Jonathan Steedman (00:01.464)

Hey food groupies, I get asked more questions about creatine than literally anything else, any other nutritional topic whatsoever. I'm pretty sure. Obviously I'm not like keeping score, but I get asked a lot about it. And I do have a podcast on it that goes through all of the nitty gritty, but I wanted to make this one specifically about creatine and its impact on hair loss because I get asked about this a lot.

Which is pretty surprising given if you do a quick little search, there's very, very limited evidence to support this claim that creatine could increase rates of hair loss. I've been targeted by a certain company's Instagram ad. They...

You know, if there's an aeroplane, there's typically someone flying that plane. would call them the, you know, anyway, so those people, they have this big Instagram ad about how they can help, you know, if you've been at the gym and you're taking creatine, it's probably promoting hair loss, of course, I think it's medication can help. And of course there are some great medications for hair loss that are way outside my script, not what I'm talking about today. But.

really what I do want to talk about is this claim that creatine can affect hair loss. And so really what it comes down from, it comes from literally one study on a group of rugby players who took creatine for three weeks. They didn't have more hair loss. They didn't notice more hair loss or anything like that. And to be fair, three weeks is not a long enough time to probably notice that. But what did happen in that study was an increase in something called

dihydrotestosterone or DHT, which is kind of a derivative of normal testosterone. So I'll be upfront and I'll say that I don't really know how this tracks in terms of female hair loss and DHT levels. I would assume it's probably similar claims, but I am more talking about male hair loss in this. Now the reality is, okay, so the results of those studies, that study,

Jonathan Steedman (02:21.613)

Firstly, it was three weeks. Secondly, it was 20 males. So like not a huge sample size. So what we would call statistical power is pretty low. And these results have never been replicated. So they haven't been repeated in another study, which is, it's hard to do replication studies because I hardly have funding for them, but they are unfortunately really helpful because, one study, it could be a whole host of things that influenced its results. And so it's good to kind of replicate that to see if we continue to find the same thing so we can be.

confident about the findings, but that's okay. That's always going to be a limitation in science because you know, money and politics, it's a hard space. But what they did see was an increase in this baseline of DHT and DHT has been linked with an increase in hair loss. Okay, so the claim, you know, was, and I see the line of reasoning, know, creatine supplementation in the group that supplemented with creatine, they had increased baseline levels of DHT.

And the therefore, I don't even think the study mentioned it or like the study certainly didn't say so this will result in hair loss. It's just that people have picked up on this and we've now got blogs and a lot of people talking about it. So a couple of important things. Firstly, that would be what we would call a mechanism, right? The way that DHT, we know that increased levels of DHT can increase your risk of hair loss. And so

What we would then want to see is a study that has actually confirmed that increased creatine supplementation results in increased hair loss. Just because there is a mechanism there, like that's an important step in the scientific process is firstly kind of nailing down a mechanism or hypothesizing a mechanism and testing it. But the next thing is just because on paper it says it's going to happen, doesn't always mean it's going to happen. We see that very regularly in nutrition and health in particular.

on paper, it's like, well, this equals this and this hormone does this. And when we do this, this happens. So clearly this is the outcome that's going to happen. Not always. Okay. So it's important that we actually test the outcome. So I would want to see a study that wasn't creating increased DHT levels. I would want to see a study that actually creating increased DHT levels and the people with increased DHT levels had increased hair loss. I hope that makes sense that extra step. Now I'm also not mad that they haven't done that study. That would be sorry, playing going overhead. That would be really hard.

Jonathan Steedman (04:47.424)

be really long, be really expensive, so I get it. And we may never be able to do that study. So we may only be able to rely on mechanistic studies. If that is the case, I would want to see a bunch more, not just one with a small group of people. So that's the first thing. The second really important thing is the difference between clinical significance and statistical significance. So the increase in DHT levels were statistically significant. Okay.

It's been a long time since I've done stats, but essentially it means that the increase was big enough for us to be confident that it wasn't due to chance. Okay. Which is good. That's what we want to see in a study. However, it's really important that we look at the, something can be statistically significant, but not clinically significant. I distinctly remember the example I was given about this in university. If there was a 12 month weight loss study and one group did something and another group did something else and we compare the results and one group lost

one kilo more than the other group. That may be statistically significant, but losing an extra kilo across 12 months, I think most people would be like, that's basically the same results. It doesn't really matter. And that means that's not clinically significant. So this increase in DHT was statistically significant, but the increase in DHT never took their DHT levels outside of the normal.

biological range. Okay, what we so if you tested a bunch of random people, some of them without creating supplementation would have those higher levels of DHT because that's still within the normal biological range. So that to me screams that that increase in DHT whilst statistically significant was not clinically significant, I would want to see increases in DHT that get people outside of their normal range before I worried. Okay, so

The last confounding thing I would say is I think it's probably easy to look and be like, but lots of bodybuilders are bald, right? And a lot of people have like bodybuilders are probably taking creatine, right? I'm sure they are. A lot of bodybuilders are also taking a lot of other stuff, drugs that performance enhancing drugs that significantly, significantly increase their DHT levels for a very long period of time. And we know that

Jonathan Steedman (07:13.546)

It doesn't mean that they're definitely going to lose their hair, particularly now as we've got more and better hair drugs, hair drugs, whatever, coming out. And then there's also a genetic component. There's certain people that are more resistant to DHT levels, DHT's impact on hair loss, right? But there's also plenty of people who take those drugs, the performance enhancing ones, get increased levels of DHT that exacerbates male pattern baldness or just hair loss in general. And then they shave their head.

because that's what I want to do. And then we look and we see a whole bunch of bald bodybuilders and people are like, it's the creatine. It's not, it's absolutely not. Okay. So as far as I'm concerned, there is zero reason to not take creatine in relation to hair loss. So if you worry about hair loss, that's got to be a thorough explanation. Hopefully it is. If it's not, please message me and I'll try and give you some more data. I will definitely link a couple of studies in the show notes. So if you want to read them.

directly do that. Otherwise, I'll chat to you next time.