SUN-129 Adverse Events and Toxicity Associated with Selective Androgen Receptor Modulators

Abstract A. Joshi: None. E. Fraser: None. D.F. Kaune: None. P. Leff: None. S. Lee: None. M. Hazin: None. Background: Selective Androgen Receptor Modulators (SARMs) are a class of androgen receptor ligands that bind to targeted androgen receptors in the body. Akin to anabolic steroids, SARMs have anabolic effects on muscle and bone. While originally developed to treat conditions like osteoporosis and muscle wasting, no SARM has received FDA approval, and limited safety and efficacy data has been published. However, outlets to purchase SARMs online as “research chemicals” have caused them to gain popularity in the fitness community. Despite a safer reputation than anabolic steroids, adverse effects on the liver, kidney, and endocrine system, along with reports of rhabdomyolysis, have emerged. This study seeks to explore the effects of SARMs through an analysis of self-reported posts on the social media platform Reddit. Methods: Posts were extracted from communities of SARMs users on Reddit using a python-based script. Posts were categorized as “pre-SARMs cycle use,” “mid-SARMs cycle use,” and “post-SARMs cycle use” based on the user’s self-reported stage. Self-reported demographic data, symptoms, laboratory values, and adjunctive medications taken were extrapolated. Results: 5,249 posts were extracted. 1,329 were removed due to an inability to categorize their SARMs usage. Of the 3,877 remaining posts, 1,694 were pre-SARMs use, 1,412 were mid-SARMs use, and 771 were post-SARMs use. The mean reported age was 27 years (range 13-63). The most common reported adverse effects were abdominal pain, decreased libido, and fatigue. Of the 418 users that reported their gender, 20 (4.8%) identified as female. An analysis of blood work revealed significant increases in AST (27.7 U/L vs 74.3 U/L, p<0.001), ALT (29.4 U/L vs 125.6 U/L, p<0.001), and estrogen (31.1 pg/mL vs 41.5 pg/mL, p=0.04) during SARMs use. Significant increases in creatinine kinase (259 U/L vs 708 U/L, p=0.02), LDL (80.6 mg/dL vs 99.1 mg/dL, p<0.001), triglycerides (50.6 mg/dL vs 61.3 mg/dL, p=0.02) along with significant decreases in HDL (44.5 mg/dL vs 31.2 mg/dL, p<0.001), total testosterone (585.5 ng/dL vs 420.2 ng/dL, p<0.001), and sex hormone binding globulin (42.9 nmol/L vs 18.0 nmol/L, p<0.001), before and after SARMs use were seen. No significant changes in alkaline phosphatase, bilirubin, creatinine, LH, FSH, cholesterol, or hemoglobin were seen. 382 out of 2183 (17.5%) SARMs users reported using tamoxifen or enclomiphene during or after SARMs use. Discussion: With the increasing popularity of SARMs, the need for studies on SARM safety is essential. This investigation found that many Reddit users experienced adverse effects from SARMs, with the most significant being liver toxicity, testosterone suppression, and metabolic dysfunction. Physicians must be aware that patients use social media forums to seek and report medical advice, and adverse events are likely underreported in the medical literature. Sunday, June 2, 2024