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

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.

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  (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 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 of 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 & maintenance 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 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 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.

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