Are SARMs Safe to Use?

✅ This article was reviewed by Ohiole Kingsley Ohikuare, PharmD, member of our MedShadow Medical Advisory Board.

Most of us know that using steroids to enhance athletic performance is a bad idea. While their use may increase muscle mass, it comes with myriad health risks, not to mention the possibility of an athlete being banished from a sports competition. 

But what if there were a drug that could help you gain muscle and strength without the downsides of steroids? Some people think a category of drugs called selective androgen receptor modulators (SARMs) might fulfill that role. So what exactly are SARMs, and can they safely improve athletic performance?

SARMs are not anabolic steroids; rather, they are a class of drugs with synthetic ligands that bind to androgen receptors. They were discovered in the late 1990s and, like steroids, they enhance performance because they stimulate anabolism (they increase muscle mass and strength) and facilitate recovery from exercise, which is especially important for athletes in competition.

Whether or not SARMs are acceptable or legal depends on what they are used for. It is legal to sell and buy SARMs marketed simply as research chemicals. It is illegal, though, to sell and buy them in capsules for human consumption or labeled as dietary supplements or both.  And sports regulators, such as the World Anti-Doping Agency (WADA), have banned them. 

However, those rules and laws haven’t kept athletes and others from using them. SARMs aficionados typically find them on the black market, largely through online sales. 

While there is not yet enough evidence to consider SARMs a safe alternative to steroids for bulking up, researchers are testing them for possible use in treating a variety of other conditions.   

What Are SARMs?

Over the last three decades, scientists started seriously considering the potential of SARMs to treat diseases like Alzheimer’s, cancer, osteoporosis, wasting syndrome, which is unwanted weight loss of at least 10% of overall body weight, and more.

SARMs, like steroids, bind to androgen receptors. While performance-enhancing steroids generally bind to androgen receptors all over the body, different types of SARMs attach to receptors in specific tissues like those of the muscle or liver, leading some users to believe that if they choose SARMs that target the right tissues, they can build lean muscle, cut fat, increase endurance and improve recovery, while limiting the harmful side effects associated with steroids.  

The Benefits of SARMs

“They [SARMs] are in development for treatment of chronic wasting disorders, such as that associated with cancer and aging,” says Richard J. Auchus, M.D., James A. Shayman and Andrea S. Kevrick Professor of Translational Medicine at the University of Michigan. 

A 2019 meta-analysis in Sexual Medicine Reviews concluded that SARMs have “numerous possible clinical applications” and have the “potential to revolutionize the treatment of many debilitating diseases,” but that “further studies are currently needed to determine the safety and efficacy of these medications before they are approved for clinical use.” 

“They also may improve cholesterol and other health markers,” says Tracy Gapin, M.D., founder of the Gapin Institute of Men’s Health and author of Male 2.0: Crack the Code to Limitless Health & Vitality.  “An interesting effect of SARMs,” adds Gapin, is that they increase the availability of bioavailable testosterone “This is something that a lot of people are trying to achieve, but the key is we really don’t know, though, what effects this may have long term.”

Are SARMs Safe?

Though SARMs have shown promise in providing an anabolic, or muscle-building, effect without the harmful side effects that can come with the scattershot approach of anabolic-androgenic steroids, they don’t have the FDA’s okay yet.  “None are FDA-approved, but some of them are sold on the black market,” says Auchus. “The safety profile is unknown, but people use them anyway.”  

Even though it’s illegal to sell SARMs as dietary supplements, the compounds have also been found in several brands of nutritional supplements. The FDA issued warning letters in June and October 2017 to  Infantry Labs, LLC, IronMagLabs, Panther Sports Nutrition,  Flex Fitness/Big Dan’s Fitness, AndroPharm and Hardcore Formulations for selling supplements that contained the drug. 

Along with the letters in October, the FDA released a statement to highlight the potential dangers of SARMs. “We are extremely concerned about unscrupulous companies marketing body-building products with potentially dangerous ingredients. Body-building products that contain selective androgen receptor modulators, or SARMs, have not been approved by the FDA and are associated with serious safety concerns, including potential to increase the risk of heart attack or stroke and life-threatening reactions like liver damage.” The agency adds: “Consumers should stop using these body-building products immediately and consult a health-care professional if they are experiencing any adverse reactions that may be associated with their use.” 

A recent study that appeared in the medical journal JAMA highlighted the availability of the compounds via the internet and found that most had other substances with only 52% containing SARMs. In 2008, WADA banned SARMs, and prohibited SARMs (both in and out of competition) for all athletes, from the highest to recreational levels. SARMs are listed in the category of  Other Anabolic Agents” under section S1.2 of the WADA Prohibited List, with examples including ostarine, andarine and ligandrol.

In response to the FDA’s public announcement on SARMs, the Council for Responsible Nutrition, the trade organization for the dietary supplement industry, issued a safety alert that reiterated that SARMs are unapproved drugs and not dietary supplements. The bottom line: “SARMs should be avoided, as they can result in potentially life-threatening consequences.”

Stay Away From SARMs… For Now

Although these androgen modulators have shown some promise in helping preserve and promote muscle mass and bone density (along with a range of other helpful hormone-regulating activities) by selectively targeting certain androgen receptors, the bottom line is that SARMs are dangerous to use. You should never take them without consulting your doctor or for recreational use. Consider carefully the potential harms against any benefits.