REDEFINING FITNESS

In the world of bodybuilding, anabolic steroids are a black-market commodity, and for decades have been used by athletes and bodybuilders to increase their size and strength.

 

But not all steroid use is illegal. For example, the growing field of research on selective androgen receptor modulators, or SARMs (https://www.anabolicshealth.com/best-sarms-for-sale/), has created a class of compounds that a doctor can legally prescribe to patients with muscle wasting or osteoporosis but that show many of the same effects as traditional steroids.

 

A number of these drugs have advanced into clinical trials, where they're being tested both alone and in conjunction with other therapies to determine whether they can help combat diseases such as cancer. For example, one drug from the class known as S23 was recently studied in a phase I trial with patients suffering from head and neck cancer.

 

A new wave of SARMs is hitting the market, too. Some are available over-the-counter at supplement stores, while others require a doctor's prescription.

 

"I think they're getting popular," says Daniel Lynch, DPT, MBA, CSCS, the cofounder of the website BeyondPhysique .com, who specializes in helping athletes develop better training regimens. "They all have different mechanisms of action, so there are different benefits to them."

 

But it can be difficult for consumers to separate hype from safety when buying these products online or through health food retailers because less research exists on this class of drugs than illegal steroids. In addition, many of the products that claim to be legal steroids are often mislabeled, says Antonio Caballero, MD, associate professor at the University of North Carolina's department of family medicine.

 

"A lot of these compounds will say they're natural because they derive from plants or plant extracts," says Caballero. "They may contain ingredients that boost testosterone production but in some cases don't meet the strict definition of being a steroid."

 

The Food and Drug Administration defines anabolic steroids as synthetic derivatives of testosterone whose known primary uses include inducing male puberty, hypogonadism, impotence, and wasting conditions. Therefore, the FDA has not approved them for any other use.
While some websites sell SARMs legally through online pharmacies that require a prescription, others market them as supplements whose effects are similar to steroids but without legal restrictions.

 

A Better Alternative?

 

Some experts consider SARMs a promising alternative for men who want an edge in increasing muscle mass and strength, increasing bone density, and improving body composition.

SARMs work by selectively activating the progesterone receptor in specific tissues while leaving it inactive in others. In animal studies, this mechanism has been shown to stimulate muscle growth and bone formation while suppressing fat deposition — just like traditional testosterone-based steroids — without adverse side effects such as enlarged prostates and testicular degeneration.

The selective nature of SARMs also might help prevent cancer, a benefit that caught the eye of researchers. In 2009, scientists at the University of Tennessee reported that SARMs could regulate prostate-specific antigen levels and reduce symptoms in men with late-stage prostate cancer.

 

But research on this class of drugs has been limited to animal studies and a few human clinical trials looking at their potential to treat metabolic disorders such as type II diabetes and osteoporosis. One 2008 trial published in The Journal of Pharmacology and Experimental Therapeutics examined seven different SARMs for possible use with atherosclerosis patients. Still, they found no significant difference between groups using the drugs compared with a placebo group. Another study from 2010 showed that one SARM was more effective than a placebo group in protecting against bone fractures.

"There's not enough data to say that they're safe," says Caballero. "But they appear to be efficacious for serious diseases such as osteoporosis and some types of cancer."

 

So while some people believe SARMs are an ideal alternative for users who want the muscle-building benefits of steroids without their adverse effects, experts still recommend extreme caution when using them. Scientists also note that SARMs can cause problems similar to traditional testosterone replacement therapy. For example, one SARM, known as Ostarine, was recently linked to reports of high liver pressure and tumors in rodents.

 

"They're still investigational drugs," says William Hiard, MD, an associate professor at the University of Florida College of Medicine-Jacksonville. "We need to learn more about their action in muscle and bone before they can be approved."

 

Meanwhile, buying them online or from local supplement stores can leave you operating in legal gray areas due to their unregulated nature. And with little guidance on how much to take, some users may face unexpected side effects.

"The biggest concern is that people are self-medicating," says Caballero. "People think they're taking something that will build muscle without working out, which isn't true."

 

Not Yet Regulated. The FDA has approved testosterone supplements only for men who lack or have low hormone levels because of medical reasons, such as genetic defects or chemotherapy.

 

SARMs are not currently regulated by the U.S. Food and Drug Administration. This means that their effects on muscle growth and bone density have yet to be thoroughly evaluated in clinical trials. In addition, some experts suspect that not all products labeled as SARMs contain selective androgen receptor modulators. Instead, they may have other potentially harmful substances such as steroidal prohormones whose side effects range from hair loss to increased risk for heart disease and liver problems.

 

"There's a lot we don't know yet," says Dr. Gholson. "SARMs may be safe and effective, but we need more research to find out."

 

Until the FDA approves SARMs for use in humans — something unlikely to occur without larger-scale clinical trials — experts recommend against using them or buying them online.