can you blast and cruise sarms

How to PCT After RAD 140 – Keep Your Gains!

When the reviews said RAD 140 would be the best steroid-free gym experience of your life; they weren’t lying. Over the last six to eight weeks, you’ve probably made more progress with your workouts than you did since your first started training.

SARMs are the real deal, they boost performance and enhance growth, with real-world results you see under the iron, and in the mirror. Testolone (RAD 140) is a powerful compound. It’s popular for dieting if you were getting ready for the stage or the beach during your cycle, it’s likely you noticed you hardly lost any muscle mass during your fat loss.

RAD 140 is ideal for a “ recomp ,” and if you’re already lean when using it, you’re going to get some amazing results as everything tightens up. Six weeks in, you’ll notice the enhanced vascularity and endurance in the gym, with workout performance soaring. During the final weeks, your muscles start to develop that hard, grainy look.

Do you have to come off? What does it feel like when you do?

Coming off RAD 140

The reality is you can’t stay “on” forever. SARMs like RAD 140 aren’t as suppressive as traditional anabolics like testosterone, but they still provide a low level of “shutdown.” Shutdown occurs in the use of Anabolic Androgenic Steroids (AAS) (1), where the body experiences a disruption in the hypothalamic Pituitary Testicular Axis (HPTS).

Exogenous AAS use halts the body’s natural production of testosterone, breaking the rhythm of the HPTA. During your AAS cycle, you feel like a million bucks. You’re hitting PRs with every workout because you’re enhancing your Test levels with injectables or oral steroids.

After a “cycle” of six to ten weeks (advanced bodybuilders can cycle for up to 24-weeks, using a blast-and-cruise” strategy with HRT (Hormone Replacement Therapy), where they never come off) You’ll need to recover your natural test production by restarting the HPTA.

To do this, you’ll need the use of either Tamoxifen (Nolvadex) or Clomifene (Clomid) , depending on the type of AAS in your cycle. Some users might also introduce hCG (Human chorionic gonadotropin) to stabilize and boost LH (Luteinizing hormone) during and after-cycle.

Looking for pure Testolone? Buy high purity RAD 140 , YK 11 , MK 677 and LGD 4033 from one of the stores in the Verified Sources list.

These drugs form the basis of a Post-Cycle Therapy (PCT) protocol. The duration and dosages involved with AAS PCT vary from person-to-person, depending on the compounds used, cycle length, and existing conditions.

Without PCT, it takes your body longer to “recover” and restart the HPTA. Some individuals may never fully recover or not recover at all, resulting in a condition known as “Hypogonadism.” Hypogonadism refers to a situation where you can no longer produce testosterone. As a result, you need Hormone Replacement Therapy (HRT) for the rest of your life.

It’s for this reason that first-time users of AAS should limit cycle length to 10-weeks maximum, use as low a dose as possible, and always do PCT (preferably with an hCG protocol during and post-cycle)

Do I need a PCT protocol for RAD 140?

RAD 140 PCT

Now for some good news. SARMs don’t cause the same level of shutdown as AAS (2). If you compare the effect on the HPTA between an oral steroid like Dianabol (Metandienone) to RAD 140 , it has vastly different results.

With Dianabol, the HPTA experiences a fast and hard shutdown, whereas RAD 140 does not suppress the HPTA at all. Some users report minimal to no suppression with doses as high as 15mg to 20mg per day. However, everyone has a different response to drugs. Where some individuals may see no sides, others might experience sides at smaller doses.

There is some indication that large doses of RAD 140, taken in extended cycles, can cause suppression (3). However, in most cases, it’s not a total shutdown, and recovery is easier with OTC supplements.

Individuals that experience a hard shutdown from a long cycle, or “Stacking” Testolone with other SARMs , might benefit from a drug-based PCT protocol. Using Nolvadex or Clomid to restore the HPTA might work, as will other aromatase inhibitors.

However, undergoing a self-prescribed PCT is never a good idea. Always consult with a medical professional for advice when attempting a drug-based PCT protocol. Drugs like Nolvadex feature in studies for male castration and the last thing you need is an inaccurate PCT dose.

What is the best RAD 140 PCT protocol?

If you stuck to a sensible dose during your cycle, you shouldn’t have any issues with “coming off.” Most users start a cycle with a 5mg dose to test the waters. If no sides present after 3-days, boost it by 5mg. In the second week, check how you feel, and up the dose again to the 15mg mark.

Most new users of Testolone don’t need to go higher than 20mg. However, you might want to kick things up a level in the last week or two of your cycle and attempt the 20mg per day limit on this drug. Read my guide to dosing RAD 140 for a more detailed explanation, or the my article on stacking RAD 140 for multi-compound cycles.

It’s time to start your PCT after finishing your cycle. PCT typically lasts four weeks, and you’ll need to take time off after you conclude the protocol. Starting another cycle directly after completing PCT is a bad idea. Chances are you won’t see the same results, and sides will be worse the second time around.

A good PCT for RAD 140 would include a test boosting product designed to enhance natural test production. Look for formulations that include arachidonic acid (AA), as well as long-jack, Yohimbe bark, ketosterone, and Urtica dioica.

Take this formula every day, and have a doctor check your bloodwork 4-weeks after completing PCT. If your hormone panel comes back as normal, you can start planning your next cycle.

Closing & FAQ

Final points and common Testolone PCT questions

Your RAD 140 cycle was probably the best training experience of your life. The PRs in the gym, the size, and definition in the mirror – everything is paying off. If you want to keep your gains, you need to cycle off the compound the right way.

Even though RAD 140 is mildly suppressive, you’ll still need cycle support and a PCT featuring OTC products. After completing your PCT, take 12-weeks off before starting your next cycle. This period gives your HPTA a chance to stabilize, ensuring you get as much benefit from your second cycle as you did from the first.

With the right PCT, you’ll keep more than 90% of your gains, and the results will stick. However, negating a PCT results in a slower recovery, and you’ll watch your gains disappear in the mirror as fast as they arrived.

Testolone PCT FAQ

Why can’t i stay on rad 140 or other sarms.

As mentioned, it’s all about managing the function of the HPTA. Some users don’t experience any shutdown on as much as 20mg of testolone. Other people experience total shutdown on the same dose.

For most, the shutdown is mild, and you can recover your HPTA function fast. However, prolonged cycles can damage the HPTA and the hormonal system, reducing the chances of making a full recovery. Stick to the protocol of 8-weeks on + 4-weeks PCT + 12-weeks off, before starting your next cycle.

Can I use RAD 140 with AAS?

Yes, you can use SARMs in bulking or cutting cycles along with other AAS. SARMs don’t have the same liver toxicity as oral AAS drugs like Dianabol, Anadrol, or Anavar. The non-methylated formulation of SARMs makes them an excellent option for replacing these harmful drugs in your next cycle.

Does an AAS and SARMS cycle require a PCT?

Yes. If you’re using AAS like testosterone, you’ll shut down the HPTA. Therefore, you’ll need a PCT. Some users state that SARMs are a good idea to use during PCT. However, you’ll do better with a proper PCT protocol designed by an anti-aging clinic.

DISCLAIMER: The author and the publishing website bear no responsibility for your use of SARMs. This post is for informational and educational purposes only. We do not condone or recommend the use of SARMs or any other research chemicals for human use.

Sources Cited:

• Pharmacology of anabolic steroids
• Expanding the therapeutic use of androgens via selective androgen receptor modulators (SARMs)  
• A selective androgen receptor modulator for hormonal male contraception

Continue reading:

• RAD 140 vs LGD 4033: Comparing These Powerful SARMs
• RAD140 vs Ostarine Comparison: Which SARM is Best For Your Cycle?
• RAD 140 Dosage Guide for Big Gains with No Side Effects

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Chris Jackson, co-founder of Sarms.io, is a renowned fitness blogger, physique model, and evolutionary bioscience researcher specializing in SARMs (Selective Androgen Receptor Modulators). His extensive work, characterized by cutting-edge research and practical training advice, has made Sarms.io a leading source for accurate, credible information on performance enhancers. With a dedication to improving the understanding and application of SARMs in optimizing human performance, his contributions have not only expanded public awareness but also shaped the conversation around these substances. Chris's pursuit of knowledge and commitment to sharing it continue to inspire many in their fitness journeys.

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Hey so what do you recommend for first time user/ beginners coming of Rad 140 after 8week cycle. To hope on pct and use the 2 that you recommended?

No you idiot

Great post and amazing pics, but what about pct? Never had an issue recovering, but PCT has always been the most effective and leaves me less depressed (as a depressive / anxious person). 50mg Clomid EOD 20mg Nolva ED – The best PCT period. Very happy I’ve got pct (Getpct365). I’d even suggest to half this dose if sensitive and im sure after 6-8 weeks you will be fine.

I took rad140 for 12 days and decided to stop. Do I need pct??

Great post ever, Thanks 😊! I would advise running a PCT supplement after every SARMs cycle. Even the slightest amount of SARMs can be suppressive for your body’s hormone system. You’re going to need a product to help you get back on your feet afterward. It’s actually essential to do so. Many bodybuilders and athletes put a lot of effort into planning their cycles and forget the importance of a proper post cycle therapy along the road. My feeling is always just be prepared. I keep pct on hand. Wouldn’t want to be stuck in a bad spot. So happy 😊 I googled ‘Pctget365’ and got both clomid and nolva. Good luck to all!

Great Article! Do you think that a product like Universal Nutrition’s Animal Stak or M-Stak would be a good PCT?

Thanks, Darren

I’ve used Universal Nutrition for a long time. I wouldn’t use their products for PCT. Go to Science.bio

Would a product like Universal’s Animal STAK or M-STAK be sufficient as an OTC PCT for RAD 140? Appreciate the feedback!

Leave a reply Cancel reply

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• v.36(7); 2021 Jul

Harm Reduction in Male Patients Actively Using Anabolic Androgenic Steroids (AAS) and Performance-Enhancing Drugs (PEDs): a Review

Alex k. bonnecaze.

1 Dept of Internal Medicine, Section on Endocrinology and Metabolism, Wake Forest University School of Medicine, Winston-Salem, NC USA

Thomas O’Connor

2 Dept of Internal Medicine, University of Connecticut School of Medicine, Farmington, CT USA

Cynthia A. Burns

Anabolic androgenic steroid (AAS) and performance-enhancing drug (PED) use is a prevalent medical issue, especially among men, with an estimated 2.9–4 million Americans using AAS in their lifetime. Prior studies of AAS use reveal an association with polycythemia, dyslipidemia, infertility, hypertension, left ventricular hypertrophy, and multiple behavioral disorders. AAS withdrawal syndrome, a state of depression, anhedonia, and sexual dysfunction after discontinuing AAS use, is a common barrier to successful cessation. Clinical resources for these patients and training of physicians on management of the patient using AAS are limited. Many men are hesitant to seek traditional medical care due to fear of judgment and lack of confidence in physician knowledge base regarding AAS. While proposed approaches to weaning patients off AAS are published, guidance on harm reduction for actively using patients remains sparse. Medical education regarding the management of AAS use disorder is paramount to improving care of this currently underserved patient population. Management of these patients must be non-judgmental and focus on patient education, harm reduction, and support for cessation. The approach to harm reduction should be guided by the specific AAS/PEDs used.

INTRODUCTION

Anabolic androgenic steroids (AAS) and performance-enhancing drugs (PEDs) represent multiple classes of compounds used to enhance one’s physique and/or improve physical performance. These include testosterone esters, synthetic androgens, aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs), selective androgen receptor modulators (SARMs), human growth hormone (hGH), fat-burning compounds, and myriad other compounds. The use of AAS has become widespread in the USA, with an estimated 2.9–4 million Americans using AAS at some point in their lifetime. 1 Worldwide, the lifetime prevalence of AAS use is estimated at 1–5%. 2 Several case series of male gym attendees found the prevalence of AAS use to be 15–30% in this population. 3 – 5 While AAS use is often associated with professional athletics, the majority of adults using AAS are non-professionals taking these compounds recreationally. 4 , 6 , 7 Despite widely reported cardiovascular, reproductive, hematologic, and neuropsychiatric effects described with these agents, there exist no guidelines or evidence-based harm reduction approaches to men actively using AAS.

It is estimated that over 98% of those using AAS are male. 1 These compounds have become readily available through illicit internet sources. 8 Men are commonly motivated to use AAS to improve their muscularity and strength. 7 An increasing societal emphasis on body image is believed to have contributed to increasing AAS use among men. 9 , 10 Many of these men may be prone to developing muscle dysmorphia, a pathologic pre-occupation with muscularity and body image that may impair quality of life. 8 , 10 AAS use has also been correlated with a history of poor self-esteem, depression, suicidality, and previously experienced physical or sexual abuse. 11 – 13

Common consequences of AAS/PED use include dyslipidemia, hypertension, left ventricular hypertrophy (LVH), arrhythmia, atherosclerosis, polycythemia and thrombosis, infertility, endocrine dysfunction, tendon rupture, and sexual dysfunction. 6 , 14 – 18 Those attempting to discontinue AAS use often experience AAS withdrawal syndrome, a state of depression, anhedonia, and sexual dysfunction which challenges prolonged cessation. 6 The lack of long-term data, medical education, and national initiatives addressing AAS use is highlighted in several recent reviews, stressing the need for swift action to prevent the worsening of this growing issue. 2 , 8 With limited public health resources available to men using AAS, 6 and general distrust of clinicians among many of these patients, 19 men often rely on other men using AAS and online sources for advice regarding use and procurement. 7 , 20

A major effect of extended AAS use is anabolic steroid-induced hypogonadism (ASIH), which refers to the disruption of the hypothalamic-pituitary-testicular (HPT) axis from prolonged exposure to supraphysiologic doses of testosterone esters, synthetic androgens, and accessory performance–enhancing drugs. 21 Men using AAS often attempt to prevent ASIH by taking various compounds such as SERMs and hCG, an unproven strategy referred to as “post-cycle therapy” or “PCT.” ASIH is proving to be a significant cause of male hypogonadism, with 20.9% of 6033 hypogonadal men reporting prior AAS use in a recent retrospective study. 22 The development, degree, and duration of ASIH is highly dependent on factors such as age, dosages used, duration of use, and compounds used. 23

While several authors have addressed the proposed management of men ready to stop AAS use with symptomatic ASIH 2 , 23 , 24 (Table ​ (Table1), 1 ), harm reduction guidance for men actively using these agents remains limited. To begin, an example of a common clinical experience for the patient using AAS/PEDs is described to highlight the challenges faced by both clinician and patient. Next, the approach to caring for such patients, review of specific AAS/PED compounds, and strategies for harm reduction are described.

Proposed Methods for Transitioning Off AAS

Clinical Example

A 39-year-old man presents to his primary-care clinic to discuss having blood work checked. Vitals are notable for a blood pressure of 142/90 mmHg and a body mass index (BMI) of 31 kg/m 2 . On exam, he has above-average muscularity and mild acne. He hesitantly discloses he has been using steroids to improve his physique and describes his regimen (Table ​ (Table2). 2 ). He obtains the steroids from the internet and a friend at the gym helps him plan his “cycle.” He has concerns regarding his use and wants to make sure his liver function and blood counts are “okay.”

Example of 12-Week AAS/PED Regimen with 6-Week Post-cycle Therapy

*Taken pre-workout with ~75 g simple carbohydrates

The clinician discusses the dangers of AAS use and recommends he discontinue. The patient expresses multiple concerns with stopping, including concern over losing strength and muscularity. The clinician tells him “it is important for your health that you stop using. Why don’t you stop for a few weeks before we check labs?”

Frustrated with the lack of understanding and lack of assistance from his physician, he resorts to following advice of other men using AAS. Despite multiple attempts to wean his use, he struggles with severe depression from acute AAS withdrawal. Due to his prior experience with his healthcare provider, he continues to self-manage his care and rely on others using AAS rather than seeking medical care.

Initial Approach to Men Using AAS Seeking Healthcare

The presented vignette highlights a common situation: A concerned patient using AAS who is unsure how to best monitor his health, seeking guidance from a well-intentioned clinician with has limited experience in assisting such patients. While the patient did not state willingness to cease use, he demonstrated concern for his health by seeking care. His clinician intended to help, but unintentionally promoted preconceived beliefs the patient had regarding the healthcare system, ultimately discouraging him to seek further care.

A recent systematic review of AAS use found common reasons for seeking medical care were overall health concerns, blood test monitoring, and prescription substances. Help with discontinuing AAS use was not a top priority. 25 Clinicians should certainly discourage AAS use, but the initial interaction should serve to obtain a better understanding of why the patient is using AAS, what concerns they have, and why they are seeking care. Doing so in a non-judgmental and supportive manner is essential. Open-ended questions may reveal motivations of the patient, such as fertility or side effect avoidance. Identifying these factors creates opportunities to build rapport, minimize harm, and eventually progress to cessation.

Alternatively, no such motivation may be identified. In this situation, harm reduction labs may be even more useful. For example, identifying previously undiagnosed dyslipidemia or cardiac disease may serve as motivation for some patients to consider cessation. The following sections will provide background, side effects, and harm reduction strategies for commonly used AAS/PEDs.

ANABOLIC ANDROGENIC STEROIDS AND PERFORMANCE ENHANCING DRUGS OF MISUSE: (TABLES  3 AND ​ AND4 4 )

Overview of AAS/PEDs, Side Effects, and Proposed Harm Reduction Approach

Initial Treatment of Diagnosed Adverse Effects of AAS/PED Use

*Contraindicated in severe liver disease and unexplained transaminitis. We suggest these agents be avoided in men actively using hepatotoxic oral AAS

+ = Off label for the purpose of treated AI-induced bone loss in men

Injectable Androgenic Anabolic Steroids

Dating back to the 1950s, numerous injectable testosterone compounds were used by elite athletes for strength and muscle gain. By the 1980s, AAS were in use by the general public. 9 There are three main classes of AAS compounds: testosterone esters, 19-nortestosterone and related derivatives, and dihydrotestosterone (DHT) derivatives 26 , 27 (Table ​ (Table5). 5 ). Each class is believed to have somewhat unique anabolic and/or androgenic effects. 26

Classes of Injectable and Oral AAS

*Both oral and injectable forms utilized

The foundations of most AAS regimens are testosterone esters and synthetic testosterone compounds taken in supraphysiologic doses. Reported doses commonly range between 500 and 1000 mg of testosterone per week, 7 which is 5–10 times the accepted treatment dose for male hypogonadism. 28

It is common for men using AAS to utilize injectable AAS for 8–16 weeks at a time, often referred to as a “cycle”. 27 “Stacking” refers to the use of multiple AAS/PEDs during a cycle. A cycle is commonly followed by a period of weeks to months where users either decrease their AAS dose or abstain completely to allow recovery of their hypothalamic-pituitary-testicular (HPT) axis. 23 Additional AAS nomenclature is available in Table ​ Table6 6 .

Commonly Used AAS Nomenclature

Adverse Effects

Cardiovascular effects of AAS are the most frequently reported and have the highest quality of data supporting their association. A recent cross-sectional study of 86 males with over 2 years AAS exposure was found to have reduced left ventricular ejection fraction (LVEF), impaired diastolic relaxation, increased left ventricular mass, and higher volumes of coronary artery plaque compared to age-matched non-users. 15 Post-mortem studies revealed increased rates of cardiomegaly, left ventricular hypertrophy, and myocardial fibrosis compared to non-users. 29 – 31 Increases in LDL and decreases in HDL were supported by a meta-analysis examining 11 studies on dyslipidemia in men using AAS 14 ; the same study found an association with AAS use and atrial fibrillation and ventricular arrhythmia. Coronary artery calcium (CAC) testing of 14 male professional bodybuilders using AAS found that 7 patients had CAC scores greater than the 90th percentile expected for their age, 3 of which were under 40 years old. 32

AAS use has been shown to cause infertility and ASIH in retrospective studies. 17 Restoration of fertility and endogenous testosterone production is more likely in men who engaged in shorter (generally under a year) and less-extreme AAS use. 2 , 23 Estrogenic side effects are common due to the aromatization of exogenous androgens, causing issues such as gynecomastia. 33 Exogenous testosterone is also shown to accelerate the growth of existing metastatic prostate cancer. 34

A wide range of behavioral effects are reported with AAS use including impulsivity, hypomanic/manic symptoms, aggression, and anxiety. 6 , 35 Multiple retrospective and cross-sectional studies found an association of AAS use with concurrent illicit substance use disorder, and body image disorders such as muscle dysmorphia. 10 , 36 , 37 AAS withdrawal syndrome is reported in men abruptly stopping AAS use and involves significant symptoms of depression, libido dysfunction, and anhedonia. 2 , 6

Other notable adverse effects include dose-dependent erythropoiesis and polycythemia, 38 thrombosis, 16 development of focal segmental glomerular sclerosis (FSGS), 39 acute kidney injury (AKI), 40 and upper extremity tendon rupture. 18

Harm Reduction Strategies

Initial screening should include blood pressure assessment, review of family history of cardiovascular disease, lipid profile testing, a comprehensive metabolic panel, and electrocardiogram (ECG) testing. Hypertension and dyslipidemia should be treated according to national guidelines. Given the increased prevalence of LVH in this population, 14 we favor angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for the treatment of hypertension. Obtaining a transthoracic echocardiogram (TTE) is reasonable if there is clinical concern for cardiac dysfunction, chronic AAS use (over 1 year), and/or strong family history of cardiovascular disease. CAC testing should also be considered if additional atherosclerotic cardiovascular disease (ASCVD) risk factors are identified.

We suggest prostate stimulating antigen (PSA) screening in this population the same way it is recommended in men receiving testosterone replacement therapy per Endocrine Society guidelines. 28 Screening involves assessing PSA in men aged 55–69 years old (or beginning at age 40 if high risk) in those agreeable to prostate cancer screening. Referral to urology is recommended in situations of abnormal prostate exam, PSA > 4 ng/mL, sudden worsening of lower urinary tract symptoms, or a confirmed PSA increase of greater than 1.4 ng/mL over a 12-month period. Testosterone levels with gonadotropins may be useful in quantifying the degree of androgen use and HPT-axis suppression, or if AAS use is suspected but uncertain.

Due to the high prevalence of behavior disorders and concurrent substance use, 13 , 36 , 37 we suggest early referral to a behavioral health specialist, ideally having experience regarding substance use disorders and body image disorders. The association between AAS use and increased psychological distress and impaired executive function 41 is one possibility as to why these issues are more frequently seen among this population.

Oral AAS/Pro-hormones

Oral AAS compounds, such as metandienone (Dianabol), oxandrolone (Anavar), and stanozolol (Winstrol) are commonly used in conjunction with injectable AAS during steroid cycles for added muscle size and strength benefits. 42 These agents gained popularity in the 1970s and continue to be common additions to user-designed AAS cycles. 27

Alkylated oral compounds are associated with hepatotoxicity due to the presence of the 17-methyl group, which prevents degradation by first-pass hepatic metabolism when dosed orally. 43

In addition to the approach advised for injectable AAS, obtaining liver function tests is of benefit due to the high prevalence of hepatotoxicity from oral alkylated AAS. Reviewing concurrent substances, medications, or supplements that may cause additional hepatic injury is advised.

Aromatase Inhibitors

AIs, such as anastrozole and letrozole, are used during an AAS cycle to minimize the conversion of testosterone to estradiol. This practice is done to minimize estrogenic side effects such as gynecomastia, 20 as well as to maximize the anabolic effects of AAS.

Previous randomized control trials of hypogonadal men have shown AI use in men results in decreased sexual function, increased adipose distribution, 44 and decreased bone mineral density. 44 , 45 While no cardiovascular event data exists for men using AIs, a retrospective study of over 13,000 female breast cancer patients using AIs showed an increased risk of valvular dysfunction, pericarditis, and dysrhythmia. 46

Obtaining yearly bone densitometry in patients using AIs is beneficial to screen for low bone mass; however, it should be discussed that insurance may not cover this cost. In men under 50 with low bone mass, but without an osteoporotic defining fracture, optimization of vitamin D levels and encouraged cessation of AI use are suggested. Bisphosphonates, or denosumab, could be considered in patients found to have osteoporosis. While no strong treatment data in this population exists, and such use would be off-label, these agents have been recommended in a joint position statement regarding management of AI-associated bone loss in post-menopausal women with hormone-sensitive breast cancer. 47 Discussing the sexual side effects of these agents may also benefit in promoting cessation.

Selective Estrogen Receptor Modulators

Commonly used SERMs include clomiphene citrate and tamoxifen. 7 Tamoxifen is used with AIs during heavy androgen use to limit estrogenic side effects. 20 , 23 Clomiphene citrate is used to assist with recovery of the hypothalamic-pituitary-testicular axis after heavy androgen use. 2 , 20 , 23 It is common for patients to take both clomiphene citrate and tamoxifen together as “post-cycle therapy” (PCT) after a cycle of AAS. 27

Clomiphene has successfully been used in men for treatment of hypogonadism for up to 7 years with no major adverse effects 48 ; however, prior systematic reviews suggested a potential correlation with thrombosis and ocular symptoms due to central retinal vein occlusion (CRVO). 49 , 50

We recommend no specific testing for SERM use; however, gathering user experiences regarding these agents may be useful for future cessation attempts. For example, men using AAS noting previous benefits from clomiphene use may be willing to attempt AAS cessation using such agents in a medically supervised manner.

Human Chorionic Gonadotropin

Human chorionic gonadotropin (hCG) is used to prevent testicular atrophy and preserve some degree of testicular function. 27 It is also utilized as PCT to expedite the recovery of testosterone production by Leydig cells. 20

The primary adverse effects of hCG include potential suppression of the HPT-axis and gynecomastia. 2

No specific testing is recommended, although this agent is rarely used in isolation.

Phosphodiesterase-5 Inhibitors

Men using AAS commonly use phosphodiesterase-5 (PDE-5) inhibitors (such as sildenafil or tadalafil) for both erectile dysfunction and improved blood flow to muscles during strength training. 51 Users may also combine these with popular workout supplements containing nitrate donors such as sodium nitrate. 52

A case series on misuse of these agents described severe hypotension, cardiovascular collapse, and death 52 ; combining PDE-5 inhibitors with nitrates is particularly dangerous given the potential for significant decreases in systolic blood pressure and coronary perfusion. 53

A review of the risks of these agents, particularly the danger of combining with nitrate compounds, should be discussed.

Fat Burning Compounds (T3, Clenbuterol, and DNP)

Commonly used compounds to reduce body fat include liothyronine (T3), clenbuterol, ephedrine, and occasionally, dinitrophenol (DNP). 27 , 42 T3 is commonly combined with the potent oral beta-2 agonist, clenbuterol. While clenbuterol is primarily used for its fat-burning properties, limited animal data has suggested it may also have an anabolic effect on skeletal muscle. 54 DNP is an organic uncoupling agent which allows proton leak across the inner mitochondrial membrane, creating heat as opposed to adenosine triphosphate (ATP). It was originally used in the 1930s as a breakthrough weight loss medication, before being banned in 1938.

Clenbuterol and T3 misuse has been associated with hypertension, arrhythmia, and myocardial ischemia in a retrospective review. 55 Patients using T3 will commonly have markedly suppressed TSH levels, suppressed T4 levels, and significantly elevated T3 levels. DNP has been associated with multiple deaths due to severe hyperthermia. 56 – 58

Screening for hypertension and ECG testing should be performed in all patients using these agents. TSH level with reflexive free T4 and total T3 levels should be obtained in patients using thyroid hormone as a PED.

Site Enhancement Oils

The use of injectable intramuscular oil (also called “site enhancement”) is utilized by some men using AAS, especially elite bodybuilders. 59 Site enhancement oil adds volume to the injected muscle, creating a “fuller” appearance. A popular formulation, known as synthol, consists of 85% oil suspended in an alcohol and lidocaine. 59 An additional compound, polymethylmethacrylate (PMMA), has been misused for cosmetic body sculpting. 60

Various complications, including injection site abscesses, systemic infection, cerebrovascular accident (CVA), intramuscular cystic disease, muscular fibrosis, vasculitis, and pulmonary emboli, have been described in case series. 59 , 61 Case reports of hypercalcemia secondary to 1,25-dihydroxyvitamin D production from granulomas formed at the areas of injection have also been described. 62 , 63

A CMP should be obtained to assess for hypercalcemia. Physical exam of injection sites should assess for potential infection, abscesses, or masses.

Insulin is used during phases of attempted weight gain due to insulin’s anabolic effects on protein and glycogen synthesis. Short-acting insulin is commonly administered pre-workout, post-workout, or both with simultaneous ingestion of simple carbohydrates. 42

Multiple cases of hypoglycemia in non-diabetic bodybuilders misusing insulin are reported, including one case of hypoglycemic coma. 64 – 66

A reasonable approach includes educating the patient on potential life-threatening hypoglycemic events, assessing a hemoglobin A1c, as well as providing glucometer and testing supplies to those who decline to stop using insulin. A hypoglycemia treatment plan should be provided.

Diuretics, such as furosemide and torsemide, are used 1–2 days prior to a physique competition to minimize subcutaneous water retention. Diuretic use occurs concurrently with extreme water and salt restriction, followed by a period of “salt loading.” Prior to competition, some competitors attempt to completely restrict sodium in addition to lowering water intake to less than 250 cc during the day of competition. 67

The combination of high-dose diuretics and electrolyte/water manipulation increases the risk of lethal electrolyte derangements such as hypokalemia. A case of hypokalemic paralysis during a bodybuilding competition was recently reported, in which the patient took 160 mg oral furosemide while restricting water intake. 68

Patients using diuretics while manipulating water and food intake are at the greatest risk of life-threatening electrolyte derangements. Potassium and magnesium levels should be assessed.

Human Growth Hormone and Related Peptides

Human growth hormone (hGH) is used during AAS cycles to enhance muscle hypertrophy and strength. 42 , 69 Doses vary significantly and generally range between 2 and 12 international units (IUs) daily. 27 , 42 Synthetic growth hormone–releasing hormone (GhRH) analogues, such as sermorelin, and IGF-1 are also used as a PEDs and sometimes prescribed by anti-aging clinics via compounding pharmacies. 27

Growth hormone excess has physiologic sequelae including hypertension, cardiomyopathy, increased malignancy risk, entrapment syndromes, and diabetes mellitus among many others, as is seen in patients with acromegaly. 70

Initial assessment should include screening for hypertension, hemoglobin a1c, assessment of cardiovascular risk factors, and ensuring patients are up to date with age-appropriate cancer screenings.

Dopamine Agonists

Dopamine agonists (DAs), such as cabergoline and bromocriptine, are occasionally taken by men using AAS to mitigate potential hyperprolactinemia. 27 While somewhat controversial, one animal study demonstrated that the use of the progestin-derived synthetic androgens nandrolone decanoate resulted in significant prolactin elevation. 71 Cabergoline is also used for enhanced sexual function and reduction of refractory period, which has been demonstrated in several randomized control studies. 72 , 73

Side effects of DAs include headaches, orthostasis, nausea, increased impulsivity, and occasionally cardiac valvular disease in chronic use. 74

Screening for and treating behavioral disorders are of importance given AAS alone has the potential to cause these issues. In rare situations patients have taken high-dose DAs for more than several years, a screening TTE is reasonable to exclude valvulopathy.

Selective Androgen Receptor Modulators

Selective androgen receptor modulators (SARMs) represent a relatively new class of non-steroidal compounds with tissue-specific agonist or antagonist activity at the androgen receptor. While the first SARM was originally developed in 1998, none has been FDA-approved. 75 Multiple professional athletes have been found using these compounds illegally in the past several years. 76 , 77 SARMs are typically purchased online as “research chemicals”. 78

While long-term data on these agents are not yet available, a clinical trial of one SARM was found to cause HDL suppression and abnormal liver function tests. 79 In a recent study involving chemical analysis of 44 products marketed online as SARMS, only 23 (52%) were found to contain SARMs, while many contained alkylated AAS compounds. 78

Given the substantial lack of data on these agents, we suggest a similar approach to patients using injectable AAS. Patients using SARMs should be educated on the lack of safety data.

AAS use among men continues to be a major healthcare issue that has not been adequately addressed by the medical community. The combination of easily procurable AAS/PEDs via internet sources and increased societal emphasis on idealistic muscular physiques across social media-fueled this health crisis. As with any substance use disorder, it is our duty as clinicians to provide empathetic, ethical, and supportive care to minimize self-harm until successful cessation is achieved. Limited formal undergraduate and graduate medical education on AAS use, distrust of clinicians among men using AAS, 19 and lack of evidence-based harm reduction approaches to this population have resulted in suboptimal care. It is a concerning disconnect between patients and clinicians which has yet to improve.

Many clinicians request these patients immediately stop AAS use; however, multiple physiologic and environmental factors challenge patients attempting to do so. Symptoms of depression, anhedonia, and sexual dysfunction due to AAS withdrawal syndrome increase the rate of recidivism in this population. 6 A recent case-controlled study suggested most men discontinuing AAS eventually recover endogenous testosterone production and spermatogenesis 80 ; however, being able to successfully abstain for long enough (months to years) to allow for HPT-axis recovery is a separate challenge altogether. Those using AAS likely associate with other men who use AAS and prioritize muscularity, strength, and body image. These ongoing environmental exposures and temptations in themselves serve as risk factors for recurring use. Given the many challenges of successful AAS cessation, it is paramount that harm minimization is prioritized to reduce the development of devastating health effects.

Harm reduction strategies are needed to assist the millions of men using these compounds who are currently unable or without the desire to quit. A recent review by de Ronde et al. 81 emphasizes the need for improved healthcare of men using AAS, but notes “It is the policy of our clinic not to offer routine health and blood checks to active users without health problems.” The authors discuss that reassuring results might encourage patients to continue using AAS. We believe this approach further propagates distrust of physicians, encourages continued reliance on other men using AAS for guidance, and reduces the likelihood of eventual cessation. A harm minimization approach to active AAS use is analogous to widely accepted public health practices such as screening active smokers for lung cancer and intravenous drug users for blood-borne viruses.

Compassionate care is paramount. It is essential that cessation of AAS use is routinely discussed with the patient. These regular discussions should be non-judgmental and caring, much like with smoking cessation. The authors strongly oppose the prescribing of medications with potential anabolic uses in patients who are currently using illicit AAS/PEDs. For example, we discourage prescribing an AI or SERM to a patient on illicit AAS who wishes to decrease his estrogen levels. In men who present with sexual dysfunction, not ready to work towards discontinuing AAS use, we discourage the use of PDE-5 inhibitors or other related treatments because clinician-supervised cessation of AAS improves/resolves this issue. We strongly support the screening and treatment of AAS-related cardiovascular conditions, behavioral disorders, and hematologic disorders to further reduce self-harm during AAS use. Once a patient acknowledges he is ready to discontinue AAS use, we currently favor a personalized approach as outlined in reviews by Anawalt 2 and Rahnema et al., 23 as no randomized control trials on this subject have been conducted.

We believe harm minimization would not only reduce adverse effects of AAS but also serve as a bridge to cessation. For example, many men using AAS are relatively young and have no prior health issues. A medical assessment revealing hypertension, dyslipidemia, and LVH may serve to have such a patient reconsider further use and consider cessation. In some men, the desire to continue AAS use will predominate despite the diagnosis of serious adverse effects. In these cases, the authors recommend continued close clinical surveillance in addition to prompt referral to appropriate behavioral health specialists. This will allow for continued health monitoring and management of adverse effects, while further building rapport and presenting ongoing opportunities to reconsider cessation.

LIMITATIONS

Most of the reviewed literature consisted of cross-control studies, retrospective reviews, and case series. The lack of randomized controlled data and limited prospective data are significant limitations. The guidance provided is based upon the current literature and the clinical experience of the authors.

CONCLUSIONS

A harm reduction approach, with a strong emphasis on reducing cardiovascular risk, should be taken with men actively using AAS who decline current cessation.

Acknowledgements

Alex K. Bonnecaze was involved with manuscript preparation and revision. Thomas O’Connor participated in manuscript review, revision, and editing. Cynthia Burns participated in formatting, editing, and manuscript revision.

Declarations

Thomas O’Connor owns and operates a private practice internal medicine clinic based out of Essex, CT, and has written a book on the adverse effects of AAS misuse. The authors have no other disclosures to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

RAD140 – Results, Clinical Trials & Reviews

Table of Contents

What Is RAD140?

RAD140 is a selective androgen receptor modulator (SARM) currently under development by Radius Health, Inc. for potential use in treating muscle wasting disorders and hormone-receptor positive breast cancer.

There are several unofficial slang terms for RAD140 in the fitness community, one of the most popular being “Testolone”.

RAD140 has all of the hallmarks of an effective SARM, exhibiting a high affinity for the androgen receptor with tissue selective anabolic effects in muscle in bone, with a relatively minimal effect on prostate, seminal vesicles, and other androgen affected tissues [ R ].

RAD140 has a high level of oral bioavailability and demonstrated high in vivo tolerability [ R ].

It is still in the preclinical stages with recruitment occurring right now into its first phase 1 human trial, and has yet to be tested on humans [ R ].

In addition, it is often referred to as a potential alternative to testosterone replacement therapy in the recreational bodybuilding community.

Its potential efficacy in a hormone replacement therapy context is implied in some of the preclinical animal data, but the scientists also acknowledge the potential limitations of RAD140 when considering it being used in this capacity.

Its lack of aromatization is all that is needed to make a definitive judgment on its overall efficacy profile as a hormone replacement therapy alternative, which I will delve into later.

Recreational users are quick to label RAD140 as the “safe non-steroidal version of testosterone.”

This is because it doesn't require injections and hasn't exhibited any notable side effects in its preclinical data.

Obviously with no human data, it is extremely presumptuous to make a statement like this, and later in the article I will delve further into the limitations of RAD140, and SARMs in general.

RAD140 is purported by many to be a very versatile SARM that provides a complete replacement for testosterone replacement therapy (TRT), without any of the side effects.

Mechanism Of Action

RAD140 doesn’t require any injections as it has a high level of oral bioavailability [ R ].

After ingestion, RAD140 binds to androgen receptors in different tissues in the body which a high level of selectivity.

After binding to the androgen receptors, RAD140 exerts tissue-specific anabolic effects in muscle tissue and bone, and neuroprotective androgen-like effects in the brain, with a relative lack of stimulation in prostate and seminal vesicles [ R ].

RAD140 is a potent androgen agonist in the levator ani, and is also a much weaker partial antagonist on the seminal vesicles and possibly the prostate.

RAD140 demonstrated excellent affinity for the androgen receptor (Ki = 7 nM) [ R ].

To put this in perspective, the affinity for the androgen receptor for Testosterone in this preclinical model was 29 nM, and 10 nM for DHT.

In other words, RAD140 has a greater affinity to bind to the androgen receptor than Testosterone and DHT.

RAD140 does not aromatize into Estrogen, and does not undergo 5-alpha reduction into a more androgenic metabolite.

One thing that needs to be noted is RAD140's preclinical characterization referring to it as a “partial antagonist” in androgen affected tissues [ R ].

While this implies it is much less androgenic than all other SARMs, this is not necessarily the case.

Most other SARMs are classified as “partial agonists” in androgen affected tissues, and while RAD140 is classified in its preclinical profile as a partial antagonist, partial agonists may also be considered ligands which display both agonistic and antagonistic effects in affected tissues [ R ].

This is important because at a first glance the majority of readers will assume that RAD140 is the only SARM that has antagonistic effects on the prostate gland, and is therefore the most viable candidate for SARM therapy to date, which is not necessarily the case.

All androgen receptor ligands that have extremely selective functions indicative of a SARM have demonstrated partial agonist activity in the prostate gland, RAD140 included, despite what its preclinical profile may imply.

RAD140 Effects

Increases muscle mass.

RAD140 is very potent at low dosages and exhibited a mean weight gain of more than 10% in 28 days at only 0.1 mg/kg in a preclinical primate model [ R ].

In a preclinical rodent model assessing the efficacy of RAD140 in comparison to exogenous Testosterone Propionate, RAD140 significantly outperformed Testosterone in myotrophic/androgenic selectivity.

In this study, rats were castrated and either given placebo, 1 mg/kg of Testosterone Propionate or graded dosages of either 0.03 mg/kg, 0.1 mg/kg, 0.3 mg/kg, 1 mg/kg, 3 mg/kg or 10 mg/kg of RAD140.

The “sham” group are untreated rats that weren't castrated that serve as a reference guide for how much anabolic/androgenic activity occurs in a normal healthy rat with normal endogenous Testosterone and DHT levels.

After castrating the rats, muscle mass and prostate size decrease because there is no longer sufficient androgen stimulation occurring in the body, as there is no Testosterone or DHT being produced.

By using RAD140 or Testosterone, this study exhibits exactly how effective these two compounds are at replicating the anabolic activity necessary to maintain normal amounts of muscle and bone mass, and how much androgenic activity will occur in the prostate relative to that.

By referring to the figure above you can see that the lowest dosage of RAD140 capable of maintaining normal levels of anabolic activity in the body was the 0.3 mg/kg treated group.

While Testosterone at 1 mg/kg was able to outperform the 0.3 mg/kg RAD140 group in muscle growth, it stimulated prostate growth as well to a much greater extent.

For therapeutic purposes, RAD140 exhibits a greater efficacy profile at low dosages than Testosterone, as it's able to maintain normal amounts of muscle mass, but greatly decrease the amount of androgenic activity in the body.

The 3 mg/kg RAD140 treated group was able to replicate the same level of muscle tissue growth as the 1 mg/kg Testosterone treated group, with about half of the androgenic activity in the prostate.

It would be interesting to see how the same Testosterone treated group would respond if they were given Dutasteride to inhibit the 5-alpha reduction of Testosterone into DHT, and if that group would still exhibit a less favorable selectivity than the RAD140 groups.

For all we know, it could be more beneficial to use Testosterone concurrently with a 5-alpha reductase inhibitor rather than RAD140, especially considering Testosterone aromatizes into Estrogen, which is a severely limiting flaw of SARMs in general, but that all remains to be seen.

In a therapeutic context, RAD140 looks very promising based on the preclinical data given, and it blatantly has the ability to selectively increase muscle tissue, even at supraphysiological levels.

No direct fat loss was noted in the preclinical trials conducted on RAD140, however, as a human accrues more muscle mass, their basal metabolic rate will increase in parallel.

This is a given, therefore anything that can increase lean muscle mass in a human would theoretically increase total daily energy expenditure.

The net result of that would be an increase in the amount of calories expended just by having more muscle tissue via RAD140 usage, and greater overall fat loss.

Therefore, it is very likely that RAD140 can indirectly increase fat loss to some extent, dependent on the amount of muscle growth it induces.

Increases Bone Mineral Density

All SARMs that have reached human trials have shown the ability to inhibit bone turnover, stimulate bone formation, and retain bone mineral density in a state of catabolism [ R ].

While RAD140 hasn't gone into human testing yet, its tissue selective anabolic effects in bone have been demonstrated in preclinical animal models [ R ].

As exemplified via other more thoroughly studied SARMs like Ostarine and LGD-4033 , these effects will very likely translate in humans just the same in further clinical trials.

Reduces Prostate Size

RAD140 has proven capable of exhibiting tissue selective anabolic effects in muscle and bone equivalent to that of a therapeutic dosage of Testosterone while simultaneously reducing prostate size by approximately 70% [ R ].

RAD140 has a much lower level of androgenicity in the body and simultaneously suppresses natural Testosterone production.

The net result of this in hypogonadal males would be a fulfilment of Testosterone's important functions, with a lack of androgenic activity.

The net result of this in healthy males with normal testosterone levels would be a drastic decrease in prostate size and androgenic activity, in parallel to natural testosterone suppression.

The reason being that healthy men still operate with a significant amount of androgenic activity occurring via their natural Testosterone production and its 5-alpha reduction to DHT.

When a healthy male has their endocrine system suppressed, they will produce less Testosterone (and consequently DHT as well), which will cause a dose dependent decrease in muscle size, bone mineral density, prostate size and the size of seminal vesicles.

This is what makes RAD140 and other SARMs so interesting, as they will suppress the endocrine system and can reduce systemic androgenic activity, while keep anabolic activity exactly the same, or even increasing it to supraphysiological levels, depending on the dosage used.

There are a variety of therapeutic applications in which a very selective potent agonist in muscle tissue with a far lower level of androgenic activity would be beneficial in a clinical setting, with just one of those being a potentially viable treatment for benign prostatic hyperplasia in men.

Neurodegenerative Disease Protection

SARMs target androgen receptors in different areas of the body, and RAD140 has also shown neuroprotective effects in the brain of androgen deficient rats [ R ].

Endogenous androgens are responsible for several important functions in the body and brain, the majority of which are mediated via androgen receptor activation [ R ].

In hormonally deficient rats RAD140 activated those androgen receptors in the brain and prevented neurodegenerative disease progression from occurring in the absence of sufficient endogenous androgens.

RAD140 was able to activate androgen receptors in the brain, protect hippocampal neurons from cell death, and induce anabolic activity in muscle tissue and bone as effectively as Testosterone, all with a near complete absence of stimulation in androgen affected reproductive tissues [ R ].

Suppresses Breast Cancer

The androgen receptor is frequently expressed in many estrogen receptor (ER)-positive, ER-negative, and triple-negative breast cancers.

As RAD140 facilitates its effects via the androgen receptor, assessing its potential clinical applications in this context was worth exploring.

In a preclinical study RAD140 significantly suppressed the growth and proliferation of breast cancer cells in in vivo and in vitro models of AR/ER+ breast cancer [ R ].

RAD140 has a promising preclinical profile, and Radius Health is currently in the process of recruiting 40 postmenopausal women with hormone receptor positive breast cancer into its first phase 1 clinical trial on humans [ R ].

The main goal of the study is to evaluate its safety profile, tolerability, and pharmacokinetic characteristics in hormone receptor positive breast cancer.

RAD140 Clinical Trials

One Phase 1 study on RAD140 has been conducted [ R ].

The Phase 1 trials are the first stage of testing in human subjects designed to assess safety, side effects, best dosage, and formulation method for the drug.

Dose Escalation Study In Estrogen Receptor Positive, HER2 Negative Breast Cancer

The first Phase 1 trial involving RAD140 was a dose escalation study with a 3 + 3 design conducted in 2017 on 16 postmenopausal women with hormone receptor positive breast cancer.

The primary objective was to determine its safety profile and the maximum tolerated dose of RAD140.

The secondary objectives were to evaluate pharmacokinetics and antitumor activity.

The median age of the 16 patients enrolled in the trial was 58 years old.

88% of them had visceral disease and 94% had androgen receptor positive tumors determined via immunohistochemistry.

6 patients were given 50 mg RAD140 orally once per day.

7 patients were given 100 mg RAD140 orally once per day.

The other 3 patients were given 150 mg RAD140 orally once per day.

The median time on treatment was 8 weeks, with a range of 1-25 weeks for the entire group of patients.

Over 30% of patients experienced an elevation of their ALT/AST levels, decreased weight/appetite, and constipation.

Dose-limiting toxicities (all grade 3 and reversible) included hypophosphatemia and elevated ALT/AST.

2 patients experienced hypophosphatemia, and they were both in the 150 mg dosage group.

2 patients in the 50 mg and 100 mg dosage groups experienced elevated ALT/AST.

No drug-related deaths occurred.

There was 1 partial response in the 100 mg dosage group and 2 patients with stable disease for over 12 weeks.

The time to partial response was 15.9 weeks and the duration was 8.6+ weeks.

SHBG levels decreased in all 12 of the patients evaluated.

PSA levels increased in 10 of the 14 patients evaluated, with the most notable increase occurring in the patient with a partial response to RAD140 treatment.

That patient remained on the treatment at the 7 month mark.

The provisional maximum tolerated dose of RAD140 was determined to be 100 mg dosed once per day orally.

Overall, RAD140 demonstrated an acceptable safety profile and exhibited preliminary evidence of target engagement and antitumor activity [ R ].

Is RAD140 As Strong As Steroids?

Yes, kind of…

RAD140 purportedly (not officially) has an anabolic:androgenic rating of 90:1 and partially antagonizes the negative effects of testosterone on the prostate.

The anabolic:androgenic ratio is essentially a ratio which exhibits how much anabolic activity a specific compound will exert in the body, and how much androgenic activity it will exert in the body.

Anabolic, meaning that they promote anabolism (cell growth), and androgenic (virilization), meaning that they affect the development and maintenance of masculine characteristics.

The androgenic:anabolic ratio of a compound is a very important factor when determining the potential clinical applications of it.

Initial steroid research sought to synthesize a compound which retained a high degree of anabolic activity, coupled with a lack of androgenic activity, the goal being to produce a compound with a high anabolic yet low androgenic effect.

Because steroids were intended for medical treatment, patients could include men and women, and even children.

The last thing you want to do is give a girl a bunch of testosterone so she can prevent muscle wasting, only to have her end up with a myriad of masculinizing side effects like the deepening of her voice, acne, clitoral enlargement, body hair growth, and all the other negative side effects associated with anabolic androgenic steroids.

The androgenic side effects of steroids in men aren't insignificant either.

The risk of Gynecomastia (man boobs), endocrine shutdown (infertility), testicle shrinkage, negative effects on cholesterol, increased risk of heart disease, among many other side effects are all very real side effects of anabolic androgenic steroids.

I'm not saying that these will absolutely happen at all, but there is a chance of them occurring with steroid use, with some of them still occurring with SARMs to a significant extent.

Considering this, it is obviously very important to synthesize compounds that have as low of a risk of any of these side effects occurring, while still maximizing the anabolic efficacy of the treatment given to patients.

Compounds with a high ratio of androgenic to anabolic effects are the drugs of choice in androgen-replacement therapy, but in the context of muscle and bone wasting prevention, compounds with a much higher anabolic/androgenic ratio are exponentially better candidates for treatment.

Based on the preclinical data, RAD140 has shown that even with a complete absence of testosterone it can still induce just as much anabolic activity in muscle and bone as testosterone would, with several-fold less androgenic activity.

This would consequently eliminate and replace the need for anabolic androgenic steroid use in degenerative musculoskeletal disease treatment.

In addition, RAD140 synergistically works alongside testosterone to induce greater amounts of muscle growth in the body if they are used concurrently, while simultaneously decreasing testosterone’s negative side effects on the prostate [ R ].

Is RAD140 The Strongest SARM To Date?

This is debatable as different SARMs act on the androgen receptor in different ways in different individuals.

In general, it is undeniable that RAD140 is very strong, and pound for pound it is one of the strongest SARMs on paper with a purported 90:1 anabolic:androgenic ratio.

It is formidable to LGD-4033 in terms of strength gains, although LGD-4033 seems to be a more potent overall muscle builder.

RAD140 seems to have a muscle hardening effect that isn't commonly reported with LGD-4033.

Increased muscular endurance from RAD140 is also reported to be one of its most redeeming traits.

The only SARM that seems to outperform RAD140 in terms of muscle building, strength gains, and muscle hardening simultaneously is S23 .

However, S23 is more suppressive and has some odd side effects that aren't reported with RAD140.

RAD140 Reviews (Anecdotal/Recreational Reports)

RAD140 is one of the most popular SARMs in the fitness and bodybuilding community in the context of performance enhancement.

It is most commonly used to gain muscle mass and increase strength.

It is reported to also be very effective at increasing muscular endurance and overall stamina.

While other SARMs help with muscular endurance to some degree, RAD140 in particular seems to excel in its ability to increase endurance, stamina and speed.

This is not to be confused with Cardarine and SR9009, which are not SARMs.

RAD140 is not as effective as Cardarine at increasing cardiovascular endurance.

RAD140 is most commonly used for bulking, or in recomposition phases, and is often referred to as a dry gainer.

It creates a harder, dryer look similar to SARMs like S4 and S23.

Users often report a very noticeable aggression unique to RAD140 that is not notable in any other SARM except S23 .

This increased aggression has made RAD140 a fairly popular pre-workout alternative in the bodybuilding community.

RAD140 Dosage

Dosages of 10 – 30 mg per day are commonly used in a recreational context for muscle building purposes.

There is no established therapeutic dosage of RAD140.

RAD140 Half-Life

Pharmacokinetic samples collected for 144 hours after the 100 mg RAD140 single dose showed variable absorption with a half-life of approximately 60 hours [ R ].

The observed human steady-state pharmacokinetic exposure at 100 mg exceeds the pharmacokinetic exposure of the efficacious dose in mice of 10 mg/kg.

RAD140 Side Effects

One thing you will often read is how there have been no reported side effects of RAD140.

This is not the case, both anecdotally as well as in the limited clinical data.

Potential Ventricular Inflammation

Unpublished preclinical toxicology studies with RAD140 indicated that it induced focal inflammation of the right ventricle in male and female Sprague-Dawley rats [ R ].

With that being said, the same side effect was not noted in the male or female cynomolgous monkeys treated with RAD140, and preclinical rat models have some underlying issues in regards to cardiovascular risk.

Androgens cause 11beta-hydroxylase inhibition in rat adrenal glands.

Inhibiting this in rats causes an increase in the adrenal output of 11-deoxycorticosterone, which can cause cardiac lesions in rat hearts.

Also, in another preclinical rodent model, high dosages of RAD140 had a protective effect on the heart.

This was the first occurrence of rat cardiotoxicity reported for a SARM.

The data supports that the focal inflammation in the rat studies cannot be extrapolated to primates and humans, so it is very unlikely that this same outcome would occur in humans.

The fact that it didn't occur in monkeys with dosages as high as 1000 mg/kg/day is very reassuring that this outcome would be less likely to occur in humans, but it is notable nonetheless.

While RAD140 exhibits one of the most impressive myotrophic/androgenic preclinical profiles, it cannot be ignored that there was still blatant increasing androgenic activity in a dose dependent manner in all animal models.

Albeit limited due to the high level of tissue selectivity, RAD140 still exhibits androgenic activity in the body and will potentially lead to accelerated hair loss.

However, it could also potentially reduce hair loss if used at a dosage that suppressed endogenous androgens and/or antagonized endogenous androgens at the androgen receptors enough that the androgen load on the body was lower than baseline, while still fulfilling the anabolic functions that would have otherwise been fulfilled via endogenous Testosterone.

This does not exclude temporary shedding (acute telogen effluvium) which can be triggered by a hormonal fluctuation.

This is not to be confused with androgenic alopecia, which is caused by follicular miniaturization induced by androgens.

Based on the efficacy data comparing S1 to Finasteride, it is likely that RAD140 (if anything) would reduce the progression of hair loss at therapeutic dosages based on its tissue selectivity [ R ].

Anecdotally, recreational users report hair loss quite fairly frequently with RAD140 usage, however, this is with dosages that likely greatly exceed what the therapeutic dosage will be in a clinical setting.

Whether this hair loss in the bodybuilding community is real androgenic alopecia or just temporary shedding is unclear and would require more data.

Gynecomastia

While the risk is relatively low based on anecdotal reports, it is safe to say that all SARMs can cause gynecomastia (gyno) as they impact the Hypothalamus-Pituitary-Testes-Axis.

By binding harder to the androgen receptors than endogenous androgens, there can be a diversion of more endogenous Testosterone to aromatize into Estrogen.

Also, suppressing Testosterone production in itself can cause an imbalance in the ratio of endogenous androgens relative to endogenous Estrogen in the body, creating a hormone imbalance that encourages gynecomastia development.

Estrogen management would be prudent during any usage of SARMs.

Lowering Of Lipids

Just like any other SARM or anabolic steroid, RAD140 exhibits a dose dependent lowering of lipids (LDL, HDL, triglycerides) [ R ].

One commonality among all anabolic androgenic compounds is that they will all suppress HDL cholesterol (“good” cholesterol) in a dose dependent manner, and this has been consistently demonstrated in clinical trials conducted on SARMs as well [ R , R ].

Every single SARM that has been evaluated has exhibited this same dose-dependent suppression of lipids.

Testosterone Suppression

Just like anabolic steroids, SARMs have all consistently exhibited suppression of luteinizing hormone (LH) and follicle stimulating hormone (FSH) through the Hypothalamus-Pituitary-Testes-Axis.

The result of this is decreasing natural testosterone production in a dose-dependent manner [ R ].

Anecdotally, RAD140 is one of the most suppressive SARMs.

In a preclinical primate model assessing its effect on endogenous Testosterone production, young monkeys with testosterone levels between 600-800 ng/dL (similar to the average Testosterone level of 25-54 year old human males) were treated with RAD140 for 28 days.

In all treated monkeys, Testosterone levels dropped to about 50% of baseline, with the average Testosterone level decreasing to 200-300 ng/dL.

This occurred even with dosages as low as 0.01 mg/kg [ R ].

Increased Estrogen Or Decreased Estrogen

RAD140 does not aromatize into Estrogen, but it still has a large impact on the ratio of Testosterone:Estrogen in the body.

RAD140 binds to androgen receptors harder than endogenous androgens, and can encourage increased amounts of endogenous aromatization of Testosterone to Estrogen by occupying vacant receptor sites.

In addition, dose-dependent suppression of endogenous Testosterone levels can lead to a Testosterone:Estrogen imbalance.

The systemic elevation of Estrogen levels in the body is often misinterpreted as the result of prohormone laced SARMs.

High Estrogen Symptoms

• Acne, oily skin
• Erectile dysfunction
• Gynecomastia (man boobs)
• Irritability
• Water retention
• High blood pressure
• Enlarged prostate
• Shrunken testicles
• Sugar cravings

High dosages and/or long-term use of RAD140 can cause a decrease in systemic Estrogen levels.

This is facilitated through higher levels of endocrine suppression.

Estrogen facilitated physiological functions in the body are mediated through the aromatization of Testosterone into a sufficient amount of Estrogen.

If RAD140 usage suppresses endogenous Testosterone levels too low, it can result in Estrogen levels dropping as a consequence of the lack of aromatization occurring in the body in a suppressed state.

When Estrogen levels get too low, a new set of side effects can occur.

Low Estrogen Symptoms

• Dull weak orgasms
• Dry skin and lips
• Dehydration
• Mood swings
• Loss of appetite

Liver Toxicity

Even at dosages 10 times higher than the efficacious dosage required to replicate the therapeutic anabolic benefits of Testosterone, RAD140 did not increase liver enzymes or exhibit any liver toxicity [ R ].

While this was just a preclinical animal model, it is promising for the development of RAD140 as other SARMs have shown potential liver toxicity concerns , albeit minimal at their therapeutic dosage amounts.

Increased Aggression

RAD140 users commonly report very blatant increases in aggression.

While this is anecdotal, it has occurred consistently enough in the bodybuilding community that it should be considered.

The interesting thing about this is that typically increased aggression only occurs when androgen index increases in the body.

This is why more androgenic steroids are commonly used pre-workout for a quick boost in aggression before training.

The fact that RAD140 is resulting in increased aggression in recreational users could potentially be indicative of some of the following outcomes:

• RAD140 isn't as selective for anabolic activity relative to androgenic activity in humans as it was in the preclinical animal studies
• The dosage humans are using recreationally is far higher than needed
• Their RAD140 is fake and is another hormone entirely

I believe the second potential outcome is the most likely reason.

Potential As A Hormone Replacement Therapy (HRT) Alternative For Men

RAD140 is often labeled in the recreational fitness and bodybuilding community as a potentially safer HRT alternative for men.

This has yet to be proven in clinical trials, and there is one massive inherent flaw that prevents RAD140 from being a standalone effective HRT alternative.

That is its lack of aromatization into Estrogen.

RAD140 does not aromatize into Estrogen, and also greatly suppresses endogenous Testosterone levels.

The net result of this is suboptimal Estrogen levels to support basic physiological functions in the male body, and a myriad of low-estrogen side effects with long term use.

Even if RAD140 was a viable alternative to Testosterone, it would either need to be used in conjunction with exogenous Testosterone, or Estrogen would need to be administered concurrently with RAD140.

RAD140 is not a viable standalone treatment for hormone replacement therapy.

While high levels of Estrogen can cause numerous negative side effects, low Estrogen levels can be just as deleterious in men.

RAD140 PCT (Post Cycle Therapy)

RAD140 is very suppressive and may require a PCT phase (post-cycle therapy) for efficient recovery.

The goal of a PCT phase would be to restore natural Testosterone production as quickly as possible.

Forgoing PCT may increase the risk of muscle loss, fat gain, among all of the other negative side effects associated with low Testosterone levels.

How much time off should be taken after PCT should not be determined with the bro-science “time on = time off” equation, rather it should be dictated by individual specific factors and blood work .

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• Posted: October 4, 2016
• RAD140 , SARMs

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Supplement Warning: Athletes at Risk from Ostarine in Supplements

Ostarine is the trademarked name for a  Selective Androgen Receptor Modulator (SARM)  that is not approved for human use or consumption in the U.S., or in any other country. Ostarine is also  prohibited at all times  under the S1. Anabolic Agent category of the World Anti-Doping Agency (WADA) Prohibited List.

In recent years, WADA has reported an increasing number of positive tests involving SARMs even though only illegal products contain ostarine and it’s not currently available as a prescription medication in any country.

For athletes, it’s especially important to be aware of the recent increase in supplement contamination and supplement-related incidences involving ostarine. The unfortunate reality is that some dietary supplement manufacturers illegally put ostarine and other SARMs in their products, and some  omit ostarine from the label entirely  or use misleading names to confuse consumers. While labels are unreliable, you should still look out for ostarine’s many synonyms, including MK-2866, enobasarm, (2S)-3-(4-cyanophenoxy)-N-[4-cyano-3-(trifluoromethyl)phenyl]-2-hydroxy-2-methylpropanamide, and GTx-024 on supplement labels.

Below are some figures that indicate just how problematic ostarine has become in the sports community.

• Positive tests involving ostarine have increased steadily in recent years, with  WADA reporting  more than 100 ostarine positives between 2015 and 2017.
• Since 2014, USADA has announced 39 cases involving the use or possession of ostarine.
• There are currently over 72 products on the High Risk List that contain ostarine. In 19 products, ostarine is not declared on the label. In many cases, there are no red flags or other indications that the product poses an anti-doping risk as the products list only vitamins, minerals, amino acids, or herbal ingredients.

As you can see, ostarine is a very real risk for athletes, and as always, it’s important for athletes to be informed consumers. This is especially true when it comes to supplements because the Food and Drug Administration (FDA) does not analyze the safety, efficacy, or label accuracy of supplements before they are sold to consumers. When considering supplements, keep in mind that product advertising or branding cannot be used to determine if a  product is more or less risky .

The only way to have zero risk is to use zero supplements, so athletes who choose to use dietary supplements do so at their own risk. Please see USADA’s recommendation on how to reduce your risk if you choose to use dietary supplements.

Read an FDA warning against using SARMS in body-building products.

____________

Team USA weightlifter, Abby Raymond, explains how she tested positive for ostarine from a contaminated supplement at the age of 14.

Need more information.

Learn about supplement risks on Supplement Connect

Contact Athlete Connect with questions:

(719) 785-2000 or toll-free (866) 601-2632 [email protected]

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• Published: 01 September 2021

Adverse effects and potential benefits among selective androgen receptor modulators users: a cross-sectional survey

• Iakov V. Efimenko   ORCID: orcid.org/0000-0002-1746-4181 1 ,
• David Valancy 1 ,
• Justin M. Dubin   ORCID: orcid.org/0000-0001-7401-6206 1 &
• Ranjith Ramasamy   ORCID: orcid.org/0000-0003-1387-7904 1  

International Journal of Impotence Research volume  34 ,  pages 757–761 ( 2022 ) Cite this article

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Selective androgen receptor modulators (SARMs) are a class of androgen receptor ligands that bind androgen receptors and display tissue selective activation of androgenic signaling. SARMs have selective anabolic effects on muscle and bone, and were originally synthesized for treatment of muscle wasting conditions, osteoporosis, breast cancer. To date, no SARM has been clinically approved and little is known about the beneficial effects and other adverse effects on users. We examined the adverse effects and potential benefits of SARMs amongst users. We performed an internet survey assessing the demographics of users via a 32-question survey. Using reddit as a platform, we distributed the survey through various subreddits that included potential SARMs users. Out of the 520 responses, 343 participants admitted having used SARMs. Most were males (98.5%), between the ages of 18–29 (72.3%). More than 90% of users acquired SARMs via the internet and did not consult with a physician. More than half of SARMs users experienced side effects including mood swings, decreased testicular size, and acne. More than 90% of men reported increased muscle mass and were satisfied with their SARMs usage. Despite having seemingly positive effects, more than 50% of SARMs users report significant adverse effects. Chi square was the main method of statistical analysis. Future studies should focus on comprehensive reproductive evaluation of men using SARMs.

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Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA

Iakov V. Efimenko, David Valancy, Justin M. Dubin & Ranjith Ramasamy

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Efimenko, I.V., Valancy, D., Dubin, J.M. et al. Adverse effects and potential benefits among selective androgen receptor modulators users: a cross-sectional survey. Int J Impot Res 34 , 757–761 (2022). https://doi.org/10.1038/s41443-021-00465-0

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SARMs for Bulking

Last updated: Oct 8, 2023

SteroidCycle.org is intended for informational purposes only and does not take the place of professional medical advice.

Selective androgen receptor modulators (SARMs) are the next big thing for bodybuilding and performance enhancement after anabolic steroids.

All SARMs are investigative drugs, so they have little to no official research to back up their benefits or their possible harms. But we have a lot to go on through the real world experience of thousands of people who use these compounds for performance enhancement and specifically for our main interest here: for bulking .

If you’re like me, you’ve probably read through hundreds of reviews, results, experiences, complaints and everything else from SARMs users. The thing is, your experience is going to be unique, and so was mine!

The best you can do if you’re new to SARMs is investigate the best possible options, narrow your choices down, be aware of risks and how to reduce them as much as possible, then (if you feel comfortable enough), go for it and get started on your first SARMs bulking cycle.

Below you’ll find all you need to know about the best SARMs for bulking and strength, cycles and bulking stacks for SARMs users.

Author’s Note: The following guide is based on my personal experience and does NOT promote the illegal use of SARMs.

Testolone (RAD-140)

Ligandrol (lgd-4033), ibutamoren (mk-677), rad-140/yk-11, lgd-4033/mk-677, rad-140/mk-677/yk-11, yk-11/lgd-4033/s-23, ostarine/rad-140/lgd-4033, how fast do you see results from sarms, do sarms work like steroids, what’s better rad 140 or ligandrol, which sarm is best for muscle gain, how much muscle can you gain in a month with sarms, do you lose your gains after sarms, do you need to do pct with sarms, my conclusion & recommendation.

Would you believe that some SARMs can be as good, and sometimes even better, than anabolic steroids for bulking?

Steroids have always been the go-to for bodybuilders, but with advancements in medical research comes new compounds, and there are many reasons why more people are now choosing SARMs for bulking cycles instead of or combined with steroids.

Below are four of my best options for the best bulking SARMs you can buy on the market today.

Testolone or RAD-140 as it’s more commonly known, is considered by many to be one of the best SARMs for bulking. It is the only SARM that is made to basically mimic what testosterone does, yet it is not an anabolic steroid. It only targets specific androgen receptors in skeletal tissue so you don’t get the extensive side effects that come with real testosterone steroids.

BENEFITS: Testolone is a powerful bulking SARM that makes it easier and faster for you to gain muscle. It boosts your strength way beyond normal levels, increases stamina substantially, and speeds up your recovery.

Basically everything you want in a bulking cycle is covered by RAD-140. It can also help you burn fat, thanks to its promotion of increased anabolic activity.

DOSAGE: Because RAD-140 is so powerful, if this is your first cycle you will want to start at a lower dosage and it’s wise to increase the dose gradually throughout your cycle.

Start at 5mg for the first week, then 10-15mg for the next three weeks. For the final 2 weeks you can either continue at 15mg for maximum gains or taper back to 5mg depending on how you’re managing any adverse effects. This 6 week cycle provides a good balance between benefits and side effects.

POSSIBLE SIDE EFFECTS: Testolone can cause some of the androgenic side effects that you might be familiar with from steroids. These RAD-140 side effects are less likely at lower doses though. These include hair loss, extra aggression or anxiety, acne and even increased blood pressure.

Some users report loss of appetite, dizziness, lethargy and insomnia as other side effects. This SARM will also cause testosterone suppression.

Testolone is one of the most powerful SARMs developed to date. With this comes some of the more serious side effects risk that we will see with any SARM, but not everyone will have the same experience!

The key is to work out how your body reacts to Testolone as an individual, and to adjust your dosage and cycles to get the best results from this compound. It certainly has great potential to be an even better choice than steroids for a serious bulking cycle.

Best SARMs Company

OK, guys, for those who follow me, you know I’d never steer you wrong. The truth always comes first, and in this world of bodybuilding, there are lies everywhere.

I always kick the real deal, and in fact, it’s my opinion that most supplements are complete bullshit. However, there are a few products that do, in fact, work well.

Crazy Bulk is my recommended source for SARMs and legal steroid alternatives based on MY RESULTS. NO BS !!

I’ve been recently using a few stacks that have given me INSANE RESULTS….. QUICKLY , and best of all, you won’t mess with your normal hormone levels when you stop using these products!!

So, if you’re seriously looking for smooth and steady gains, give Crazy Bulk a run for a few months. Crazy Bulk is highly effective, affordable, and legal .

Guys… save yourself time, money, and headache, and start growing and getting shredded today!!

LGD-4033 targets androgen receptors in the muscles and bones, leading to direct effects on the growth of lean muscle.

LGD-4033 is one of few SARMs that has had some human studies done, and the results are impressive with excellent muscle gains on very low doses seen. With its specifically targeted androgen receptor activity, we can see benefits in all related areas, but there are some downsides with this powerful SARM when it comes to side effects.

BENEFITS: Quick muscle gains are the major benefit of using LGD-4033. It’s entirely possible, if your diet and training are right, to gain 15 pounds in a standard cycle of 8 to 12 weeks. Expect excellent gains in strength, plus improvements in your recovery time. LGD-4033 will increase the strength of tendons and ligaments, as well as bone density.

DOSAGE: Keeping in mind that some studies have shown side effects at doses as low as 1mg, you can consider starting a LGD-4033 cycle on as little as 2mg daily. Most males will aim for a 10mg daily dose at the most which you can gradually taper to as your cycle progresses, simply increasing your dose by 2mg each week.

POSSIBLE SIDE EFFECTS: LGD-4033 causes a reduction in the amount of testosterone your body naturally produces. Some early research indicates that this SARM might have some disruptive effects on hormone signalling as well. Hair loss is a possibility but the exact cause of this effect is still not known.

More seriously, LGD-4033 poses a high risk to cholesterol health with studies showing that HDL levels can reduce significantly, so those with existing cholesterol problems should reconsider using this SARM. Potential liver toxicity is believed to be dose dependent, but detailed data isn’t yet available – therefore keeping your dose as low as possible is the best way to minimize that risk.

Ligandrol is a powerful bulking SARM – in fact it is probably the best SARM for mass gaining – but it also comes with a list of possible side effects that are at the longer end and often the more serious end compared with most other SARMs. This isn’t a compound for the beginner SARMs user, but one that should be used cautiously.

MK-677 is technically not a SARM; instead it is a growth hormone secretagogue which stimulates the release of human growth hormone. With this comes all the benefits that are expected with elevated HGH levels – but it’s vital to be aware of the perils that come with too much growth hormone as well.

BENEFITS: Quick muscle gains and fast reduction in body fat are the core benefits of Ibutamoren. Increasing bone mineral density and bone strength are additional benefits.

You can expect an increase in appetite; some people might not see this as a benefit, but for bulking up you are likely to welcome this effect. A more unexpected benefit is a possible improvement in sleep quality, which can only help with your recovery process.

DOSAGE: Ibutamoren can be taken once daily, and it’s ideal to start low at the beginning of the cycle, and increase the dose halfway through. Starting at 15mg daily for the first 4-6 weeks, then if you’re comfortable, double the dose to 30mg for the second half of your 8-12 week cycle, with some users taking this cycle to 16 weeks due to MK-677’s slower acting nature.

Some users will take 50mg at the high end – but keep in mind that Ibutamoren works very well at lower doses so there is absolutely no need or benefit in jumping straight to a high dose with this compound.

POSSIBLE SIDE EFFECTS: MK-677 may cause some serious side effects, especially at higher doses which is to be expected when we are talking about a compound that raises growth hormone levels. Muscle and joint pain may occur and in some cases, even swelling.

Some individuals might be at risk of high blood pressure and increased glucose levels. In the most serious cases, heart failure could occur. Needless to say, your dosage should be carefully planned to minimize these risks.

Ibutamoren is mostly an unresearched compound so many of it’s potential risks are still largely unknown. However we do know it can cause some very serious issues in some people, especially when the dosage is too high.

There are certainly some very appealing benefits to using Ibutamoren for bulking, and using Ibutamoren at a moderate dose is going to provide very impressive results to rival that of some anabolic steroids. Click here for my full Ibutamoren cycle guide.

YK-11 is definitely one of the most powerful SARMs we can use today. It’s also slightly different from most other SARMs because it has an additional property: it is also a myostatin inhibitor .

When YK-11 attaches to androgen receptors, it also halts the production of myostatin in the muscle which can stop the muscle breaking down while promoting the growth of new muscle.

BENEFITS: Lean muscle gains as well as preserving muscle are the two big benefits of YK-11, and this makes it a versatile SARM. When it comes to bulking, YK-11 can deliver some of the biggest possible gains from any SARM. This is mostly thanks to the unique myostatin inhibition properties that you don’t get with other SARMs.

Bonus benefits include increased bone strength, which you’ll need for that extra muscle as well as enhanced strength so you’ll be seeing a remarkable ability to lift heavier and heavier weights as the cycle progresses.

DOSAGE: If it’s your first time using YK-11 and side effects concern you, starting low at 5mg per day will still get results. If all goes well, the second week can be increased to 10mg daily.

15mg is still considered a moderate dose and is unlikely to cause severe side effects, but again you will need to gauge your own response to this SARM and adjust the dosage accordingly. The cycle length should be 8-12 weeks maximum and PCT will be required.

POSSIBLE SIDE EFFECTS: YK-11 brings about much more androgenic effects than other SARMs because it is actually a steroidal SARM, so you will be dealing with the familiar steroid-like androgenic side effects like hair loss and acne if you’re prone to these things.

Other side effects can include headaches, aggression, joint pain, fatigue and low to moderate testosterone suppression. YK-11 is potentially toxic to the liver. As always, the side effects you experience depend on your individual reaction and your dosage.

YK-11 comes with massive benefits for bulking cycles, and when used at low to moderate doses the side effects should be manageable for most users. It is not generally considered the best SARM to start with for those who are new to SARMs since it is steroidal, but if you already have some SARMs experience this is definitely a compound to consider for your next bulking cycle.

SARM Stacks for Mass and Strength

Using one SARM on its own can give you great results, but combining or stacking two or more SARMs together means you are not only compounding on the muscle building benefits of all them, but you’re also grabbing extra unique effects from each one to turn your bulking cycle into one that is all encompassing across the spectrum of performance enhancement and recovery.

Most SARMs will stack well together, and below are 5 of the best SARMs stacks for bulking!

YK-11 is a very powerful SARM and is highly effective on its own. Beginners will probably not look at using this bulking stack, but advanced users with more specific needs will benefit by combining YK-11 with RAD-140 in what I consider to be my best bulking stack ever!

BENEFITS: The immense benefits of this stack are unbeatable: massive gains in mass and strength. Your gains will come on fast, and they will be dry gains without any bloating. Substantial increases in stamina, strength and recovery are big benefits of this stack, and you’ll even find you can burn fat easier but you won’t lose muscle.

DOSING: Starting low is a good idea because the effects of this stack come on hard and fast. 15mg daily of RAD140 and 10mg each day of YK11 is a good starting point. If things are going well, look to boost your dosing to 30mg per day of RAD-140 and 20mg each day of YK-11 for the rest of the cycle which can go for 8 to 12 weeks.

Your dosage of YK11 will heavily determine your results, and we know it can cause a range of side effects so you’ll need to find a balance between the results you want and the side effects you need to control.

RESULTS: Expect noticeable gains in strength by day three of this cycle and it will increase from there to pretty substantial levels. Your training ability will be beyond anything you could do naturally including both endurance and length of time you can train, and the sheer amount of power and extra weight you can work with. The sky’s the limit with how much mass you can gain with this stack with 15-20lbs more than achievable. You might have to deal with some androgenic type side effects here, but if you take care to control them they should not have a negative impact on your results.

PCT: YK-11 can suppress testosterone, but it is very dose dependent and also individual dependent. RAD-140 is the more suppressive of these two compounds, so you will need to prepare your PCT plan for the end of this cycle. Start PCT at the end of your cycle using either Nolvadex or Clomid for 4 weeks at between 20-40mg per day depending how suppressed you feel or how high your dosage was during the cycle (higher dose and longer cycle equals much greater chance of more severe suppression).

This is a great stack if your goal is to lose a good amount of fat while bulking up. This stack will give you impressive size gains, while providing amazing improvements in overall muscular definition thanks to the inclusion of MK-677.

BENEFITS: LGD-4033 is going to allow you to put on impressive size and see a notable improvement in muscle strength, so you’ll be able to lift heavier and increase the intensity and length of your workouts. MK-677 increases muscle gains and speeds up loss of subcutaneous fat, so if better muscle definition is what you’re after then this stack provides that specific benefit.

A bonus benefit of combining these two compounds is that MK-677 has a longer lasting effect, so once you stop MK-677 halfway through the cycle, LGD-4033 takes over and keeps the body in an anabolic state, essentially acting as a form of PCT so you aren’t going to start losing muscle.

DOSING: MK-677 is a slower acting compound compared with true SARMs, so get best results many people will run this stack for up to 16 weeks. Take 15mg daily of MK-677 for the entire 12-16 week cycle, and 6mg daily of LGD-4033 for the first 8 weeks.

RESULTS: Overall muscle gains can be anywhere from 10lbs and up, and we know from studies that even at very low doses of 1mg of LGD 4033, muscle gains can be made during a very short time. MK-677 can result in some water retention which is a temporary effect, but one to keep in mind as you evaluate your results during this cycle.

PCT: LGD-4033 can negatively affect the HPTA so PCT is advised. 20mg daily of Nolvadex for a period of 3-4 weeks is an effective protocol. Clomid can be used instead at 25mg daily for 3 to 4 weeks. Some guys will not need PCT at all, depending if signs of low libido, muscle loss and low energy occur – you can also obtain a blood test to determine your actual testosterone levels as a result of this cycle.

A very powerful combo with two of the best bulking compounds combined with MK-677 which comes with a host of additional benefits that will take care of your recovery and healing needs.

BENEFITS: The combination of RAD and YK11 is going to boost your muscle gaining ability to massive levels, plus a substantial increase in strength. Possibly the most appealing benefits of this stack come from MK677 which adds some very welcome effects like increased bone density and better sleep while also contributing to lean mass gains.

DOSING: An 8 week cycle can consist of 10mg-20mg of YK-11, 10-15mg of RAD-140 and 10-20mg of MK-677. Many users will start at the low end and evaluate positive and negative effects for the first 3-4 weeks, then adjust your dosage up if needed.

RESULTS: First and foremost you will gain big and fast with this stack, anywhere in the order of 10-15lbs. Body composition will be improved and you will certainly notice positive changes to your recovery times. If fat loss is on your agenda, this stack can help you achieve that as well and you won’t have to worry about losing muscle – all these compounds ensure you stay in a positive anabolic state.

PCT: RAD-140 and YK-11 are suppressive compounds so you will certainly going to need to do PCT after this cycle. Clomid or Nolvadex will take care of your PCT needs, though Clomid is considered the slightly better option. You should start at the end of the cycle and do PCT for 4 weeks, with the dosage at 20-40mg daily depending on your level of suppression.

We’ll be using one of the most powerful SARMs here with YK-11, and when it’s combined with two other excellent compounds you have a recipe for success in this bulking stack.

BENEFITS: YK-11 on its own delivers huge gains in a short period of time, and you’ll get that and more in this stack. An additional benefit is the lack of water retention, so your gains will be dry and hard. S-23 adds even more to the hardening and drying effects, and that’s the main benefit of its addition to this stack. Ligandrol provides an extra punch to your muscle gains, a strength boost and support for tendons and ligaments.

DOSING: This stack should be an 8 week cycle, and ideally you will increase your dose as you go. Start with daily doses of 10mg of YK-11, 10mg Ligandrol, and 10mg S23 for the first 4 weeks. Then adjust your dosage up as you’re comfortable, adding an extra 5-10mg to each compound for the rest of the cycle.

RESULTS: Gains of 10 to 15 pounds are more than achievable with this powerful stack, with some guys reaching 20 pounds with the right training. You should also feel less general muscle and joint pain and overall improved recovery.

PCT: You will need PCT due to YK-11’s suppressive nature. Nolvadex or Clomid for 4 weeks at between 20-40mg daily starting at the end of your cycle, with the dose dependent on how suppressed you feel.

For an extra fat loss boost, try this stack with Ostarine that is noted for its excellent ability to help you cut fat and preserve lean muscle.

BENEFITS: Fast, big and dry gains with RAD-140 and LGD-4033, while your physique hardening and toning is taken care of by Ostarine with its fat burning properties. This stack is therefore benefited by being very versatile; you can use it to gain massive size, or for body recomp or even cutting. Your endurance and recovery times will be vastly improved, taking your training to the next level.

DOSING: 2-8mg per day of Ligandrol, 20mg each day of Ostarine, and anywhere from 5-15mg daily of RAD-140. Monitor any side effects, and adjust your dosage accordingly. The cycle should run for at least 8 weeks and no longer than 12 weeks.

RESULTS: LGD-4033 will ensure impressive lean muscle gains, just how much you gain will be determined by your training effort and diet but you can easily aim for 10-15lbs, and even more. If you’re wanting to shred fat while gaining muscle, Ostarine gets the body burning fat efficiently and you will notice that you’re maintaining excellent muscle strength even while dropping fat.

PCT: With RAD-140’s highly suppressive effects, this is a stack that WILL require PCT for the vast majority of users. Clomid is the ideal choice due to RAD-140’s quite high suppression. 25mg daily starting from the end of the cycle and running for 4 weeks should have you back up and running.

SARMs are fast acting compounds that start working very quickly in the body, so it’s entirely possible you can start seeing noticeable improvements in the very first days of your SARMs cycle. It will take longer to see noticeable muscle gains, but you can certainly see great improvements in strength and endurance during the first two to three days.

SARMs are similar to anabolic steroids in that both bind to androgen receptors, BUT SARMs are very different because they only bind to SELECTIVE receptors (hence the name selective androgen receptor modulators). This essentially means SARMs can be a lot more targeted in the receptors they bind to for specific purposes, and reduce unwanted side effects that come from steroids that are binding to all your androgen receptors. SARMs mostly target skeletal muscle tissue which is what makes them so appealing for muscle growth and athletic uses.

Both of these SARMs are powerful, but Ligandrol can have the edge when it comes to muscle gains and stamina. RAD 140 excels at strength and power gains. Both of these SARMs have their pros and cons but if muscle mass gains are your top priority, Ligandrol is likely to come out on top.

All SARMs will promote muscle gains because they target androgen receptors in the skeletal muscle. Some are more effective at promoting big gains and out of all the SARMs and similar compounds currently available, the best for muscle gains is probably going to be YK-11.

There are so many factors that will influence how much you can gain on a SARMs cycle, but let’s say you’re using one or more of the best muscle building SARMs, and your diet and training is as good as they can be – it’s more than possible to make gains of 15 pounds or more in a 12 week cycle. This is even more than a lot of guys can gain on steroids, which shows just how powerful SARMs can be.

If you use a SARM for bulking that suppresses testosterone, then you don’t follow up with an effective PCT cycle you can definitely lose a lot of your gains due to low testosterone levels. This is one of many reasons PCT is so critical when using suppressive SARMs.

Some SARMs can actually suppress your testosterone, and even though it often won’t be at the same level of suppression caused by steroids, post cycle therapy can still be required. The most suppressive SARMs are YK-11, RAD-140 and Ligandrol. At the other end of the spectrum, Ostarine is one of the least suppressive SARMs and when using it alone, you are very unlikely to need PCT. SARMs PCT make use of the same drugs as steroid PCT – usually Clomid and/or Nolvadex used for four weeks after a SARMs cycle.

For sheer muscle and strength gains, you can not look past my number one bulking stack pick which is RAD-140/YK-11. Yes this is a very powerful combo that is best suited for those with SARMs experience under the belt already, but you definitely will NOT be disappointed with the results.

Adding Ostarine to any SARMs bulking cycle will provide that extra edge if aesthetics is a priority and you really want to for the chiselled look as well as put on size. However, ANY of the above bulking stacks are going to deliver results that are probably better than you could imagine, and it is difficult to go wrong no matter what you choose.

Real-life Experience, not Theory

I don't claim to know everything; what I talk about here is something I've done. From anabolic steroids to HGH, to peptides, insulin, and supplements, I've done it at some point in my life, and I can relate.

Copyright © 2023 SteroidCycle.org. All rights reserved.

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Here's when you need (and don't need) a passport to cruise.

It's the type of sailing – closed-loop or open-loop – that largely determines whether or not you need a passport to cruise.

Do You Need a Passport for a Cruise?

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A passport isn't always required for cruising.

To determine whether or not you need a passport to cruise, you first need to figure out if the itinerary is closed-loop or open-loop (also known as open-jaw).

Closed-loop cruise: A closed-loop cruise typically doesn't require a passport since it begins and ends in the same U.S. port (though there are some exceptions to this rule).

Example: Royal Caribbean International 's seven-night Western Caribbean & Perfect Day cruise stops in several countries – the Bahamas, Jamaica, Haiti and Grand Cayman – but the itinerary is considered closed-loop because it starts and ends in Fort Lauderdale, Florida.

Open-loop cruise: An open-loop cruise begins in one U.S. port and ends in a different U.S. port.

Example: Carnival Cruise Line 's 16-day Panama Canal from Seattle itinerary is not considered closed-loop because it departs from Seattle and completes its journey in New Orleans.

All of the above regulations have been determined by the Western Hemisphere Travel Initiative: a plan by the departments of State and Homeland Security that determines which documents are acceptable for proving identity and citizenship when entering the United States.

Where to cruise without a passport

There are several destinations where you can cruise without a passport on a closed-loop sailing. They include the following:

• The Bahamas

When looking at cruises to these locations, be mindful of the home ports. The Bahamas, Mexico, Bermuda, the Caribbean and Canada are all foreign ports, which means they only qualify for the passport exception if they are a stop along your cruise itinerary . If the cruise originates in any of these countries, it is likely you will need a passport.

Since Alaska, Hawaii and New England are all U.S. destinations, any closed-loop routes departing from these locations will not require a passport. However, keep in mind that it can be hard to find closed-loop cruises originating in Hawaii or Alaska.

To find closed-loop itineraries for a Hawaiian voyage or Alaskan cruise , try searching for sailings departing from major cities on the West Coast, like Seattle or Los Angeles . By contrast, quite a few closed-loop cruises leave from New England ports, but they are often marketed as Canadian cruises.

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When you need a passport for closed-loop cruises

Some cruise itineraries include foreign ports that require a passport for disembarkation. This is most commonly an issue for travelers on a closed-loop Caribbean cruise. Barbados , Guadeloupe , Haiti, Martinique , St. Barts , and Trinidad and Tobago all require U.S. citizens to present a valid passport to disembark and enter the country, despite WHTI regulations not requiring a passport for these destinations. Labadee, Royal Caribbean's private island , is an exception and does not require a passport despite its location in Haiti.

If your itinerary includes a country requiring a U.S. passport, your cruise line will require you to have the passport at check-in. Note that your passport must not expire within six months of your arrival in a foreign country or else it won't be considered valid for international travel.

Read: The Easiest Way to Renew Your Passport

Acceptable forms of ID

All travelers – U.S. citizens and foreign nationals alike – must present documents that show identity and citizenship when entering the United States. A U.S. passport can show both. If you don't have one or don't want to bring one, be aware that you may need to present more than one document.

U.S. citizens 16 and older

If you're a U.S. citizen age 16 or older sailing on a closed-loop cruise without your passport, you will need a government-issued photo ID like a driver's license. In addition, you must present a document that proves your U.S. citizenship. These include:

• Passport card
• State-issued enhanced driver's license (EDL)
• Government-issued birth certificate
• Trusted Traveler Program card (NEXUS, SENTRI or FAST)
• American Indian Card (Form I-872) or Enhanced Tribal ID Card

The Trusted Traveler Programs are risk-based programs to facilitate the entry of travelers who have been vetted and preapproved. Most of these programs will provide you with a machine-readable card that allows you to pass through border checkpoints quickly. Keep in mind, some of these IDs are only available to travelers 16 and older.

Read: TSA Precheck vs. Global Entry

U.S. citizens younger than 16

U.S. citizens younger than 16 are only required to present proof of citizenship, such as one of the following documents:

• Original, notarized or certified copy of their government-issued birth certificate
• Consular Report of Birth Abroad issued by U.S. Department of State
• Certificate of Naturalization issued by U.S. Citizenship and Immigration Services

Read: How to Get a Passport for Kids

Non-U.S. citizens

If you are a lawful permanent resident (or LPR) of the United States, you are required to present a permanent resident card or other valid evidence of permanent residence status.

Non-U.S. citizens, with the exception of Canadians and Mexicans, are not subject to passport exceptions, so a valid passport will need to be provided. Canadian citizens can present a valid passport, Enhanced Driver's License or Trusted Traveler Program card. Mexican citizens must present a passport with a visa or a Border Crossing Card.

Unacceptable forms of ID

While most common forms of identification are accepted, there are a few exceptions. U.S. military identification cards and U.S. Merchant Mariner documents are valid forms of identification, but only when traveling on official orders or in conjunction with official maritime business, so it is unlikely they will be accepted when traveling on a cruise.

Here are some other documents that will not be accepted as proof of citizenship:

• Voter registration cards
• Social Security cards
• Baptismal papers
• Hospital certificates of birth (for anyone older than a newborn)

It is important to note that many of the permitted forms of identification, such as a passport card or EDL, are only accepted at land and sea border crossings. Unforeseen circumstances, such as a medical air evacuation, may cause you to return to the U.S. by air travel. In this case, these documents won't be accepted when you try to reenter at the border crossing.

To avoid extra delays in your return to the U.S. following unforeseen travel complications, the Department of State recommends that everyone taking a cruise from the United States carry a valid passport book in case of emergency.

Why Trust U.S. News Travel

Erin Vasta has traveled extensively to international destinations, gaining a deep knowledge of travel regulations in the process. Her expertise in this area has saved her family and friends from unnecessary travel delays and ensured stress-free trips through border security in nearly 15 countries. To write this article, Vasta used her international travel experience and research skills.

You might also be interested in:

• The Top Passport Holders
• Cruise Packing List: Essentials to Bring
• Safe at Sea: The Best Cruise Insurance

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