Fitness influencers and online communities can create rapid demand for a product based on limited or questionable evidence, which can then put bodybuilders at risk.
Harrison “Skip” Pope, MD, MPH
If you’ve ever watched the documentary Pumping Iron or browsed the shelves at your local GNC, you’re probably aware that the bodybuilding world is full of competitors who are looking to gain any possible advantage in the quest for more muscles. There is no shortage of products promising to help them gain muscle mass fast.
What’s more, there’s a large network of online bodybuilding sites and forums where word about the latest supplement trends can spread like wildfire, and it can be difficult to separate the truth from the hype.
But do those products actually work as advertised, and are some as “safe” and “natural” as they claim to be? Those were the questions investigated in a recent research study by Harrison “Skip” Pope, MD, MPH, Director of the Biological Psychiatry Laboratory at McLean Hospital and Rohil Dhaliwal, MS, of Harvard College.
Here are five things to know about their study, which was recently published in the journal Performance Enhancement and Health:
There is a widespread, largely unregulated marketplace of non-steroidal compounds that are promoted on social media forums run by and targeted to amateur weightlifters and bodybuilders.
Three examples of these compounds are turkesterone, ibutamoren (MK-677) and ostarine.
While anabolic steroids are widely known and regulated, these non-steroidal compounds are widely available online and implied to be safe, natural, and legal to use, despite a lack of scientific evidence on the bodybuilding benefits or health risks of using them.
For this study, Pope and Dhaliwal sought to assess the level of online interest and sales activity for these three supplements; determine the level of published scientific evidence for the efficacy of these substances (particularly studies in humans); measure awareness of these substances among sports medicine professionals; and in the case of turkestrone, analyze the product quality of 10 different supplements.
The team’s findings confirm that there is significant online interest in all three substances, each of which generated much more search interest than a commonly used anabolic steroid.
Internet forums and social media posts on the substances had millions of views with extensive advice about dosing, stacking and results. The interest in these products also extended to teen bodybuilders.
For turkestrone supplements alone, Amazon data suggests there have been potentially millions of purchases.
Despite their surging popularity, there is extremely limited published research on all three compounds, the researchers found.
Only a handful of in-human studies exist, and most of them focus on short-term outcomes with almost no research examining their long-term safety.
A survey of researchers who had published in the field of sports medicine on PubMed in recent years found that medical professionals are largely unfamiliar with these substances as well.
Each of the three supplements also had potential health and consumer concerns:
- For turkestrone, there was limited evidence of muscle-building effects and at least one case of serious gastrointestinal symptoms associated with use. An analysis of 10 turkestrone products purchased by the research team found that all 10 contained significantly less than the advertised quantities of the substance, while some contained significant amounts of ingredients not mentioned on the label.
- Ibutamoren, which surged into popularity after a 2019 study, can potentially affect hormones, insulin sensitivity, appetite and fluid balance, the researchers found. It has caused significant side effects in clinical trials and is not FDA-approved.
- Ostarine is the most well-studied of the three drugs, but it is also associated with serious side effects, including liver injury, hormonal disruption and cardiovascular risk. It is banned in sports and illegal to sell as a supplement for human ingestion.
The researchers say that their study highlights a disconnect between a massive, fast-moving online supplement marketplace and a comparatively slow response from science, medicine and regulatory bodies.
Fitness influencers and online communities can create rapid demand for a product based on limited or questionable evidence, which can then put bodybuilders at risk.
Describing the online bodybuilding supplement market as a medical “Wild West,” the researchers call for better regulation of online supplement sales, more clinician awareness and routine screening for supplement use, and increased efforts to educate consumers about the potential hazards of taking products marked “safe” or “natural” without scientific evidence to back up those claims
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