Creatine is a compound that helps produce energy for your muscles. Your body makes creatine naturally, and you can get creatine through some foods and supplements. About 95% of your body’s creatine levels are found in muscle.

Most people use creatine to improve exercise performance and increase muscle mass, which research supports. Creatine has also been used to treat muscle cramps and fatigue, multiple sclerosis (MS), and depression. However, there is little scientific evidence to support these uses.

Many people worry about taking creatine because of its link to hair loss. However, there is limited evidence that it may impact hair growth.

Creatine is a nitrogen-containing compound comprised of amino acids. It helps your body produce adenosine triphosphate (ATP)—the energy your muscles need to be active. You can get creatine from foods or supplements, and your body naturally produces some creatine in the liver, kidneys, and pancreas.

Because creatine helps boost ATP production, it can enhance your exercise capacity and improve your training capabilities. Some research suggests that people taking creatine experience a 10-20% improvement in performance.

Currently, creatine is the most effective nutritional supplement available to athletes because of its ability to enhance exercise capacity and lean body mass during training. It may also support overall health, fitness, and well-being. Some studies have found creatine has the potential to:

• Lower cholesterol, triglycerides, and manage blood lipid levels
• Reduce the accumulation of fat in the liver
• Lower the risk of heart disease
• Improve glycemic control
• Minimize bone loss
• Improve function for people with osteoarthritis and fibromyalgia
• Enhance cognitive function in older people

There is limited evidence that creatine can cause hair loss, and the evidence that does exist is either dated or anecdotal (based on personal accounts and not research). One small study from 2009 notes creatine may cause hair loss; this is likely where the idea originated.

The study involved college rugby players who were taking creatine supplements. Researchers found that the athletes’ levels of dihydrotestosterone (DHT) increased while taking creatine. DHT is often linked to increased hair growth on the face and chest and inhibited hair growth on the scalp, especially since it can cause hair follicles to shrink.

Since that study, 12 other studies have examined how creatine supplementation—in doses ranging from 3-25 grams daily—affects testosterone, specifically DHT. Two of the 12 studies found small increases in testosterone, while the remaining 10 studies showed no change. Five of those 10 studies also measured DHT and found no increases. These findings have led many researchers to conclude that creatine supplementation does not cause hair loss.

Initial research found several side effects associated with creatine supplementation, including muscle cramps, dehydration, and kidney stress. However, there is little concrete evidence to support these claims. For instance, one team of researchers concluded that creatine supplementation does not always lead to water retention, muscle cramping, or fat gain, and does not cause kidney damage when consumed in appropriate doses.

Another study notes that many of the adverse reactions to creatine have been found in studies of men and not in women. Some of the potential adverse reactions have included renal dysfunction, lower leg compartment syndrome, rhabdomyolysis, liver injury, atrial fibrillation, and hepatitis. Stroke has also been reported in some studies. However, researchers note that these results have not been repeated in placebo-controlled clinical trials.

Other researchers note that the incidence of muscle cramps, pulled muscles, muscle strains, dehydration, and kidney stress resulting from creatine use has been overstated. They also note that no placebo-controlled, double-blind studies of healthy people have ever reported these effects.

If you have a pre-existing condition, it’s possible that supplementing with creatine may exacerbate your symptoms. For instance, creatine supplements may cause mania in people with bipolar disorder, and when taken with caffeine, it could worsen the symptoms of Parkinson’s disease. Creatine may also worsen kidney disease. Always talk with a healthcare provider before taking a supplement, especially if you have a pre-existing medical condition.

Most research supports taking about 3 grams of creatine a day, though people with larger bodies may need slightly more. If you are using a protein powder containing creatine, this amount is likely found in one scoop, possibly more. Make sure to check the label to determine the exact dosing.

Some people will initially take larger doses of creatine to build their creatine stores before dialing down to a lower regular dose. However, research is mixed on whether this is helpful or even needed. One study found that creatine loading may boost muscle stores of creatine by 20-40%. Meanwhile, an older study found that people who took 3 grams of creatine a day were able to effectively build their creatine stores.

Most experts recommend taking creatine, along with protein and carbs, after exercise—though more research is needed to determine if this timing is most effective. Also, taking higher doses may not always be necessary. Unused creatine is typically filtered and excreted in your urine.

If you are considering creatine supplementation, talk to a healthcare provider or sports dietitian for advice. They can advise you on the amount that is right for you to meet your health and fitness goals.

Creatine is generally well-tolerated, but if you have a pre-existing condition like kidney disease, creatine supplementation may not be the best option for you. However, you can get creatine in more manageable doses by eating foods like beef, pork, poultry, fish, and seafood.

You may already get enough creatine to meet your needs if you regularly consume meats and fish. Conversely, young people who limit these foods may not grow as well as adolescents who consume enough creatine through diet.

If you’re looking for an alternative supplement that can provide some of the benefits of creatine, here are some options to consider:

• Antioxidants: May reduce muscle fatigue, inflammation, and soreness but may not improve athletic performance
• Beet juice: Dilates blood vessels when exercising and improves energy production
• Beta-hydroxy-beta-methylbutyrate (HMB): Helps speed recovery of muscles
• Betaine: May boost your body’s creatine production
• Caffeine: May reduce perceived pain and improve performance
• Glutamine: May reduce muscle soreness after exercise
• Sodium bicarbonate: Might improve performance in high-intensity activities

Creatine is a compound that helps produce energy for your muscles. It can be found in some foods or as a supplement. Some people have speculated that using creatine can lead to hair loss, but the research supporting this claim is limited.

There is also limited evidence that creatine causes other negative side effects, with the exception of people who have a pre-existing medical condition like bipolar disorder, kidney disease, or Parkinson’s. Before taking creatine, talk with a healthcare provider to determine if it’s right for you and how much you should take.