SARMs: The Unapproved Anabolics Selling As ‘Research Chemicals’
SARMs (Selective Androgen Receptor Modulators) are a class of compounds that activate androgen receptors in muscle and bone while, in theory, minimising activity in prostate and other tissues. Several have been in clinical development for cachexia, sarcopenia, and osteoporosis. None are FDA-approved for any indication. Yet ostarine, andarine, ligandrol, and others are widely sold online as "research chemicals" with predictable adverse events and regulatory action.
The Drug-Induced Liver Injury Signal
A 2020 JAMA Internal Medicine case series documented drug-induced liver injury (DILI) in young healthy men using ostarine, ligandrol, and related SARMs. Presentations included cholestatic hepatitis with bilirubin >20 mg/dL, some requiring hospitalisation. Unlike classical anabolic steroid hepatotoxicity, SARM DILI can occur at recreational doses over 8–12 weeks.
Suppression of the HPG Axis
SARMs potently suppress endogenous testosterone production in men. Recovery after cycles is variable; some users develop persistent hypogonadism requiring testosterone replacement. Women using SARMs can develop voice deepening, clitoral hypertrophy, and menstrual irregularities, some of which are irreversible.
Cardiovascular Effects
SARMs lower HDL cholesterol significantly (often 20–40% reductions) and raise LDL. Clinical trials of enobosarm (ostarine) showed consistent adverse lipid changes even at low doses. Reversal typically occurs after discontinuation but the cumulative exposure effect of stacking cycles is unknown.
The Contamination Problem
Independent testing of SARM products consistently shows: mislabelled compounds, undeclared anabolic steroids, undeclared selective estrogen receptor modulators, heavy metals, and label doses divergent from actual. A 2017 JAMA analysis found only 52% of purchased SARM products contained the labelled compound. Buyers do not know what they are taking.
Sport Regulation
All SARMs are banned by WADA, NCAA, military testing programs, and most professional sports organisations. Positive tests have ended many careers; ostarine is a particularly common positive because of food and supplement contamination even in athletes who did not intentionally use it.
The Legal Status
SARMs are not legal to sell for human consumption in the US, EU, UK, Canada, or Australia. Vendors sidestep this with "research chemicals" labels that would not survive a regulatory challenge but that allow grey-market sales. The FDA has issued warning letters, some companies have been fined, and state attorneys general have filed consumer-protection cases.
What About Future Approval?
Some SARMs are in Phase 3 trials for specific medical indications (cachexia, sarcopenia). If approved, use would be under medical supervision with monitoring, not as recreational anabolics. Self-medication with unapproved SARMs at unknown purity is fundamentally different from regulated medical use.
Sources
- Flores JE, Chitturi S, Walker S. "Drug-induced liver injury by selective androgenic receptor modulators." Hepatology Communications, 2020;4(3):450–452. (Case-series companion to JAMA Intern Med 2020 reports.)
- Van Wagoner RM, Eichner A, Bhasin S, Deuster PA, Eichner D. "Chemical composition and labeling of substances marketed as selective androgen receptor modulators and sold via the internet." JAMA, 2017;318(20):2004–2010. PMID 29183075.
- Solomon ZJ, Mirabal JR, Mazur DJ, Kohn TP, Lipshultz LI, Pastuszak AW. "Selective androgen receptor modulators: current knowledge and clinical applications." Sexual Medicine Reviews, 2019;7(1):84–94. PMID 30503797.
- Bedi H, Hammond C, Sanders D, Yang HM, Yoshida EM. "Drug-induced liver injury from enobosarm (ostarine), a selective androgen receptor modulator." ACG Case Reports Journal, 2021;8(1):e00518.
- Hilkens L, Cruyff M, Woertman L, Benjamins J, Evers C. "Disordered eating, drive for muscularity, and use of supplements/anabolic-androgenic steroids in male and female fitness center attendees." Performance Enhancement & Health, 2021;9(1):100190.
- U.S. Food & Drug Administration. "FDA In Brief: FDA warns against using SARMs in body-building products" (2017, 2023 updates). FDA.gov. Multiple warning letters issued to SARM distributors.
- U.S. Drug Enforcement Administration. "SARMs Control Act" proposals and federal scheduling deliberations (2019–2024). DEA.gov.
- World Anti-Doping Agency. "WADA Prohibited List" — SARMs (S1.2 Other anabolic agents) banned at all times in and out of competition. wada-ama.org.
- U.S. Anti-Doping Agency. "Ostarine and SARMs in supplements: contamination and supplement-related sanctions." usada.org.