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SARMs Side Effects & Their Prevention – Comprehensive Guide

SARMs Side Effects and how to prevent & mitigate them

Many “experts” claim that SARMs are side effects free, and that you’ll only experience something light.

SARMs just like AAS (steroids) have side effects – though to a much lesser extent. Some SARMs like S23, YK11 or LGD 3303 can be compared to mild steroids in terms of side effects, while others like Ostarine or Andarine are far safer and very mild.

Fortunately, the side effects that SARMs cause can be mitigated and some of the time even completely prevented with the right measures.

This article is a comprehensive guide on the side effects of SARMs, and their prevention. Based on the current scientific literature and the analysis of thousands of anecdotal reports and experiences. 

You will learn about each side effect in detail, as well as what you can do to minimize and prevent it.

Testosterone Suppression

Applies To: ALL SARMs

One of the main reasons users opt for SARMs instead of steroids is because they don’t shut your endogenous testosterone production down completely but merely suppress it.

Testosterone suppression can be mitigated with a PCT and a testosterone base. Though depending on the level of suppression you might not need to do either, or you might need both.

We can group SARMs based on the level of suppression in three categories:

Mildly Suppressive SARMs

The mildly suppressive SARM include:

  • Ostarine
  • Andarine
  • ACP-105
  • AC-262536

These SARMs when taken at their recommended dosages will cause a mild but notable drop in testosterone that’s naturally recoverable for most people. On rare occasions, and if used on a caloric deficit these SARMs can require a low dose 3 week PCT with a SERM.

Moderately Suppressive SARMs

The moderately suppressive SARM include:

  • Testolone
  • Ligandrol

These SARMs when taken at their recommended dosages will cause a moderate drop in testosterone that will more often than not require a PCT with a SERM for 4 weeks. Though it’s not uncommon to recover from them naturally if taken at a low dose and while on a caloric surplus.

Highly Suppressive SARMs

The highly suppressive SARM include:

  • S23
  • LGD 3303
  • YK11

These SARMs will cause a significant drop and even a complete shutdown of your natural testosterone production. They will require you to do a test base if you want to function normally during your cycle, and doing PCT with a SERM is mandatory.


Applies To: ALL SARMs

SARMs have a detrimental effect on the lipid panel, which is one of their major drawbacks.

Low HDL and high LDL cholesterol are associated to cardiovascular disease, therefore keeping cholesterol in check during the cycle should be a top priority.

The extent of the impact on your lipid panel will differ from SARM to SARM.

Unfortunately, regardless of what they take or do to control it, most people will not be able to keep both their HDL and LDL within the healthy ranges during a cycle, but getting as close as possible to those ranges is better than nothing and will help with restoring these levels after the cycle.

Controlling Cholesterol

What can you do to reduce the negative effects of SARMs on your lipid profile? 

  • Keep your diet as clean as possible. Avoid processed foods, junk food, and unhealthy fats since they can worsen the dyslipidemia caused by SARMs.
  • Do cardio, as much as possible, it doesn’t matter if you bulking or cutting. Do it as frequently as possible.

What supplements can you take to ensure that your cholesterol levels remain as low as possible? 

  • Take Omega 3 fatty acids, either in the form of fish oil or preferably, in the form of Krill oil. You should take up to 6 capsules a day if you go with fish oil (each brand will have a slightly different dose, but that is not a problem) or up to 3 capsules a day if you go with Krill Oil (better absorbed).
  • Take 1000mg of Citrus Bergamot every day, divided into two 500mg servings once in the morning and once in the evening/at night.
  • Other supplements you could take are CoQ10 (up to 200mg/day) and Niacin (Nicotic Acid) at 500mg/day. Niacin can cause insulin resistance (so don’t take it if you are on MK-677) and skin flushing often referred to as “Niacin Flush” (which isn’t harmful, but you wouldn’t want people to see you like that).
  • Finally, Cardarine (or GW0742) at 10 to 20mg per day is the most effective cholesterol-lowering drug. If used correctly, SR-9009 and SR-9011 can also be beneficial.

Hair Loss / Hair Shedding

Applies To: RAD 140; YK11; S23 – Rare With Others

Losing hair as a result of SARMs though very rare is a possibility, especially in men who are prone to it and have a family history of hair loss.

Hair related side effects are almost only reported with YK11, RAD 140 and S23. My hypothesis is that these SARMs are not selective enough, and as a result can attach to the androgen receptors in the scalp, causing hair loss much like DHT would.

Another explanation is that hair loss is caused by SARMs crashing SHBG, raising free testosterone, and therefore increasing DHT, the major hormone responsible for male hair loss.

How to Prevent Hair Loss

If you want to avoid hair loss throughout your cycle, there are certain compounds you may take:

  • Nizoral – Ketoconazole shampoo. This shampoo will keep dandruff at bay while also working as a moderate topical anti-androgen in the scalp if used 2-3 times per week.
  • Finasteride or Dutasteride, both 5-alpha-reductase inhibitors (meaning they prevent the reduction of Testosterone into DHT). But if I’m right about SARMs attaching directly to the receptors in the scalp, then these two drugs will be useless. 
Finasteride dosing:
Start with 0.25mg per day and gradually increase to 0.5mg if needed. Low sex drive, erectile dysfunction, and lethargy are some of the possible side effects, but the majority of men respond well to this drug.


  •  RU58841 is the third and final chemical. Using this topical anti-androgen on a regular basis should nearly totally eliminate the possibility of hair loss throughout a cycle. For a complete guide to this compound click here.

Liver Toxicity

Applies To: ALL SARMs [Excluding other Research Chemicals]

Most of the SARMs are likely to cause some liver toxicity to some degree. Fortunately, the liver is one of the easiest organs to care for, and it can heal even after extensive damage.

Keep in mind that some SARMs are less, and other more liver toxic.

How to Preven Liver Toxicity

Avoiding alcohol and non-essential liver toxic drugs, as well as taking liver supplements, can help to prevent liver damage. 

  • Milk Thistle (500-700 mg/day) and N-Acetyl Cysteine (NAC) (800-1200mg/day) are both amazing supplements you could take during your cycle.

NOTE: Milk Thistle can interact with Tamoxifen and Raloxifene and cause negative effects, so do not take it alongside them.

NAC aids the liver by boosting glutathione, one of the liver’s most potent antioxidants. Injectable glutathione is hard to find, but it is the most efficient liver-protective compound available.

  • TUDCA is particularly effective for healing the liver completely after a cycle (and PCT), however, it may cause the SARMs to be flushed out instead than absorbed if used on-cycle.

Some say that Milk Thistle can induce this to a lesser amount as well, although I have not personally witnessed this. Choose NAC if you don’t want to take any chances.

Gynecomastia (Gyno)

Extremely Rare [Common for Genetically Prone Individuals]

Gynecomastia or gyno is one of the most unpleasant side effects one can endure. It is the growth of breast tissue in males as a result of an inbalance between testosterone and estrogen.

Who Is At Risk?

Gyno almost exclusively affects people who experienced gynecomastia during puberty, those who are very overweight (the fatter you are the more aromatase enzymes you have, resulting in more Testosterone into Estrogen conversion) and those who naturally have higher estrogen.

You are very likely to develop gynecomastia during your cycle if you have any of these risk factors.

The reason SARMs can cause gynecomastia is very simple. They initially lower SHBG, which causes your Free  Testosterone to increase, which then leads to more aromatization (conversion) of testosterone into estrogen. This unbalance between them can cause gynecomastia as well as other feminizing side effects.

How To Prevent Gyno

One way is to take an Aromatase Inhibitor – AI. If you aren’t using a testosterone base, this treatment has the potential to crash your estrogen levels, exacerbating the symptoms of suppression. If you decide to go with Arimistane, take it at 25mg/day as soon as symptoms show and stop using it a few days after the symptoms are gone.

An AI is usually preferable to a SERM for addressing gynecomastia and other high estrogen symptoms when you’re on a testosterone base.

For those not on a test base, the best solution is to use either Tamoxifen or Raloxifene. Since these SERMs completely block the development of breast tissue, and will even shrink the little tissue that will have developed since the start of gyno symptoms.

If any symptoms emerge, take Tamoxifen at 10mg/day or Raloxifene at 30mg/day until the end of your cycle.

If you already have gynecomastia it is very important that you get rid of it before starting SARMs or any anabolic for that matter. If you ignore this warning and start your cycle anyway, your gyno will probably get worse.

Prolactin-induced gyno - MK-677

MK-677-induced prolactin gyno is also a possibility though very rare. Every day of the cycle I recommend taking 100mg of Vitamin B6 (P5P form) before bed.

Do this even if you don’t think you’re prone to gyno because this dose of P5P has no harmful side effects and will improve your general health and sleep quality.

If B6 doesn’t work, try 0.25mg of Cabergoline every three days or 0.125mg of Pramipexole every day.


Applies To: ALL SARMs – Rare

Insomia during SARM cycles is also very rare, but possible. Luckily it’s one of the easiest side effects to mitigate.

How To Mitigate Insomnia

If you experience difficulties in falling asleep during a cycle there are three things you can take:

  • Melatonin: 1- 2mg taken 30 minutes before bed (make sure your melatonin is synthetic)
  • L-Theanine: 200mg taken 30 minutes before bed
  • CBD oil: 25 to 50 mg 30 minutes before bed

If you have trouble staying asleep, the supplements I just mentioned will help, but you could also take:

  • Vitamin B6: 100mg 30 minutes before bed
  • Glycine: 1000mg 30 minutes before bed
  • Magnesium: 300-500mg 30 minutes before bed

Also, avoid consuming caffeine up to 12 hours before sleeping, or if possible completely cut it out.

NOTE: Take L-theanine with caffeine in a 2:1 ratio if you are caffeine sensitive, it will sublime the effects of anxiety and twitchiness. These two are an excellent synergy overall.

NOTE: There is some evidence showing that Melatonin can decrease testosterone levels, so avoid it if you are not using a testosterone base with your cycle. 

Water Retention

Applies To: LGD 4033; MK 677 (Not a SARM); Other GH Secretagogues

The only two compounds that can cause water retention are MK-677 (Ibutamoren) and LGD-4033 (Ligandrol). Even though water retention can be beneficial, if it becomes excessive it can act against you. This is how to reduce it:

  • Drink more water
  • Lower carb and sodium consumption as much as possible without sacrificing your caloric intake
  • Take 200mg of Potassium at least 5 times each day

You could also try natural diuretics such as Dandelion Root (500mg/day), Hawthorn Berry (about 500mg/day).

High Blood Pressure

Applies To: LGD 4033; MK 677 (NOT A SARM)

SARMs don’t usually cause elevated blood pressure, but it can still happen due to water retention. Although I also believe that even dry SARMs like RAD-140 and YK-11 can also cause high blood pressure through other pathways.

Symptoms of high blood pressure include:

  • Headaches
  • Nosebleeds
  • lethargy
  • Blood in urine
  • Dizziness
If you’re using wet compounds like LGD 4033 or MK 677 and you’re having problems with both water retention and high blood pressure, return to the water retention section and follow the steps to reduce it or lower your doses.
If you’re not using wet compounds and you’re getting high BP symptoms but not water retention, you can still use the supplements indicated for water retention, and if they are not enough, also try adding L-Citrulline (5 to 10 grams per day) or Tadalafil (5 mg every other day) or Sildenafil (25 mg twice a day) to your regimen. Also, stay away from all stimulants.
Water retention from SARMs nearly always occurs when taking MK 677 with another SARM like LGD 4033 and stimulants. Or when using an outrageous amount of MK 677 on its own.



During a cycle, headaches are usually always an indication of elevated blood pressure, but they can occasionally occur for no apparent cause or as a result of taking a dose that your body cannot tolerate.

Even though pain relievers like Ibuprofen and Aspirin can help, they are only a temporary fix, and you should not use them on a daily basis during your cycle.

If decreasing your blood pressure doesn’t help, consider lowering your dose of any SARM(s) or research chemicals you’re using, especially if using MK 677. If headaches persist after following these measures, stop the cycle.

Androgenic Side Effects

Applies To: S23; YK11

Besides hair loss which is very rare on SARMs, there are also other even rarer androgenic side-effects that SARMs can cause.  Acne breakouts and increased aggression are both possible, though they aren’t always caused by androgenic factors.


Applies To: S23; YK11; RAD 140

Aggression is most commonly reported with RAD 140 and S23. It can be mitigated by supplementing with:

  • L-Theanine: 200mg up to 3 times a day
  • CBD: 25mg 2-3 times a day
  • Ashwagandha: 250-500mg 2-3 times a day


Ance outbreaks usually happen when there are hormonal fluctuations, during the first few weeks of a cycle and/or after going off and experiencing a rapid boost in testosterone levels as a result of PCT.

Those who are naturally prone to acne are more likely to break out throughout a cycle than those who aren’t.

If you are one of those people, be cautious while adding a test base or coming off a SERM. Slowly raise your test base dose throughout the first several weeks of PCT, then taper off your SERM dose during the final week.

It’s also important to have a proper skincare regimen and avoid inflammatory foods.

Hardcore drugs such as Isotretinoin (Accutane) should only be used if your acne is severe and uncontrolled, and only under the supervision of a specialist.

I’m by no means a “beauty” or skincare expert, but I’ve had my battles with acne, things that could help:

  • Regularly exfoliate
  • Topical Clindamycin, in the morning and before bed
  • Wash your face 3-4 times a day with warm water, and buy a face wash

Insulin Sensitivity

Applies To: MK 677

MK 677 when taken for long periods of time causes low insulin sensitivity (also known as insulin resistance) and high blood sugar levels

This can be easily mitigated by taking two days off per week. Ex. you can take MK 677 from Monday to Friday, then stop taking it over the weekend and resume it on Monday.

Or you can do it in mini-cycles, 4 weeks on 1 week off.

Another option, for those who do not want to take breaks, is to supplement with:

  • Berberine (or another more advanced glucose disposal agent) at 300-500mg before a carb-heavy meal (more than 50g of carbs)

You can alternatively also use:

  • Ashwagandha: 250-500mg 2-3 times a day
  • Chromium Picolinate: 200 micrograms 3 times a day
  • Cinnamon Bark at 600mg twice a day
It’s critical to take these supplements before carb-heavy meals for optimal results.
And if you are taking Ibutamoren on a calorie deficit for the purpose to lose fat, you can do intermittent fasting and/or decrease your carb consumption for better results while also managing insulin resistance and blood sugar.

Kidney Damage

Overall Rare

It’s not all that rare for people to report instances of kidney pain during their SARM cycle, as well as elevated Creatinine and BUN levels in their bloodwork after their cycle.

SARMs can cause minor kidney damage by being discharged in the urine (straining the kidneys) or by dehydrating the body. There is a section in this article dedicated to dealing with dehydration, but in a nutshell, drink more water and keep your electrolytes in balance!

As far as supplements go, there are only three things you could take and are going to be taking anyways as a part of the liver health and cholesterol control protocols. (take at same doses you would be if you were using for liver and cholesterol) They are:

  • NAC 
  • Niacin 

Lastly, a multi-ingredient supplement – Kidney Cleanse by NOW Foods. Follow the label for dosing and instructions.

Heart Palpitations

Overall Very Rare

Heart palpitations due to SARMs are possible but are very rarely reported by users. They are frequently caused by anxiety, stress, or high blood pressure, so address those underlying issues to resolve the problem. If the palpitations continue, stop the cycle.


Overall RARE: RAD 140

Dehydration during a SARM cycle is definitely possible, although users very often overestimate their water consumption. Some common symptoms of dehydration are fatigue, constant thirst, dry mouth, darker urine and dizziness.

Any SARM can cause dehydration, but it is most often reported by users who are researching RAD-140, especially when it’s suspended in PG (Propylene Glycol), which might worsen dehydration.

How to fix it? Drink more water and increase your electrolyte intake.

Dry Joints

Applies To: S23; RAD 140; YK11

Dry joints are very often reported during S-23, RAD-140 and YK-11 cycles. This side-effect, sadly, is one that directly hinders your progress as it can limit your strength and make you prone to more injuries.

There are things you can take to mitigate this side-effect (you should already be taking one of these for cholesterol):

  • Fish Oil: 6 capsules a day OR Krill Oil: 3 capsules a day

Other supplements:

  • MSM (1000mg per day)
  • Undenatured Collagen (40mg per day)
  • or any supplement that combines these compounds with others like Glucosamine, Chondroitin, SAMe, etc

There are also options like MK-677 (Ibutamoren) or a peptide like TB-500, BPC-157, or GHK-Cu if you want to go down the research chemical route. Be very careful with ibutamoren though as too much water retention will have a negative impact on the joints and will further worsen the problem.

Some individuals take Ostarine for this reason as well, but I don’t see the sense in adding a suppressive chemical that might harm your cardiovascular health just to preserve your joints when there are safer and more effective options.

Blood Thickness

Applies To: All SARMs

SARMs can make your blood thicker by increasing RBC (Red Blood Cell) count. So if elevated RBC count and/or Hematocrit show up in your bloodwork results, you will have to donate blood to bring it down. 

Blood thickness can cause a variety of short-term and long-term negative effects. In the short term, it can cause headaches, high blood pressure, blood flow issues and dizziness, heart attack, and other extreme cardiovascular complications in the long run.

How Safe Are SARMs Realistically?

After reading this long list of side effects you might be in disbelief. The truth is SARMs, just like steroids, or any other drugs, whether PEDs or not, are only as “healthy” as the human (or rat) taking them.

SARMs have adverse effects and depending on what you take, at what dose, and for how long, you might experience none of these side effects, some of them, or many of them.

Your baseline health, lifestyle, diet, genetics, all play a huge role.

Some users only experience one or two of these and blow up in size, others, experience many of them and only gain a bit of muscle.

Anyone that tells you that SARMs are completely safe and you shouldn’t worry has alteroir motives – and probably wants to sell you something. 

SARMs Safety & Optimal Use

The fact that you know what you know after reading this article will hopefully steer you toward a methodical, objective, and optimal path of PED use.

SARMs have so much to offer for the avid gym bro. They are far, far safer than steroids, and have the potential to deliver comparable results with only a fraction of the side effects – if you’re objective, know what you’re doing, and know when to stop if need be.

So, where to start?

Learn, learn learn. The more you know, the more gains you will make, and more importantly the safer you will be.

Some good sources include:


– @alek.mitrevski, a veteran and someone with a very high level of understanding and knowledge of PEDs.

– Ryan Russo

– VigorousSteve

– @drmikeisraetel

Beware of Fake SARMs

Fake SARMs are very common and can lead to many of the side effects on this list and much worse. That’s why you should always shop from a reputable vendor to ensure the chemicals you’re getting are real and of high quality.

On the trusted sources page you will find the most tried & tested, well-known vendors where you can buy the highest quality SARMs available.

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