SARMs vs Steroids: Are SARMs Safer?

Dr George TouliatosDisclaimer: The following article is for educational purposes only and NOT to promote the use of illegal substances. If you have any questions or concerns, Dr. Touliatos is currently available for consultations.

SARMs (selective androgen receptor modulators) are highly coveted among the bodybuilding community, due to high-promise marketing claims.

SARMs manufacturers claim they mimic the effects of steroids for building muscle mass, yet with less side effects.

Is this true? Find out how SARMs really compare to steroids, based on existing medical research and anecdotal evidence/observations.

SARMs, if deemed safe, will serve the same purpose as anabolic steroids in medicine, helping to increase: lean muscle mass, red blood cell count and bone mineral content; in patients suffering from cachexia (muscle wasting), anemia and osteoporosis.

Thus, SARMs were formulated by scientists with the same objectives of anabolic steroids, however SARMs are intended to be a superior medicine that will not present the cardiovascular, androgenic, hepatic or estrogenic effects of anabolic steroids being prescribed today.

How They Work

SARMs and steroids share similarities in how they function, strongly binding to the androgen receptor to promote muscle-building, strength and fat loss in users.

However, new generation SARMs, formulated in the late 1990s, are non-steroidal and thus are not exogenous testosterone. Consequently, this has sparked debate among the bodybuilding community, with the claim of being able to take SARMs and remain ‘natural’.

A unique structural characteristic with SARMs is tissue selectivity, a mechanism which aims to stimulate anabolism in desirable cells, whilst inhibiting unwanted effects in others; thus potentially eliminating or reducing the side effects associated with anabolic steroids.

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Legal Status

Anabolic steroids are classed as Schedule III controlled substances and thus are illegal in the US and many other countries in the world. The only exception to this is being prescribed steroids by a doctor to treat a medical condition, such as issuing testosterone for hypogonadism.

The legality of SARMs is more of a gray area. They are perfectly legal to purchase for ‘research purposes‘, thus if you are buying SARMs to administer liquid drops to your rat and observe the effects, this is perfectly within the confines of the law.

However, as SARMs have not been approved by the FDA for human use, they are technically illegal to purchase or sell for human consumption; due to their recent formulation and long-term effects not yet being established.

Do Steroids Build More Muscle?

SARMs and anabolic steroids largely produce the same benefits in users, being: increased muscle mass, strength and fat loss (albeit to varying degrees).

There is medical research to suggest users’ results on anabolic steroids are significantly enhanced, compared to SARMs, with the latter only building a fraction of the lean mass in comparison.

In one trial, researchers found that humans being administered SARMs increased their fat-free mass by 1kg-1.5kg over 4-6 weeks (1).

However, the testosterone enanthate group gained 5-7kg in fat-free mass (on dosages of 300 and 600mg/week).

Furthermore, Dr. Thomas O’Connor has observed major adverse effects in numerous patients on SARMs, relating to their cholesterol and liver profiles. Yet he mentions such patients reporting little to no change in body composition.

Are SARMs Really Safer Than Steroids?

There is almost a century’s worth of medical research concerning anabolic steroids’ effects, since the creation of testosterone in 1935. Thus, steroids’ benefits, side effects and safety are generally well-known over the short and long term.

However, there is only a limited amount of research available for SARMs (particularly concerning the effects in humans), due to their recent discovery. Thus, SARMs are classed as investigational drugs, whereas anabolic steroids are not.

Some anabolic steroids are FDA approved in medicine, such as: anavar (oxandrolone), testosterone and deca durabolin (nandrolone); indicating an acceptable level of safety for treating chronic diseases.

For example, Anavar has been successfully prescribed to men, women and children for cachexia, indicating its mild nature and high tolerance.

Dr. Thomas O’Connor, on our medical team, has treated thousands of men on anabolic steroids for almost two decades.

In contrast, he has also treated over 2,000 men on SARMs, accumulating data over a ten year period.

Based on his vast anecdotal evidence and extensive analysis of patients’ labs, Dr. Thomas O’Connor concludes SARMs to be more dangerous than anabolic steroids. The main side effects he has observed include: cardiovascular strain, testosterone suppression and liver stress.

Dr. O’Connor likens the hepatotoxic effects of SARMs, being the equivalent of taking a huge dose of anavar (50mg/day).

The FDA has also found evidence of liver and cardiovascular complications in SARMs-users (even in the short term). In 2017, the FDA labeled SARMs as ‘potentially dangerous‘ and successfully shut down numerous online websites, that were labeling them as ‘dietary supplements’ (for human use), instead of ‘research chemicals’.

Side Effects (SARMs vs Steroids)

In theory, SARMs’ side effects should be milder than anabolic steroids, due to the mechanics of tissue selectivity.  However, in practice, SARMs’ side effects are similar (or even more severe) according to Dr. O’Connor.

Blood Pressure

One of the reasons why anabolic steroids are not a perfect medicine, is due to their negative effect on HDL/LDL cholesterol and blood pressure.

Different steroids will pose different levels of cardiovascular risk. For example, oral steroids such as dianabol or anadrol can cause large fluctuations in cholesterol, significantly increasing the risk of hypertension. However, injectable steroids, such as testosterone or deca durabolin only have mild effects on blood lipids.

There is also evidence of SARMs notably reducing HDL cholesterol levels (beneficial cholesterol), increasing the risk of arteriosclerosis.

SARMs’ negative effects on the heart may be similar in severity to oral steroids, due to the same method of administration (orally).

When taken by mouth and swallowed, SARMs and oral steroids are processed by the liver; in turn increasing the hepatic lipase enzyme, having an adverse effect on HDL cholesterol.

Thus, it is possible that certain injectable steroids are actually safer from a cardiovascular perspective, compared to SARMs; essentially bypassing the liver and maintaining a healthier blood lipid profile.

Liver Toxicity

As previously mentioned, liquid SARMs will be broken down by the liver, causing ALT/AST enzymes to rise, signifying inflammation and stress to the organ.

This is a similar effect to C-17 alpha alkylated oral steroids, which have the potential to cause liver damage, if abused.

There is research demonstrating high hepatotoxic effects of SARMs, after two previously healthy males developed hepatocellular–cholestatic liver injuries via short-term use (2). The first male used LGD-4033 (Ligandrol) for 9 weeks and the second male used RAD140 (Testolone) for 4 weeks.

These outcomes are extremely alarming, due to the short nature of use and given the typical resilience of the liver, displaying powerful self-healing properties (3); and thus the ability to endure high levels of stress without injury.

Injectable steroids will almost certainly be safer than SARMs, in regards to liver health. Even mild oral steroids such as: anavar, primobolan acetate and testosterone undecanoate, are likely to present significantly less hepatic risk.

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Testosterone Suppression

Anabolic steroids are forms of exogenous testosterone, thus when the body detects excessive levels of artificial testosterone, it shuts down natural production.

The effects of which can be felt in full force when a steroid cycle ceases, with users experiencing: diminished libido, sexual function, low energy and decreased well-being. Such side effects are often temporary, lasting several weeks or months depending on the steroids used.

Potent compounds like anadrol or trenbolone may cause hypogonadism (total shutdown), whereas mild steroids, such as: anavar or primobolan, may only cause a moderate decrease in testosterone.

SARMs are not steroidal compounds, however their high affinity when binding to the androgen receptor can cause decreases in endogenous testosterone (4). This results in a similar, transient effect on testosterone levels, like steroids.

The extent of testosterone suppression is not yet fully known with SARMs, however it is common practice for bodybuilders to utilize post cycle therapies after SARMs-cycles, in an attempt to recover their natural testosterone production.

Thus, moderate interference with the HPTA (hypothalamic-pituitary-testicular axis) can be expected on SARMs.

The more potent SARMs will cause greater decreases in natural testosterone, such as: LGD-4033 (Ligandrol) and RAD 140 (Testolone), in comparison to milder SARMs, such as: S4 (Andarine) and MK-2866 (Ostarine).


Certain anabolic steroids can cause gynecomastia, otherwise known as gyno, which essentially is the expansion of breast tissue in men.

In mild stages, this can appear as puffy nipples, however in latter stages the pectorals can resemble female breasts.

Several steroids can cause gynecomastia, due to the aromatase enzyme converting testosterone into estrogen. Other steroids can directly stimulate the estrogen receptors at a cellular level, such as anadrol (which does not have the aromatize enzyme present).

SARMs do not aromatize, however they can indirectly elevate estrogen levels, resulting in gynecomastia. This occurs due to SARMs competing with a user’s natural testosterone for binding to the androgen receptor. SARMs comfortably win this battle, due to a significantly higher binding affinity, leaving natural testosterone levels more readily available for binding to estrogen and DHT receptors.

Thus, gynecomastia is still possible on SARMs, as well as water retention and hair loss.

A mild anti-aromatase inhibitor, such as Arimistane (Androsta-3,5-diene-7,17-dione), may be taken during SARMs cycles, to counteract high estrogen side effects.

In contrast, bodybuilders will typically take more potent AI’s or SERMs during steroid cycles, to counteract estrogenic effects.

Note: there are ‘dry steroids’ that do not raise estrogen levels, creating a dry physique that poses no threat of gynecomastia. A few examples of such compounds are: anavar, superdrol, turinabol and winstrol.


Anabolic steroids are typically available in injectable or oral form.

However, due to SARMs technically being a ‘research chemical’, they seldom come in tablet form — but instead as a liquid.

Bodybuilders generally will administer liquid SARMs orally, either by swallowing it immediately or placing it under the tongue (sublingually), and letting it sit for 10-15 seconds before swallowing (for greater absorption via contact with the mucus membrane).

Injection is generally considered the less convenient, yet more optimal, administration method for both compounds. This is due to injectables causing less hepatic and cardiovascular stress.

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Increased damage to the liver can occur with orals, as they have to be broken down by the organ, upon entering the bloodstream (5). Furthermore, when being processed by the liver, orals can elevate hepatic lipase; exacerbating blood pressure via the increase of hepatic lipase.

When rating SARMs vs steroids for method of entry, steroids are more convenient, as users can simply swallow a tablet or inject the substance.

Finding SARMs in tablet form is possible, yet much less common. When swallowing liquid SARMs, they often have a strong/foul taste, that lingers afterwards.

SARMs More Suitable for Women

Many anabolic steroids are not suitable for women to take, due to high incidents of virilization (masculine side effects).

Women taking steroids can experience: enlarged clitoris size, breast reduction, deeper voice, irregular menstrual cycles and hair growth on the body.

There are exceptions to this rule, such as anavar, which females can take in moderate dosages and avoid masculine effects.

Despite limited research regarding SARMs’ relation to virilization, early anecdotal evidence suggests they are better tolerated by women; due to tissue selectivity reducing androgenicity.

However, notable risks to the liver and heart still apply to women taking SARMs. Such health risks appear to be considerably less when taking mild, female-friendly steroids, such as anavar.

Fake Products

Both anabolic steroids and SARMs are commonly counterfeited on the black market, presenting risks to users’ health.

However, pharmaceutical grade steroids are available to purchase, with several being prescribed for medical purposes (which then leak onto the black market).

Thus, pharmaceutical grade ensures a high quality product, being produced in a lab by scientists working for a pharmaceutical company, rather than being formulated in an underground lab (by a non-medical professional).

There is no pharmaceutical grade available for SARMs, as it is not currently prescribed by doctors, due to a lack of FDA approval.

Therefore, finding a reliable SARMs source that provides what is truly on the label, may be more challenging than finding pharmaceutical grade steroids.

SARMs vs Steroids: Who Wins?

There is almost a century’s worth of research documenting the effects of anabolic steroids, compared to just two decades worth of research for SARMs (with limited human trials).

Based on existing studies and anecdotal data, there is evidence to suggest SARMs are more harmful than steroids, with considerably less impact on body composition.

Therefore, the risk-to-reward ratio looks significantly better for steroids vs SARMs, particularly when administrating ‘safer steroids‘, such as: testosterone — which physicians routinely prescribe on a daily basis to men worldwide.

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