SARMs
Selective Androgen Receptor Modulators (Ostarine, Ligandrol, RAD-140, etc.)
Evidence grade 2 of 5, Thin. Read how the Atlas grades evidence.
The written rationale for this grade is still being prepared.
- FDA
- Not FDA approved; investigational, illegal in supplements
- WADA
- Prohibited (S1 Anabolic Agent)
Reference only. Not medical advice.
What can go wrong
The FDA has connected SARMs with risks including liver injury and acute liver failure, increased risk of heart attack or stroke, and testicular atrophy. Products marketed as SARMs are frequently mislabeled or contaminated. Because they are unapproved and unregulated, dose, purity, and identity cannot be assured, and the long-term safety in humans is not established.
This is something to take to a clinician. The Atlas can tell you what is known about sarms in general. It cannot tell you what is happening in your body, and the difference matters most for exactly the symptoms that bring people to this page.
Selective androgen receptor modulators (SARMs) are investigational compounds designed to stimulate the androgen receptor in muscle and bone with theoretically fewer effects on prostate and other tissues. None are FDA-approved for any use. The FDA has repeatedly warned that selling SARMs in dietary supplements is illegal and has linked them to serious risks. The World Anti-Doping Agency prohibits SARMs at all times for athletes; the list of named SARMs includes andarine, enobosarm (ostarine), ligandrol (LGD-4033), RAD140, S-23, and YK-11.
Marketed as safer steroids - sold illegally, none FDA approved.
What people take it for
These are the reasons people give for taking it. They are not effects it has been shown to have.
How it is supposed to work
SARMs are non-steroidal molecules that bind the androgen receptor and act as tissue-selective agonists, aiming to favor anabolic effects in muscle and bone over androgenic effects elsewhere. The selectivity is partial and varies by compound. Like testosterone, they activate androgen-receptor-driven protein synthesis, and many suppress the body's own LH, FSH, and testosterone.
Safety in detail
This intervention involves significant physiological effects and requires evaluation and monitoring by a qualified physician. SARMs are not FDA approved, are illegal to sell in dietary supplements, and self-administration carries documented health risks.
Replacement is not the same as a cycle
SARMs are not physiological replacement; they are unapproved anabolic agents used at non-medical doses to mimic or exceed androgenic muscle-building effects. As such they carry supraphysiological-type risks (HPG-axis suppression, lipid and possible cardiac effects, liver injury with some compounds) without the regulatory oversight, dosing accuracy, or monitoring that accompany prescribed testosterone.
What it does to fertility
Many SARMs suppress LH, FSH, and endogenous testosterone, causing testicular atrophy and impaired spermatogenesis; recovery is variable and not guaranteed, and unregulated dosing compounds the uncertainty.
What has to be monitored
The bloodwork this needs, and the reason it belongs with a clinician rather than a website.
- Liver function tests
- Lipid panel
- Testosterone, LH, FSH
- Cardiovascular risk assessment
What people get wrong
Nothing recorded here yet. There is almost certainly something people get wrong about this one, and the blank space means we have not written it down, not that the record is clean.
Who profits, and who pushes back
Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.
Set against the alternatives
SARMs are promoted as a middle ground between supplements and anabolic steroids, but unlike approved testosterone they have no FDA-approved indication, no regulated supply, and limited human safety data. They are not a legal or proven substitute for medically supervised testosterone therapy.
At a glance
- FDA status
- Investigational; none approved; illegal in supplements
- WADA
- Prohibited at all times (S1 anabolic agents)
- Marketing claim
- Muscle/bone selectivity with fewer side effects
What this entry does not yet cover
What follows is unfinished work on our side, not a finding about SARMs. A short entry is not a safe entry.
- Timeline. We have not built the dated record of research and regulatory events.
- Cost and market. We have not documented what it sells for or who sells it.
- Supply chain. We have not mapped where it is made.
- Who uses it. We have not documented the user groups.
- What could change. No forward-looking summary yet.
- Children and teenagers. We have not checked what is known about younger people.
- Where we land. We have not taken a position on this yet.
Sources
The studies below are named and described, but not linked. You cannot open them from here and check our reading against them, which means this page is our summary of the literature rather than a document you can verify. Weigh it accordingly until the links exist.
The studies that matter
Systematic review of SARM safety in healthy adults2023
Found suppression of endogenous testosterone and signals of harm including liver and lipid effects, concluding the safety profile does not support recreational use
Enobosarm (ostarine) muscle-wasting trials2010s
Showed lean-mass gains in cancer cachexia studies but the compound has not achieved FDA approval