What Do I Need to Know?
- SARM stands for Selective Androgen Receptor Modulators
- They were developed to treat health conditions triggered by low testosterone caused by ageing or clinical hormonal imbalances without the side effects that regular testosterone top ups can cause.
- SARMs are drugs not supplements, and in the U.S. they still haven’t crossed the threshold of usefulness and safety to be FDA approved.
- Online sellers are marketing SARMs as a miracle short cut to rapid gains for bodybuilders and fitness enthusiasts.
- Like anabolic steroids, testosterone and other hormone targeting treatments, SARMs have side effects and can cause adverse events. There’s no such thing as a free lunch.
What are SARMs Anyway?
In recent years, a new class of performance-enhancing substances has been making waves in fitness and bodybuilding communities. Selective Androgen Receptor Modulators, or SARMs, promise muscle gains and fat loss with fewer side effects than traditional anabolic steroids. However, as their popularity surges, so do concerns about their safety, legality, and long-term health impacts.
SARMs are synthetic compounds designed to selectively target androgen receptors in specific tissues. This selective action aims to provide the benefits of testosterone – such as increased muscle mass – while theoretically minimizing unwanted side effects like prostate enlargement or hair loss. Unlike anabolic steroids, which affect multiple organ systems, SARMs are intended to focus on building muscle and bone tissue more precisely.
SARMs Spotlight: Key Types
Several types of SARMs have gained popularity in the fitness community and have been subject to clinical trials:
- Ostarine (MK-2866 or enobosarm): One of the most well-researched SARMs, showing promise in increasing lean body mass.
- Ligandrol (LGD-4033): Known for its potent anabolic effects.
- Testolone (RAD-140): Noted for its high selectivity for androgen receptors in muscle and bone tissue.
- Andarine (S-4): Initially developed for treating osteoporosis and muscle wasting.
Evaluating SARMs: Insights from Clinical Research
Is There Evidence that SARMs Work?
A 2022 systematic review of the safety profile of published in Journal of Xenobiotics analysed 18 clinical studies on SARMs, involving 2,136 patients, with 1,447 exposed to a SARM. Of these, five studies collected data about the efficacy of the drugs – that is how well did they work. So did they succeed? Well, sometimes. MK-0773 improved lean body mass in frail, elderly women, but this increase didn’t translate to an upgrade in strength. GTx-024 performed a little better, helping elderly men and postmenopausal women gain lean body mass and improving their physical function. LY900010 was investigated to see if it helped erectile dysfunction, it didn’t. Researchers looked into whether GTx-024 helped with stress incontinence unfortunately, the drug failed to help. OPK-88004 was evaluated to see if it had any effect on benign prostate hyperplasia but the clinical trials were terminated without any published results.
A 21-day study on Ligandrol, published in the Journal of Gerontology, reported increased lean body mass and leg press strength in healthy young men, with mild side effects such as headaches and dry mouth.
So that’s about it. It’s been over a decade since these drugs started phase II clinical trials and still none have been brought to market, that should tell you something.
Researchers continue to test these drugs in different applications, but without much success. They might help you to recruit some new muscle, but the jury is out on whether this muscle improves physical performance enough to make the expense and the side effects worth it.
Is There Evidence that SARMs are Safe?
While the efficacy reports were perhaps not so helpful, all of the 18 clinical trials featured in the 2022 review did report adverse events and side effects.
These included:
- Jaundice – a sign that your liver is not working as well as it should
- Increased blood pressure
- Reduced testosterone
- Shrinking testicles
- Acne
- Elevated haemoglobin/haematocrit
- Headaches
- Dry mouth
- Upper respiratory infections (URIs),
- Constipation
- Dyspepsia
- Nausea
What Does the FDA Say?
The U.S. Food and Drug Administration (FDA) has issued strong warnings about the use of SARMs, citing potential serious health threats including liver damage, increased risk of heart attack and stroke, and hormonal disruption.
According to the FDA, ‘SARMs cannot be legally marketed in the U.S. as a dietary supplement or drug at this time.’ They continue to receive adverse event reports related to SARMs, warning consumers about the dangers of these unapproved substances.
A case report in the journal Hepatology described a 24-year-old male bodybuilder who developed drug-induced liver injury after using Ligandrol purchased online, experiencing jaundice and elevated liver enzymes.
The Black Market and Legal Issues
Despite regulatory efforts, a thriving black market for SARMs exists. Many online vendors exploit legal loopholes by marketing SARMs as ‘research chemicals’, bypassing regulations governing dietary supplements and pharmaceuticals.
A study published in JAMA analysed products sold as SARMs and found that only 52% contained actual SARMs, with many containing unapproved drugs or substances not listed on the label.
Personal Stories
The allure of SARMs has attracted users from various demographics, each with unique motivations and experiences.
Tim’s Story: A Cautionary Tale
Tim, a 30-year-old fitness enthusiast, shared his experience with SARMs in a blog post for the Therapeutic Goods Administration of Australia. He purchased SARMs online, believing they were a safer alternative to steroids. However, he suffered severe side effects, including mood swings and testicular pain. Tim’s story highlights the risks of using unregulated substances and the importance of seeking reliable information about the safety and legality of performance-enhancing drugs.
‘I thought SARMs were a safer option compared to steroids, but I ended up with severe mood swings and testicular pain. It was a wake-up call about the dangers of these substances,’ Tim stated.
The Athlete’s Dilemma
In 2019, CrossFit athlete Ricky Garard tested positive for Ligandrol and was stripped of his bronze medal from the 2017 CrossFit Games. He admitted to taking SARMs, stating he believed they were legal supplements. This case underscores the challenges sportsmen face in navigating the complex world of performance enhancement and the potential consequences of using prohibited substances.
‘I thought I was taking a legal supplement, but it turned out to be a banned substance. The consequences were devastating,’ explained Ricky Garard.
Talk to Your Doctor
As SARM use continues to rise, healthcare providers find themselves on the front lines of education and harm reduction. The FDA recommends consumers talk to healthcare professionals about the consumption of any products for increasing muscle mass or enhancing athletic performance.
Steve Mister from the Council for Responsible Nutrition (CRN) emphasizes, ‘‘SARMs are not legitimate dietary supplements; they are unapproved drugs. While some SARM-containing products masquerade as being supplements, these products are patently illegal.”
Reality Check
As the landscape of performance-enhancing substances evolves, so too must our approach to education, regulation, and harm reduction. The story of SARMs serves as a cautionary tale about the dangers of prioritizing physical performance over long-term health.
For those considering SARMs, it is imperative to consult with healthcare professionals and rely on evidence-based information. The allure of quick gains should not overshadow the prospective long-term health risks. As research continues, the future of SARMs remains uncertain, but the current consensus among medical specialists is clear: the perils of using unapproved SARMs outweigh any potential benefits for healthy individuals seeking performance enhancement.
What’s Next After SARMs?
As interest in SARMs persists, another class of performance-enhancing substances is gaining attention: peptides. These short chains of amino acids are being explored for their capacity to enhance muscle growth, recovery, and overall athletic performance. While some peptides have shown promise in clinical settings, their use in sports and bodybuilding raises similar concerns as SARMs, particularly regarding legality and safety.
One peptide that has attracted notice is BPC-157 (Body Protection Compound-157). Originally discovered in human gastric juice, BPC-157 is being studied for its potential to accelerate wound healing and tissue repair. Some athletes and bodybuilders are using it off label in an attempt to speed up recovery from injuries and intense training sessions. A study published in the Journal of Physiological Science suggested that BPC-157 might enhance the healing of muscle and tendon injuries in rats, but human trials are still limited.
As with SARMs, the long-term effects and safety profile of peptides like BPC-157 in healthy individuals are not well established. While they may offer exciting possibilities for performance enhancement and recovery, they also come with potential risks and legal considerations.
References
Papanicolaou DA, Ather SN, Zhu H, et al. A phase IIA randomized, placebo-controlled clinical trial to study the efficacy and safety of the selective androgen receptor modulator (SARM), MK-0773 in female participants with sarcopenia. The Journal of nutrition, health and aging. 2013;17(6):533-543. doi:10.1007/s12603-013-0335-x
Solomon ZJ, Mirabal JR, Mazur DJ, Kohn TP, Lipshultz LI, Pastuszak AW. Selective Androgen Receptor Modulators (SARMs) – Current Knowledge and Clinical Applications. Sex Med Rev. 2019;7(1):84-94. doi:10.1016/j.sxmr.2018.09.006
Vignali JD, Pak KC, Beverley HR, et al. Systematic Review of Safety of Selective Androgen Receptor Modulators in Healthy Adults: Implications for Recreational Users. Journal of Xenobiotics. 2023;13(2):218-236. doi:10.3390/jox13020017
Dalton JT, Barnette KG, Bohl CE, et al. The selective androgen receptor modulator GTx-024 (enobosarm) improves lean body mass and physical function in healthy elderly men and postmenopausal women: results of a double-blind, placebo-controlled phase II trial. J Cachexia Sarcopenia Muscle. 2011;2(3):153-161. doi:10.1007/s13539-011-0034-6
Basaria S, et al. The Safety, Pharmacokinetics, and Effects of LGD-4033, a Novel Nonsteroidal Oral, Selective Androgen Receptor Modulator, in Healthy Young Men. J Gerontol A Biol Sci Med Sci. 2013;68(1):87-95.
“FDA Warns of Use of Selective Androgen Receptor Modulators (SARMs) Among Teens and Young Adults.” U.S. Food and Drug Administration, 2023.
Barbara M, et al. Drug induced liver injury caused by “legal steroids”: A case report. World J Hepatol. 2020;12(12):1346-1352.
Van Wagoner RM, et al. Chemical Composition and Labeling of Substances Marketed as Selective Androgen Receptor Modulators and Sold via the Internet. JAMA. 2017;318(20):2004-2010.
“Consumer story: Tim and selective androgen receptor modulators (SARMs).” Therapeutic Goods Administration, 2019.
“CrossFit Athlete Ricky Garard Admits to Taking SARMs, Stripped of 2017 Games Medal.” BarBend, 2019.
“Selective Androgen Receptor Modulators (SARMs): What You Need to Know.” Council for Responsible Nutrition, 2023.
Chang CH, et al. Oral administration of BPC-157 enhances healing of muscle and tendon injuries in rats. J Physiol Sci. 2011;61(Suppl 1):S524.
