SARMs vs. Steroids: What Are Their Similarities and Differences?

Scientists have formulated selective androgen receptor modulators (SARMs) as a potential treatment for cachexia. SARM manufacturers claim they mimic the effects of steroids for building muscle mass, yet with fewer side effects. However, at this time, SARMs have not been approved by the Food and Drug Administration (FDA) for human use.

If SARMs are found to be safe, they may be used in medicine to treat:

• Cachexia
• Anemia
• Osteoporosis
• Red blood cell count
• Low bone mineral content

What Mechanisms Allow Both Compounds to Stimulate Anabolism?

Both SARMs and steroids strongly bind 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. Consequently, this has sparked debate among parts of the bodybuilding community, with the claim of being able to take SARMs and remain natural.

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

However, in practice, we have found this to be inaccurate, with SARMs demonstrating comparable levels of toxicity to anabolic steroids via our liver function and blood pressure tests. Research also shows that SARMs can induce hepatic injury and cause cholesterol alterations in certain users.

What Are the Legal Restrictions?

• The US and many other countries around the world classify anabolic steroids as Schedule 3 controlled substances, making them illegal.
• A doctor’s prescription for specific steroids, such as testosterone for hypogonadism, is an exception to this rule.

The legality of SARMs is less clear. They are legal in certain countries to purchase for research purposes; thus, if researchers are acquiring SARMs to administer liquid drops to rodents and observe the effects, this is within the confines of US 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.

Which is the More Anabolic Substance?

SARMs and anabolic steroids produce similar benefits for users, albeit to varying degrees. These include:

• Muscle mass
• Strength
• Fat loss

There is medical research to suggest users’ results on anabolic steroids are enhanced compared to SARMs, with the latter often building a portion of the lean mass in comparison. Our anecdotal findings also support this viewpoint.

• Researchers found that administering SARMs to humans increased their fat-free mass by 1–1.5 kg over 4–6 weeks (1).
• In comparison, the testosterone enanthate group gained 5–7 kg in fat-free mass on dosages of 300 and 600 mg/week.

Furthermore, Dr. Thomas O’Connor has observed adverse effects in numerous patients on SARMs, relating to their cholesterol and liver profiles. Also, such patients reported “little to no change” in body composition.

What Are the Potential Risks of Steroids and SARMs?

We have almost a century’s worth of medical research concerning anabolic steroids’ effects since the creation of testosterone in 1935.

Thus, steroid benefits, side effects, and safety are more thoroughly understood over the short and long term compared to SARMs.

We have a limited amount of clinical research available on SARMs, particularly concerning their effects on humans. Therefore, SARMs are classified as investigational drugs, unlike anabolic steroids.

The FDA has previously approved several anabolic steroids for use in medicine, including:

• Anavar (oxandrolone)
• Testosterone
• Anadrol (oxymetholone)
• Deca Durabolin (nandrolone)

Thus, the FDA once deemed these compounds to be safe for treating chronic diseases under medical supervision in therapeutic doses. However, the FDA has now retracted approval for oxandrolone as a treatment for cachexia.

What Has Dr. O’Connor Observed?

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

In contrast, he has treated over 2,000 men on SARMs, accumulating data over 10 years. Based on Dr. O’Connor’s anecdotal evidence and extensive analysis of patients’ laboratory tests, he has evidence to suggest that SARMs may be just as compromising as anabolic steroids in the dosages commonly administered by bodybuilders today. The main SARM side effects Dr. O’Connor has observed are:

• Cardiovascular strain
• Testosterone suppression
• Liver stress

Dr. O’Connor likens the hepatotoxic effects of most SARMs to “taking a large dose of Anavar, such as 50 mg/day.”

The FDA has also found evidence of liver and cardiovascular complications in SARM users in the short term.

In 2017, the FDA labeled SARMs as “potentially dangerous” and successfully shut down numerous online websites that were labeling SARMs as dietary supplements for human use instead of research chemicals.

What Are Dr. Israetel’s Thoughts?

Dr. Mike Israetel states that, despite SARMs being marketed as relatively safe supplements, they also pose health risks. Furthermore, Dr. Israetel warns that SARMs’ adverse effects can be similar to anabolic steroids with potentially less reward.

Some of our patients report taking SARMs, such as ostarine, without experiencing notable side effects. Therefore, SARMs may present reduced toxicity compared to anabolic steroids, depending on:

• The type of SARM utilized
• Dosage
• How the individual responds based on their body chemistry.

SARMs vs. Steroids: Which is More Toxic?

Individual responses can vary when taking SARMs or anabolic steroids, and unregulated use of either is potentially dangerous.

In theory, SARMs’ side effects could be milder than those of anabolic steroids due to the mechanics of tissue selectivity. However, in practice, we have observed toxicity with SARMs.

Blood Pressure

Anabolic steroids can have negative effects on:

• High-density lipoprotein (HDL)
• Low-density lipoprotein (LDL)
• Blood pressure

Different steroids can pose varying levels of cardiovascular risk. For example, oral steroids such as Dianabol or Anadrol can cause notable fluctuations in cholesterol, increasing the risk of hypertension. However, injectable steroids, such as testosterone or Deca Durabolin, have less toxic effects on blood lipids.

• Based on patients’ lipid profiles, we have evidence of SARMs notably reducing HDL cholesterol levels and increasing the risk of arteriosclerosis in some users.
• We find SARMs’ negative effects on the heart are similar in severity to steroid tablets, which may be attributed to them sharing the same method of oral administration.

When SARMs and steroids are taken by mouth, they are broken down by the liver. This can increase the hepatic lipase enzyme and lower HDL cholesterol.

Dr. Rand McClain has observed that SARMs, including ostarine, can cause deleterious effects on HDL cholesterol. Dr. McClain says, “From a medical perspective, it can make sense to administer anabolic steroids over SARMs” due to steroids being more extensively researched and able to induce higher levels of anabolism.

Liver Toxicity

As previously mentioned, liquid SARMs are broken down by the liver, potentially causing alanine transaminase (ALT) and aspartate transferase (AST) enzymes to rise, signifying inflammation and stress for the organ.

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

• Researchers have found that SARMs can damage the liver after two healthy men developed hepatocellular-cholestatic injuries (2).
• The first male used LGD-4033 for 9 weeks, and the second used RAD 140 (testolone) for 4 weeks.

These outcomes can be considered notable due to the short nature of use and the typical resilience of the liver, which displays self-healing properties (3). However, some SARM users’ ALT and AST enzymes do not rise to clinically high levels, and thus, there may be additional lifestyle factors that can exacerbate SARMs’ hepatotoxicity.

Testosterone Suppression

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

When a steroid cycle ceases, users may experience hypogonadal effects, such as the following:

• Diminished libido
• Impaired sexual function
• Low energy
• Decreased well-being

The above side effects can be temporary, lasting several weeks or months, depending on the steroids used. However, if an individual abuses anabolic steroids, these symptoms may be experienced long-term.

Anavar or Primobolan may cause a moderate drop in testosterone, while stronger compounds such as Anadrol or trenbolone can cause clinical hypogonadism.

SARMs have a strong affinity for the androgen receptor, which can lower the amount of testosterone your body produces naturally (4). This can result in a similar, transient effect on testosterone levels, comparable to steroids.

• The extent of testosterone suppression is not yet fully known with SARMs. However, we have seen 60–70% reductions in total testosterone via our sex hormone binding globulin (SHBG) tests.
• It is also common practice for bodybuilders to utilize post-cycle therapies following SARM cycles in an attempt to recover their natural testosterone production. Therefore, users can potentially anticipate moderate interference with the hypothalamic-pituitary-testicular axis (HPTA) on SARMs.

We see the more potent SARMs exacerbating natural testosterone, such as LGD-4033 and RAD 140. However, milder SARMs, such as S4 and MK-2866, can have a less negative effect.

Gynecomastia

Certain anabolic steroids can cause gynecomastia, which is essentially the expansion of breast tissue in men. This occurs 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 aromatase enzyme present.

• SARMs do not aromatize. However, they can indirectly elevate estrogen levels, resulting in mild cases of gynecomastia. This transpires due to SARMs competing with a user’s natural testosterone for binding to the androgen receptor.
• SARMs have a significantly higher binding affinity, resulting in natural testosterone levels being more readily available for binding to estrogen and dihydrotestosterone (DHT) receptors.

Thus, gynecomastia remains possible on SARMs, in conjunction with water retention and hair loss. However, estrogenic side effects are often less prominent compared to aromatizing anabolic steroids.

Researchers can use a mild aromatase inhibitor (AI) such as arimistane during SARM cycles to counteract the side effects of estrogen.

In contrast, we see bodybuilders typically utilize more potent AIs or selective estrogen receptor modulators (SERMs) during steroid cycles to inhibit estrogenic effects.

There are dry steroids that do not raise estrogen levels, creating a dry physique that decreases the risk of gynecomastia. Four examples of such compounds are:

1. Anavar
2. Superdrol
3. Turinabol
4. Winstrol

Anavar vs. SARMs: Which is More Effective?

Anavar has been the subject of continuous research for over 50 years. Thus, there is extensive clinical data detailing its effects. In contrast, the arrival of SARMs is more recent. Therefore, we do not entirely understand their effects.

Our patients on SARMs have experienced mixed results. Some users notice moderate muscle gains, while others fail to notice any significant benefits.

Several SARM users at our clinic have reported side effects equal to or worse than Anavar, relating to:

• Suppressed testosterone levels
• Elevated liver enzymes
• Low HDL cholesterol levels

Dr. O’Connor has observed moderate doses of Anavar being less toxic than SARMs and more efficacious, with increased anabolism and fat loss in some users. However, further scientific research is required on selective androgen receptor modulators to definitively conclude such.

• SARMs are legal for research and typically do not cause masculinization in women.
• Anavar is illegal to purchase in most countries, and with high doses, it poses the risk of virilization.
• Purchasing Anavar can be a riskier endeavor for women because underground laboratory products may not contain Anavar but Dianabol, which is known for its masculinizing effects. However, acquiring genuine SARMs can eliminate this risk.

Administration Methods: Which Are More Convenient?

Anabolic steroids are typically available in injectable or oral form. However, due to SARMs being classified as research chemicals, they are less commonly manufactured in tablet form but instead as a liquid.

There are no official dosing or administration guidelines for humans, as SARMs are currently only intended for research purposes.

• Bodybuilders can administer liquid SARMs orally, either by swallowing immediately or sublingually. The latter method involves placing the liquid under the tongue and letting it sit for 10–15 seconds before swallowing.
• Sublingual administration allows for greater absorption via contact with the mucous membrane.

Orals can cause hepatic stress because the liver must break them down once they enter the bloodstream (5). Orals commonly elevate hepatic lipase, exacerbating blood pressure via the reduction of HDL cholesterol.

When comparing SARMs vs. steroids for methods of entry, SARMs may be more straightforward for some users, as they are predominantly oral drugs and do not require injections.

However, when swallowing liquid SARMs, they can have a strong taste that lingers afterward.

What Are the Effects of SARMs on Women?

We find that most anabolic steroids are not suitable for women due to high incidents of virilization or masculinization.

Women utilizing anabolic steroids may experience:

• Clitoral hypertrophy
• Breast atrophy
• A deeper voice
• Irregular menstrual cycles
• Hirsutism

There may be exceptions to this rule, such as Anavar, which females can cycle in conservative dosages and commonly avoid masculine side effects.

Despite the paucity of research on the virilizing effects of SARMs, our anecdotal findings indicate that women do not experience such effects because their tissue selectivity inhibits androgenicity. However, notable risks to the liver and heart may still apply to women taking SARMs.

Which Are the Most Counterfeited Substances?

Illicit sellers frequently counterfeit both anabolic steroids and SARMs, posing health risks to users.

• Physicians prescribe specific anabolic steroids for medical purposes, which can later appear on the underground market.
• Medical professionals formulate pharmaceutical-grade steroids in a laboratory, ensuring users receive the correct active ingredient and dose.

Due to a lack of FDA approval, doctors do not prescribe pharmaceutical-grade SARMs. Therefore, it may be equally challenging to find a reliable SARM source that meets the label’s specifications as it is to find pharmaceutical-grade steroids.

Reviews

Researchers have published these steroid and SARM anecdotes in our private Facebook group.

I like SARMs; they do the job but can be suppressive like most PEDs. MK-2866 is probably the safest and least suppressive. RAD 140 is my favorite SARM, but it can get pretty suppressive, and I’ve used every one of them. But the key to all PEDs is bloodwork.

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SARMs are easily accessible. A lot fewer side effects, but there is a ceiling. It really depends on your ultimate goal. Long term, it’s going to be SARMs for me because I’m not competing. For me, having an option where I don’t have to stab myself with stuff is a huge plus.

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Technically not a SARM, but I love MK 677, especially when bulking. Side effect of being hungry all the time. Find you sleep a lot better on it as well.

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SARMs are weak steroids that still reduce or shut down your test in most cases. If you are going to use PEDs, stick with the old tried-and-true AAS.

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I’ve tried SARMs. They work. If you use actual gear, YK-11 could be interesting to you. The ones for muscle gain are nowhere near the effectiveness of gear. However, the ones to increase endurance are a nice addition to a tren cycle.

SARMs vs. Steroids: What is the Verdict?

Based on existing studies and our anecdotal data, there is evidence to suggest SARMs can cause toxicity similar to anabolic steroids.

SARMs may also produce less anabolism compared to anabolic steroids. Therefore, the risk-to-reward ratio at this stage may be more optimal for anabolic steroids than SARMs. This could be especially true when administering less cardiotoxic and hepatotoxic steroids such as testosterone, which US physicians prescribed to over 1,000,000 men in 2017 (6).

However, testosterone and other anabolic steroids can also cause deteriorations in health, potentially leading to fatal outcomes. Thus, anabolic steroids and SARMs are not advised in supraphysiological doses or for cosmetic purposes.

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