long-term consequences of using SARMs are largely unknown, and people
who purchase products marketed as them cannot be entirely sure what
they are putting in their bodies, said Dr. Shalender Bhasin, the
director of research programs in men’s health, aging and metabolism at
Brigham and Women’s Hospital and an author of the JAMA report.
don’t know whether these compounds are safe,” he said, “but we do know
that some of them have side effects.”
has not stopped many people from experimenting with them.
Owen, 42, a self-described biohackerwho lives in Saint Paul, Minn.,
began using SARMs in 2016 in combination with a diet and exercise
program. He said that the pills helped him pack on five pounds of
muscle in four weeks, which he documented on his website,
“PrimalHacker.” He argued that informed adults should be allowed “to
experiment on ourselves and improve our biology,” but added, “this is
definitely a use-at-your-own-risk type of supplement.”
officials have known about SARMs for some time and have seen an
increasing number of elite athletes using them. Since 2015, the United
States Anti-Doping Agency has imposed sanctions on more than two dozen
track and field stars, weight lifters, cyclists, mixed martial artists
and others for testing positive for a variety of SARMs, most
frequently one called ostarine.
year, Joakim Noah, a center for the New York Knicks, was suspended
for 20 games for testing positive for a SARM.
The college basketball star Allonzo Trier of the Arizona Wildcats was
also suspended for using SARMs. And in October, a top CrossFit Games
competitor, Ricky Garard, was stripped of his third-place title after
testing positive for two SARMs: ostarine and testolone.
the underground use of SARMs has made them controversial, the drugs
could one day serve a crucial purpose for many patients.
developed SARMs decades ago to counter the age-related
decline in muscle and strength that tends to
begin around middle age and that can contribute to falls and broken
bones. Many chronic diseases, such as cancer, heart failure and kidney
disease, are also punctuated by a loss of muscle and physical
and androgenic steroids such as testosterone can help people regain
muscle and physical function. But they act on many tissues throughout
the body and have been tied to a litany of potential side effects,
including prostate problems and cardiovascular events.
were designed to selectively target skeletal muscle and spare other
tissues, in an attempt to reduce some of these unwanted side effects.
A number of trials are looking at their usefulness in
cancer patients, people recovering
from hip surgery, and postmenopausal
women with urinary incontinencelinked to weak pelvic muscles.
trial at Boston University demonstrated that
LGD-4033, a SARM developed by Ligand Pharmaceuticals, was safe and
tolerable in healthy men, producing “significant gains in muscle mass
and strength” without raising levels of a protein linked to prostate
cancer. But it had other effects as well, for instance causing a drop
in HDL cholesterol, the protective kind, which raised questions about
its effects on heart health.
studies are needed to clarify the effects of long-term SARM
administration on cardiovascular risk,” the authors concluded.
O’Connor, a doctor who founded a
men’s health clinic and wrote a book called “America
on Steroids,” said that many of his patients are anabolic
steroid users who turned to SARMs because they were told that they
were safe and nontoxic. He said that since 2010 has seen “hundreds,
maybe over 1,000 men on SARMs” from all walks of life: police
officers, defense workers, amateur athletes, accountants and others.
hard to determine the precise impact of SARMs because many people who
use them combine them with other drugs, supplements and substances,
Dr. O’Connor said. But one thing he often sees among people using
SARMs is that their cholesterol profiles worsen and their liver
enzymes rise, a sign of increased strain on their livers. Some also
experience diminished sex drive, hair loss, acne and irritability,
though it’s often difficult to know whether it’s the SARMs causing
these symptoms or some other unlisted ingredients in the products.
a longtime power lifter, Dr. O’Connor said he relates to a lot of his
patients and understands their desire to be bigger, stronger and
fitter. But he counsels them to give up the drugs they are using
because they are jeopardizing their health.
always tell them the same thing,” he said. “These are illicit agents.
They’re not supported by expert guidelines and they’re dangerous. So
don’t take them.”
Council for Responsible Nutrition, a supplement industry trade group, launched
a campaign on social media, #SARMSCanHarm, and is working with
sports clubs, fitness groups and coaches around the country. The
military and federal government also have an awareness campaign about
risky products called Operation
Deuster, a professor of military and emergency medicine at the
Uniformed Services University of the Health Sciences, said SARMs are
popular among some soldiers because they are easier to access than
anabolic steroids, but she warns them there are hazards, citing one
soldier who suffered liver damage and could not deploy with his unit
because he was hospitalized after using a product containing SARMs and
try to tell them that there are other ways that they can achieve their
goals without risking their health or their ability to maintain their
deployment status,” Dr. Deuster said. “We are trying to educate them.”