Consumer story: Tim and selective androgen receptor modulators (SARMs)

Selective androgen receptor modulators (SARMs) are a group of experimental, prescription-only medicines sometimes used illegally by bodybuilders.

People who use SARMs purchased online take three risks:

• SARMs are risky to use because they haven't been approved for human use, are still being researched, have documented health risks and may have other unknown health risks.
• An illegal medicine sold online may not contain what the seller says it will. It could contain other, potentially dangerous ingredients, or a different dose to the one on the label.
• Access to SARMs without a valid prescription, license or authority is illegal, and in some cases may result in fines and/or jail time. SARMs also require a permit to import.

Tim's story explains the risks of using SARMs, and how to find reliable information about the safety, effectiveness and legality of a medicine.

Tim's story

Tim is 32 and an enthusiastic amateur bodybuilder.

Tim wants something that will boost his performance in the gym, but doesn't want to break the law or risk his health.

While looking at photos from a fitness competition on social media, Tim sees an online ad for a bodybuilding supplement. The ad claims that this supplement will help build muscle, but without the unwanted side effects of steroids.

Tim clicks through to the retailer's website, which offers for sale a bodybuilding supplement that contains SARMs. The website hosts medical-sounding language about the safety and effectiveness of SARMs compared to similar products, including suggested doses. The website also claims that the product is legal because they are selling it "for research purposes only".

Tim is convinced by the claims on the website, and decides to purchase the SARMs supplement.

A company in China mails Tim's order to Australia, but when the package reaches Australia it is seized by the Australian Border Force. In Australia, SARMs are a prescription-only medicine, and can only be imported with a permit. Tim does not have a prescription or permit, and is breaking the law.

Tim loses his money, and is open to serious legal action including a fine and/or jail time.

What are SARMs?

SARMs are experimental medicines claimed to build muscle mass and bone density, and claimed to have fewer side effects than similar products such as steroids. SARMs were originally developed as a potential treatment to build strength in the elderly and people with wasting diseases, and are prescription-only medicines because their use should always be monitored by a doctor.

No SARM has been fully researched, or approved for human use.

What are the health risks of SARMs?

Because research into SARMs for human use is limited, the full risk of using SARMs has not been established, especially the possible long-term impact on health. In 2017, the Food and Drug Administration (FDA) in the United States warned that use of SARMs was linked to liver failure, and increased risk of heart attack or stroke.

There is limited information on how SARMs interact with other medications or conditions, and no official guidance on appropriate dosage.

What are the additional risks of buying a medicine online?

Illegal medicines sold online may not contain what they say they will. Some products sold as SARMs actually contain other ingredients such as steroids.

A study published in the Journal of the American Medical Association examined the contents of 44 products sold online as containing a SARM. This study found that only 52% of the products examined actually contained SARMs, and that 25% of the products examined contained an unlisted ingredient. Some products contained a different dosage to the one advertised, and some had no active ingredients at all.

What laws is Tim breaking?

In Australia, patients require a doctor's prescription to access SARMs. Access for any other reason requires an appropriate license or authority consistent with state and territory laws.

SARMs also require a permit from the Office of Drug Control (ODC) to import. These are only granted to the treating medical practitioner or pharmacist.

Generally, products similar to SARMs are likely to also require a prescription to access, and a permit to import.

For some products, the laws can be stricter. The drug cardarine is sometimes sold as a SARMs-like fitness product, but is so dangerous to health that in Australia all sale, supply and use are prohibited.

Claims by sellers such as "for research purposes only" do not evade the law, and are often only intended to mislead potential buyers into breaking the law.

Illegal importation of SARMs can result in fines and/or jail time.

How can Tim check if a medicine is safe and legal?

Rather than believing claims made online, Tim can find out whether a product is safe and legal by checking a reliable source:

• A doctor or pharmacist can provide advice on a medicine, including any potential benefits and risks, and whether a prescription is necessary.
• The Office of Drug Control (ODC) website maintains a list of controlled substances, which shows whether a particular medicine will require a permit or license to import. However any substance that purports to be a SARM will likely require an import permit even if not on the list.
• The Therapeutic Goods Administration (TGA) approves prescription medicines for use and records approved medicines on the Australian Register of Therapeutic Goods. At present, no SARMs medicines are approved for use.

By learning about medicines from reliable sources, in the future Tim will be protected against potentially dangerous products and misleading claims by online retailers.

A doctor can guide Tim on how to achieve his performance and image goals without risking his health or breaking the law.