Earlier this year SAIDS charged a minor athlete for a doping offence after his urine sample tested positive for the presence of multiple Anabolic Agents; LGD-4033, RAD140 and Enobosarm (Ostarine). These substances are ‘selective androgen receptor modulators’, that fall under Section S1 (Anabolic Agents) of the WADA Prohibited List (2020, currently in force) – it is prohibited in-and-out of competition. These substances have not yet been approved for human use and as such is not available as a prescription medication on the SA market (as is also the case in the majority of countries globally).
The athlete did not identify the source of how the anabolic agents came into his system and further denied all intentions to cheat or enhance his performance. Nonetheless, an Independent Doping Tribunal Panel was left with no option but to apply the full sanction outlined in the Anti-Doping Rules for such an offense. In November 2020, the Panel handed down a four (4) year ban to the minor.
The Chairperson appointed to adjudicate this case was quoted from the written decision to state that “The combination of 3 non-specified prohibited substances in a 15-year-old schoolboy is alarming. It is most improbable that these 3 related but compatible banned substances appear naturally or by contamination in the urine sample of any athlete. The probabilities are overwhelmingly in favour of these 3 prohibited substances being ingested in a stacked form. This suggests a level of sophistication that is, in our view, far beyond the capabilities of a 15-year-old schoolboy”.
SAIDS takes note of the recommendation in the decision of the tribunal panel, to report this matter to the headmaster of the high school, the Minister of Basic Education, SAPS and the South African Child Welfare Services.
Further reading on harmful side-effects related to these substances:
|Evidence-based Publication||Main Conclusion(s) from Publication:|
|Drug-Induced Liver Injury Associated With Alpha Bolic (RAD-140) and Alpha Elite (RAD-140 and LGD-4033).|
ACG Case Rep J. 2020 Jun 18;7(6):e00409. doi: 10.14309/crj.0000000000000409. Free PMC article.
*Available in our Education Resource Library.
|In conclusion, we [researchers] reported severe drug-induced hepatotoxicity associated with RAD-140 and LGD-4033. Although RAD-140 and LGD-4033 are not FDA-approved for clinical use, they are freely sold over the counter and via the internet as a dietary supplement. A higher level of regulations for these products is required to protect public health.|
|Ligandrol (LGD-4033)-Induced Liver Injury.|
ACG Case Rep J. 2020 Jun 11;7(6):e00370. doi: 10.14309/crj.0000000000000370. Free PMC article.
*Available in our Education
|In conclusion, we [researchers] reported a severe Ligandrol (LGD-4033)-induced hepatotoxicity. Despite FDA’s warning, Ligandrol and other SARMs continue to be sold over the counter and via the internet as body-building products. Therefore, a higher level of regulations for these products is required to prevent future life-threatening hepatotoxicity and potential cardiovascular adverse events.|
|Chemical Composition and Labeling of Substances Marketed as Selective Androgen Receptor Modulators and Sold via the Internet. |
JAMA. 2017;318(20):2004-2010. doi:10.1001/jama.2017.17069
|Chemical analyses of 44 products marketed as selective androgen receptor modulators and sold via the internet, showed that most products contained unapproved drugs and substances. Only 52% did indeed contain SARMs and many were inaccurately labeled.|
|U.S. Food & Drug Administration (FDA) warns against using SARMs in body-building products|
|FDA analysis shows body-building products labeled to contain steroid and steroid-like substances continue to inflict serious liver injury.
We [FDA] are extremely concerned about unscrupulous companies marketing body-building products with potentially dangerous ingredients. Body-building products that contain selective androgen receptor modulators, or SARMs, have not been approved by the FDA and are associated with serious safety concerns, including potential to increase the risk of heart attack or stroke and life threatening reactions like liver damage.”
|FDA issues warning about body-building products labeled to contain steroid and steroid-like substances|
|FDA recommends consumers immediately stop using over-the-counter body-building products labeled or promoted to contain steroid and steroid-like substances due to the risk of serious liver injury and other adverse health consequences including kidney injury, increased risk of heart attack and stroke, and shrinkage of the testes and male infertility.
Consumers should consult their health care professional if they are experiencing symptoms that have been associated with these products, particularly nausea, weakness or fatigue, fever, abdominal pain, chest pain, shortness of breath, jaundice (yellowing of the skin or whites of the eyes), or brown/discolored urine.
Health care professionals should be on alert for patients with the warning signs associated with the use of steroids or steroid-like substances including liver injury, kidney injury, stroke, and hormone-associated adverse effects including pulmonary embolism and deep vein thrombosis.
|Legal Performance-Enhancing Substances (PES) and Substance Use Problems Among Young Adults.|
Pediatrics. 2020 Sep;146(3):e20200409.
|Among young men, legal PES use was prospectively associated with higher odds of problematic alcohol use and drinking-related risk behaviors, incl. binge-drinking, injurious and risky behaviors, legal problems, cutting down on activities and socialization and emotional or physical health problems.
Among young women, legal PES use was prospectively associated with higher odds of emotional or physical health problems.
Overall: Use of legal PES should be considered a gateway to future problematic alcohol use and drinking-related risk behaviors, particularly among young men.
|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 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.
...be aware that some dietary supplement manufacturers illegally put SARMs like ostarine in their products and sell them as “legal steroids” or “research only” chemicals. Moreover, they may omit ostarine from the label entirely, or use misleading names to confuse consumers. For example, ostarine may also be called enobosarm, MK-2866, or GTx-024.
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.