If you spend time on the fitspo side of the internet, it’s likely you’ll have heard of SARMs. SARMs – short for selective androgen receptor modulators – are a type of image or performance-enhancing drug (IPED) that promote fast muscle growth. The biggest difference between SARMs and steroids is that, while steroids need to be injected, SARMs are taken as a pill, like a supplement. 

A recent BBC News investigation found that SARMs, which are unregulated, are being sold illegally in shops around the UK, but they’re also available to purchase online. Research suggests that SARMs use is becoming more and more prevalent (as are SARMs-related health issues). While it’s not clear just how common SARMs use is, an analysis of London’s sewage systems in 2018 found that it was more prevalent than MDMA and Cocaine.

It is social media that has a big hand in the proliferation of SARMs use, particularly among young people, studies have found. Google search data shows searches for ‘sarms’ spiked this year and, although the search term is regulated on TikTok, ‘sarmsinfo’ and ‘ssarms’ have 14.2M and 509K views respectively. By the end of 2021, YouTube had more than 1,000 videos with SARMs in the title, with the top 100 videos on YouTube racking up 60,000,000 views (suffice to say, it’s likely this figure has increased). 

Britain has been facing a growing “epidemic” of IPED use for a few years now, and SARMs are simply an extension of that. Ryan Jones, a sports massage therapist based in Manchester, says it comes down to body dysmorphia. “Some of my clients who use SARMs and PEDs will be training multiple times a day and using, but that definitely comes down to body dysmorphia,” he tells Dazed. “It’s not wanting to ever change their shape or stop being lean, because there are people on social media who are lean all year round, which is pretty much impossible without being fully undernourished.” 

Jones estimates that some 50 per cent of his clients – all men – use some kind of IPED, most commonly SARMs. He’s also found that many are experiencing adverse side effects as a result, from one client who can “no longer [naturally] produce testosterone” to others who have ligament and tendon damage due to their muscles growing at a faster rate than their supporting tissue can handle. “It’s got to the point where I straight up ask people if they’ve been using performance-enhancing drugs, that’s how common it is,” he adds. 

The general consensus appears to be that SARMs aren’t as dangerous as steroids because they don’t need to be injected – but health experts say that this is far from the case. While there is limited research on the short and long-term effects of SARMs, some doctors say they may in fact be more harmful than steroids, with potential damage to the liver, hormone production and tendon rupture as well as harder-to-measure mental health problems. 

As always, the safest option will always be not to use SARMs (or any other IPEDs) at all, but for those of you who will read that and do it anyway, here’s what you need to know.

HOW DO SARMS WORK?

Similar to steroids, SARMs work by binding to your androgen receptors, increasing your potential for muscle growth. Unlike steroids, SARMs are tissue-selective, meaning they are capable of stimulating some receptors and not others. (It’s important to note that SARMs, which are relatively new, aren’t 100 per cent tissue-selective). Essentially, if you work out and use SARMs, it’s likely you’ll see a faster increase in muscle mass than if you didn’t use SARMs.

WHAT ARE THE MAIN PROBLEMS ASSOCIATED WITH IT?

The issue with SARMs, says Laura Wilson, head of the Royal Pharmaceutical Society (RPS), is that there’s such little research on their harms, in the short term but definitely in the long term. 

LACK OF REGULATION

With SARMs being so unregulated, the reality is that the majority of what is being sold isn’t what it’s marketed as. One American review of SARMs being sold found that 48 per cent did not contain any SARMs, 39 per cent contained other unapproved drugs, and nine per cent didn’t contain any active substances. “You could literally be taking anything,” says Wilson. “These products often use other cheap and unregulated products, so you’ll have no idea what the effects could be on the body. They’ll also mix in other things like talcum powder and acidic products, which are also harmful to the body.” This is one of the key harms of SARMs – you have no idea if what you’re getting is legit.

HORMONAL PROBLEMS

If you do manage to get actual SARMs, the health risks are similar to those of steroids. “What we do see are the sort of effects you get with steroid use,” Wilson tells Dazed. These include hormonal changes, such as lower testosterone and higher oestrogen. “In men, this can lead to the development of breast tissue, issues with fertility, low libido, hair loss and erectile dysfunction.” While there is even less research relating to women in SARMs use, Wilson says that they are also likely to experience low libido and problems with their menstrual cycle. SARMs may also cause acne

It’s important to note that, due to the limited research available, there’s no way of knowing whether or not these harms are reversible. One TikTok user who said he’d been abusing SARMs since he was 15 claims that he can no longer naturally produce testosterone, just like Jones’ client. When people use SARMs the testosterone produced by their body has no use, explains Wilson. “When you suppress a hormone for long enough, your body will generally think it doesn’t need it,” she says. “In the short term, the body usually corrects itself, but if the damage is longer term it may not be reversible.” In this instance, someone may have to take a testosterone supplement for the rest of their lives. 

There’s also evidence of SARMs-related liver damage and, worst case, liver failure – something that would affect people of all sexes. On top of that, America’s Food and Drug Administration (FDA) says that SARMs can increase risk of heart attack or stroke.

MENTAL HEALTH

Finally, SARMs, like steroids, can have an impact on your mental health. Some people report severe depression, mood swings, irritability (yep, roid rage) and, according to the FDA, SARMs may even be able to induce psychosis. According to Wilson, there are also the mental health impacts that directly tie to the side effects of using SARMs, like low libido, poor sexual performance and the development of tissue in the wrong places. You can also become dependent on SARMs, which can cause withdrawal symptoms when stopped.

HOW TO BE SAFE IF YOU REALLY WANT TO USE SARMS 

If, after reading all of that, you still want to use SARMs, there are a few things you can do to make sure you’re safe.

BE WARY ABOUT WHERE YOU’RE GETTING THEM FROM

As mentioned, the majority of SARMs sold online and in shops aren’t SARMs at all. If you can’t get them from a trusted source who can guarantee that what you’re taking are genuine, then your best bet would be not to buy it at all.

TALK TO SOMEONE WHO KNOWS

The biggest difference between SARMs and steroids is that steroids are injected – this fact alone often causes people planning to use steroids to seek out reliable advice from a specialist or at least someone who also uses steroids. Since SARMs are taken as a tablet, says Wilson, people are less inclined to ask for advice, but that doesn’t mean you shouldn’t. Find a trusted professional or a local IPED clinic, such as the Juice Bar in Yorkshire or Glasgow Image and Performance Enhancing Drugs Clinic in Scotland, who can give you non-judgemental and trustworthy advice on using SARMs.

GET YOUR BLOOD TESTED REGULARLY

While it’s unlikely you’ll be able to get your blood tested on the NHS for SARMS use, you could either pay to have it done privately or visit a local IPED clinic. This is vital to check whether your hormones and liver are functioning properly. Liver damage rarely has any symptoms before it's too late, so attending regular health screenings is paramount!

Finally, keep an eye out for any warning signs that might indicate you’re having an adverse reaction to SARMs. “If you feel more tired than usual, for example, or you notice tissue growth in places you weren't expecting it, or your libido has decreased or you’re feeling more irritable than usual, these are all warning signs,” says Wilson. “If you feel anything that is not normal for you, then you should seek help and advice as soon as possible.”

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