A study appearing in the Journal of the American Medical Association reveals that products sold online as “selective androgen receptor modulators (SARMs)” are often adulterated, improperly labeled, or both. In this 150 Second analysis, F. Perry Wilson, MD, discusses the results and calls on physicians to stand up to this unregulated industry.
Selective Androgen Receptor Modulators (SARMs): A group of drugs that promise to target testosterone receptors in muscle cells to increase bulk and performance. They have names like ostarine and andarine, but I have never prescribed a patient one of these drugs. No one has, in the U.S. at least, since they aren’t FDA-approved for any indication.
But that doesn’t stop companies selling these drugs as nutritional “supplements” in an end-run around FDA regulation.
How easy is it to get these biologically active compounds? It took me about 20 seconds of Googling to arrive at this online store, where this happy fellow seems to be screaming the benefits of this class of agents.
A few clicks, and I was ready to order – via an unsecured web page – some “Black Magic” compound which purports to contain no less than 6 active ingredients, including SARMs. My massive gains were just around the corner.
But this article appearing in the Journal of the American Medical Association left me deflated.
Researchers ordered 44 different compounds from the Internet, each purporting to contain a SARM. Full disclosure here – they don’t report which sites they went to to get these drugs, so I can’t say that the site I referenced earlier was included in the study or not.
Anyway, the research group used advanced mass spectrometry to determine just what was in each of these 44 compounds. Let’s just say the quality of these compounds is not too strong.
Only 23 of the 44 compounds had any SARMs in them at all. Only 18 of those 23 had the amount of the compound that appeared on the label. Four of the 44 compounds had absolutely no active ingredient, and many compounds were adulterated with other chemicals, like the growth-hormone secretagogue ibutamoren.
Perhaps most upsetting to would-be bodybuilders out there, four products actually contained tamoxifen. Yup – a selective estrogen receptor modulator. Whoops.
These drugs – and I refuse to call them nutritional supplements – these are drugs – are not harmless. All the effects of anabolic steroids – baldness, rage, testicular atrophy, liver damage, stroke, and gynecomastia – have been seen in people taking SARMs.
And for my libertarian friends, I tend to agree that an individual should be entitled to make choices about the risks they take with their own body. But they at least deserve accurate labeling information.
The FDA seems to agree, issuing warnings to three supplement companies in October saying, no, these compounds are not nutritional supplements.
And in case it comes up, I don’t, and have never taken money from a pharmaceutical company for research, speaking fees, or any other purpose. We need to start standing up to the corrupt, unregulated, nutritional supplement industry not because we want to protect traditional pharma, but because we want to protect our patients.
F. Perry Wilson, MD, MSCE, is an assistant professor of medicine at the Yale School of Medicine. He is a MedPage Today reviewer, and in addition to his video analyses, he authors a blog, The Methods Man. You can follow @methodsmanmd on Twitter.