Evidence memo / Anabolic androgens & PEDs

LGD-4033 (ligandrol)

Also: ligandrol · LGD4033 · VK5211 · anabolicum

The SARM with the cleanest early human study and almost nothing after it. One 21-day phase 1 trial in 76 healthy men showed dose-dependent lean mass gain and dose-dependent testosterone suppression; a decade later the published literature is mostly anti-doping detection work and a liver injury case report.

Early human signalEarly human signalSafety / regulatory watch

The verdict

Our read at a glance.

Whether a SARM that adds lean mass over three weeks in healthy men has been shown to be safe or useful over the months and years people actually take it.

The signal
The phase 1 trial is real and worth reading properly: 76 healthy men, 21 days, ascending doses to 1.0 mg daily, placebo-controlled. Lean body mass rose dose-dependently and the drug was tolerated over that window. The same trial recorded dose-dependent suppression of total testosterone, sex hormone binding globulin, HDL cholesterol and follicle stimulating hormone, with hormone levels returning toward baseline after stopping. A later observational study of people self-administering LGD-4033 with MK-677 reported changes in body composition alongside altered circulating biomarkers and skeletal muscle androgenic signalling. Almost everything else indexed under this compound is anti-doping metabolite work: elimination profiles, micro-dose detection windows, in vitro metabolite generation. That distribution is the finding. The literature that exists is mostly about catching people using it, not about whether it helps them.
The unknown
Everything beyond 21 days. There is no published trial of the duration people actually run it, no outcome trial, and no controlled data on recovery of the hypothalamic-pituitary-gonadal axis after months of use rather than three weeks.
Our read
The honest version of the pro-SARM argument. Yes, there is a real placebo-controlled human trial, and it did show lean mass gain. It also showed testosterone, SHBG and HDL falling dose-dependently, it ran for three weeks, and nothing comparable has been published since. A 21-day safety window is not a safety record.

The mechanism

How it works.

LGD-4033 is a non-steroidal selective androgen receptor modulator. It binds the same androgen receptor testosterone does, but because it is not a steroid it activates that receptor differently in different tissues: strongly in skeletal muscle and bone, less so in prostate and skin. That tissue selectivity is the design goal, the idea being muscle and bone effects without the full androgenic profile. The trade-off is not avoided, though: the brain reads androgen receptor activation as a signal that there is enough testosterone around, so the pituitary drops luteinising hormone and follicle stimulating hormone output, and the body's own testosterone production falls. That suppression is visible in the dose-response data of the one controlled human trial.

Safety & regulatory boundary

The consequential part.

Not approved by FDA or any comparable regulator for any indication, and not a dietary supplement ingredient. FDA has warned consumers directly about bodybuilding products containing SARMs. A published case report describes ligandrol-associated drug-induced liver injury, which sits inside a wider pattern of SARM-associated liver injury reports. Prohibited in sport at all times as an anabolic agent. Product sold under this name is a research chemical of unverified identity and purity.

What's next

What we're watching.

Any trial longer than the 2013 phase 1, any regulatory filing, and continued case surveillance for liver injury and endocrine suppression.

Context

Why this is discussed.

It is one of the two or three most-purchased SARMs, and it is the one most often defended by pointing at a real, published, placebo-controlled human trial.

The evidence base

10 cited references.

Indexed literature (PubMed)10

Ligandrol (LGD-4033)-Induced Liver Injury

Barbara M et al. · ACG Case Rep J · 2020

Human in vivo metabolism study of LGD-4033

Fragkaki AG et al. · Drug Test Anal · 2018

Human in vivo metabolism study of LGD-4033

Fragkaki AG et al. · Drug Test Anal · 2020

Keep reading

Related published memos.