Author: Dr. William Rassman

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Crash diet, lost hair (photo)

No real history of MPB in family other than normal hair loss after ~50 years old. I am 23 and was fat all of my childhood. I lost about 70-80 lbs in under a year and a half about 2-3 years ago. I basically lost it in the worst way possible… starving, keto, etc. Barely functioned during that time. Since then my hair seemed noticeably thinner on the entire hairline and crown a bit. However, it seemed to get bad and then stay the same since then. Hasn’t really gotten worse. I read that weight loss can trigger MPB somehow. Does this mean I’m basically starting now what I would start at 45/50 years old? Does it necessarily mean it’s going to keep getting worse? Or is there a chance it’ll take some time? I’d really rather get a hair transplant than take drugs daily.

Significant weight loss causes hair loss. 30 pounds in a month is very extreme. A safe number is 1 pound/week and should reflect a new lifestyle of eating, not crash dieting. Even though your family history doesn’t show balding, you have developed a Norwood Class 3 Vertex pattern of balding which was mot likely accelerated by your crash diet.

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Creatine increases DHT

In this published article, Creatine was taken by a Rugby player and his serum DHT levels went up. Although the article did not relate this to hair loss, we have seen men who take Creatine as a supplement and find that they notice more hair loss if they have the genes for balding present: https://pubmed.ncbi.nlm.nih.gov/19741313/.


2020-08-08 11:12:26Creatine increases DHT

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Counterpoint to Dr Rassman’s War on Drugs Opinion

This was received in response to my post — The Economic Impact of Illicit Drug Use on American Society:

I am surprised to see your post on the issue of The War On Drugs. I believe there are a lot of opinions on this matter some in favor of yours (Ron Paul for example) and many who would disagree with you mainly people of a substance abuse history who are now recovering. You use the words lives lost and lives ruined. These words can fit perfectly with a opposing argument in which lives have been lost and families ruined from a love one overdosing or simply using certain drugs.

I for one do not believe legalizing and taxing and distributing meth or any other lethal drug would solve the ultimate problem at hand. And that is that our nation at its present state could possibly have the biggest drug abuse problem in the world, and this is not counting the millions on prescription medication. Its a shame that government has to step in and help us or hurt us, depending on how you look at it, but do you really think that having a legal distributor supplying an addict with a harmful substance and making money so we all can benefit from it is such a good idea? I was taught that the bad guy was the drug dealer and that drugs ruin lives.

There is no easy answer. Our prisons are filled with drug victims and I would not want to promote that we let them out of prison and then encourage them to overdose on legalized drugs. I know that we can not stop people from doing what they will do, one way or the other, legally or illegally. I just see what is not working… and what we are doing is not working.

I agree with you that our drug dependent society goes all the way into the doctor’s office. People demand the prescription medications that they see advertised on TV and some of the problems like “restless leg syndrome” were not even taught to me in my medical school curriculum, yet the industry that surrounds all of the restless legs out there is growing and growing and growing.

When I see patients in my hair transplant practice, I encourage the use of Tylenol, aspirin, and other non-narcotic medications to use after surgery and with the power of my suggestions, my patients seem to manage without heavy use of narcotics. Some of my patients call to ask for antibiotics when they sneeze, sniffle, or cough and I tell them that their body can handle the sneeze, sniffle, or cough without prescription antibiotics, as most of the sneezes, sniffles, or coughs are caused by allergies or viruses that will not respond to antibiotics. I try to be proactive.


2011-06-20 07:33:46Counterpoint to Dr Rassman’s War on Drugs Opinion

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Cowlicks, Widow’s Peaks, and Hair Transplants

I have a question. The hair on the left side of my head, from the hairline to about 1 to 1.5 inches behind it moves in a fully forward direction instead of backwards and down. This cowlick creates a very messy look and contrasts with the normal direction of hair on my right side.

Is there any procedure that can be done to just change the angle of direction of those hairs? If so, who performs this?
Thanks very much

Cowlicks are hairs that grow in a different direction than adjacent hairs. They can be very sexy or they can be annoying, much like your complaint about them. Grooming can be a problem if you are a perfectionist, your hair character is strong, and the direction abnormality is in an obvious place, like the very frontal hair line. This is most often seen in the central area of the frontal hair line, frequently in association with a ‘widow’s peak’ or as in your case, it can be off center. There is little to do about them without damaging the frontal hair line. When we transplant near them and they are strong, there are many artistic judgments that the surgeon must make on how to deal with them. I love and hate them, depending upon what I am asked to do with them and the patient’s opinion of what he wants and what he can reasonably achieve.

My suggestion is for you to accept the cowlick, learn to style around it and not to aggressively go after it unless it is very limited to a small area, in which case, FUE might be possible. You need an expert to evaluate this in person and to protect your interests.


2005-12-22 14:45:44Cowlicks, Widow’s Peaks, and Hair Transplants

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Creatine and Body Hair Loss

I recently read your entry about monohydrate creatine…I did a little reading & it seems that quite a few doctors think it causes hair loss. I take ce2 ethel ester creatine (28yr old male,caucasian), are you aware if this product can cause body hair loss? or would this most likely be restricted to head hair?
Thank you.

“A little reading” can be dangerous, because you will always find conflicting facts or opinions.

The good news is that you have a choice! If you believe it causes hair loss, you have a choice not to take it. If you are taking creatine for bodybuilding and you are also worried about hair loss, you have to make the choice.

It is my opinion that creatine does not cause hair loss. It is also my opinion that creatine does not have much effect in bodybuilding. I have personally taken it for a year and I have always found harder workouts made me stonger/bulkier (without creatine).

By Dr. Jae Pak


2007-03-05 14:33:06Creatine and Body Hair Loss

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Creatine Supplements May Increase DHT Levels And Possibly Hair Loss

College-aged rugby players taking creatine monohydrate supplementation for three weeks had their Testosterone and DHT measured. The results of these tests indicated a rise in DHT levels when using this supplement in their diet. A rise in DHT levels can accelerate, at least in theory, the hair loss seen in genetically balding patients.

https://www.ncbi.nlm.nih.gov/m/pubmed/19741313/

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Does Creatine Really Cause Hair Loss?

Have you come across any studies which go on to show with considerable evidence that the bodybuilding supplement creatine can promote/speed up hair loss/mpb? There seems to be a lot of “broscience” when searching around, and I’d like to hear the thoughts of a professional.

Over the many years in this business, I have seen supplements that contain steroids (some labeled and some not labeled). I remember an article (didn’t save it) where the FDA caught some supplement company of putting steroids in with the Creatine, and not labeling it. They broke the law. Creatine, by itself, should not cause hair loss.


2018-11-14 07:35:44Does Creatine Really Cause Hair Loss?

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Creatine Increases DHT?

Based on the questions and answers on your excellent blog, you seem to have taken an ambivalent position on creatine and hair loss in the past. I am 25 and very athletic, and I have a medical background so would never consider taking steroids or other dangerous substances. Creatine is a safe and effective athletic supplement that I have been taking for some time, but a recent study published in the Clinical Journal of Sports Medicine found that creatine raised serum DHT by 40 percent when taken at the moderate dose of 5 grams per day. In addition, creatine has recently been shown to increase the ratio of DHT to testosterone in young athletes. Do you think this is sufficient evidence for young hair loss sufferers to entirely avoid this otherwise excellent ergogenic aid?

I found the study you’re referencing — Three Weeks of Creatine Monohydrate Supplementation Affects Dihydrotestosterone to Testosterone Ratio in College-Aged Rugby Players

The study was very limited (only 20 men) and the amount of creatine taken can vary wildly amongst those that use it, but I would avoid creatine if it indeed increases DHT levels in the body and you’re worried about possible hair loss. The study itself concludes, “Further investigation is warranted as a result of the high frequency of individuals using creatine supplementation and the long-term safety of alterations in circulating androgen composition.”

I appreciate you bringing it to my attention.