SARMs vs Anabolic Steroids: What the Evidence Says

SARMs are often sold as a “safer steroid”: muscle without the side effects. The research does not support that pitch. They are a genuinely different class of drug with some interesting properties, but none is approved for any use, they still suppress natural testosterone and lower HDL, and the products sold online are often not what the label says. Here is a fair comparison.

Two different designs

Anabolic steroids are versions of testosterone or DHT. They act on androgen receptors everywhere: muscle, bone, skin, prostate, brain and hair follicles. Many also convert to estrogen or DHT. SARMs are non-steroidal molecules designed to activate the androgen receptor strongly in muscle and bone while having less effect in tissues such as the prostate. They do not convert to estrogen or DHT. That selectivity is the whole idea, and in animal studies it works reasonably well.

What human trials showed

Most human data come from studies of compounds such as ostarine (enobosarm) and ligandrol (LGD-4033) in older adults, cancer patients and people losing muscle. These trials found modest gains in lean mass, usually around one to three kilograms over weeks to months, at amounts far below what is commonly used outside research. They also found suppression of testosterone and falls in HDL cholesterol that grew with the dose. None of these drugs reached approval. Our guide to how SARMs work explains the receptor science.

Side by side

	SARMs	Anabolic steroids
Medical approval	None	Several (testosterone, oxandrolone historically, others)
Human research	Early-phase trials only	Decades of clinical use
Converts to estrogen or DHT	No	Many do
Suppresses natural testosterone	Yes, dose-dependent	Yes
Lowers HDL cholesterol	Yes	Yes
Liver injury reports	Yes, published case reports	Mainly with oral compounds
Product reliability	Frequently mislabelled	Varies by source

“No side effects” is a marketing claim

Suppression is the clearest example. Studies of ligandrol in healthy young men found total testosterone dropped noticeably within three weeks, along with HDL. Case reports describe liver injury, including cholestatic hepatitis, linked to several SARMs. Regulators in Canada and the United States have warned consumers about unauthorised SARM products and the risks of liver injury, heart attack and stroke. None of this means SARMs are more dangerous than steroids, but it does mean they are not the free lunch they are sold as.

The product quality problem

A study published in a major medical journal analysed SARMs bought online and found that only about half contained the SARM on the label in the stated amount; some contained a different SARM, unapproved drugs or none at all. When a product’s identity is uncertain, so is every risk estimate.

Which is “safer”?

For a healthy adult, neither is safe, and the comparison depends heavily on amount and duration. Testosterone at medical levels has the strongest safety data of any androgen because it is a prescribed medicine with decades of monitoring. SARMs have far less data, mostly in older or ill people over short periods. What both share is the need for baseline and follow-up bloodwork.

Bloodwork for anyone considering either

Testosterone, LH and FSH to measure suppression; a lipid panel; liver enzymes; a complete blood count; and blood pressure. Our article on what to have in place before you start covers the full list.

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