Selective androgen receptor modulators (SARMs) are an increasingly popular form of appearance- and performance-enhancing drugs that are sold online and sometimes used by bodybuilders, athletes and soldiers. Compared to more commonly used anabolic steroids, SARMs are more selective, making them an attractive target for use in the development of drugs to treat aging and muscle wasting disorders. However, SARMs are still under investigation, and have not been approved by the Food and Drug Administration, and products sold through the internet and advertised to contain SARMs may not contain these ingredients. Shalender Bhasin, MD, an investigator from Brigham and Women's Hospital, in collaboration with colleagues at the United States Anti-Doping Agency and the Uniformed Services University of the Health Sciences, analyzed the chemical composition of products sold online as SARMs. This systematic investigation found that many products sold over the internet as SARMs contained unapproved drugs and substances and many were mislabeled. Their results are published online this week in JAMA.
"Our investigation shows how easily these products can be obtained over the internet, despite the fact that their safety and effectiveness have not been determined," said corresponding author Bhasin, MD, director of the Research Program in Men's Health in the Division of Aging and Metabolism at BWH. "Many of these products are sold as dietary supplements, although these compounds do not meet the definition of a nutritional supplement. For many products, the ingredients and amounts found through our analysis did not match label information."
The researchers conducted simple Google searches with common SARM search terms and found more than 210 products for online purchase. Many were out of stock, discontinued or restricted, but 44 were available for purchase. Product labels listed common SARMs including ostarine, andarine, RA140, ibutamoren, GW501516 and SR9009. The team followed strict chemical analysis procedures approved by the World Anti-Doping Agency to evaluate these 44 drugs. They report:
- SARMs accounted for only 23 of 44 products tested (52 percent)
- In only 18 of the 44 products (41 percent) the amount of active compound in the product matched that listed on the label
- In 11 products (25 percent) the listed compound was detected but at an amount that differed from the label
- In 8 products (18 percent), the compound listed on the label was not found
- Three products (7 percent) contained the amount listed but also an unlisted compound
- In four products (9 percent) no active compounds were detected
The authors note that their findings should not be viewed as representative of all products sold. However, they note that greater regulatory oversight of these substances is needed, especially because of the growing abuse of appearance- and performance-enhancing drugs by young men and the increasing prevalence of body image disorders in young men, adolescents and members of US armed forces.
"This investigation demonstrates the ease with which unapproved appearance- and performance-enhancing drugs can be purchased over the internet, which could increase abuse by adolescents, military personnel and recreational weightlifters," said Bhasin. "Small laboratories can easily synthesize, package and sell compounds on the web, creating and removing sites to stay ahead of law enforcement, and profiting while end users experience adverse effects. More stringent regulatory oversight of these substances is needed because these appearance- and performance-enhancing drugs pose a threat to the health of our young men and soldiers."
This project was partially funded by Defense Health Program grant HT9404-13-1-0017 through the Henry M. Jackson Foundation for the Advancement of Military Medicine to the US Anti-Doping Agency.