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Your buddy at the gym can’t say enough about the bodybuilding products he’s been taking to help build muscle mass and strength. You wonder, are they all safe to use?

The U.S. Food and Drug Administration found some bodybuilding products may illegally contain steroids or steroid-like substances associated with potentially serious health risks, including liver injury, which can be life-threatening. The FDA has received hundreds of adverse event reports, including those showing evidence of serious liver injury. 

In addition to liver injury, anabolic steroids have been associated with serious reactions such as:

• Severe acne
• Hair loss
• Altered mood
• Irritability
• Increased aggression
• Depression

They have also been associated with life-threatening reactions such as:

• Kidney damage
• Heart attack
• Stroke
• Pulmonary embolism (blood clots in the lungs)
• Deep vein thrombosis (blood clots that occur in veins deep in the body)

These bodybuilding products are promoted as hormone products and/or as alternatives to anabolic steroids for increasing muscle mass and strength. Many of these products make claims about the ability of the active ingredients to enhance or diminish androgen, estrogen, or progestin-like effects in the body, but actually contain anabolic steroids or steroid-like substances, synthetic hormones related to the male hormone testosterone.

Bodybuilding Products May Contain Steroids

The FDA found many of these bodybuilding products labeled as “dietary supplements” both online as well as in retail stores. Many of these products are not dietary supplements at all; they contain undisclosed or unproven ingredients and are illegally marketed, unapproved new drugs. The agency has not reviewed these products for safety, effectiveness, or quality before these companies began marketing.

These potentially harmful, sometimes hidden, ingredients in products promoted for bodybuilding continue to be a concern. The companies making these products are breaking the law by exploiting an easily accessible marketplace to get these products to consumers. In the end, it’s consumers who may not understand the risks who are put in harm’s way by taking dangerous ingredients from products promoted as having miraculous results or making empty promises.

Some who use bodybuilding products engage in “stacking,” which is when a person uses two or more bodybuilding products at once (including stimulants or products providing false assurances of liver protection) to enhance results or “gains.” These combinations may put consumers at greater risk for serious and life-threatening reactions.

What to Do

If you’re taking any bodybuilding products that claim to contain steroids or steroid-like substances, the FDA recommends that you immediately stop taking them because of the potentially serious Health risks associated with using them. The agency also recommends that you:

• Talk to your health care professional about any bodybuilding products or ingredients you have taken, or are planning to take, particularly if you are uncertain about those ingredients.
• Talk to your health care professional if you are experiencing symptoms possibly 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 or discolored urine.

FDA Taking Regulatory Action

In addition to issuing warning letters, the agency can pursue other regulatory actions as well as enforcement actions against sellers of these illegal products. However, this can be challenging, particularly when sellers operate exclusively online. Firm names or websites often are easily changed, or products can be relabeled to evade authorities and scam consumers.

The FDA encourages consumers and Health care professionals to report adverse events or serious side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program (MedWatch) or to the Safety Reporting Portal.