SARMs, Metabolic Modulators and Growth Hormone Secretagogues in Suspected Illegal Medicines, Bought as Sport Performance Enhancers: A Retro- and Prospective Study Within the GEON.

Although the abuse of muscle-building compounds in elite sports is already known for a long time, these products have become more popular in recreational sport over the past years. Although anabolic steroids are still the most popular ones in this context, the use of other molecules with anabolic properties is on the rise. Three categories of such products are the selective androgen receptor modulators (SARMs), the metabolic modulators and the growth hormone secretagogues (GHS). Based on this trend and the outcomes of a previous market surveillance study in the domain of illegal products (MSSIP), the Falsified Medicines Working Group of the General European Official Medicines Control Laboratories (OMCL) Network (GEON) decided to conduct an MSSIP with focus on SARMs, metabolic modulators and GHS over a period of 5 years. In total 324 samples and 354 results, reported by 14 laboratories in 13 countries, members of the GEON, were taken into account, for which the majority of the samples originated from illegal distribution. Sixty-five percent of the seized products were represented as medicine, though 24% as dietary supplements, which is of concern because here the (recreational) sporter is not aware he is taking an (unapproved) pharmaceutical. Eighteen different molecules, within the scope of the study, were reported with as top 5: ibutamoren, ligandrol, ostarine, cardarine and andarine. From the limited quantitative data reported, it can be assumed that the majority of the samples contain active doses and some are even overdosed, so health risks for the consumers cannot be neglected.