SARMs
Selective Androgen Receptor Modulators (e.g. Ostarine, LGD-4033)
Unapproved 'research chemicals' sold illegally as supplements.
Evidence tier
Banned / Harmful
Research weight
Not supported
Citations
20 verified / 20
Classification
Banned & Harmful
⊘
What the evidence says. Linked to serious harm and/or banned in sport and many jurisdictions. Listed for awareness and safety only — NOT a recommendation.
⚠
Health warning. SARMs are unapproved investigational drugs illegally marketed as 'legal' supplements. They are not safe alternatives to steroids — they suppress hormones, can injure the liver, and products are frequently mislabeled or contaminated.
What is SARMs?
SARMs (Selective Androgen Receptor Modulators (e.g. Ostarine, LGD-4033)) is a banned or harmful substance marketed for muscle gain with 'fewer side effects'. NutriDex grades the human evidence as Banned / Harmful. SARMs are experimental drugs designed to stimulate androgen receptors in muscle. Marketed online as a 'safe, legal' steroid alternative, they are in fact unapproved investigational compounds that the FDA has explicitly warned against. The 'fewer side effects' claim is unproven: trials and case reports show testosterone suppression, adverse lipid changes and drug-induced liver injury. Analyses repeatedly find products are mislabeled — containing unlisted drugs, wrong doses, or no SARM at all.
Marketed Claims (unproven)
✕(Claimed) muscle gain with 'fewer side effects'
Dosing & Compounds
Use & Legality
No approved or safe dose — not legal dietary ingredients and not approved for human use.
Active Compounds
Safety & Cautions
⚠ Testosterone suppression, lowered HDL ('good') cholesterol, and drug-induced liver injury (hepatotoxicity) reported. Long-term safety is unknown. Not FDA-approved, not legal dietary ingredients, and banned by WADA. Products are frequently adulterated and mislabeled — you often don't know what you're actually taking. Educational only — always check with your doctor or pharmacist before combining SARMs with any medicine.
Evidence & Risk Findings ★ 20 studies
systematic review
Vignali 2023 (J Xenobiot)
✓ PubMed
Systematic review of 33 studies (2,136 patients; 1,447 SARM-exposed) found 15 cases of drug-induced liver injury plus tendon rupture and rhabdomyolysis, concluding recreational SARM use poses significant health risks.
systematic review
Vasireddi 2025 (Am J Sports Med)
✓ PubMed
Systematic review (72 articles, 15 case reports, median age 32, all male) found athlete SARM abuse associated with hepatotoxicity, cardiotoxicity, testosterone suppression, tendon damage and frequent product contamination.
systematic review
Leciejewska 2023 (Eur J Clin Pharmacol)
✓ PubMed
Pharmacovigilance review of 20 published adverse-event reports (since 2020) found SARM use predominantly associated with drug-induced liver injury, mostly a cholestatic pattern with jaundice, in otherwise healthy recreational users of unregulated products.
Systematic review
Wen et al. 2025 (Clinical Endocrinology)
✓ PubMed
PRISMA systematic review of 9 RCTs (6 SARMs: LGD-4033, PF-06260414, GSK2881078, GTx-024/enobosarm, MK-0773, OPK-88004; 970 patients, mean age 57). SARMs produced positive effects on body composition and physical performance (e.g., mean lean body mass rose ~49.5 to 50.9 kg; 1-RM leg press ~1823 to 2191 N) with moderate rates of mild-to-moderate adverse effects and a low rate of severe AEs.
Agency / regulator
FDA 2023 (Consumer Update)
✓ Source
FDA formally warned that SARMs are unapproved drugs associated with increased risk of heart attack, stroke, psychosis, liver injury/failure, infertility and testicular shrinkage, and cannot be legally marketed as supplements, specifically cautioning teens and young adults.
Agency / regulator
FDA Warning 2017/2021
✓ Source
Public warnings that SARMs are associated with serious safety concerns and are illegally marketed.
RCT
Palmieri 2024 (Lancet Oncol)
✓ Full text
Randomised open-label phase 2 trial of enobosarm in AR+/ER+/HER2- advanced breast cancer (Study G200802) showed clinical benefit in the higher-dose arm, the main legitimate clinical context for a SARM.
RCT
Palmieri et al. 2024 (Lancet Oncology, Study G200802)
✓ PubMed
Randomized open-label phase 2 trial of oral enobosarm (9 mg vs 18 mg) in 136 postmenopausal women with AR-positive, ER-positive, HER2-negative advanced breast cancer. Clinical benefit at 24 weeks in 32% (9 mg) and 29% (18 mg); demonstrated AR activation yields anti-tumour activity. Grade 3-4 drug-related AEs in 8% (9 mg) vs 16% (18 mg), mainly raised hepatic transaminases.
RCT
Yuan et al. 2021 (The Oncologist)
✓ PubMed
Open-label phase 2 trial of enobosarm 18 mg plus pembrolizumab in AR-positive metastatic triple-negative breast cancer (18 enrolled, 16 evaluable). Modest 16-week clinical benefit rate of 25% (response rate 13%); well tolerated with few grade 3 AEs; median OS 25.5 months. Stopped early due to drug-supply withdrawal.
guideline
USADA / WADA Prohibited List
✓ Source
Authoritative anti-doping guidance confirming all SARMs (e.g. ostarine, ligandrol/LGD-4033, RAD-140, andarine, S-23, YK-11) are prohibited at all times under class S1.2 (other anabolic agents) of the WADA Prohibited List, banned in sport since 2008 for athletes at every level.
RCT
Crawford et al. 2016 POWER design (Curr Oncol Rep)
✓ PubMed
Design/rationale paper for the twin randomized double-blind placebo-controlled phase 3 POWER trials of enobosarm 3 mg for prevention/treatment of muscle wasting in >600 NSCLC patients on first-line chemotherapy. Enobosarm increased lean body mass vs placebo in both trials, but the co-primary lean-mass + stair-climb-power responder endpoints were mixed and not met.
RCT
Dobs et al. 2013 (Lancet Oncology)
✓ PubMed
Double-blind placebo-controlled phase 2 RCT in 159 cancer patients with cachexia. Enobosarm significantly increased total lean body mass vs baseline (1 mg: median +1.5 kg, p=0.0012; 3 mg: +1.0 kg, p=0.046), whereas placebo did not change (+0.02 kg, p=0.88), without androgenic toxicity.
RCT
Dalton et al. 2011 (J Cachexia Sarcopenia Muscle)
✓ PubMed
12-week double-blind placebo-controlled phase 2 RCT in 120 healthy elderly men and postmenopausal women. Enobosarm (GTx-024) produced dose-dependent, statistically significant increases in total lean body mass (3 mg vs placebo, p<0.001) plus improved physical function (p=0.013) and insulin resistance (p=0.013); AE incidence similar to placebo.
review/reference
LiverTox 2024 (NCBI/NIDDK)
✓ Full text
NIH LiverTox monograph reports SARMs (ostarine, LGD-4033, RAD-140) cause clinically apparent cholestatic drug-induced liver injury, typically arising weeks to months after use in otherwise healthy young men.
Observational
Mohideen 2024 (Cureus / PMC)
✓ Full text
Case report of drug-induced cholestatic liver injury in a healthy adult using LGD-4033 (ligandrol) off-label, illustrating hepatotoxicity risk from recreational SARM use in otherwise healthy individuals.
Safety / toxicology
Case reports
✓ PubMed
Drug-induced liver injury and hormonal suppression linked to SARM use.
case report
Cureus 2024 (LGD-4033 DILI)
✓ PubMed
Case report of a healthy adult developing cholestatic drug-induced liver injury after off-label LGD-4033 (ligandrol) use, highlighting hepatotoxic risk in recreational users.
case report
Schwartzman 2024 (JACC Case Rep)
✓ PubMed
Case report of a 16-year-old boy presenting with acute myopericarditis (pleuritic chest pain radiating to the left arm) hours after his first and only dose of RAD-140, documenting life-threatening cardiac injury even with minimal SARM exposure.
case report
Cabrera Rodríguez 2022 (Cureus)
✓ PubMed
Case report of a 32-year-old man who developed acute myocarditis (chest pain, elevated troponin, reduced ejection fraction) after self-administering the SARM RAD-140 (testolone) for bodybuilding, illustrating reversible SARM-induced cardiotoxicity.
Study
Van Wagoner 2017 (JAMA)
✓ PubMed
Only ~52% of SARM products were accurately labeled; many contained unapproved drugs.