SARMs

Summary

Survey of the 16 compounds that circulate as SARMs, in PubMed and ClinicalTrials.gov. The evidence ranking is almost the inverse of the sales ranking: enobosarm has 17 registered trials and two in phase 3; RAD140, the most discussed on training forums, has a single trial in its entire history, with 20 patients; andarine, YK-11, S-23, ACP-105, LGD-3303 and RAD-150 have zero. The field's two phase 3 trials, with 651 patients combined, were never published in a journal — the results exist only as tables posted on ClinicalTrials.gov, and one of them took seven and a half years to be posted. An umbrella review of performance drugs in healthy athletes looked for SARM studies and found none eligible. On the other side, harm has numbers: 23 cases of liver injury in an Australian series, 17 hospitalizations and one transplant. In Brazil, RE 791/2021 bans sale, import, advertising, use and also compounding.

This page's question

A SARM is not a peptide. It is a small, oral molecule that acts on the androgen receptor — the same pathway as testosterone, with the promise of acting on muscle and bone without acting on the prostate and scalp. It enters this reference because it circulates in the same places, is bought on the same sites and is stacked in the same cycles as the rest of the material here.

The question this page answers is the same as on the other primary-source pages: how much evidence exists in people. But with an aggravating factor the peptides do not have — in the case of SARMs, there is measurement of what comes inside the vial, and it changes the entire conversation.

That is why the page starts with the vial, and only then talks about the molecule.

Start with the vial, not the molecule

Two independent chemical analyses bought products sold as SARMs and measured what was inside. The numbers below are theirs, not mine.

Why this comes before everything else

• Discussing the profile of a specific SARM assumes the vial contains that SARM. In the largest published analysis, that held for little more than half the samples.
• Whoever received MK-677, GW501516 or SR9009 instead did not even take a SARM — they are a GH secretagogue, a PPARδ agonist and a REV-ERB agonist. Different mechanism, different literature, different risk. The mental package insert the person read does not describe what they took.
• The problem reaches people who never even looked for a SARM. In a survey of 170 gym-going adolescents in Athens, 9% of supplement users were consuming products contaminated with anabolic steroids, prohormones, SARMs and aromatase inhibitors not declared on the label. 63% bought online, and none had spoken to a doctor or a nutritionist.
• Everything below describes molecules. The table above describes merchandise. The two are not the same thing, and the second is what arrives at your door.

How much evidence exists, compound by compound

The Query column carries the exact term that produced the number next to it. Paste it into PubMed and the result has to be the same — if it is not, the number here is stale, and what counts is what the database returns to you.

On ClinicalTrials.gov the search was by intervention, with the same synonyms — including VK5211 for ligandrol, under which the hip fracture trial is registered. Without that synonym the search returns zero, and the page would claim there is no trial of the compound at all.

Survey done in PubMed and ClinicalTrials.gov on September 4, 2026. The column that decides is not the one for papers: it is the one for registered trials in humans.

What this table means

• The evidence ranking is almost the inverse of the sales ranking. The compound with phase 3 (enobosarm) is not the one that sells; the best-selling and most-discussed one on training forums, RAD140, has its entire human base in 20 cancer patients, once, in 2020.
• Four popular compounds have zero registered clinical trials: andarine, YK-11, S-23 and the ACP-105 / LGD-3303 / RAD-150 block. Their literature is rodents, cell culture and anti-doping analytical chemistry — not studies in people.
• The systematic review covering the field lists six SARMs — LGD-4033, PF-06260414, GSK2881078, GTx-024, MK-0773 and OPK-88004 — pooling 9 randomized trials and 970 patients, mean age 57.1 years and mean follow-up of 80 days. Note who is not on that list: RAD140, andarine, YK-11 and S-23.
• The studied population is sick and old. The outcomes are cancer cachexia, sarcopenia, hip fracture, COPD, prostatic hyperplasia and breast cancer. Nobody studied the thirty-year-old man who trains.
• No SARM has been approved by any agency, anywhere, for any indication.

The only human trial of RAD140, from the inside

This trial is worth opening, because it is the entire human base of the grey market's best-selling compound — and because what is inside it is almost never cited.

It is NCT03088527, first-in-human, published by LoRusso and colleagues in 2022. A 3+3 dose-escalation design in postmenopausal women with ER+/HER2− metastatic breast cancer, heavily pretreated. The dose levels were 50 mg (n=6), 100 mg (n=13) and 150 mg (n=3), once daily.

Keep those three numbers in mind. Whenever any source cites a “clinical trial dose range” for RAD140, this is where it comes from — there is no other. And it is an oncology range, calibrated against metastatic cancer, not against hypertrophy.

How to read this trial

• The only clinical dose that exists for RAD140 is an oncology dose. That resolves an oddity that shows up in the hepatotoxicity literature: the RAD140 “trial” range (50 to 150 mg) is higher than the range reported in the liver injury cases (5 to 30 mg), the opposite of what happens with ligandrol and enobosarm. It is not an anomaly — it is that, for the other two, a low-dose trial exists for comparison. For RAD140 there is none. The table that puts the two ranges side by side is in dose adjustment by liver function.
• The liver was already showing up there. Under medical supervision, for at least 28 days, almost half the patients had elevated ALT and almost three in five had elevated AST. It is not a new finding from the grey market: it is what the compound's first contact with the human body showed.
• “Acceptable safety profile” is the authors' conclusion, and it is correct in their context. Acceptable compared with metastatic breast cancer in a patient with no other line of treatment. Carrying that phrase over to someone who wants to build muscle swaps out the entire denominator of the judgment.
• ⚠️ A discrepancy between the sources, which I did not resolve. ClinicalTrials.gov declares 20 participants; the published paper says 22 enrolled, 21 of them androgen receptor positive. Both sources are legitimate and do not match. The frequencies in this table are the paper's, out of 22.

The field's only two phase 3 trials

The POWER 1 and POWER 2 trials tested enobosarm against placebo in muscle wasting from lung cancer, with 651 patients combined. They are the top of the evidence pyramid for all SARMs.

And there is no paper on them. No results publication has been indexed in PubMed or appears linked to the registrations themselves — the only reference tied to the two is the design paper. The numbers below were extracted from the ClinicalTrials.gov API v2 on September 4, 2026, which is the only place they exist.

Both trials had co-primary endpoints, measured at day 84 as the percentage of responders: a gain of ≥10% in stair-climb power for physical function, and a change of ≥0% (that is, not losing) for lean mass.

How to read these numbers without overreaching

• The registry posts no statistical analysis, no p-value and no secondary endpoint — only the proportions and their intervals. That is why this page claims no significance in any direction.
• In physical function the effect does not show up. In POWER 1 the intervals overlap across almost their entire range. In POWER 2 the drug's estimate falls below placebo's — 19.5% versus 24.8%.
• In lean mass the drug is ahead in both, with differences of 11.5 and 8.6 percentage points — but the intervals still overlap in both.
• Because the endpoints were co-primary, a physical-function result that does not separate from placebo is enough for the program to fail to deliver what it needed. What came next is consistent with that: no approval application for cachexia, and enobosarm moved on to breast cancer and, now, to preserving lean mass in people on GLP-1.
• No safety signal against the drug: serious adverse events practically identical between arms in both trials.
• The POWER 2 results were only posted on November 9, 2020 — seven and a half years after primary completion, in May 2013. Those of POWER 1 came out on March 3, 2016.
• Both records declare a restrictive publication agreement: the sponsor receives an advance copy of any communication of results 60 days ahead, has 60 days to request changes and can request a further 60 days of delay; the investigator does not present data before publication by the sponsor or before 18 months after the end of the study.

A note on the numbers of these two trials

The group sizes cited above for POWER 1 and POWER 2 are those of the evaluable population — those who reached the end with efficacy data. The ClinicalTrials.gov registration gives the randomization numbers, which are larger: 321 in POWER 1 and 330 in POWER 2, the latter with 165 in each arm.

I record the difference because it is a common source of confusion when comparing a publication with the registration of the same trial — and because it was checking one against the other that revealed the distinction here.

The efficacy numbers that exist, and how big they are

Outside the POWER trials, three published trials support almost everything that is claimed about SARMs. It is worth seeing what each one measured, in whom, and for how long.

The review that looked for an effect in healthy people and found none

It is the most uncomfortable finding on this page, and it is not mine: it comes from an umbrella review of systematic reviews and meta-analyses on seven pharmacological performance-enhancing interventions in healthy athletes.

SARMs were in the search protocol. The result: no SARM study met the inclusion criteria. There was nothing to review.

In the same review, creatine is the only intervention with a performance benefit considered safe at controlled doses — and it costs a fraction, is legal and has a package insert.

In other words: for the healthy person who trains, which is who buys, the level of aggregate evidence on SARMs is zero eligible systematic reviews. Meanwhile, harm already has case series, hospitalization and a transplant — the next section.

Safety: what is documented

Unlike efficacy, harm has numbers, has case series and has hard outcomes.

In Brazil, this is banned — and the ban includes compounding

This is the practical difference between the SARM page and almost every other page on this site. Here there is no grey zone of personal import or compounded formula: there is a resolution that closes both doors.

The three that are sold as SARMs and are not

All three showed up as substitutes or adulterants in the products analyzed by JAMA. None acts on the androgen receptor.

What this page did not do

• It gives no dose, half-life, cycle protocol or reconstitution scheme, by decision. It is the second page on the site without dosing, after the one on prescription-only items. Describing a usage scheme for a substance whose compounding has been banned would be writing what must not be followed.
• I did not check the full text of RE 791/2021. The number, the date and the scope of the measure came from the official page; the named list of seized products, which circulates in secondary sources, was not checked against the text of the resolution.
• There is no formal hypothesis test in the POWER trials. The registry posts no p-value. Everything this page reads is limited to comparing estimates and intervals.
• I did not look up the secondary endpoints of the POWER trials because they do not exist publicly: the design called for durability at day 147 and a pooled survival analysis, and none of it was posted.
• I did not verify the halt of GW501516 development over carcinogenicity in rodents, which is widely cited in the field. I did not look up the primary source, so it is not a claim of this page.
• There is no Brazilian data on prevalence of use. The 1% to 3% estimate is from athletes, in the international literature.

What is left after all this

• The top of this field's evidence pyramid never went through peer review. The only two phase 3 trials of any SARM, 651 patients combined, exist only as tables in a public registry — no paper, no p-value, no secondary endpoint, and one of them posted seven and a half years late. When people say evidence on SARMs is lacking, it is not only absence of studies: it is evidence produced and not published.
• Where there is an efficacy number, it is modest and odd — +1.5 kg of lean mass in 113 days in the best case, with the higher dose yielding less than the lower one.
• The absence of evidence in healthy people is formal, not impressionistic. An umbrella review looked and did not find a single eligible study.
• Risk, by contrast, has numbers: 15 cases of DILI in one review, 23 in an Australian series with 17 hospitalizations and one transplant, 58 days of median latency, 175 days until the liver normalized.
• And the biggest risk is not even pharmacological. Half the products do not contain what they claim to contain. Before choosing the molecule, there is a merchandise problem to solve — and it is not solved by reading about the molecule.

References

1. Van Wagoner RM et al., 2017 — chemical analysis of 44 products sold online as SARMs. JAMA 318(20):2004-2010. It is the source of the table that opens this page.
2. Gaudiano MC et al., 2024 — illegal SARM products bought in Italy: analysis by mass spectrometry and quantitative NMR. Sex Med 12(2):qfae018.
3. Tsarouhas K et al., 2018 — supplements contaminated with doping substances in adolescent athletes in Athens. Food Chem Toxicol 115:447-450.
4. Wen J et al., 2024 — systematic review of SARMs on physical performance: 9 randomized trials, 970 patients, six compounds. Clin Endocrinol 102(1):3-27.
5. Vignali JD et al., 2023 — systematic review of the safety of SARMs in healthy adults, with implications for recreational use. J Xenobiot 13(2):218-236.
6. Vasireddi N et al., 2025 — systematic review of SARM abuse by athletes. Am J Sports Med 53(4):999-1009.
7. Warrier AA et al., 2023 — umbrella review of systematic reviews on performance-enhancing drugs in healthy athletes. No SARM study met the inclusion criteria. Sports Health 16(5):695-705.
8. Nash E et al., 2024 — liver injury from SARMs, anabolic steroids and bodybuilding supplements in Australia: 23 cases, one transplant. Aliment Pharmacol Ther 59(8):953-961.
9. Mohideen H et al., 2023 — SARMs as an emerging liver toxin: cholestatic pattern of injury. J Clin Transl Hepatol 11(1):188-196.
10. Basaria S et al., 2013 — safety, pharmacokinetics and effects of LGD-4033 in healthy young men, 21 days. J Gerontol A Biol Sci Med Sci 68(1):87-95.
11. Dobs AS et al., 2013 — effect of enobosarm on muscle wasting and physical function in patients with cancer: phase 2 trial. Lancet Oncol 14(4):335-345.
12. Palmieri C et al., 2024 — activity and safety of enobosarm in AR+/ER+/HER2− advanced breast cancer: phase 2. Lancet Oncol 25(3):317-325.
13. LoRusso P et al., 2022 — phase 1, first-in-human study of RAD140 in ER+/HER2- metastatic breast cancer. Source of the dose levels and adverse event frequencies on this page. Clin Breast Cancer 22(1):67-77.
14. Crawford J et al., 2016 — design and rationale of the enobosarm phase 3 program (POWER trials). It is the only publication linked to the two registrations. Curr Oncol Rep 18(6):37.
15. ClinicalTrials.gov, registration NCT01355484 (POWER 1) — co-primary endpoint results, extracted from API v2 on September 4, 2026.
16. ClinicalTrials.gov, registration NCT01355497 (POWER 2) — co-primary endpoint results, posted on November 9, 2020.
17. Brazilian Doping Control Authority — World Anti-Doping Code, 2026 Prohibited List, in force since January 1, 2026. Section S1.2, page 6.
18. FDA — 'FDA Warns of Use of Selective Androgen Receptor Modulators (SARMs) Among Teens, Young Adults', page dated April 26, 2023.

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