Are SARMs safer than steroids?

Short answer

No. SARMs lowered testosterone and good cholesterol within 3 weeks, and liver injuries keep being reported. Of 44 products sold online, only 52% actually contained SARMs, and some even contained testosterone.

Are SARMs safer than steroids?
'Acts only on muscle → fewer side effects' — does this formula hold?
SARMs (selective androgen receptor modulators) are said to act only on muscle and bone, so they supposedly cause fewer side effects than steroids. They are not approved as medicine in the US or Europe. We checked the research on whether they really act only on muscle.
Muscle did grow
Lean mass went up in 3 weeks
76 people were randomly given one SARM (LGD-4033) or a fake pill for 21 days. The bigger the amount, the more lean mass (muscle and everything except fat) they gained, while fat did not change. The muscle-building effect was real.
But it didn't act only on muscle
Testosterone and good cholesterol dropped
In the same 21-day trial, the bigger the amount, the more the body's own testosterone and good cholesterol (HDL) dropped. They returned to normal after stopping. A review pooling 33 studies found that 8 SARM trials reported lower good cholesterol. These are the same kinds of changes seen with steroids.
The liver got hurt too
On average, 7.1% of trial participants had raised liver enzymes
A review of 33 studies, including 1,447 people exposed to SARMs, found that on average 7.1% of trial participants had raised liver enzymes, and 15 cases of liver injury were reported. At 9 hospitals in Australia, 17 of 23 people with liver injury from steroids, SARMs or supplements were admitted; liver tests took a median of 175 days to normalize, and 1 needed a liver transplant.
What about real-world users?
Over half of 343 users had side effects
A survey of 343 people who had used SARMs found that over 90% bought them online and used them without seeing a doctor. More than half had side effects such as mood swings, shrinking testicles and acne. A 2025 review of 72 papers noted that users take far larger amounts than those studied.
The bigger problem: what's in the bottle
Only 52% of 44 products contained SARMs
Analysis of 44 products bought online found that only 23 (52%) contained SARMs. 17 (39%) contained other unapproved drugs, and 25% had ingredients not on the label. In 13 products bought in Italy, 30% contained undeclared drugs, including testosterone and a steroid-type drug.
Bottom line: not safer than steroids
Hormones, cholesterol, liver — the same price paid
SARMs built muscle, but within 3 weeks they lowered testosterone and good cholesterol, and liver injuries keep being reported. Only half of online products contained SARMs as labeled, and some even contained testosterone. The formula 'a safe drug that acts only on muscle' did not hold.