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Research · Peptides and SARMs

SARMs

Grey marketNot approved for human use in the US, and sold anyway.

In placebo-controlled trials lasting 3 to 16 weeks, enobosarm and LGD-4033 raised lean body mass, while physical function changed inconsistently. LGD-4033 lowered testosterone and HDL cholesterol. Of 44 products sold online as SARMs, only 52% contained one. Published case reports describe liver injury, and FDA warns of liver injury, heart attack and stroke.

Add to Bio HackChecked 2026-11-09
Status
Investigational in the US. No SARM is FDA-approved for any use. They are not peptides. FDA states that products marketed as SARMs are unapproved drugs, not dietary supplements. Prohibited at all times by WADA (S1.2).
Also called
selective androgen receptor modulators, ostarine, enobosarm, MK-2866, GTx-024, RAD-140, testolone, LGD-4033, ligandrol
Taken for
muscle growth, lean mass, strength, fat loss, recovery, bone density, testosterone alternative

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help1

Reported risks6

What people take it for, and what was found

Shown to help1

Moderate

Lean body mass

Shown to add lean mass, about 1 to 1.5 kg across short trials, in healthy adults and people with cancer weight loss. Lean mass is not the same as strength.

The numbers and sources
Effect
LGD-4033 raised lean body mass in a dose-dependent way over 21 days [1]. Enobosarm raised total lean body mass in a dose-dependent way over 12 weeks, significant against placebo at the higher dose [2]. In people with cancer-related weight loss, lean mass rose by a median 1.5 kg and 1.0 kg in the two enobosarm groups by day 113, against 0.02 kg on placebo [3]. A 2026 review reports lean mass rising by roughly 1 to 1.5 kg across randomized trials [4].
Population
76 healthy men aged 21 to 50 [1]; 120 healthy men over 60 and postmenopausal women [2]; 159 men over 45 and postmenopausal women with cancer and at least 2% weight loss, 100 in the efficacy analysis [3].
Sources
[1], [2], [3], [4]
Caveats
The trials were short. In the cancer trial, the gains were changes from baseline within each group, and the trial was funded by GTx, the developer [3]. Lean mass by DEXA is not the same as muscle strength.

Mixed results1

Limited

Physical function and strength

Limited evidence: one trial found better physical function in healthy older adults, and a review found improvement inconsistent across trials.

The numbers and sources
Effect
In healthy older adults, physical function improved on enobosarm against placebo (P = 0.013) [2]. The 2026 review reports that physical function improved inconsistently across trials [4].
Population
120 healthy older adults over 12 weeks [2]; trials summarized in a review [4].
Sources
[2], [4]
Caveats
One phase 2 trial plus a narrative review.

Risks

Reported risks6

ModerateHow often is not known

Lower testosterone and HDL cholesterol

Shown to lower testosterone and HDL cholesterol in healthy men, more at higher doses. Levels returned to baseline after stopping.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
LGD-4033 lowered total testosterone, sex hormone-binding globulin, HDL cholesterol and triglycerides in a dose-dependent way. FSH and free testosterone fell at the highest dose. Levels returned to baseline after stopping [1]. The 2026 review reports suppression of testosterone, sex hormone-binding globulin and HDL cholesterol across randomized trials, with reversible rises in liver enzymes for some compounds [4].
Population
76 healthy young men over 21 days and 5 weeks of follow-up [1]; trials summarized in a review [4].
Sources
[1], [4]
Caveats
Trial doses were lower and shorter than the stacked, unmonitored use the review describes [4].
LimitedHow often is not known

Liver injury

Case reports: severe liver injury with jaundice after SARM products, usually reversible after stopping. Products were rarely tested, so hidden steroids cannot be ruled out.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
A review of published reports found 20 reports of adverse events since 2020, most described as drug-induced liver injury, with cholestatic or hepatocellular injury and jaundice [5]. A 32-year-old man developed severe liver injury after using LGD-4033, with cholestatic hepatitis and mild fibrosis on biopsy [6]. A 52-year-old man developed liver injury after products containing RAD-140 and LGD-4033, and his liver enzymes returned to normal about 3 months after stopping [7]. The 2026 review describes cholestatic liver injury as the main serious harm, prolonged but usually reversible [4].
Population
Published case reports of people using SARM products [4][5][6][7].
Sources
[4], [5], [6], [7]
Caveats
Case reports cannot give a rate. In almost all cases the product was not analyzed, so undeclared steroids cannot be ruled out [4]. LGD-4033 did not change liver enzymes over 21 days in the controlled trial [1].
LimitedHow often is not known

Heart and tendon harms in case reports

Case reports: 15 men had liver injury, myocarditis or tendon rupture after SARMs. Most were athletes taking doses far above those in clinical studies.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
A systematic review of 72 articles from 2003 to 2022 found 13 case reports describing 15 people harmed after using SARMs. All were men, median age 32 (range 19 to 52), more than half were athletes, and all took SARMs by mouth for a mean of 8 weeks. Reported harms included drug-induced liver injury, myocarditis and tendon rupture. Athletes reported doses much higher than those used in clinical studies [8].
Population
15 published cases, plus preclinical and clinical studies summarized in the review [8].
Sources
[8]
Caveats
Case reports cannot give a rate, and the review rates its own evidence as level 4. The review estimates SARM use among athletes at 1% to 3% [8].
LimitedHow often is not known

Mislabeled products

One analysis found only 52% of 44 online SARM products contained a SARM, and 39% held another unapproved drug. Label amounts matched in 41%.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Of 44 products sold online as SARMs, 23 (52%) contained one or more SARMs. 17 (39%) contained another unapproved drug, including ibutamoren, GW501516 and SR9009. 4 (9%) contained no active compound, and 11 (25%) contained substances not on the label. The amount matched the label in 18 (41%) [9].
Population
44 products bought from online sellers in 2016 [9].
Sources
[9]
Caveats
One analysis of products bought at one time. The 2026 review cites the same pattern [4].
LimitedHow often is not known

FDA warnings

FDA states life-threatening reactions, including liver injury needing hospitalization, have occurred with SARM products, and lists potential heart attack, stroke, psychosis and infertility.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
FDA states that life-threatening reactions, including liver injuries that required hospitalization, have occurred in people taking products containing SARMs. It lists potential heart attack or stroke, psychosis or hallucinations, sleep disturbance, sexual dysfunction, liver failure, infertility, miscarriage and testicular shrinkage. FDA testing of one product labeled as containing YK-11 found an undeclared anabolic steroid, after an adverse event report of a stroke [10]. Warning letters in 2023 and December 2025 told sellers that SARM products were unapproved new drugs, despite labels saying they were for research only [11][12].
Population
US consumers and sellers [10][11][12].
Sources
[10], [11], [12]
Caveats
Regulator statements of potential harm, without rates.
LimitedHow often is not known

Positive doping tests

WADA prohibits SARMs at all times. Positive tests rose from 15 in 2014 to 142 in 2019, then fell to 106 in 2024.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
WADA lists SARMs, including enobosarm, LGD-4033 and RAD140, under S1.2, prohibited at all times [13]. Adverse analytical findings for SARMs rose from 15 in 2014 to 142 in 2019, then were 139 in 2023 and 106 in 2024 [4].
Population
Athletes subject to the World Anti-Doping Code [4][13].
Sources
[13], [4]
Caveats
Counts depend on how many tests were run and how broad the screening was [4].

Claims tested and not found

  1. That SARMs leave natural testosterone alone. LGD-4033 lowered total testosterone in a dose-dependent way over 21 days [1].
  2. That SARMs reduce body fat. In the LGD-4033 trial, fat mass did not change significantly [1].

Sources

  1. Basaria S, Collins L, Dillon EL, et al. The Safety, Pharmacokinetics, and Effects of LGD-4033, a Novel Nonsteroidal Oral, Selective Androgen Receptor Modulator, in Healthy Young Men. Journals of Gerontology: Series A. 2013. https://doi.org/10.1093/gerona/gls078
  2. Dalton JT, Barnette KG, Bohl CE, et al. The selective androgen receptor modulator GTx-024 (enobosarm) improves lean body mass and physical function in healthy elderly men and postmenopausal women: results of a double-blind, placebo-controlled phase II trial. Journal of Cachexia, Sarcopenia and Muscle. 2011. https://doi.org/10.1007/s13539-011-0034-6
  3. Dobs AS, Boccia RV, Croot CC, et al. Effects of enobosarm on muscle wasting and physical function in patients with cancer: a double-blind, randomised controlled phase 2 trial. The Lancet Oncology. 2013. https://doi.org/10.1016/S1470-2045(13)70055-X
  4. Adolf J, Enev G. Selective Androgen Receptor Modulators (SARMs) in Sport: Patterns of Use, Product Contamination, Health Risks and Doping-Control Implications. Drug Testing and Analysis. 2026. https://doi.org/10.1002/dta.70174
  5. Leciejewska N, Jedrejko K, Gomez-Renaud VM, et al. Selective androgen receptor modulator use and related adverse events including drug-induced liver injury: Analysis of suspected cases. European Journal of Clinical Pharmacology. 2024. https://doi.org/10.1007/s00228-023-03592-3
  6. Barbara M, Dhingra S, Mindikoglu AL. Ligandrol (LGD-4033)-Induced Liver Injury. ACG Case Reports Journal. 2020. https://doi.org/10.14309/crj.0000000000000370
  7. Barbara M, Dhingra S, Mindikoglu AL. Drug-Induced Liver Injury Associated With Alpha Bolic (RAD-140) and Alpha Elite (RAD-140 and LGD-4033). ACG Case Reports Journal. 2020. https://doi.org/10.14309/crj.0000000000000409
  8. Vasireddi N, Hahamyan HA, Gould HP, et al. Athlete Selective Androgen Receptor Modulators Abuse: A Systematic Review. The American Journal of Sports Medicine. 2025. https://doi.org/10.1177/03635465241252435
  9. Van Wagoner RM, Eichner A, Bhasin S, et al. Chemical Composition and Labeling of Substances Marketed as Selective Androgen Receptor Modulators and Sold via the Internet. JAMA. 2017. https://doi.org/10.1001/jama.2017.17069
  10. U.S. Food and Drug Administration. Certain bodybuilding products put consumers at risk for heart attack, stroke, serious liver damage and more. 2025. https://www.fda.gov/drugs/fraudulent-products/certain-bodybuilding-products-put-consumers-risk-heart-attack-stroke-serious-liver-damage-and-more
  11. U.S. Food and Drug Administration. Warning Letter: Warrior Labz SARMS, MARCS-CMS 655280. 2023. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/warrior-labz-sarms-655280-06122023
  12. U.S. Food and Drug Administration. Warning Letter: Dynamic Health Group dba SARMS AMERICA, MARCS-CMS 719257. 2025. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/dynamic-health-group-dba-sarms-america-719257-12122025
  13. World Anti-Doping Agency. The Prohibited List. 2026. https://www.wada-ama.org/en/prohibited-list

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