation of muscle mass and strength.

It is worth considering, though, that the purported elevations in DHT that result from supplemental creatine use may be more than simply “side effects” and may actually contribute to creatine’s well-documented anabolic and strength-building effects. Relatively recent research suggests that DHT may indeed have anabolic and strength-building qualities—albeit non-genomic (i.e., that do not manifest themselves by virtue of androgen receptor binding on muscle tissue).

Briefly, recent literature suggests that:

1)  DHT, unlike Testosterone, may lead to an enhancement of force production in fast-twitch skeletal muscle fibers (“Dihydrotestosterone activates the MAPK pathway and modulates maximum isometric force through the EGF receptor in isolated intact mouse skeletal muscle fibres”)

2)  DHT, unlike Testosterone, stimulates amino acid uptake into fast-twitch skeletal muscle fibers (“Dihydrotestosterone stimulates amino acid uptake and the expression of LAT2 in mouse skeletal muscle fibres through an ERK1/2-dependent mechanism”)

It’s beyond my level of knowledge or expertise to speculate further on how the significant elevations in serum DHT that purportedly take place with creatine use according to the discussed study might produce the non-genomic DHT effects suggested above, but the aforementioned research suggests some possible mechanisms by which creatine may exert its well-documented anabolic and strength-building effects. At the very least, these studies may provide us with a stimulus to rethink the negative associations many of us have with this hormone.

Dan | Wed January 04, 2012  

I find this very interesting. I was supplementing with CM for about 4 years as a 25 year old. I had massive gains in terms of muscle, but i did notice my hair shedding as i cycled the supplement. I took a blood test to see my DHT levels, they were about 30% above ” normal “.

I for a short time used propecia to regulate my DHT. It rectified the problem I then moved to a herbal method which works great got rectify the long term issue of regulating my DHT. (Saw palmento). Don’t stay on Propecia too long, its not worth the damage it does to your hormones.

I also used a topical chemical called aminexil to clear my follicle damage. This removed the DHT sebum, most underrated hair product out there.

I however missed the muscle gains I was getting on creatine Mono, so i started again, once again same spike in DHT levels, so I had to stop.  Same with my best mate, this actually caused him prostate issues.I spose everyone’s body is different, but i know of at least 2 cases ( mine and my best friends ) where creatine boosted DHT through the roof. Its a real shame because it was an awsum supplement and i put on massive gains with it.

thanks for the post. Very good.

Erik | Sun April 08, 2012  

Hi Anoop! I can´t find the answer to this in the study but could one expect that the DHT levels returned completely to the “before levels” during the 6 week wash out period?

Which, in the context of hair loss, would mean that one should not experience any accelerated hair loss after discontinuing creatine? The effect one DHT is just temporary?

Thanks for the post.

John | Sun May 06, 2012  

Low DHT levels cause those health issues not elevated.

Sandra | Tue May 15, 2012  

Creatine is a great supplement, its been extensively tested over a long period, as a supplement on atheletes and it has shown great results. This new information is quite interesting and deserves further investigation, thanks for the great article.

Tammy | Sat July 14, 2012  

I just want to say that my boyfriend use creatine and it really messed up our sex life. He was fine before, but there has been no studies done on long term use.  After about 5 yrs use he can get an erection but it isn’t the same and can’t stay erect long enough for me.  He can be very agressive. I know this is from the creatine. The doctor told him to stop eating red meat and that he may has prostrate problems. Also liver and kidney problems are starting. You guys are great, you don’t need to have huge muscles for us to love you. I hate creatine. No one even cares how it effect the people around you.  Thanks for letting me vent.  Tammy

Anoop | Tue July 17, 2012  

Hi Tammy,

Thanks for the comments.

Creatine has nothing to do with what you are saying.

He might be taking something else and he is probably not telling you. And it sounds like it.

He might not be taking anything and could be other reasons that is hard to guess from here.

Johno | Tue August 07, 2012  

Hi Louis,
I would like to know if u went ahead and tried the use of creatine and weight training to help with your side effects from the use of DHT blockers. I am in a similar situation and have also considered trying this also. How is your recovery going?

Regards Johno.

jW Wallace | Fri February 01, 2013  

Your news is out of date,Testosterone neither causes prostate cancer or worsens it if you have prostate cancer !!! Read articles or books by Dr Abraham Morganthaler—urologist-Professer at Harvard university orcall Life extension foundation.They can bring you up to date.—-Todays medical truths are tomorrows medical myths!!!

David | Tue February 19, 2013  

To everyone posting on this site, thank you. I’ve been doing personal research on the negative effects of creatine supplementation for years and have never found such a wellspring of personal stories on hair loss and/or prostate issues.
  In 2006, I took creatine on two months on - one month off cycles, and never thought about my hair loss as a side effect. In 2011 or so I suddenly had the idea that it was the creatine doing this to me. I thought back to the pillows full of hair when I woke up in the morning, visible hair in the shower as I rinsed my hair out, AND difficulty urinating due to prostate swelling (particularly after doing squats). After putting two and two together, I freaked out and decided to permanently stop taking CM.
  I haven’t taken creatine in over a year and I’m not experiencing any of the issues I experience while cycling on and off of creatine. I had great gains and almost immediate gains in strength. I loved it for this since I started working out as a 6’2” guy weighing in at 145 pounds.
  To those of you who may be worrying about permanent effects, I haven’t had any unusual hair loss since I stopped taking CM and it does appear to me that my hair is as thick as it was when I started taking CM years ago. No obvious change in hair line either.
  I think these anecdotes are enough for any layman to see that there is a clear influence CM has on many people’s bodies. It may not effect everyone, but I believe the percentage of those negatively affected is substantial. Now let’s see how long the multi-billion dollar supplement industry can keep this information away from the general public. Happy (healthy) lifting everyone. (In case you’re wondering, I’m now a comfortable 205lbs; only the first 30 pounds were gained on CM)

borys | Thu April 11, 2013  

Hi Anoop

I suppose you are well aware of this, but just to make sure, in your comment you said “But there was a recent study which showed no effect of exercise on prostrate cancer risk.”, also, in the post you mention some studies in which no adverse effects were found.

A significant finding of this kind is a reason for concern, but the lack of significant finding in itself does not mean much, that’s because of the inherent assymetry of the significance test:

If an effect is found to be significant we can conclude that it probably exists

If an effect is not found to be significant *we cannot conclude anything* - it could be small, large or nonexistent, there is no way to tell.

If an effect is not found to be significant AND we have a lot of statistical power (low residual variance or large sample size) than what we can say is: perhaps the effect exists, perhaps not, but if the effect exist it is probably small.

Anoop | Thu April 11, 2013  

Hi Borys

Thanks for the comment.

I would sum it up and say use confidence intervals instead of p values.

Even if effect is statistically significant, it doesn’t mean a thing. If it not significant, it could be clinically significant and needs to be repeated.

sully | Mon April 22, 2013  

Hi Anoop,
I’m one of few that you mention that have some severe gastric problems when taking creatine.

Any suggestions?
Thanks,
Sully

stu | Sat August 31, 2013  

I am 60 years old and have been using cm for over 5 years.I have noticed my sex drive diminishing for the last six months or more. At first I thought that maybe there is something in the protein that I have been taking. I started a different brand 8 months ago. After reading this string of emails, I now suspect the cm. i know that there is a direct link between prostrate cancer and sex drive.I read what Tammy wrote in this string of letters and am feel that she was correct. Time will tell if I will be lucky enough to recover some of my drive and be able to maintain my strength or even add to it by working even harder. I have not gone more than 6 weeks in the last 5+ years without cm.

Richard | Sun February 16, 2014  

Enjoyed reading everyone’s personal account of CM use, as for me I stated using the product when it first entered the weight training arena. I am still using it and at 66 years old my body is still responding. Haven’t noticed any side effects , except during the early years but do see some hair in the drain and my sex life is strong with my buddy Viagra. My opinion, the real culprits of to our health isn’t CM but is GMO in our food, contaminated water and polluted air. Train hard as your life depends on it.

Robert | Thu July 10, 2014  

Everything is harmful smile, remember we live once.

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